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Biomedical subjects

D Chevalier

Publications and source records attributed to D Chevalier.

At least 73 records · Page 4Linked to original sources
PubMed1994

[Hyo-sub-glosso-epiglottectomy in the surgical treatment of tumors of the vallecula and anterior laryngeal margin].

Hyo-sub-glosso-epiglottectomy was performed in 56 patients with a tumour of the vallecula or the anterior laryngeal margin. Tumour classification in most of the patients was T2 and N0-N1. Survival rate at 3 years was 54% and 40% at 5 years. Major impairment of deglutition occurred in 5.4% of the cases. This operation is indicated for limited tumours of the vallecula and the anterior laryngeal margin.

Adult↗
PubMed1993

[Results of the surgical treatment of cancers of the supraglottic area].

The authors report a retrospective analysis of the results of surgery in 169 patients with supraglottic cancer referred to the Lille ENT clinic from 1976 to 1985. Partial surgery was performed in 53% of patients versus total laryngectomy in 47%. The 5 year survival rates in the patient groups treated by supraglottic laryngectomy and supracricoid laryngectomy with cricohyoidopexy were similar, 69.4% and 75.2%, respectively. The 5 year survival rate in the patient group treated by total laryngectomy or by total laryngectomy extended to the base of tongue was 62.8%.

Adult↗
PubMed1993

[Laser and glottis excision].

The CO2 laser is being used in several department for primary treatment of limited vocal cord carcinoma. The surgical resection is not the same in several department. One speaks of vaporisation, laser excision, cordectomy, deep cordectomy. The purpose of this paper is to definitive 3 types of laser surgery for glottic cancer = partial cordectomy, cordectomy with exposition, enlarged cordectomy. This classification allow to know with precision the importance of the surgical resection in each case.

Glottis↗
PubMed1993

[Midline congenital fistula of the nose].

Midline congenital fistulae of the nose requires early diagnosis to avoid infectious complications. This dermoid cyst of the nose may have intracranial extension and is the consequence of an anterior neural tube closure abnormality. The authors report 2 cases revealed by ophthalmic complications. Computed tomographic scan or magnetic resonance imaging provides precise information concerning the extent. Surgical treatment is always necessary.

Child, Preschool↗
PubMed1993

[Celioscopic gastrostomies and jejunostomies].

The authors describe a technique of laparoscopic gastrostomy and jejunostomy, which has been used in 23 patients between May 1991 and August 1992: 13 laparoscopic gastrostomies (LG) and 10 laparoscopic jejunostomies (LJ), all performed under general anaesthesia. There were no operative deaths, one intraoperative complication and 3 postoperative complications. Twelve patients had died by the end of the study, 7 patients were still using their feeding tube and 4 patients ate normally. The mean duration of use of the feeding tubes was 4 months for LG and 43 days for LJ. The secondary complications consisted of 3 tube obstructions and one case of pyloric obstruction. Laparoscopic gastrostomy and jejunostomy, performed according to the method described, constitute an effective and reliable alternative to open operations. They can be performed in cases in which endoscopic gastrostomy is impossible. Due to its technical simplicity, laparoscopic jejunostomy should be preferred to gastrostomy whenever there is a risk of inhalation.

Acute Disease↗
PubMed1992

Calcium-activated potassium transport and high molecular weight forms of calpromotin.

Investigations of human red blood cells show that a cytoplasmic protein called calpromotin is involved in the regulation of calcium-activated potassium transport. Calpromotin associates with the membrane in the presence of calcium and undergoes a chemical transformation. High performance gel filtration and gel electrophoresis show that the cytoplasmic and membrane-bound calpromotin can exist in both low and high molecular weight forms. The biochemical properties of the high molecular weight membrane-bound calpromotin are not the same as the high molecular weight cytoplasmic calpromotin. The high molecular weight membrane forms of calpromotin are increased by leupeptin and diminished by iodoacetic acid. Therefore, the leupeptin enhancement and iodoacetic inhibition of calcium-activated potassium transport may involve the high molecular weight forms of membrane-bound calpromotin.

