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Biomedical subjects

F X Roux

Publications and source records attributed to F X Roux.

At least 73 records · Page 4Linked to original sources

[Intra-orbital hydatid cyst. An uncommon site of hydatidosis. Discussion apropos of a recent case].

The authors present an observation of intraorbital hydatid cyst. They review the literature and discuss the main data of such a rare lesion. Hydatid cyst should be systematically evoked in any case of tumoral exophthalmia developed in a young patient, particularly if he comes from an endemic country. The pre-operative diagnosis relies on the confrontation between clinical and echographical data, and C.T.-scan imaging. The only treatment is surgery. A puncture performed at the beginning of the surgical procedure will confirm the diagnosis. In fact, it should be indicated for every intra-orbital neoplasm observed in a country of endemicity, mostly when the preoperative diagnosis is difficult, that is when no C.T.-scan or echography are at disposal. The infectious prognosis is excellent; but the functional one depends on the precocity of surgery and remains reserved in most cases.

Echinococcosis↗

[Esthesioneuroblastomas. Could a preoperative chemotherapy improve their prognosis?].

The prognosis of malignant tumours of the olfactory epithelium of the nasal vault stays very poor. In the literature, the 5-year actuarial survival rate ranges between 50% and 65%; the 5-year recovery rate is 15% due to the high frequency of locoregional reoccurrences (60%) and metastasis (35-40%). Up to now chemotherapy was suggested as palliative treatment; but as Esthesioneuroblastomas (ETNB) appear to be sensitive to several chemotherapeutic agents (such as CDDP and 5-FU), we have decided to administer, from now on, to all patients harbouring an ETNB, an inductive chemotherapy whatever the staging and eventual diffusion of the tumour. The present paper presents our recent experience, dealing with such lesions: since 1984, 60 tumours of the ethmoid were treated in our department among which 7 ETNB (11.5%). We discuss our results concerning ETNB.

Adult↗

1.32 microns Nd:YAG laser during neurosurgical procedures experience with about 70 patients operated on with the MC 2100 unit.

The authors present their clinical experience with 1.32 microns Nd-YAG Laser. After a series of experimental studies which demonstrated the adaptability of such a wavelength to central nervous surgery, they used such a Laser during current neurosurgical procedures. The MC 2100 unit combines two wavelengths 1.32 microns and 1.06 microns, and two emission modes: continuous wave (c.w.) and pulsed. This Laser has been used during 70 procedures: 54 supra-tentorial, 8 infra-tentorial, 5 intra-spinal, 3 intra-orbital, 600 microns and 400 microns fibers were preferred in most cases, either with a telescopic light handpiece or- less often--with a focussing handpiece. The quality of vaporization--close to that of CO2 Laser- and of haemostasis-close to that of 1.06 microns Nd-YAG Laser-makes this 1.32 microns wavelength very suitable for neurosurgery. The manoeuverability due to the optic fibers is most interesting. Furthermore, such a Laser should have in the near future large applications in stereotactic and/or endoscopic neurosurgery.

Brain Neoplasms↗

Effects of 1.32-micron Nd-YAG laser on brain thermal and histological experimental data.

Considering that the 1.32-microns Nd-YAG laser should have physicothermal properties close to those of the CO2 laser, a series of experiments were conducted on rat cortex (N = 51). Three laser wavelengths were compared: CO2 laser (10.6 microns), 1.06-microns Nd-YAG, and 1.32-microns Nd-YAG lasers. For each shot, temperature measurements were recorded with an infrared thermographic videocamera. The digitized signals were figured as thermal profiles and temperature developments. Ninety-five shots were correctly studied and analyzed: CO2, N = 29; 1.06-microns Nd-YAG, N = 20; 1.32-microns Nd-YAG, N = 46. The histological lesions produced by these three lasers were compared on animals killed 24 hours (N = 20), 8 days (N = 20), and 30 days (N = 5) after the laser impacts. For equivalent densities of energy, the depth of cortical necrosis was comparable for the CO2 laser (200-250 microns) and the 1.32-microns Nd-YAG laser (210-260 microns) whatever the date of death; the 1.06-microns Nd-YAG laser shots were responsible for much more important damage (400-550 microns). Because of its important absorption in water and nervous tissue, the authors consider the 1.32-microns Nd-YAG laser most suitable for neurosurgery, particularly because it is conducted through optic fibers, and therefore is easy to handle during neurosurgical procedures.

