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J J Pessey

Publications and source records attributed to J J Pessey.

At least 19 recordsLinked to original sources
PubMed2005

[Pseudoaneurysm of the internal carotid artery revelated by epistaxis: report of two cases].

OBJECTIVES: Pseudoaneurysms of the carotid artery are a rare but serious cause of epistaxis. They can be rapidly life-threatening. Usually resulting of a surgery or a traumatism, pseudoaneurysms can express themselves by recurrent epistaxis. Management of these epistaxis is discussed. METHODS: The authors present two cases and effect a review of the literature. RESULTS: The first patient presented with a pseudoaneurysm few days after a transsphenoidal surgery. The second patient presented with a pseudoaneurysm fourteen years after a radio-surgical treatment of an ethmoidal and frontal epidermoid carcinoma. Diagnosis was suspected during nasal endoscopy and confirmed in both cases with angio-CT and arteriography. The first patient underwent a selective embolization. The second patient had to have a carotid occlusion due to a sudden severe haemorrhage, resulting from a pseudoaneurysm rupture following the embolization attempt. CONCLUSION: Review of the literature confirms the indication of endovascular intervention. The optimal management is carotid occlusion, provided the patient can tolerate carotid test occlusion and the circle of Willis is satisfactory. In some cases, a preservative treatment may be possible, which could be either pseudoaneurysm embolization or the placement of a covered stent.

Adult↗
PubMed2004

[Voice after supracricoid partial laryngectomy: comparison of two phonatory mechanisms].

INTRODUCTION: Different laryngeal phonatory mechanisms may be observed at long term after supracricoid laryngectomy. For this study two mechanisms are differentiated. The "dilated" mechanism is the consequence of a forward movement of the neolarynx creating a new resonance cavity. The "contracted" mechanism tallies with the backward contraction of the base of the tongue and the contraction of the posterior pharyngeal wall compressing the neolarynx. OBJECTIVE: The aim of the study is to determine if the voice outcome is different between these two kinds of mechanisms. MATERIAL AND METHOD: The method is based on the selection of a homogeneous group: 12 patients operated by cricoepiglottopexy with a follow up superior to two years and with a stable voice and a full neoglottic closure during phonation. The voice quality and the phonatory mechanism are analysed. Regarding voice assessment, a self evaluation with the vocal handicap index adapted for the study and the GRBAS scale are carried-out. Frequency (usual, minimum, maximum, range) and loudness are used to appreciate the vocal capacities. The phonatory mechanism is studied by videolaryngostroboscopy, performed tongue free, with a normal /e/ and a high-low transition pitch. RESULTS: The outcomes point out a difference between the two mechanisms. The best vocal results are observed in the "dilated" mechanism for the studied parameters and mainly for the frequency parameters. CONCLUSION: The discovery of numerous phonatory mechanisms after supracricoid laryngectomy independent from neoglottic closure lead us to further studies of the impact of this type of surgery on articulatory patterns.

Aged↗
PubMed2003

[Nasal polyposis: long term functional results in 203 patients treated by ethmoidectomy combined with intranasal corticotherapy].

OBJECTIVE: Evaluate the long term quality of life in patients after ethmoidectomy associated with intranasal corticotherapy for nasal polyposis on the appreciation of the intensity of nasal symptoms. MATERIAL ET METHOD: The authors report their experience about 203 patients treated by endonasal endoscopic ethmoïdectomy intranasal followed by a long term intransal corticotherapy, with a mean follow up of six years. In this prospective study, each symptom was evaluated using an analogic visual scale and a questionnaire. The evolution of asthma after surgery and the patients global satisfactory rate were noted. RESULTS: There is a global improvement of the nasal symptoms with a mean postoperative individual scores calculated at 32% for nasal obstruction, at 34% for rhinorrhea and at 51% for anosmia. No impact on asthma or improvement of asthma was encountered in 92% of the patients. The patients global satisfactory rate of this medico-surgical approach of the disease is 93.6%. A positive correlation was found between the severity of the olfactory disorders and the oral corticosteroid therapy. CONCLUSION: Endoscopic endonasal ethmoïdectomy followed by intranasal corticotherapy represents a valuable protocol in treating patients with severe nasal polyposis.

Adolescent↗
PubMed2002

Lingual thyroid and hyperthyroidism: a new case and review of the literature.

