Biomedical subjects

F Braccini

Publications and source records attributed to F Braccini.

At least 19 recordsLinked to original sources

PubMed2006

[Surgical anatomy of the nose].

A good anatomical knowledge is a pre-requisite to all surgeries. In rhinoplasty, where many steps are performed without visual control and are only guided by palpation, anatomy must be mastered. Based on classical static anatomy and dynamic surgical modifications of the nose, this study analyses anatomical and surgical correlation and reports their technical implications. Correction of the shape of the nose is to be able to conceptualize the underlying skeleton and to program adapted surgical procedure for each case.

Cartilage↗

PubMed2006

[Rhinoplasty: morphodynamic anatomy of rhinoplasty. Interest of conservative rhinoplasty].

OBJECTIVES: To highlight the morphodynamic anatomical mechanisms that influence the results of rhinoplasty. To present the technical modalities of nasal dorsum preservation rhinoplasties. To determine the optimized respective surgical indications of the two main techniques of rhinoplasty: interruption rhinoplasty versus conservative rhinoplasty. MATERIALS AND METHODS: Based on anatomical dissections and initial morphodynamic studies carried out on 100 anatomical specimens, a prospective study of a continuous series of 400 patients operated of primary reduction rhinoplasty or septo-rhinoplasty by one of authors (YS) has been undertaken over a period of ten years (1995-2005) in order to optimize the surgical management of the nasal hump. The studied parameters were: (1) surgical safety, (2) quality of early and late aesthetic result, (3) quality of the functional result, (4) ease of the technical realization of a possible secondary rhinoplasty. The other selected criteria were function of the different nasal hump morphotypes and the expressed wishes of the patients. RESULTS: The anatomical and morphodynamic studies made it possible to better understand the role of the "M" double-arch shape of the nose and the role of the cartilaginous buttresses not only as a function but also the anatomy and the aesthetics of the nose. It is necessary to preserve or repair the arche structures of the septo-triangular and alo-columellar sub-units. The conservative technique, whose results appear much more natural aesthetically, functionally satisfactory and durable over the long term, must be favoured in particular in man and in cases presenting a risk of collapse of the nasal valve. CONCLUSION: The rhinoplastician must be able to propose, according to the patient's wishes and in view of the results of the morphological analysis, the most adapted procedure according to his own surgical training but by supporting conservation of the osteo-cartilaginous vault whenever possible.

Cadaver↗

PubMed2006

["Mini-rhinoplasty"].

OBJECTIVES: To define the interest of the so called "mini-rhinoplasty" in aesthetic nose surgery and to report the surgical technique. METHOD: The experience of the authors, based on more than 500 mini-rhinoplasty surgical procedures is reported. The surgical procedure such as technical tips are reported. RESULTS: Mini-rhinoplasty procedure is indicated in patients with small deformities, particularly in patients with nasal hump or hyper-projected noses, with no deviation. The nasal tip should be normal or slightly drooping. The surgical technique is safe and reproducible. Surgical aesthetic outcomes are excellent. This technique is also indicated in elderly patients willing a facial rejuvenation. CONCLUSION: Mini-rhinoplasty surgical technique is a minimal invasive procedure with no complication in the postoperative period. The postoperative management of patients undergoing this procedure is of main importance.

Humans↗

PubMed2006

[Cervical liposuction: a reliable procedure to rejuvenate the face].

Cervical liposuction belongs to aesthetic surgical procedures. It gives a new oval of the face, which is a characteristic of beauty and youth. The aim is the reduction of sub-mental and sub-maxillary fat accumulation. This procedure is reliable and not invasive. This article reports on the indications of this procedure, insisting on the physiopathology of fat tissue, technical procedures, results and complications, through the experience of authors.

Aging↗

PubMed2006

[Temporal lift].