Biological Transport↗
PubMed1992

[Our experience of meatotomy in the treatment of paranasal sinus diseases].

Results are presented of patients treated by endonasal microsurgery in the ORL clinic of the Lille UCH between January 1986 and July 1990. The principal affections treated were: chronic sinusitis, aspergillosis and Killian's polyp. The objective of the technique employed, which has evolved progressively, was in each case to eradicate the infectious focus or its cause, and to maintain satisfactory ventilation and drainage of the maxillary sinus. The technique used is described, and results presented based on the responses received from a questionnaire sent to 164 patients.

Drainage↗
PubMed1992

[Endonasal microsurgery of antro-choanal polyps].

Between 1986 and 1991, 33 patients were operated on by the senior author. Neither sex, nor side prevalence has been observed. In 50% of the cases, the patient was a teenager. In 18% of the cases, a cystic oedematous transformation was the cause of the polyp. Its treatment must be surgical. Five cases were operated on by gingival access, the others by median and inferior meatotomy which is recommended by the authors. They found one recurrence out of the recorded 24 cases.

Adolescent↗
PubMed1991

Subtotal laryngectomy with crico-hyoido-epiglotto-pexy for the treatment of extended glottic carcinomas.

We first described subtotal laryngectomy with crico-hyoido-epiglotto-pexy in 1974. This procedure is a modification of Majer's operation and results in the complete resection of the intact thyroid cartilage. The epiglottic petiole, the false cords, the true cords, and one arytenoid are also excised, along with the paraglottic space. The pharynx is closed by suturing the cricoid to the epiglottis and the hyoid bone. The neoglottis is occluded during deglutition by the epiglottis and the base of tongue, which come into contact with the remaining arytenoid. Postoperative hospitalization lasts approximately 3 weeks, and patients have a strong but deep voice. Between 1972 and 1985, we treated 104 patients with stage T2 and T3 lesions of the glottis using this method. A retrospective analysis showed that the overall survival rate of patients was 86% at 3 years and 75% at 5 years. Five patients experienced local recurrence. Seven patients had recurrences in the neck, and eight developed second primaries. Thirteen patients were lost to follow-up or developed intercurrent disease. Patients with T3NO lesions were treated with unilateral prophylactic neck dissection, and positive nodes were found in 23% of cases. We believe that the high proportion of positive nodes justifies routine prophylactic neck dissection in these patients. Because our operation is associated with good local control (5% recurrence rate), we propose that, for the treatment of extended glottic cancers, it replace transcartilaginous procedures that are associated with much higher recurrence rates.

Carcinoma, Squamous Cell↗
PubMed1991

[Use of the PVC, a laryngoscope for difficult intubation].

The PCV (Piquet-Crinquette-Vilette) laryngoscope has been designed for use in difficult endotracheal intubation in the adult. Its blade, 170 mm long, is curved, narrow (12 mm internal diameter) and semicircular in cross-section, like a closed C. An 8 mm endotracheal tube can be pushed through this blade. There is a cold light source. The use of this blade requires a teeth protector. The epiglottis will be lifted directly, and the blade will be moved into the vestibule, stopping short of the vocal cords. The endotracheal tube will then be introduced into the laryngoscope blade which guides it in between the cords. Once the tube has been checked to be within the trachea, the laryngoscope is removed by sliding the blade backwards over the tube. The PCV may be introduced into the mouth either on the right, or on the left, or behind the molar teeth, or between two teeth. It can held with the handle horizontal in case of a prominent sternum. The limits of this tool are a mouth opening of less then 20 mm, and some rare predictable difficulties which require an X-ray assessment to determine the best intubation technique to be used. Of 115 patients with a predicted difficult endotracheal intubation, fifty were intubated with the PCV without any failures. Also, twenty-five patients, out of thirty, were successfully intubated with the PCV after an attempt with a MacIntosh blade had failed. Of these five failures, one was never intubated by any technique whatsoever, two were intubated by fibroscopy and two by the ENT surgeon.

