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Biomedical subjects

D Portmann

Publications and source records attributed to D Portmann.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Autoimmune Menière's disease: current concept].

The participation of an immunological mediation is unmistakable in certain cases of Ménière's disease. After exposition of the different experimental and clinical research, it is nevertheless still not possible to precisely determine the role of these immunological occurrences in the genesis of this disease. Clinical criteria should evoke this participation and lead to the detection of certain biological anomalies most frequently found by the different teams.

Animals↗
PubMed1991

[Cochleovestibular syndrome disclosing dolicho-ectasis of the basilar trunk and vertebral artery].

The authors present a case of a cochleovestibular syndrome with a scanner showing a calcified dolico-ektasis of the basilar truncus and the left vertebral artery. The patient had typical Ménière's disease symptomatology. A retrolabyrinthic diagnosis with substantial recruitment was indicated by the results of the audio-vestibular explorations (stapedius reflex, electroculography, early brainstem evoked response, electrocochleography). The electrocochleography with glycerol test indicated labyrinthic hydrops. Finally, some reflections on the role of neurovascular problems in the pathogeny of some cochleovestibular syndromes are put forward.

Aged↗
PubMed1991

[Exostosis of the external auditory canal: clinical and therapeutic aspects].

Based on the study of 25 cases, the authors recall the frequency and pathogeny of these lesions, specifying the surgical technique and presenting their results. The risks of this surgery lie in the ever possible impairment of the facial nerve and labyrinthization on treble frequencies (2 cases). The incidents are tympanic perforation (1 case) and the opening of the temporomandibular joint. It is not always possible to preserve the skin of the external auditory canal. It can be reconstructed by a free (3 cases) or pedicle (3 cases) graft of more simply in case of small loss of substance by a temporal fascia graft.

Adolescent↗
PubMed1990

A technique for reembedding celloidin sections for electron microscopy.

A new technique for reembedding celloidin sections of human temporal bones for transmission electron microscopy is described. It consists of four steps: 1. loosening of celloidin sections from glass slides with use of xylene and dissection of the area of interest, 2. removal of celloidin with use of clove oil, 3. staining with 1% osmium tetroxide and 1% tannic acid, and 4. embedding in epoxy resin. Autolytic changes were seen due to poor fixation. TEM of reembedded celloidin sections of optimally fixed tissue revealed that the celloidin-embedding procedure affected ultrastructural preservation to some degree. This included less well-preserved cell membranes and some increased electron density of the cytosol decreasing the EM resolution of intracytoplasmic organelles. The technique allows TEM analysis of the intact labyrinth at all regions in the same specimen without dissection of the fragile tissue components of the membranous labyrinth. This might make the technique useful for processing freshly fixed human inner ear tissue and temporal bones for ultrastructural histopathological analysis.

Animals↗
PubMed1990

Transmission electron microscopy of previously embedded celloidin sections.

A technique to re-embed celloidin sections of human temporal bones for transmission electron microscopy (TEM) is presented. The procedure consists of basically four different steps, starting with loosening of the celloidin sections from the glass slides, removing the celloidin using clove oil, to staining and embedding in epoxy resin. The technique allows TEM analysis of the intact labyrinth in various regions in the same specimen, as well as on the same section. This may prove useful, as prior dissection of the fragile tissue components of the membranous labyrinth is not longer necessary. The technique makes possible the retrospective study of temporal bone collections. It may also be of value for the study of the ultrastructural histopathology of the human inner ear in optimally preserved tissue.

Animals↗
PubMed1990

[Efficacy and tolerability of morniflumate in acute otitis in infants: results of a randomized study versus placebos].

In a randomized double-blind placebo-controlled, parallel group study, 79 infants with acute otitis media received treatment with suppositories containing either Nifluril (400 mg daily, morniflumate) or placebo for five days. Both groups of patients also received amoxicilline (50 mg/kg daily) for eight days. The combination of Nifluril with antibiotic therapy gave significantly greater relief from abnormalities of the tympanic membrane (after two days treatment), inflammation of the throat and nasal congestion than did antibiotic therapy alone. Overall clinical assessment confirmed a significantly greater recover rate in the Nifluril group compared with the placebo group. Very few side effects were recorded, limited to diarrhoea, without any drug interruption. Nifluril may be recommended as an effective safe adjuvant to the antibiotic treatment of acute otitis media in infants.

Acute Disease↗
PubMed1990

[Management of open and closed cavities in otology].

Surgery of chronic otitis follows a few basic principles, some of which are long-standing but still topical. In the majority of cases, opening of the cavities of the middle ear uses one of the following two techniques: the open technique (radical mastoidectomy), or the closed technique (transmastoid approach or canal up technique). Whatever the technique used, a readjustment of the cavity is often indispensable to avoid any recurrence of the pathology (cholesteatoma) or the appearance of a new pathology (chronic otorrhea) and facilitates a functional step if required. Open techniques must therefore always follow the rule of the ratio V/S (where V = the volume of circulating air coming from outside, and S = the surface area of the skin of the cavity). This ratio is specific to each individual. The readjustment must enable either an increase of V (meatoconchaplasty) or a decrease of S (reconstruction of the posterior auditory canal, obliteration of the cavity), or a combination of the two. Closed techniques must also be adjusted to avoid any retraction towards the posterior or upper cavities. Depending on the clinical background and on the aggressivity of the pathology, the posterior tympanotomy can be closed, and the attic and aditus cavities of the middle ear separated by a bony fragment leaving the protympanum open upwards to enable normal ventilation towards the attic, the aditus and the antrum, or much more rarely, these cavities can be completely closed.