UNLABELLED: The temporal lift belongs to the traditional face lift which is in fact temporo-cervico-facial. It also forms part of the face lift "upper part of the face" which is in fact temporo-frontal. It is to say that it relates to a junction zone between the superior and inferior part of the face. OBJECTIVES: In a first part the authors recall the essential anatomical data including the eyebrow, the Charpy's fat pad, the galea and the temporoparietal fascia, the nerves (temporo-facial branch of the facial nerve and supra-orbital nerve) and the veins (sentinel vein). Then they expose the various surgical techniques (galeapexy, endoscopic temporal lift, brow lift, facial threads, standard fixing Endotine forehead, botulinic toxin. This makes it possible to define in a more precise way the indications and counterindications of the temporal lift. CONCLUSION: The indications of the temporal lift are the lateral ptosis of the tail of the brow. On the other hand, the total ptosis requires a frontal lift. In this case one can associate a concomitant blepharoplasty. The temporal lift is frequently carried out in a way combined with a cervico-cheek lift. The prospects for technical progress to improve perenniality of an isolated temporal gesture are large and will allow us to widen the indications.

Blepharoplasty↗

PubMed2003

Adipose graft: an original option in myringoplasty.

OBJECTIVE: To describe the fat graft as a reconstructive material in myringoplasty. METHOD: In a review of 45 patients conducted between 1993 and 1999, the authors analyzed their patients' outcomes after having myringoplasties with fat graft. Median follow-up was 2.5 years (range, 6 mo-6 yr). RESULTS: We achieved a success rate of 91.1%. Different features of the patient and the tympanic perforation were studied to demonstrate their role in the quality of the surgical closing. A review of the literature was done to compare our results with the results of other series using this type of graft as well as with studies of the temporalis fascia as a graft material. CONCLUSION: The high reliability of the fat graft and the technical simplicity of this procedure in anterior perforations, especially with the use of intraoperative endoscopy, make it an attractive technique.

Adipose Tissue↗

PubMed2001

[Recurrent acoustic neurinoma after complete surgical resection].

BACKGROUND: Mortality of acoustic neurinoma surgery is currently very low, well below the figures reported by the first surgeons. Morbidity has also declined with attempts at preserving the facial function and more recently hearing function. Long-term follow-up has demonstrated the well-known risk of recurrence after partial resection, but also evidenced a risk after complete resection. PATIENTS AND METHODS: We reviewed two series of patients, the first including 40 patients treated and followed at the Timone Hospital since 1975 and the second including 97 operated patients who were followed by the ENT Federation over 8 to 16 years. We studied recurrence after partial and complete resection. RESULTS: Recurrence rate was 20% after partial resection and 9.2% after complete resection. DISCUSSION: The 20% recurrence rate after partial resection was similar to that reported in the literature. After total extirpation, our 9.2% recurrence rate appears well above the 1% reported by others. Although our series could have a bias due to the large number of patients lost to follow-up, the large population size and the fact that we had a majority of large tumors would suggest that recurrence rate is generally underestimated. An 8 to 10% rate appears to be closer to reality. Most recurrences were late, with a peak around 8 years. We did however observe recurrences as early as 1 year and as late as 20 years. Delay appears to be shorter after partial removal. A wide range of localizations were observed but two areas predominated: the internal auditory canal and the components of the acousticofacial pedicle, and to a lesser degree the brain stem. Most patients were asymptomatic. The principal manifestations were balance disorders or trigeminal nerve lesions, more rarely facial palsy. But these clinical signs came late and generally signaled a bulky tumor measuring more than 3 cm. CONCLUSION: These findings lead us to insist on the need for radiological monitoring of all operated neurinomas irrespective of the initial surgery. MRI appears to be more accurate than computed tomography. Images must be interpreted carefully due to possible postoperative remodeling. For us, these observations point to the need for prolonged follow-up of at least 8 years, longer for young subjects, for all patients undergoing surgical resection of an acoustic neurinoma.

Adolescent↗

PubMed2001

[An original case of laryngomucocele after Tucker surgery].

Although discovered since nearly 2 centuries, the cystic tumours of the laryngeal ventricle remain very badly known by otorhinolaryngologists. Air-containing or cystic, these lesions can be congenital or acquired. We present an original case of laryngomucocele, acquired after a partial laryngectomy of Tucker type for a laryngeal neoplasty. Through a review of the literature, we expose in the second time, the etiopathogenic mechanisms of these lesions. If this pathology contributes to mislay the diagnosis during the post-operative survey, small surgical details at the time of the initial intervention, can prevent the appearance of this lesion. The treatment is a surgical procedure, with an endoscopic way or a cervicotomy.