Lingual thyroid is the result of a defective migration of the thyroid anlage occurring between the 3rd and 7th week of gestation. Whereas mutations in the transcription factor-2 (TTF-2) and PAX8 and in the TSH receptor genes (TSH-R) have been reported in a minority of patients with thyroid dysgenesis, the etiopathogeny of the majority of cases, and in particular of thyroid ectopy, remains unclear. The majority of patients with thyroid ectopy are asymptomatic, but obstructive symptoms as well as hypothyroidism have been observed. Hyperthyroidism is an exceptionally rare finding. To our knowledge, only 2 cases have been reported in the literature to date. Herein, we describe an unusual case of thyrotoxicosis related to a nodular lesion in a lingual thyroid. Treatment consisted in restoration of a euthyroid state with thionamide followed by surgical removal of the ectopic gland. The underlying molecular cause of the ectopic lingual thyroid and the toxic adenoma in this case could not be identified. We speculate that abnormally early differentiation of the thyroid gland could interfere with the migration process, a hypothesis yet to be confirmed.

Adult↗
PubMed2002

[Value of of fine-needle aspiration cytology and MRI in parotid gland masses].

INTRODUCTION: The objective of our study was to discuss the valve of fine-needle aspiration cytology (FNAC) and magnetic resonance imaging (MRI) in the diagnosis and treatment of parotid gland masses. MATERIALS AND METHODS: Forty patients were included in the prospective study. They had undergone clinical examination, FNAC and MRI before parotidectomy. The results of these examinations were compared with the corresponding histopathological diagnosis. RESULTS: When it is positive, FNAC is a good examination of malignant tumours (sensitivity 67%, specificity 79%, positive predictive value 86%, negative predictive value 100%). The MRI allows a good assessment of the tumoural mass and its anatomical relationships (sensitivity 55%, specificity 86%, positive predictive value 89%, negative predictive value 75%). If the T2 sequence shows reduced density (p < 0.05) or in case of bad limitation (p = 0.004), a malignant character is strongly suspected. CONCLUSION: In cases of parotid gland mass, where surgical intervention is necessary, there is no need of special investigations: however FNAC and MRI allow us to anticipate what operation will be required.

Adult↗
PubMed2002

[Value of interventional video-endoscopy in the assessment of cancer of the upper airways and digestive system].

INTRODUCTION: The aim of our study was to evaluate the video fiberoscope with operator canal (FOC) in he diagnosis of head and neck carcinoma compared to direct laryngoscopy (DL). METHODOLOGY: From August 2000 to May 2001, 82 patients were included in a prospective study. They were examined for pharyngolaryngeal cancer with the FOC, DL and a CAT-SCAN. The compared elements were the visualization of the different regions of the pharyngolarynx. A three dimensional description of the lesion, the presence of secondary localisations as well as the anatomo pathological results were obtained with FOC and DL. RESULTS: Although the pharyngolarynx is less well visualized in FOC than in DL (p = 0.04), no statistically significant difference was found between the two methods in terms of visual diagnosis and assessment of the extent of the lesion. The sensitivity of the biopsies made with FOC is lower than those performed with DL (66% FOC, 97% DL). Moreover, we have noted that FOC is highly reliant on the experience and ability of the surgeon. CONCLUSION: DL remains the most reliable technique for the exploration and diagnosis of the pharyngolarynx. If it is not possible to perform a DL or if it is not indicated (trismus, contra-indication to general anaesthesia) FOC should be considered as the examination of choice.

Adolescent↗
PubMed2001

[Pilomatrixoma].

Explore the source record for details and available documents.

Hair Diseases↗
PubMed2000

Short therapy with amoxicillin-clavulanate and corticosteroids in acute sinusitis: results of a multicentre study in adults.

Evolution of bacterial resistance shortens antibiotic treatment in ENT infections. The efficacy and tolerance of amoxicillin-clavulanate (ACA), with and without associated short steroid therapy, was evaluated in acute sinusitis of adults at a dosage of 1.5 g/d for 5 d vs. 10 d. This multicentre, randomized, double-blind, placebo-controlled study included 433 patients, 417 of whom were suitable for intent-to-treat (ITT) analysis. The therapeutic success rate in the ITT population, assessed according to strict clinical and radiological criteria, was respectively, 80% and 85% in the 5-d and 10-d treatment groups. Due to the statistical risks that were evidenced, the 2 durations of treatment could not be considered equivalent. The analysis of medical history shows that some risk factors (recurrence of sinusitis, previous surgical sinus drainage) seem to promote therapeutic failure and that 5-d treatment is inappropriate in these patients. The persistence of therapeutic success on day 30 was not influenced by the initial duration of treatment. The efficacy and good tolerance of ACA in acute sinusitis in adults were confirmed. Further studies will be needed to define the indications of short treatments better, which seem to be indicated in the absence of specific risk factors.

