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Biomedical subjects

H Laccourreye

Publications and source records attributed to H Laccourreye.

At least 19 recordsLinked to original sources
PubMed1992

T1 squamous cell carcinoma of the arytenoid.

Twenty-two cases of early squamous cell carcinoma of the arytenoid cartilage staged as T1 according to the 1983 American Joint Committee for Cancer Staging Classification system were reviewed. Eighteen percent of the patients showed no symptoms. In the remaining 82%, the main presenting symptom was pain in the form of sore throat, odynophagia, or otalgia. Radiotherapy and partial laryngeal surgery were the options retained for the treatment of the larynx. A "watch and wait" policy or preventive treatment of the ipsilateral jugulocarotid lymph nodes were the treatment options retained for the neck. Significant differences were noted in terms of local and nodal recurrence between the two programs. Results indicate that partial laryngeal surgery with total arytenoidectomy and preventive treatment of the neck appear to be advisable for this particular type of primary lesion.

Adult↗
PubMed1992

[Partial posterior cordectomy with laser CO2 in bilateral recurrent paralysis].

Thirteen patients with bilateral vocal cord abductor paralysis were treated by Carbon Dioxide Laser Posterior Cordectomy. 6 out of 7 patients were decannulated. 92% of patients recovered a physiologic respiration. Advantages of this surgical technique are discussed in comparison with Endoscopic Laser Arytenoidectomy.

Adult↗
PubMed1992

[Stage T1 malignant tumors of the arythenoid. Analysis of a series of 26 cases].

26 malignant tumours of the arytenoid classified as T1 according to the UICC 1987, were treated in the ENT and Cervico-Facial Surgery wards to Hospital Laennec between 1961 and 1990. The natural history of these lesions, locoregional efficiency of the different treatments used, the part played by chemotherapy, survival, causes of death and therapeutic modalities used as a last measure, have been analysed. The frequency of tumours with neuroendocrine has been emphasized. Such a diagnosis should be questioned when the initial biopsy does not diagnose a well differentiated epidermoid carcinoma. The use of argyrophil colouring in order to find neurosecretive granules helps in carrying out the diagnosis. The treatment of tumours, classed T1 N0 M0, of the arytenoid, is based on partial, laryngeal surgery associated with a preventive, jugulo-carotidian-ipsilateral ganglionary intervention.

Actuarial Analysis↗
PubMed1992

[Adjuvant chemotherapy in supraglottic epidermoid carcinoma stage T3].

92 squamous cell carcinomas of the supraglottic larynx classified as T3 were treated from 1977 through 1987 and retrospectively analyzed. All the patients of this series received chemotherapy as initial treatment (2 cycles). From 1977 through 1981 the combination of Vincristine-Methotrexate-Bleomycin (VMB) was employed; after 1981, the protocol: Cisplatinum-5 FU with or without Bleomycin (CF) was administered instead of VMB. All the patients were then surgically treated on the tumoral site and cervical lymph chains. At 5-year, there was no significative difference between the two chemotherapeutic regimen in term of locoregional recurrences and second primaries. 5-year actuarial survival rate was higher for patients treated with the CF protocol (71%) versus (54%) with the VMB regimen. Systemic metastases occurred less frequently after CF (4.5%) than after VMB (22.4%). These findings suggest that chemotherapy has substantially some activity against microscopic distant metastases.

Actuarial Analysis↗
PubMed1992

[Evaluation and treatment of chronic pain after cervicofacial cancer surgery].

When lasting pain occurs after surgery of head and neck cancer, tumoral recurrence should be considered. In addition to curative treatment, relief of pain is often provided by opioid analgesics. Doses vary according to tolerance and patient. Other than digestive routes of administration may be required. Here are two clinical reports: the first case with cervical epidural analgesia by ambulatory autoadministration device (Patient control analgesia), the other one with intrathecal in C7-T1 catheter with port access in which morphine was injected every 24 hours resulting in efficient analgesia, in metastatic Pancoast's syndrome. Surgical or radiotherapy sequelae sometimes bring about pain; bilateral cervicalgy described as burns associated with pain-related depression, 18 months after glotto-subglottic partial laryngectomy, requires psychological support and carbamazepine for desafferation pain removed within 6 months. When the only treatment left appears to be analgesia after surgery of head and neck cancer, follow-up in a multidisciplinary pain treatment centre allows a therapeutical management with optimum tolerance and efficiency.

Adult↗
PubMed1992

[Deglutition and partial supracricoid laryngectomies].