Acute Disease↗

PubMed2000

[Endolymphatic sac tumors].

Tumors of the endolymphatic sac are rare and can be found in patients with Von Hippel Lindau disease. They most often develop within the intrapetrosal part of the sac but can sometimes be located in the distal part. Their growth is slow and they spread in two directions: laterally toward the external and middle ear and in the direction of the jugular foramen and medially into the ponto-cerebellar angle. The symptoms are usually auditive, with a constant neurosensorial deafness of sudden onset in 50 % of cases and sometimes associated with a tinnitus and dizziness. The varieties with medial extension result in a cerebellopontine angle syndrome. Diagnosis is made by imaging (CT scan and MRI) that reveals a heterogeneous tumor between the lateral sinus and the internal auditory meatus, hypervascularized showing contrast, with cystic zones and associated with bone lysis. Histological examination of a papillary cystadenoma is performed and the differential diagnosis is essentially made with a papillary of the choroïd plexus. They require total surgical excision in order to avoid possible recurrence and can be performed by retrosigmoïd approach, or more ideally, by transpetrosal approach.

Adult↗

PubMed2000

[Essential parathyroid cysts: a misleading lesion].

Though a rare lesion, non-functioning parathyroid cyst is of clinical significance because it usually mimics a thyroid nodule. The cyst can be ectopic in location and therefore constitutes a differential diagnosis to a bronchial or thymic cyst. Two recent cases of non-functioning parathyroid assay are reported. Needle puncture with estimation of the level of parathyroid hormone in the aspirate allows the diagnosis to be made before surgery.

Adult↗

PubMed2000

Hemangioma of the facial nerve.

UNLABELLED: To discuss the interest of the etiologic diagnosis of a facial palsy. STUDY DESIGN AND PATIENTS: Two cases of geniculate ganglion hemangioma with progressive facial palsy are reported. RESULTS: Hemangioma of the facial nerve is a rare and benign vascular tumor that originates from the venous plexus surrounding the facial nerve. The most common locations are the internal auditory canal and the geniculate ganglion. Diagnosis of these small tumors is radiological with CT-scan and MRI studies. Surgical excision through a supra-petrosal approach is the gold standard treatment. Hemangiomas of the facial nerve and particularly those developed in the geniculate ganglion area constitute a rare but not inconsiderable facial palsy etiology. An acute diagnosis and an early excision are fundamental to preserve a satisfactory facial function.

Cranial Nerve Neoplasms↗

PubMed1999

Idiopathic temporal encephalocele: report of two cases.

BACKGROUND: Idiopathic brain herniation into the middle ear is a rare condition that represents diagnostic and therapeutic challenges. OBJECTIVE: The authors present here two new cases of idiopathic brain herniation with special clinical presentation and emphasis on radiographic studies, particularly computed tomographic scan and magnetic resonance imaging, which allowed the authors to detect the malformation. RESULTS: The two patients underwent surgical treatment with infratemporal approach and recovered perfectly.

Diagnosis, Differential↗

PubMed1999

[Role of imaging and endoscopy in the follow up and management of cholesteatomas operated by closed technique].

The endoscopic approach to the middle ear in the eradication of cholesteatoma is now usually performed in association with the microscope utilisation. During the second look procedure, otoendoscopy allows to develop a new concept of surgery under video-control including minimal approach with a height quality of eradication control. In our series, we report 54 consecutive cases operated on intact canal wall-up technique, by the same surgeon. The mean follow-up delay was 29 months. Systematic second look was performed within the two first years following surgery. 76% of the patients underwent minimal endoscopic approach. CT scan and/or MRI were performed in 37 patients before second look in order to correlate radiological and surgical findings. Second look results shows 45 patients on 54 (83.3%) with normal ear (no cholesteatoma recurrence), and 9 patients (16.66%) with residual cholesteatoma. Free air cavities were demonstrated by CT scan in 40.5%, localised opacities in 7.9% and total opacities in 51.4%. All free air cavities on CT scan and MRI were non residual cholesteatoma ears. MRI cannot be used to screen for small cholesteatoma or to determine the characteristics of an opacity of the middle ear seen on CT in order. Therefore second look surgery is the gold standard study to diagnosis a residual cholesteatoma. Minimal endoscopic second look approach is a new cholesteatoma surgery concept better accepted by patients.