Acute Disease↗
PubMed2000

[Results of 248 patients with sleep apnea syndrome treated by continuous positive pressure ventilation between 1990 and 1995. A study of compliance and outcome of the apnea-hypopnea index].

Between 1990 and 1995, 369 patients were investigated for obstructive sleep apnea syndrome (OSAS) by polysomnography. Among them, 248 patients with a mean Apnea-Hyponea index (AHI) of 37.7 per hour were treated by nasal continuous positive airway pressure (n-CPAP). Mean follow up was 39.5 +/- 20.4 months. In this group, 23 patients (9.2%) refused nCPAP immediately or after the first night and 39 (15.7%) gave up later. 15 patients (6%) died during the period of the study. The cumulative compliance reached 70% at 72 months. Non compliant patients usually gave up n-CPAP before the end of the first year. We compared the group of 150 patients always treated at the date of 31/12/95 with the group of 62 patients who refused nCPAP initially or gave up later. There was no difference in clinical parameters or polysomnographic data between the two groups. In 94 patients treated by nCPAP for more than a year we evaluated the outcome of AHI by a polysomnography performed after 72 hours of nCPAP cessation. Mean AHI of the group at this time was 38.2 +/- 20.3/h and was well correlated with the initial index (r = 0.41, p < 0.0001). However for 28 patients (29.7%) we observed, at the time of this second AHI determination, a variation (plus or minus) of at least 50% of the index. 6 patients, without any significative weigth loss, had an AHI below 5/h at this second determination. In this small group nCPAP was interrupted for 6 to 12 months, then another polysomnography was performed. At this time mean AHI was 42.4/h and clinical symptoms had reappeared in all patients. This study demonstrated that compliance to nCPAP in OSAS patients is good. No clinical or polysomnographic factors allow to predict non compliance. AHI is not modified by long term treatment with nCPAP.

Female↗
PubMed2000

[Acute rhinosinusitis in the adult: national survey of general practice management].

Between the 17/1/2000 and the 31/3/2000 a study was carried out in 5000 general practitioners in the management of patients with acute maxillary sinusitis. The general practitioners filled out a questionnaire in 2 parts: the first part about their management (diagnosis-treatment) and the second part included 1 case study. According to the results of the first part, acute maxillary sinusitis occurred frequently during the winter months adding further complications. The second part of the study confirmed the finding of the first part. Analysis of case study demonstrates that this pathology affected men at the median age 37.6. The incidence of bilateral sinusitis is (61.4%) maxillary (61.1%), frontal (31.7%), ethmoidomaxillary (9.4%) or sphenoidal (1.7%). One quarter of patients participated in further medical investigations that included regular X rays of sinus and 14% patients in anterior rhinoscopy. In the older patients, on the patients with unilateral sinusitis, or sphenoidal sinusitis, the investigations were more frequent and these patients appealed for the specialist frequently (Ear Nose and Throat specialist mainly). The first line of treatment included 3.2 products of which antibiotics 98.5%, vasoconstrictors 55%, anti-inflammatory 55% (corticosteroids 46.8%, non corticosteroids 8.7%), mucolytics 41.6%. In total, general practitioners confirmed their pragmatic management in the treatment of acute sinusitis based on clinical diagnosis.

Acute Disease↗
PubMed1999

[Pristinamycin in the outpatient treatment of acute sinusitis in adults].

TWO MAIN GERMS: The risk of severe complications of acute bacterial sinusitis warrants empirical antibiotic therapy targeted against the two main causal agents: S. pneumoniae and H. influenzae. PRISTINAMYCIN VS CEFUROXIME AXETIL: A double-blind placebo-controlled randomized multicentric study conducted with two treatment arms including 310 patients has demonstrated that pristinamycin, 2 g/d for 8 days, has a clinical efficacy equivalent to cefuroxime axetil, 500 mg/d. IN CLINICAL PRACTICE: Pristinamycin is an interesting alternative to beta-lactams for the first intention treatment of purulent acute sinusitis in adults. Its efficacy against penicillin-resistant pneumococci and H. influenzae is a further reason for its use in case of failure after conventional treatments.

Acute Disease↗
PubMed1999

Nasopharyngeal tuberculosis.

