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Biomedical subjects

J M Thomassin

Publications and source records attributed to J M Thomassin.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Trimetazidine and degenerative deafness. Effect on hearing and integration].

This study was conducted in order to assess the activity of trimetazidine dosed at 60 mg/day in patients presenting degenerative loss of hearing. Ten centers participated in this multicenter double-blind placebo-controlled trial which spanned 6 months. Included were 251 patients (118 women, 133 men) presenting with pure perception bilateral symmetrical deafness concerning predominantly the acute frequency range. 228 patients terminated the study, including 115 in the trimetazidine group and 113 in the placebo group. The evolution over a 6-month treatment period was significantly better with trimetazidine as regards the following parameters: audibility as assessed by pure-tone audiometry, namely at the acute frequency range (p = 0.002), intelligibility as assessed by speech audiometry (p = 0.008), subjective evaluation of hearing loss and its impact on the patient's social life. Results confirm the value of trimetazidine hearing loss management, based on clinical, subjective criteria as well as audiometric ones. Parameters reflecting best trimetazidine's efficacy were intelligibility and the psychological/behavioral impact of the impairment, allowing for better social integration of the subject.

Aged↗
PubMed1990

[Dysphonia in children].

Numerous cases of early dysphonia in children are due to congenital lesions of the vocal cord. Others, developing later, appear within a context of maltreatment of the vocal cords, and become part of the child's psychological and psychomotor developmental disorder. Hearing and seeing dysphonia are the two parts of our diagnostic stage, assisted by the use of optic fibres and audiovisual methods. Treatment must be global, putting dysphonia back into its proper context, leaving a substantial part to vocal re-education, as laryngeal microsurgery only comes into play when the result is inadequate, or when the vocal imperatives of a child musician lead to that choice.

Child↗
PubMed1990

[Seeing the timbre in the singing voice: training and retraining].

Voice clinicians, as well as singers, always correlate the assessment of the singing voice to the vocal and corporal gestures that model singing, and among these parameters, especially timbre. The authors have shown how and what to see in the timbre; first of all, through analysis of the voice by oscillography and sonagraphy, then through observation of the singing act in artists, with special interest for dynamic recordings by vuccal and nasal fibroscopy. In this manner, each variation of the timbre heard clearly corresponds to modifications of the glottic vibratory cycle, volume changes of the resonators, pharynx, oropharynx and buccal cavity. The analysis of the action of the different muscles coming into play in singing, their synergies and their antagonistic effects, give a physiological basis to the singer's vocal work. This analysis also makes it possible to more effectively guide the rehabilitation of dysacusia which effect the timbre.

Female↗
PubMed1989

[Congenital cholesteatoma of the petrous bone. Etiopathogenic discussions apropos of 11 cases].

The authors report on 11 cases of congenital cholesteatomas, treated between 1979 and 1988. In all cases, there was a long-standing history of deafness. The diagnosis revealed 6 cophoses, 5 cases of mixed deafness, 9 cases of impairment of the facial nerve (7 cases of paralysis including 4 with sudden onset and 2 hemispasms), 2 facial neuralgias with facial hypesthesia, one Gradenigo-Lannois syndrome, 2 leaks of the C.S.F. (1 nasal, 1 very abundant auricular leak). In 6 cases, the surgical approach route was trans-cochlear, and in 5 cases surpa-petrosal, two of which were extended to a petrectomy. Of the 5 cases of partial deafness, only one was preserved. In 5 cases, the facial nerve was destroyed at the level of the ganglion of the facial nerve, a region where a frankly epidermal tissue is always found. In 4 cases the facial nerve was repaired (three hypo-glosso-facial anastomoses and one end-to-end suture, after re-routing). The authors share the opinion of Fisch that the origin of the intra-petrosal congenital cholesteatoma always occurs at the level of the ganglion of the facial nerve.

Adolescent↗
PubMed1989

[Laterocervical paraganglioma].

Diagnostic and surgical features of lateral cervical chemodectomas are discussed in relation to a personal series of 16 patients with carotid body tumors and 10 with tumors of the intravagal glomus. Clinically, these affections are poor in symptomatology, those of the carotid glomus presenting as an isolated cervical tumor, intravagal glomus tumors as parapharyngeal masses of the restrostyloid type. Arteriographic findings are discussed in detail, as they constitute the only pathognomonic signs, enable differentiation between the two tumor sites, and supply essential pre-operative data: location of the pedicles, possible invasion of arterial walls, and the limits of the tumor. Surgical approach should be wide to enable control of the distal end of the internal carotid artery, if necessary under the base of the cranium, excision of the tumor usually being possible by employing the sub-adventitial resection technique.

Adult↗
PubMed1988

[Tissucol in septorhinoplasties].

There are two major indications for Tissucol: 1. Stabilization of structures separated by the operative procedure or of graphs, in particular cartilaginous, whether placed along the crest of the nose or at the level of the columella in sagittal position between the mesials, or frontal position under their lower edges. 2. The construction of grafts. a) Mixing of bone powder and Tissucol provides "laminated" graphs which, when placed laterally and below iliac bone grafts, avoid the grooves which all too often form along the edges of such grafts. b) Coherent moulding graphs can be obtained using Tissucol with crushed cartilage (from septum or auricular concha).

Aprotinin↗
PubMed1988

[The base of the nose in corrective rhinoplasty].