Adult↗

PubMed1999

[Translabyrinthine approach and venous prolapses (jugular bulb and lateral sinus)].

Temporal bone venous prolapse with or without meningeal prolapse are a frequent problem in middle ear and labyrinth surgery. 178 translabyrinthine approaches with prolapse study are reported in this retrospective study. Superficially, the approach was narrow in 43% of the patients because of a lateral sinus prolapse in 27 cases or a temporal meningeal prolapse in 50 patients. Surgery was technically difficult in 8 patients with lateral sinus prolapse associated with meningeal prolapse. Deep labyrinth structure reaming was difficult in 40% because of an abnormal position of the jugular bulb and/or the superior petrosal sinus. Both superficial and deep approach was narrow in 22% of the cases. 23 lateral sinus prolapses associated with transhigh jugular bulb and 17 lateral sinus prolapses associated with superior petrosal sinus prolapses were noted and reported. Expectation of these anatomical variations, more frequent on the right side, should be established before surgery with imaging studies in order to perform a safe and efficient surgical procedure.

Cranial Sinuses↗

PubMed1999

[Imaging and traumatic, inflammatory and neoplastic pathologies of the external and middle ear].

CT and MR imaging have a growing place in the assessment of pathologic ear. Nowadays, Ultra-high resolution CT scan is the method of choice to detect traumatic, tumoral or inflammatory lesions. MR imaging is frequently proceed in second place after CT evaluation. MR remains essential to evaluate the extension of malignant tumor of the temporal bone in particular to the fatty tissues or cerebral parenchyma. Our aim is to present the radiologic semeiology of external and middle ear pathologies, precising for each one the role of CT and MR imaging.

Ear Diseases↗

PubMed1999

[Extramedullary plasmocytoma of the nasal cavity: a case report].

PURPOSE OF STUDY: To establish a diagnosis and therapeutic management in patients with extramedullar plasmocytomas. METHOD: There is no consensus concerning extramedullar plasmocytoma treatment. One patient with a nasal cavity tumor location and a review of literature are reported. RESULTS: Extramedullar plasmocytoma is a rare tumor that occurs most frequently in the upper respiratory tract. The most common location is the nasal cavity. Diagnosis can only be made after histological and immunohistochemical examinations. Localized tumors are treated by radiation therapy, combined or not with surgery. Disseminated diseases are treated by chemotherapy. CONCLUSION: Diagnosis can only be confirmed after the exclusion of a systemic disease (multiple myeloma).

Adult↗

PubMed1999

Craniofacial fibrous dysplasia associated with primary hyperparathyroidism.

Isolated presentation of fibrous dysplasia or primary hyperparathyroidism is a common finding. Only few cases of craniofacial dysplasia associated with hyperparathyroidism have been reported in the literature. A case of a patient with fibrous dysplasia of craniofacial bones associated with primary hyperparathyroidism without additional endocrinophaties or associated disorders, will be presented. Beside the facial dysmorphism caused by dysplasia, the only clinical symptoms were due to the primary hyperparathyroidism.

Adult↗

PubMed1998

[Fixed mallear head syndrome].

Fixed head malleus syndrome is a rare anatomoclinical entity first described by Goodhill in 1966. We present a series of 9 patients who underwent surgery between 1991 and 1997 and discuss the technical procedures used and functional outcome. Ossicular mobility can be re-established with two surgical methods. The more simple method consists in a classical incus transposition with malleus neck section. The more physiological method consists in drilling the synostosis fixing the malleus without disrupting the ossicular chain; stapedotomy is associated in certain cases (Type III).

Adult↗