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Biomedical subjects

F Chabolle

Publications and source records attributed to F Chabolle.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Tongue base reduction with hyoid-epiglottoplasty. A surgical alternative in severe sleep apnea syndromes].

We present preliminary results and indications of tongue base reduction with hyo-epiglottoplasty for the treatment of severe obstructive sleep apnea syndrome (OSAS) due to isolated hyolingual abnormalities. The procedure consists in a subtotal resection of the tongue base after identification and derouting of the lingual neurovascular bundle. Hypopharyngeal enlargement, epiglottis verticalization, floor of the mouth tension and hyoid bone repositioning are also performed during the procedure. 14 severe OSAS male patients (mean apnea-hypopnea index of 71) were treated in our institution from November 1992 to February 1996. Indications were determined after a cephalometric analysis and a magnetic resonance imaging evaluation. Results were evaluated on clinical and polysomnographic criteria. No neurovascular complications occurred. Clinical results were excellent but success rate based on polysomnography was 50%. These preliminary results led us to change some of the steps in the technique. We also identified a predictive factor of success on the cephalometrics: an oropharyngeal area greater than 25 cm2.

Adult↗
PubMed1997

[Persistent facial paralysis: contribution of imaging to identification of perineural infiltrating tumor].

To describe imaging features suggestive of retrograde perineural spread in progressive facial palsy without known tumoral origin. Two reports of perineural infiltration by salivary malignant tumors were diagnosed on abnormal enhancement of the facial nerve associated with an abnormal nerve enlargement (1/2). These unsuspected tumors were located in parotid gland (1/2) and the sub-maxillary gland (1/2). ENT tumors (especially adenoid cystic carcinomas) should be carefully searched in case of perineural spread, as these tumors may be misdiagnosed due to their size, location and signal. Therefore, imaging studies of facial palsy should include temporal bone, skull base, parotid gland, submaxillary gland and sub cutaneous areas of the face. A sub-maxillary gland tumor should be searched in case of facial palsy associated with glossodynia.

Carcinoma, Adenoid Cystic↗
PubMed1996

[Photochemotherapy in the treatment of carcinoma of the vocal cords of early stage (Tis, T1)].

Photodynamic Therapy (PDT) is a treatment which can prove interesting in head and neck oncology for small squamous cell carcinomas. We studied 33 patients with vocal cord squamous cell carcinoma at an early stage who have been treated by Photodynamic Therapy from 1986 to 1992. We used a Dye Laser Aurora which produces light with a wavelength of 630 nm. The intervention was done under general anesthesia, 72 hours after the injection of hematoporphyrin derivative. The mean and the maximum follow-up was respectively 66 and 93 months. The local control after an exclusive PDT was 73% at 3 years, 5 years, 7 years. If this method fails, a conventional treatment may be used.

Adult↗
PubMed1996

[Frontal mucoceles of orbital or cerebral extension: therapeutic strategy].

The aim of this study was to investigate ten patients who underwent surgery for mucoceles of the frontal sinus. Bicoronal direct access was required by the localization of the mucocele limited to the frontal sinuses, its extension to the orbit and/or the brain and because of the anatomy of the frontal sinuses (large size, lateral horn...) as evidenced at imaging. Direct access to the frontal sinuses was achieved in 9 patients allowing marsupialization associated with repermeabilization of the naso-frontal duct (7 cases) or exeresis of the mucocele by cranialization (2 cases). Mean follow-up is 27 months. Repermeabilization of the naso-frontal duct was effective in 7 out of 8 cases. There were no complications after cranialization and no recurrence has been observed. Drainage of frontal mucoceles is a first intention strategy. In case of complication or recurrence, cranialization of the frontal sinuses would appear to be better than an exclusion-filling procedure.

Adult↗
PubMed1995

[Congenital neck masses. Embryonic origin and diagnosis. Report of the CIREOL].

Various congenital cervical anomalies are found in the neck region including defects of the branchial apparatus (branchial, thymic and parathyroid anomalies) and vascular anomalies. They manifest as cystic masses, sinuses, fistulas and as ectopic glands. This multicentric retrospective imaging study done in 5 different radiological centers (4 adult radiological departments and 1 pediatric radiological department) shows the result in understanding the congenital cervical anomalies and include 63 patients. The age of the patients varied between 24 days-81 years with a mean age of 23 years. This study included 27 patients having congenital branchial pouch anomalies (4 cases of anomalies of obliteration of the 4 th arch), 14 cases of cervical cystic hygromas, 11 thyroglossal tract cyst cases, 1 congenital laryngocele case, 1 case of jugular ectasia, 3 cases of capillary haemangioma. The embryologic basis of these different malformations were reviewed. Their characteristic findings and sites were illustrated together with their typical et atypical appearances. The frequency of occurrence of each branchial anomaly were plotted, the second branchial cleft cyst being by far the most common congenital cystic neck mass (70%). The study revealed the role of different imaging modalities in the diagnosis of various congenital cervical anomalies, especially in some particular complicated cases of congenital neck masses presenting in adult. Imaging study helps the clinician to anticipate any difficulties in unforeseen circumstances that may arise including infection haemorrhage, or parapharyngeal extension. Understanding the various radiologic appearances of these anomalies is greatly aided by familiarity with their embryologic origin. Moreover, considering the anatomic location and radiologic appearance, the precise embryologic origin can be accurately predicted.

