[Reconstructive laryngeal surgery].
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Biomedical subjects
Publications and source records attributed to J Darras.
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The authors report on their treatment of 39 patients with bilateral laryngeal abductor paralysis, observed over a 10-year period. Medical treatment was given in 5 cases, and tracheotomy was performed in 5. Ten patients underwent endoscopic surgery with very good results in 7. Arytenoidopexy was carried out by the extra-laryngeal route in 19 cases with 16 excellent results.
Thyroidectomy for different thyroid disorders was conducted in 422 patients during 1978, after normal pre-operative laryngoscopy findings. Dissection of the recurrent laryngeal nerve was employed systematically in all patients except those having isthmectomy or enucleation operations, with a total number of 556 nerves dissected. Pre-and post-operative laryngoscopic examinations in the alert patient was conducted in all cases. After one year, 8% of the patients with abnormal post-operative laryngoscopic findings had not returned for follow-up. The known rate of recurrent nerve paralysis after one year was 0.7% of the nerves exposed, the maximum rate being 2% if patients not followed-up are included. These results confirm the value of systematic recurrent nerve dissection during thyroid surgery.
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Radiologic assessment after sinus surgery requires not only a good knowledge of the primary disease, but also a mandatory understanding of every surgical technique and approach. After having described these techniques, we will illustrate immediate, possible but rare, post-operative complications. The various pathologies responsible for a delayed recurrence will also be illustrated. A chapter will be dedicated to paranasal sinuses malignant tumors follow up after surgery.
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