Animals↗

The use of 1.32 Nd:YAG laser in neurosurgery: experimental data and clinical experience from 70 patients.

The authors present their experience with the 1.32 mum Nd:YAG laser in neurosurgical procedures. In a first step, they conducted experiments on rat cortex. The thermic data and histologic results confirmed that the 1.32 Nd:YAG laser has physical properties quite close to the CO2 laser. Furthermore, the fact that the 1.32 mum wavelength can be conducted through optic fibers makes it well adapted to neurosurgery. The authors present experimental data (50 rats) and comment on their surgical experience with such a wavelength (70 patients). In the future, this laser should see its indications broadened in conventional neurosurgical procedures as well as in endoscopic and stereotactic neurosurgery.

Animals↗

[The use of coral in bone surgery. Results following 4 years of utilization].

The authors have used Porites coral as a bone substitute in more than 200 patients since 1985, initially for reconstruction after craniotomy or removal of graft from the iliac crest. Encouraging results have prompted wider use. No complications have occurred. The biological properties of coral are described. It is easily available and appears to be a promising bone substitute.

Calcium Carbonate↗

Adenocarcinoma of the ethmoid sinuses. Results of a new protocol based on inductive chemotherapy combined with surgery. Four years experience.

New therapeutic modalities for Ethmoidal Adenocarcinomas are presented. Thirty three patients harbouring such a tumour have been treated during the last four years. Twenty three were included in the following protocol:--the first step consisted in inductive chemotherapy based on a four-day course of continuous cisplatine (CDDP) and 5-fluoro-uracyl (5-FU infusion)--the second step was the tumour removal, which was performed through a combined transfacial and subfrontal approach. A contralateral ethmoidectomy was always performed. The integrity of the sphenoidal sinus was systematically checked. The cranial base was reconstructed with madreporic coral grafts; then a large extra-dural pediculated galea flap was placed onto the anterior base to line the sub-frontal dura. The authors discuss the results of this series of rare tumours.

Adenocarcinoma↗

[The 1.320 micron Nd-YAG laser. Experimental study of a new wavelength adapted to neurosurgery].

The authors present a new laser wavelength for neurosurgery: the 1.32 micron Nd-YAG laser. Schematically, it combines the advantages of both the 1.06 micron Nd-YAG laser and the CO2 laser. As for nervous tissue it has the same physico-thermal properties as the CO2 laser: an important absorption and little thermal diffusion. Like the 1.06 Nd-YAG laser, the 1.32 Nd-YAG has very good maneuverability, because its beam is conducted through optical fibers. Experimental studies have been made on rats. They consisted of comparison between the thermal effects and the consequent histological lesions of three lasers: 1.32 micron Nd-YAG, 1.06 micron Nd-YAG, CO2. 145 impacts on the cortex of 45 rats have been studied. Each shot was registered with an infrared camera, measuring the cortex surface temperature around the impact. The signals were digitalized; they allowed us to obtain a numerical image and the profile of temperature for each shot, as well as the development of temperature of each point of the profile. These results have been correlated with the histological data. It appears that for equivalent efficient outputs, the cortical lesions, 8 days after the shots, were similar for the 1.32 Nd-YAG laser and the CO2 laser. For instance, the depth of the coagulation necrosis varied from 200 to 250 microns after CO2 laser impacts (P = 3W; t = 0 05s; Fluence = 5 Joules/cm2), and from 210 to 260 microns after 1.32 Nd-YAG laser impacts (P = 5-14W; t = 0.4s; F = 50-170 J/cm2).(ABSTRACT TRUNCATED AT 250 WORDS)

Aluminum Silicates↗

[The versatile midface degloving approach. Re-updating the method, apropos of a case].

A recurrent adenoid cystic carcinoma of the hard palate extending to the maxillary sinus was resected through the versatile midface degloving approach. The surgical technique is discussed, and advantages and limits of the procedure are analyzed. The authors recommend this approach for midface tumors which avoids a facial scar and which sounds oncological.

Carcinoma, Adenoid Cystic↗

[Primary carcinoma of the external auditory canal and the middle ear. Apropos of 14 cases].