Adolescent↗
PubMed1995

[Analysis of results of pharyngotomy in the surgical treatment of sleep apnea syndrome. Apropos of 150 cases].

The indications and limitations of simple veloamygdalotomy as surgical cure for sleep apnoea were analyzed on the basis of results obtained in the first 150 cases treated prospectively by pharyngotomy. Clinical and polysomnographic results were analyzed as possible factors predicting success or failure. With a success rate of 80%, pharyngotomy is a simple and effective treatment for patients with minor forms of sleep apnoea (initial apnoea/hypopnoea index < 20) and no severe obesity. It appears unreasonable to propose isolated pharyngotomy if the initial index is < 30 since the success rate in the cases is only 27%. Nasal repermeation does not improve overall results significantly. The lack of patient compliance to diagnostic and therapeutic modalities is an unavoidable reality due to human, social and economic implications.

Adult↗
PubMed1995

[Primary non-Hodgkin lymphoma of the nasal fossae and sinuses. Apropos of 8 cases].

The authors report their experience about 8 cases of nasal lymphomas diagnosed and treated between 1987 and 1993. Behind ordinary symptoms, a very bad forecast lymphoma may be hidden. Histological diagnosis is sometimes difficult and needs voluminous fresh fragments. During the evolution of this affection, local temporary nasal and paranasal remissions are often noted after chimiotherapy and/or radiotherapy, but rapidly appear visceras secondary localisations, suggesting an underestimation of the nasal and paranasal sinuses localisations among the treated non-Hodgkin's lymphomas population.

Aged↗
PubMed1995

[A new technique of gene transposition in the surgical treatment of sleep apnea syndrome].

Pharyngotomy appears to be insufficient for the treatment of severe sleep apnea. For patients who refuse or abandon mechanical ventilatory assistance, surgery can be used to widen the retrobasilingual space adapting it to the cephalometric profile defined by cineradiography and MRI in combination with velopharyngeal plasty. For patients with no maxillomandibular or lingual malformation, the pharyngotomy can be combined with an anterior transposition of the genial insertions of the tongue without rotation. A method different from that described by Riley and Powel is proposed. The details of the surgical procedure are exposed. The operation is indicated in snorers with sleep apnoea with an Apnea Index Superior to 30 who refuse nocturnal ventilatory assistance and who do not have a hypertrophied tongue (Surface less than 30 cm2) or maxillomandibular retroposition.

Cephalometry↗
PubMed1995

[Attic emptying in cholesteatoma and precholesteatoma states. Technique, indications and results].

A surgical procedure different from the open or closed technique is presented. The attic is emptied through the meatus after a retromeatal access to the antromastoidal cavities. By blocking the aditus ad antrum, the procedure produces an antrio-attic microcavity with no recessus. Results of resection of epidermal lesions are quite satisfactory with a low rate of residual pathology. Retraction pouches do not develop because the mastoid is excluded and no attic recessus is formed. Surveillance of the cavity is easy and the disadvantages of functional sequellae inherent in open techniques are avoided. The preliminary results would confirmed the quality of the procedure. In 22 cases, there were 3 residual perles on the windows and 2 retraction pouches (anterior and posterosuperior). This technique is indicated in precholesteatoma states with poor prognosis and cholesteatomas of the attic. For more advanced lesions, this technique is less reliable and the open procedure is required.

Adolescent↗
PubMed1995

[Laser CO2 arytenoidectomy by endoscopic approach in bilateral laryngeal paralysis. Apropos of 45 cases].

Between 1980 and 1993, 45 patients with bilateral cord abductor paralysis were treated by carbon dioxide endoscopic laser arytenoidectomy. Thyroid surgery was the main cause of bilateral laryngeal palsy (67%). Seven patients, who were tracheotomised before treatment, were decanulated. Ninety-one percent of the patients recovered physiologic respiration. The follow up period lasted from one month to thirteen one-half years. Advantages and disadvantages of laser arytenoidectomy are compared with other techniques.

Adult↗
PubMed1995

[Ambulatory laser and turbinectomy in the treatment of nasal obstruction. Apropos of 68 cases].

The purpose of this prospective study was to compare subjectively and objectively the efficiency of laser vaporisation against surgical procedure in treatment of nasal obstruction related to vasomotor rhinitis. 40 inferior nasal turbinates laser vaporisations were compared to 28 surgical inferior turbinectomies. This trial was based on rhinomanometric data before and after laser or surgical management and on appreciation of individual nasal comfort. The results obtained with conventional surgery were slightly better than laser vaporisation; however this new procedure succeed in 75% of cases with a mean of one year follow-up. The rhinomanometric++ findings appeared especially contributing when significant disorders exist before treatment.

