Biomedical subjects
Publications and source records attributed to F Legent.
Nine patients with early phase mandibular osteoradionecrosis received conservative treatment involving closure with mucosal and periosteal graft. Early intervention and the limited nature of the osteoradionecrosis are the two fundamental elements for a successful outcome to this conservative therapy, thus avoiding progression to an extensive form requiring interruption mandibulectomy.
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Three patients presented with pulsatile tinnitus due to post-traumatic vascular lesions of the preauricular region. Lesions of this type should be investigated routinely by auscultation since the injury may have left no cutaneous traces.
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Dermatologic epithelioma of the nose is usually a basocellular and more rarely a spinocellular epithelioma. Small tumors less than 5 mm in diameter can be treated by electrocoagulation, whereas those over 1 cm should be treated by surgery or physical methods. Of a total of 144 cases of epithelioma operated upon, 10% were reconstructed by a flap. Increasing use is being made of local anesthesia with subsequent reduced hospital stay. The quality of the carcinologic results, similar to that of physical methods, and the excellent healing obtained, particularly in elderly patients, are arguments in favor of extensive surgery for epitheliomas in this region. The quality of the resection is difficult to evaluate, unless results of a fresh specimen examination are available. When not possible then it is preferable to await results of histology to show limits of excision before performing an autoplasty with flaps.
Collapse of the auditory meatus constitutes an audiometric trap provoking a false transmission deafness. It can also permanently affect audition, whether it be primary in origin or post-mastoidectomy. The association of conservation of the stapedial reflex and transmission deafness is noticed immediately, but this is in fact compatible with an interruption in the chain by incus luxation. These notions must be known in order to avoid operation in false transmission deafness, and inversely to decide when to explore the cavity in certain post-mastoidectomy sequelae with meatal collapse.
Mesencephalic tractotomy employing the stereotaxic method was conducted 12 times in 11 patients with pain due to cervicofacial cancer only partially relieved by high doses of opiates. Immediate results were spectacular in 10 cases and partial on the other 2 occasions. However, relief was not permanent even in patients in whom the greatest improvement was obtained, and the usual analgesics had to be prescribed after 3 months. The operation, which requires only a short period of anesthesia, was always well supported, complications being anesthesia of one side of the body in 2 patients and convergence paralysis in two cases, one of which was transient. Mesencephalic tractotomy constitutes a new weapon for the treatment of diffuse cervicofacial cancer pain not responding to major medical treatment. Elective thermocoagulation of the Vth and IXth nerves was also successfully employed for systematized pains.
A mild head injury could have played a role in the development of post-myringotomy cerebrospinal fluid rhinorrhea and otorrhea in an 18-month-old child with Mondini's syndrome. This notion of trauma may prevent exploration of the site of the fistula when these labyrinthic dysplasias are poorly understood. Once suspected, full radiological examination should precede closure of the gap using an otological approach.
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Among the many procedures proposed for re-establishing bone continuity in cases with a mobile foot of the stapes, an effective solution has been found to be the employ of a malleus-foot of the stapes prosthesis. Austins prosthesis is surtable in such cases, but must be modified to adapt to different situations and to avoid complications. Surtably adapted in this way, good results can be obtained in the sequelae of chronic otitis and injuries.
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