The indications of partial supracricoid laryngectomy have become more numerous since the first descriptions made by Majer, Labayle and Piquet. The study of the published functional results emphasizes that false passages during deglutition are the main postoperative problem. This technical note is aimed at drawing attention to the various points to be respected intra- and postoperatively to allow swallowing in as physiological a manner as possible.

Cricoid Cartilage↗
PubMed1991

Carcinoid (neuroendocrine) tumor of the arytenoid.

We reviewed three cases of neuroendocrine carcinoid tumors of the larynx, located on the arytenoid cartilage, treated between 1962 and 1985 at the Laennec Hospital, University of Paris (France) V. Staging was performed according to the 1979 American Joint Committee for Cancer Staging Classification. None of the lesions were associated with symptoms of the carcinoid syndrome. Local and nodal recurrences, distant metastasis, and survival were analyzed. Among the 112 reported carcinoid (neuroendocrine) tumors of the larynx, arytenoid location represented 28.6% (32/112) of the cases. A review of these 32 patients was performed to analyze the problems associated with that location.

Adult↗
PubMed1991

Synchronous arytenoid and pancreatic neuroendocrine carcinoma.

Neuroendocrine laryngeal carcinoid tumours are uncommon. The supraglottis is the main location of these tumours. Eighty-one cases have been reported in the world literature. We present the first case of a synchronous laryngeal and pancreatic neuroendocrine tumour.

Arytenoid Cartilage↗
PubMed1991

Vertical partial laryngectomy: a critical analysis of local recurrence.

The purpose of this study was to evaluate local recurrence following vertical partial laryngectomies in 416 patients with either T1N0M0 or T2N0M0 glottic carcinoma. Local failure was reported according to the T stage, the precise tumor location within each stage, the true vocal cord mobility, and the surgical procedure performed. No local recurrences were observed among 42 patients who underwent thyrotomy and cordectomy when the tumor was confined to the middle third of the mobile true vocal cord. Local failure occurred in 8 of 111 (7.2%) patients in whom hemilaryngectomy was performed for tumors confined to one mobile true vocal cord. There was a diverse group of lesions within each T stage that responded differently to the surgical approaches. The differences in the initial recurrence rates are discussed in terms of careful preoperative assessment and choice of surgical technique for early glottic carcinoma.

Adult↗
PubMed1991

[Comparative study of temporal parameters of alaryngeal voices. Esophageal and tracheo-esophageal voices].

Recent studies have established significant acoustic and phonetic differences between tracheo-oesophageal (TE) and conventional esophageal voices (EV). 12 alaryngeal voices (2 esophageal, 6 myomucosal shunts, 4 tracheoesophageal phonatory protheses), and 7 normal laryngeal voices were recorded and analyzed. Speech timing including voicing and pauses distribution was evaluated and compared to laryngeal voices. Speakers with TE voices using pulmonary air were able to preserve the rythm and the syntactico-semantic structure of their speeches, as opposed to speakers with EV who often had to insufflate air into the esophagus and therefore had a staccato-like speech. The phonation time was quite similar in both situations, but the length and the number of pauses made the difference.

Aged↗
PubMed1991

[Adenoid cystic carcinoma of the parotid gland].

The authors report 7 cases of adenoid cystic carcinoma arising in the parotid gland between 1969 and 1990. All patients underwent surgery. Radiotherapy was performed twice following surgery. Local failure, nodal failure and distant metastasis are analyzed. Death appears to be related mainly to local failure. Radiotherapy does not seem to improve the local control obtained by surgery alone. Surgery must then be total and if necessary mutilating. Radiotherapy associated to surgery might be useful in case of extensive tumors for which complete eradication is not possible. A review of the world literature is performed.

Adult↗
PubMed1991

[Extension to the infratemporal fossa of malignant tumors of the face].

The authors report about the experience of the N&T department of Laënnec Hospital with tumors of the upper facial structures invading the infratemporal fossa. This invasion is currently diagnosed preoperatively owing to the progress made in imaging. The involvement of the posterior wall of the sinus is the first CT sign. 45 tumors extended into the ITF, including 35 maxillary tumors. For the latter, the frequency of invasion of the ITF was of 38% for all histological types, and of 26% for epidermoid carcinomas. Trismus, the most characteristic sign, was present in 45% only of the tumors studied. Facial pain also was frequent. The prognosis of these tumors is extremely poor, as the survival rate was of 17% at 3 years, with a mean survival of 10 months. The failures of treatment were essentially local. The surgical treatment proposed associates scooping out the ITF to maxillary resection.

Carcinoma, Squamous Cell↗
PubMed1991

[Muco-epidermoid tumors of the parotid gland. Diagnostic and therapeutic attitudes].