Fourteen carcinomas of the external auditory canal and middle ear are presented regrouping eleven squamous cell carcinomas, two adenocarcinomas and one adenoid cystic carcinoma. Results are analyzed according to the treatment employed: surgery and/or radiotherapy. Four local recurrences occurred, two after radiation as initial treatment and two after surgery completed by radiation. Tumors strictly limited to the skin of the auditory canal and treated surgically are free of disease. A new classification is proposed in order to simplify and clarify the therapeutic indications and prognosis.

Actuarial Analysis↗

[Orbital varices. Apropos of a case].

The authors report on a typical case of orbital varix, which was operated on by neurosurgical way. Orbital varices are rare venous anomalies, easily suspected on the clinic. The diagnosis is usually made on ultrasonography, CT Scan, and orbital venography. Conservative treatment is the rule except when complications have happened.

Exophthalmos↗

Symptomatic Rathke's cleft cysts; clinical and therapeutic data.

The authors report on a case of symptomatic Rathke's Cleft Cyst (RCC). The only clinical feature was headache. The cystic fluid was aspirated through a trans-sphenoidal approach. The postoperative course was uneventful. The rarity of symptomatic RCC (70 cases described in the literature; 30 operated patients) makes necessary the comparison of all data quoted in the different publications so as to define an appropriate attitude to treatment. It thus seems that the surgical procedure should be limited to an aspiration of the cyst contents through a trans-sphenoidal approach; such a procedure is more reliable than a craniotomy to avoid leakage of the cystic fluid into the subarachnoid space and possible postoperative aseptic meningitis. Some authors discussed the possibility of postoperative radiotherapy although only six patients developed recurrence of their clinical features several years after operation and also the efficacy of such a procedure has not been proved.

Adult↗

Cerebral astrocytoma in association with HIV infection.

Cerebral astrocytoma has been found in two patients with AIDS related conditions. The fortuity of this unusual association is discussed, insofar as immunosuppression could favour the growth of certain neoplasms.

Acquired Immunodeficiency Syndrome↗

Madreporic coral: a new bone graft substitute for cranial surgery.

Since 1985, the authors have been using madreporic coral fragments (genera Porites) as a bone graft substitute. Of the 167 coral grafts implanted, 150 were coral "corks" used to obliterate burr holes (diameter 10 mm), five were large implants (length 20 to 40 mm) to repair skull defects, and 12 were coral blocks to reconstruct the floor of the anterior cranial fossa. Previous experimental studies suggested that coral grafts would be well tolerated and become partially reossified as the calcific skeleton was resorbed. The authors describe their experience and detail the main biological properties of these materials, which appear to be very promising for use in cranial reconstructive surgery.

Animals↗

[Stereotaxic approach in extensive lesions of the septum-fornix-callosal region. Apropos of 14 cases].

Stereotactic approach of anterior midline lesions which involve the septum-fornix-callosal region is a logical alternative to open surgery as a first choice. It contributes to know anatomical relations--particularly vascular and ventricular--of the lesion; it provides an accurate neuro-pathological diagnosis, with grading and spatial configuration of the lesion, and therapy in some cases. In other cases, it is a guide for appropriate therapeutic choice.

Adolescent↗

[Olfactory meningioma with ethmoido-orbital extension. Diagnostic and therapeutic problems. Apropos of a case].

Our purpose is to present a case of olfactory meningioma with extensive invasion of the orbit and the ethmoid sinuses revealed by an exophthalmia. Diagnosis discussions with others tumors of the ethmoid sinuses are presented. Meningioma resection was realized simultaneously by ENT surgeons and neurosurgeons through a bifrontal coronal skin flap and orbital roof remaining. Anterior skull base reconstruction was performed with a madreporic coral graft, which is a simple, fast and reliable technique, permitting a complete skull base closure.

Ethmoid Sinus↗

[Reconstruction of the anterior face of the base of the skull using coral grafts].

Following experimental investigations on animals, small coral grafts have been utilized on patients since 1985 to fill in burr holes (42 patients). This first clinical experimental step has been satisfactory. Therefore, blocks of corals have since then been used as bone graft substitutes for anterior skull basis reconstruction (12 patients). Cheap and easily sterilized, coral implants have the advantage of being inert (99% of calcium carbonate), biodegradable and well reossified. They shorten surgical procedures by avoiding the use of iliac and/or costal grafts. No infectious complications have been noted.

Biocompatible Materials↗