Rhinopharyngeal tuberculosis is a rare pathological condition. It is most often associated with lymph node and pulmonary lesions, but it may be an isolated finding. The authors report a recent case of an isolated rhinopharyngeal tuberculosis in a 64-year-old female. A review of the literature is presented. They emphasize the clinical presentation, that, in all aspects, may resemble a malignant tumour of the nasopharynx, as well as the difficulty of obtaining a pathological and bacteriological diagnosis.

Diagnosis, Differential↗
PubMed1999

Short course therapy with cefuroxime axetil for acute otitis media: results of a randomized multicenter comparison with amoxicillin/clavulanate.

BACKGROUND: Otitis media is a common infection of childhood. Increasing antibiotic resistance rates among the principal causative pathogens, Streptococcus pneumoniae and Haemophilus influenzae, are associated with failure of first line agents. OBJECTIVE: This open, randomized, multicenter study compared the clinical efficacy of a short 5-day course of cefuroxime axetil (CAE) suspension with that of amoxicillin/clavulanate (A/CA) suspension for 8 or 10 days. METHODS: Children age 6 to 36 months with acute otitis media with effusion, diagnosed by tympanocentesis and microbiologic culture, were randomized to receive CAE (30 mg/kg/day in two divided doses for 5 days) or A/CA 40 mg/kg/day in three divided doses for 10 days (A/CA-10). In French centers A/CA was given at 80 mg/kg/day in three divided doses for 8 days (A/CA-8). Patients were assessed 1 to 4 days after completing the course (posttreatment) and followed up at 21 to 28 days after completing the course. RESULTS: Of the 716 patients randomized, 252 were treated with CAE, 255 with A/CA-10 and 209 with A/CA-8. In the clinically evaluable population, the proportions of patients with clinical cure at posttreatment were 175 of 203 (86%), 181 of 205 (88%) and 145 of 164 (88%) in the CAE, A/CA-10 and A/CA-8 groups, respectively, demonstrating equivalence among the three treatments. For patients <18 months old, clinical cures were 111 of 134 (83%), 116 of 131 (89%) and 83 of 99 (84%) in the CAE, A/CA-10 and A/CA-8 groups, respectively; equivalence was also demonstrated. At follow-up, 130 of 175 (74%) CAE, 121 of 172 (70%) A/CA-10, and 112 of 142 (79%) A/CA-8 had maintained cure. A total of 837 pretreatment pathogens were isolated from middle ear fluid in 73% (522 of 716) patients, the majority of isolates were S. pneumoniae (30%) and H. influenzae (27%). The most common adverse events were gastrointestinal, the incidence of drug-related diarrhea being higher in the A/CA-10 group (18%) than in either the CAE or A/CA-8 groups (10%). CONCLUSIONS: A 5-day course of CAE, given twice daily, was shown to be equivalent to the two regimens of A/CA for treatment of acute otitis media with effusion in children.

Acute Disease↗
PubMed1999

[Does allergic fungal sinusitis exist? Preliminary results of a prospective study].

Allergic aspergillar sinusitis is a very controversial clinical feature. We present results of a prospective study aimed at evaluating the reality of allergic aspergillar sinusitis in a nosologic and clinical point of vue. During a 5 months period, 31 patients underwent surgery: 21 sino-nasal polyposis, 5 chronic sinusitis without polyposis, 5 chronic sinusitis with radiologic images evocative of mycosis. The study was carried out using clinical criteria (per-operative discovery of glue-like, thickened and viscous aspect of the secretions), pathologic criteria (the presence of elements consitutive of allergic mucin), mycological criteria (direct examination and culture), and immunoallergic criteria (specific IgE for Aspergillus fumigatus, serology for Aspergillus fumigatus and Aspergillus flavus (IgM, IgG), skin tests for Aspergillus fumigatus). In three cases we suspect an allergic aspergillar sinusitis (one patient presenting a bilateral chronic sinusitis and two patients presenting a sinonasal polyposis). In two patients presenting a sinonasal polyposis, a allergic fungal sinusitis was suspected, fungal identification was not possible.

Adult↗
PubMed1999

[The place of imaging in the investigation of the parotid and parapharyngeal space].

What strategy should be adopted and what results should be expected from imaging techniques in the various pathological process affecting the parotid and parapharyngeal space? When the pathological process is associated with morphological changes in the parotid, it is sometimes necessary to have recourse to imaging. MRI is the method of choice. Pathology in the parapharyngeal space (PPS) always requires an MRI and/or CT scan. It is necessary to have a very thorough understanding of the anatomy of the PPS and associated spaces to obtain a precise preoperative assessment and, where possible, an indication of the nature of the lesion.

Cerebral Angiography↗