Anesthesiology↗
PubMed1991

[Subtotal laryngectomy in the treatment of extensive tumors of the larynx].

The authors assess the possibility to perform subtotal laryngectomy for extensive tumors of the endolarynx. They describe a particular variety of T3/T4 tumor extending anteriorly to the thyroid cartilage or to the pre-epiglottic space. Such tumors do not affect the arytenoid cartilages posteriorly, which makes functional subtotal laryngectomy with CHP or CHEP possible. This surgery was performed in 28 patients from 1972 to 1985, with 20 patients still living after 5 years, ie. 72% of all cases.

Humans↗
PubMed1991

[Liposarcoma of the infratemporal fossa. Apropos of a case].

The authors report about one female patient with a liposarcoma of the right infratemporal fossa. Such tumors are rare, making up 10 to 12% of all soft-tissue sarcomas. Their occurrence in a cervical site is rare, unlike that in the inguinal region, the retroperitoneum or the lower limbs. Their diagnosis is mainly established by the histopathological study. Computed tomography and magnetic resonance imaging are particularly useful to choose the surgical approach. The technique chosen for this infratemporal tumor was a transmandibular cervical approach. Evolution was favorable, and the patient has currently had no reoccurrence after two years.

Adult↗
PubMed1990

[Medium-malignancy tumors of the parotid gland].

Among the 437 parotidectomies performed from 1966 to 1989, we observed 2 acinar-cell tumors and 11 mucoepidermoid carcinomas, ie. 3%. The acinar-cell tumors occurred in 2 men aged 45 and 71. A conservative complete parotidectomy was performed in both cases with a 6 and 7-year survival without local recurrence. The mucoepidermoid tumors affected 4 women and 7 men. The clinical appearance in 2 cases was highly suggestive of a malignant tumor, the picture including facial palsy, fixed gaze and adenopathy. In spite of excision completed by radiation therapy, the outcome soon was unfavorable. In the other 9 patients presenting with a limited tumor of the parotid gland, the facial nerve had to be partly sacrificed in 2 cases because no dissection was possible even under a microscope. The prognosis was generally favorable in the limited forms with 6/6 patients alive at more than 5 years and 3 patients alive at 3 years, 2 years and 1 year. Postoperative radiation therapy was not performed systematically, but only in 2/3 of cases (ill-delineated or ill-differentiated tumor).

Adolescent↗
PubMed1990

[Laryngectomy with Tucker's epiglottoplasty].

From 1980 to 1987, 37 patients were operated with a reconstructive anterior frontal laryngectomy including epiglottoplasty such as described by Tucker. These patients presented with epidermoid carcinomas of the glottis. The carcinological results are satisfactory, with a survival rate of 33 of 37 patients at 3 years and 22 of 25 patients at 5 years. However, the control of the paraglottic space still is insufficient after this type of surgery, and we reserve it for the tumors confined to the glottic level, without impairment of mobility. The anterior frontal laryngectomy performed is extensive and frontolateral. It is used for a few of its former indications, as showed by the comparison of the periods before and after 1980.

Carcinoma, Squamous Cell↗
PubMed1989

Surgical treatment of angiofibromas of the nasopharynx--34 cases.

Between 1966 and 1987 we have treated 34 angiofibromas. The patients were between 9 to 28 years of age (average 16.5 years). The tumour extension was determined formerly by tomography and angiography, but these two methods have been replaced by angioscanning, which give the best results. Nineteen patients were classified stage I, fourteen stage II and one stage III. The surgical approach was transmaxillary in most cases. After tumour resection, two local recurrences were seen and a second operation was necessary to achieve a definitive cure in these patients.

Adolescent↗