Adolescent↗
PubMed1995

[Endonasal treatment of iatrogenic or spontaneous cerebrospinal rhinorrhea of the anterior cranial fossa].

There is a 25% risk of meningitis in case of cerebrospinal fluid rhinorrhea from the anterior cranial fossa. Treatment usually is based on neurosurgery when medical management is unsuccessful. The risk of morbidity and mortality in such operations is important and recurrence is observed in 25% of the cases. The development of endonasal surgery has increased the incidence of iatrogenic breaches but has also allowed the development of new techniques for closing breaches. Certain authors recently published a recent series of patients treated via the endonasal route. We present here six cases of cerebrospinal fluid rhinorrhoea from the anterior cranial fossa treated at the Foch Hospital. Etiology was iatrogenic in 4 cases, trauma in 1 and spontaneous in 1. The operative technique and mid-term results are presented. Cure was achieved in all cases after a mean follow-up of 2 years. One patient with osteopetrosis of the cranial floor who underwent neurosurgical decompression of the optic nerve complained of recurrent rhinorrhoea which could not be confirmed by endoscopy nor by imaging. Early endoscopic treatment of cerebrospinal fluid rhinorrhoea should be the first intention option as it preserves olfactive function, limits operative morbidity and mortality and leaves open the option of neurosurgery in case of failure.

Adult↗
PubMed1995

[Treatment of velopharyngeal stenosis after pharyngotomy for chronic snoring. Apropos of 13 cases].

Velopharyngeal stenosis is a rare complication of pharyngotomy (UPPP) for chronic snoring. Its treatment is hard because of its recidivant feature. The aim of this study was to determine a therapeutic strategy accorded to each stenosis from clinical and anatomical features of 13 velopharyngeal stenosis. Therapeutic behavior was function of patients complains, of the ground (associated chronic rhinosinusitis and obstructive sleep apnea) and clinical findings (partial or total stenosis, tonsil remainders, short or long residual soft palate). From these data, treatment was medical (1 case) or surgical (12 cases), searching lateral velopharyngeal mucosa recovery in order to avoid recidive of stenosis. This aim needed locoregional mucosal grafts in 4 patients with short soft palate. Patients complains were improved in all cases and there was no patient with recurrence of stenosis. The best treatment of velopharyngeal stenosis still remains a preventive one, by respecting a severe surgical technique during pharyngotomy for chronic snoring.

Adult↗
PubMed1994

[Embolization by direct puncture of hypervascularized ORL tumors].

Direct intratumoral embolization was used to treat five patients with vascularized tumors of the head and neck: 2 nasopharyngeal angiofibroma, 2 glomus jugulare tumors and 1 hemangiopericytoma. Embolization was performed by direct puncture and intratumoral injection of a plastic mixture under angiographic control. In 4 patients, embolization was performed preoperatively. Devascularization was induced in at least 90% of the volume of these tumors, thus facilitating subsequent surgical removal of the tumor. In 1 patient, embolization was performed with palliative intent. Good regression of symptoms was obtained.

Adolescent↗
PubMed1994

[An unusual cause of dysphagia: cervical schwannoma of the prevertebral space. Radioclinical correlations].

The authors report a case of cervical schwannoma with an atypical clinical expression, site and imaging features. The anteromedian lesion lying in the prevertebral and retropharyngeal spaces accounts for its clinical expression in the form of dysphagia. The target appearance on computed tomography and on the T2-weighted MRI sequence was suggestive of a neurofibroma and was due to deposition of fibrin and haemorrhagic exudates in the center of the lesion. The presence of a prevertebral ansa cervicalis in front of the long muscles of the neck, between the longus capitis and longus colli muscles, accounts for the vertical, elongated appearance of this tumour involving the prevertebral space.

Deglutition Disorders↗
PubMed1992

[Treatment of simple snoring. Surgical pharyngoplasty vs. laser CO2 pharyngotomy].

CO2 laser pharyngotomy is a newly described technique used in treatment bronchopathy without sleep apnea syndrome. Retrospective results of 70 CO2 laser pharyngotomies and 63 surgical pharyngoplasties are studied and compared. All patients were SAS free snoring patients. The results were rated satisfactory by 54% of the CO2 Laser treated patients against 78% for classical surgery. CO2 laser pharyngotomy is an easy procedure done in the office. The complication rate is very low. The predictive criteria upon which one can select the best procedure for each particular patient remain largely unknown.

Adult↗
PubMed1992

[Unusual localization of an olfactory esthesioneuroma].

Olfactory neuroblastoma, a nerve tumour arising in the olfactory mucosa, is a relatively easy diagnosis in the case of a mass centered around the cribriform plate. It is more difficult to diagnose in its exceptional ectopic forms (maxillary sinus) in the absence of any cytological and histochemical arguments (fibrils, olfactory rosettes). Its local malignancy is variable with a 42% 5-year survival for stage C and metastases in 30% of cases (principally cervical nodes, bone and liver). The role of imaging is to define the criteria of a mass syndrome and to perform the preoperative staging in a case of apparently simple sinus obstruction.

Brain Neoplasms↗