On the basis of a retrospective series of thirteen cases treated between 1969 and 1989, the authors have studied the diagnostic and therapeutic issues connected with mucoepidermoid parotid tumors. The diagnosis is histopathological, but it is sometimes difficult to establish because of the histological polymorphism of these tumors. The degree of malignancy is variable and generally low. It is determined according to clinical and histopathological criteria, although there is not always a correlation between these criteria and the malignancy of evolution. Surgical exeresis is sufficient to cure most of these tumors. However, postoperative radiation therapy is indicated in case of tumoral invasion. Out of the ten cases of mucoepidermoid parotid tumor, nine were treated in first intention with exclusive surgery, and one case underwent postoperative radiation therapy. No local recurrence was noted. Out of the three patients who had a second-intention surgical exeresis, one died after repeated recurrence in spite of the complementary radiation therapy.

Adolescent↗
PubMed1990

Supracricoid laryngectomy with cricohyoidoepiglottopexy: a partial laryngeal procedure for glottic carcinoma.

The partial horizontal supracricoid laryngectomy with cricohyoidoepiglottopexy consists of resection of the whole thyroid cartilage and paraglottic space. The cricoid cartilage, the hyoid bone, most of the epiglottis, and at least one arytenoid cartilage are conserved. Thirty-six patients with squamous cell carcinoma of the glottis who underwent this procedure from 1974 through 1986 are presented. All 36 recovered physiologic deglutition and phonation. None required a permanent tracheotomy. The 3-year actuarial survival rate was 86.5%. The local recurrence rate was 5.5%. The indications for the procedure are carcinomas of the glottis that 1) spread beyond the confines of the membranous portion of the true vocal cord or 2) present with limitation of true vocal cord mobility. The procedure is presented as a useful alternative to radiotherapy, partial vertical laryngectomy, and total laryngectomy in select cases of glottic carcinoma.

Adult↗
PubMed1990

Treatment of Frey's syndrome with topical 2% diphemanil methylsulfate (Prantal): a double-blind evaluation of 15 patients.

Fifteen patients with severe gustatory sweating after total parotidectomy and facial nerve preservation were asked to take part in a double-blind study. All patients were alternatively treated with topically applied placebo and topically applied 2% diphemanil methylsulfate (an anticholinergic agent). A 10-day period was allowed between applications for return of symptoms. Two-percent diphemanil methylsulfate provided partial relief in 33.3% of patients and total relief in 40% of patients. Involvement of the hairy temporal line region with gustatory sweating was the main reason for failure. Duration of relief varied from 2 to 4 days. The only side effect was dryness of the mouth noted in two patients.

Administration, Topical↗
PubMed1990

Supracricoid laryngectomy with cricohyoidopexy: a partial laryngeal procedure for selected supraglottic and transglottic carcinomas.

The partial horizontal supracricoid laryngectomy with cricohyoidopexy consists of resection of the whole thyroid cartilage and paraglottic space, as well as the epiglottis and the whole pre-epiglottic space. The cricoid cartilage, the hyoid bone, and at least one arytenoid cartilage are spared. Sixty-eight patients with squamous cell carcinoma of the supraglottis who underwent this procedure during the period from 1974 through 1986 are presented. Conventional horizontal supraglottic laryngectomy was contraindicated in all cases. All but three patients (95.4%) recovered physiologic deglutition, and none required a permanent tracheostomy. The 3-year actuarial survival rate was 71.4%. No local recurrences were encountered. The indications for the procedure are carcinomas of the supraglottis that 1. involve the glottis and anterior commissure, 2. invade the ventricle, 3. present with a marked limitation of true vocal cord mobility (transglottic lesions), and 4. invade the thyroid cartilage. The procedure is presented as a useful alternative to radiation therapy, horizontal supraglottic laryngectomy, and total laryngectomy in select cases of supraglottic carcinoma.

Adult↗
PubMed1990

[Surgical treatment of associated bronchial, upper respiratory and digestive tract cancers].

Between 1980 and 1987, 63 lung cancers associated with upper aero-digestive tract carcinomas were operated on 50% of the primary malignancies of the upper aero-digestive system were laryngeal. These tumors developed synchronously in 13% and metachronously in 87%. The operative mortality rate was 3%. The five years survival rate was 30%. Our results were found identical to those observed in a single lung cancer series. Coin lesion of the lung should be therefore considered as a second primary cancer. Thus, the best treatment is surgical resection. When the option exist, the lung cancer should be treated before the upper airway cancer to avoid the impact of previous irradiation and/or surgical treatment of the upper airway cancer upon the post-thoracotomy management.

Adult↗