Chronic Disease↗
PubMed1990

[Pneumatocele caused by ballistic injury of the anterior stage of the skull base, a case report].

The authors present a case of intracerebral expansive pneumatocele following a ethmoido-sphenoidal fracture by a bullet. The case presented is exceptional, as the bullet went through the brain case without injuring the neurological structure. The patient is operated on through the low paralateronasal approach, by filling the ethmoid and the sphenoid with autologous bone material. This surgical treatment makes closure of the fistula and disappearance of the pneumatocele possible, however, not enough time has gone by for making other judgments. This approach, which has a much lower morbidity rate than the approach of the anterior stage through craniectomy, is effective for fractures of the sphenoid and the posterior ethmoid.

Adult↗
PubMed1989

Modern diagnostic strategy for acoustic neuromas.

We have reviewed the most recent 120 cases of acoustic neuromas operated upon in Bordeaux, France. In so doing, we have defined the strategy required to reach an accurate diagnosis as essentially comprising three stages. The first of these is to understand that the presenting symptom complex may be typical with progressive unilateral hearing loss, tinnitus, etc., or atypical with sudden hearing loss (10%), recovering facial paralysis (3.3%) or a Menière's syndrome (3.3%). Included in the first stage of diagnosis are audiovestibular investigations. An absent stapedial reflex was noted in 41% of our cases and an abnormality in vestibular testing in 95% of cases tested. These findings would be clear indicators to proceed to the second stage of the diagnostic strategy. This second stage comprises electric response audiometry consisting of auditory brainstem response (ABR) testing and electrocochleography (ECochG) employed as a filter for determining which patients should proceed to the third stage of testing. A combination of ABR and ECochG provides the clinician with results of high sensitivity and specificity. The false-negative rate for combined results in our experience has been less than 1%. The final diagnostic stage is radiological imaging, in particular using magnetic resonance imaging (MRI) with gadolinium contrast as the modality of choice. MRI is superior to CAT scanning, especially in the diagnosis of stage I intracanalicular tumors.

Audiometry, Evoked Response↗
PubMed1989

[Mérocel's method in otorhinolaryngology].

Merocel intra-nasal pack are very effective in controlling epistaxis. Different forms of Merocel are very usefull in external otitis and after endonasal and middle ear surgery. They can protect some particular structures during oto-neuro and head and neck surgery.

Bandages↗
PubMed1989

[Labyrinthine fistulae].

The study is based on 44 cases of labyrinthic fistulas which were almost always discovered per-operatively. The authors describe the different stages of evolution, grouped under the term of "fistula". Having summed up the main therapeutic guidelines published since 1950 and following the study of the different cases presented, a therapeutic approach is proposed which takes into account the condition of the opposite ear and the open or closed technique selected. As far as audiometry is concerned, the cochlear reserve must be safeguarded. Technically speaking, the best attitude is to carry out the ablation of the matrix in one or two phases depending on the size, to prefer a closed technique and to drain the fistula at the end of the operation.

Audiometry↗
PubMed1989

Techniques of tympanomastoidectomy.

The authors describe the various techniques of tympanomastoidectomy that can be used to eradicate chronic disease processes. The techniques are either open or closed operations; the factors in determining the choice of technique for specific conditions are presented.

Humans↗
PubMed1989

[Use of a temporoparietal fascial flap in difficult reconstructions of the external ear].

Temporo parietal fascial flap is a way of total ear reconstruction when there is not a sufficient quantity of available skin in auricular region. This flap very thin, supplied by superficial temporal vessels is located above the auricle and can cover the framework's convolutions. This technique has been well described by Burt Brent. Our experience is based upon 12 total ear reconstruction with this kind of flap. When there is an extreme skin shortage, but of good quality, we discuss the technique of skin expander.

Ear, External↗
PubMed1989

[treatment of an epistaxis using a bilateral nasolabial flap in Osler-Rendu disease].

Severe and recurrent epistaxis in cases of Rendu-Osler disease (Hereditary hemorrhagic telangiectasia) are very difficult to treat. For one case the authors propose a bilateral nasolabial flap with inferior pedicle. They describe the technique and after 15 months of follow-up there is no recurrency. This treatment is used for particular cases: old people with short expectation of life, severe anaemia involving the vital prognosis.

Aged↗
PubMed1989

[Stapedectomy and micro-stapedotomy in the treatment of otospongiosis. A comparative study].

This is a comparative study of 622 patients undergoing either stapedectomy or stapedotomy for otosclerosis. 379 underwent stapedectomy, which in the majority of cases employed interposition of the posterior crus of the stapes into a venous graft placed over the newly created fenestra. The results of this technique are compared with 243 microwindow stapedotomies performed since 1976. For all patients a minimum of 5 years had elapsed between surgery and evaluation of outcome. In some instances, this time period was 20 years. One month post-surgery the closure of the air-bone gap was more frequently superior with stapedectomy, particularly in the low frequencies. The degree of an incidence of overclosure was comparable for both techniques. However, at 4,000 Hz, bone threshold levels deteriorated more usually following stapedectomy. The air-bone gap widened progressively over the proceeding years post-stapedectomy. This was in contrast to the effect seen during the same period after stapedotomy, namely a narrowing of the air and bone threshold levels. Additionally a progressive loss of bone thresholds was noted after the latter technique. The incidence of sudden total deafness, either immediate or delayed, was less than 1% for both procedures. Even after 15 years or more poststapedectomy, the air-bone gap (13 dB average) and bone thresholds remained stable. Revision surgery was necessary in 8% of stapedectomies and in 4% stapedotomies. However, the post-operative follow up period is much shorter for the latter.

Auditory Threshold↗