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Biomedical subjects

J L Goubert

Publications and source records attributed to J L Goubert.

28 records · Page 2Linked to original sources

[Hypoglossofacial anastomosis, results in 19 cases].

Hypoglossofacial anastomoses was performed in 19 patients, in the majority of cases for tumors located in the pontocerebellar angle. Results were a total success in 16 cases, one patient has not been seen again, and operation had been performed too recently to assess results in two cases. Anastomosis was conducted during initial surgery in 12 cases, and at a later stage in the other 7. In one patient, anastomosis 3 years after facial paralysis following excision of an acoustic nerve neuroma resulted in satisfactory re-innervation of the face after 13 months. Results were not significantly different in 6 patients with an intramastoid anastomosis and in 13 where it was performed in the parotid region. In 11 cases, a classical anastomosis was performed, involving suture of the XIIth and VIIth nerve trunks (type I anastomosis). A more complex procedure in the remaining 8 cases involved separate anastomosis of the XIIth and facial nerve branches, with, in some patients, implantation of sternothyroid muscle fragments, supplied by the descending branch of XII, into the orbicularis muscle. Results were good using these modifications, but valid comparison with those following classical methods cannot be made at the present time. Technical features of the procedure employed are described. Hypoglossofacial anastomosis is currently the only method giving satisfactory constant results when end-to-end suturing of the facial nerve or a superficial cervival plexus graft is obligatory.

Cerebellar Neoplasms↗

[Reconstructive anterior frontal laryngectomy (author's transl)].

Sliding epiglottoplasty was employed for reconstruction of the glottis after subtotal laryngectomy. Technical aspects are described, and the indications and limitations of this reconstructive partial laryngectomy procedure are discussed from the anatomic and carcinologic points of view. Its advantages include lack of postoperative complications, the very good functional results obtained, and the fact that it can be conducted following radiotherapy and in debilitated patients. It has a limited but definite place among partial laryngectomy procedures.

Adult↗

[The parathyroid risk in thyroidectomy].

The authors report their experience of parathyroid risk in thyroid surgery on the basis of 1 188 thyroidectomies performed between 1973 and 1980. The benign thyroid pathology, the risk is negligeable, approximately 1%, though with the exception of operations for recurrence. In malignant tumour pathology, amongst 98 carcinomas treated by total thyroidectomy and mediastino-recurrent laryngeal lymph node dissection, the authors report an overall percentage of definitive major hypocalcaemia of 22.5%. Routine identification of the parathyroids at the start of the operation, at least on the healthy side, and care not to damage their vascular supply has made it possible to reduce the rate of hypoparathyroidism to 10% in the past two years. A study of anatomical dissection of 200 parathyroid glands with vascular injection is reported in the preamble. Finally, the authors analyse in the literature the results of parathyroid transplant and report their own experience.

Humans↗