The authors describe a study of the labio-columellar region and of the alae of the nose in corrective rhinoplasty excluding malformations. Esthetic characteristics and the anatomical structure of this junctional area between the mobile nose and the facial plane are revealed. Surgical problems are analyzed with study in succession of surgical approaches, maxillo-septal angle, the columella, the maxilla, the muscular layer and the alo-jugal junction. Surgical techniques which can be divided into inferior septoplasties, columelloplasty and labio-columelloplasty have precise indications in accordance with the type of formation of the labio-columellar region. A technique of nostril resection with the absence of damage to and shortening plasty of the muscle layer is described.

Esthetics↗
PubMed1988

[Contribution of nuclear magnetic resonance in the neuro-otologic diagnosis of acoustic neuroma. Screening and evaluation of its extension].

Forty patients with suspected tumoral syndrome of ponto-cerebellar angle were investigated by NMR imaging. The method proved to be reliable, less invasive (lack of irritation and absence of iodized contrast) and as rapid as CT scan imaging for the diagnosis of presence and extension of an VIIIth nerve neurinoma. It also allowed avoidance of computerized gas meatography during screening for intracanal neurinomas.

Audiometry↗
PubMed1988

[Initial results of free bone transposition of the iliac crest in pelvi-mandibulectomy].

Mandibular reconstruction in 6 patients was by free flap from iliac crest in pelvi-mandibulectomies. The different technics proposed for mandibular reconstruction are described with emphasis on the specificity of repair surgery in cervicofacial oncology. In this precise indication stress is placed on the limitations of conventional graft and endoprosthesis procedures and the need to transfer a vascularized bone fragment. Among the technics for transfer of vascularized bone, preference is accorded to the composite flap from iliac crest as against the osteo-musculo-cutaneous flap, and details for removal of the former are given. The osteo-musculo-cutaneous flap from iliac crest appears to be the procedure of choice for reconstruction of bone in all cases where mandibular reconstruction is necessary after loss of continuity.

Humans↗
PubMed1987

[Spheno-ethmoidectomy in recurrent nasal polyposis. Technic, indications, results].

Spheno-ethmoidectomy can be legitimately included within the therapeutic schema for nasosinusal polyposis causing incapacity and resistant to medical treatment. Benefiting from recent technical progress, a very precise medical therapeutic framework and improved knowledge of ethmoid surgical anatomy, a marked reduction in complications of this operation has been observed. Results of a series of 175 ethmoidectomies performed in 90 patients confirm the good results reported in the literature, even though follow up is still insufficient.

Ethmoid Sinus↗
PubMed1986

[Tumors of the cerebellopontile angle, with the exception of acoustic neuromas].

Based on a review of 38 cases of tumors of pontocerebellar angle, excluding acoustic neurinoma, and a literature review, clinical, radiologic and therapeutic characteristics of these lesions are described. Diagnosis depends on accurate pre-operative identification of the type of tumor. Based on frequency data it can be estimated that tumors of pontocerebellar angle are nearly always acoustic neurinomas : this infers that these other tumors of the angle represent a differential diagnosis where major orientation signs are radiologic. This is fundamental, since when considering all tumors of pontocerebellar angle those requiring a totally different approach to treatment than that for acoustic neurinomas must be distinguished from those for which inability to identify them is not of marked importance since their operatibility is identical.

Adult↗
PubMed1986

[Requisite selection of surgical technics in the treatment of cancer of the larynx].

Rules for functional surgery of cancer of larynx are defined by means of a detaited analysis of results of 43 cases of reconstructive anterior frontal laryngectomy, 17 cases of crico-hyoide-epiglottopexy and 32 cases of crico-hyoidopexy. The carcinologic features of this surgery are discussed, and emphasis placed on the importance of the paraglottic space and its functional conditions in the light of recent physiologic data. Surgical procedures used are outlined with, for each of them, the neoplastic localization suitable for treatment and a critical analysis of postoperative functional results. Carcinologic follow up is still insufficient for several techniques used, preventing any precise conclusions to be drawn, but the authors consider it is justifiable to perform 66% of partial as against 34% of total laryngectomies.

Humans↗
PubMed1985

[The external fronto-ethmoidal approach].

A lateral fronto-ethmoidal approach simultaneously exposing the frontal sinus and the nasal fossae appears to be a necessity for the surgical treatment of fronto-ethmoidal pathology. It is possible to fashion an osteo-plastic flap in the fronto-naso-maxillary region. The technique of the approach is described. The operation leaves no ocular functional sequelae and the scar is minimal. Twenty one operations by fronto-nasal flap approach are described, 10 for benign tumours of the fronto-ethmoidal system and 11 with the aim of re-aerating the frontal sinus for cases of complicated or iatrogenic serious sinusitis. The results are studied. The indications of the fronto-nasal flap are described: In tumour pathology, this technique must be used for osteomas and mucoceles of the fronto-ethmoidal system as soon as the ethmoidal component reaches or goes beyond the middle ethmoid. If the fronto-ethmoidal lesion only involves the anterior ethmoid, it is then accessible via simple frontal flap. Inverted papillomas which require wide exposure should also be treated via this approach. In infectious pathology, the fronto-nasal flap offers the possibility, after eradication of fronto-ethmoidal lesions and calibration of the naso-frontal canal, of re-aeration of the frontal sinus which seems preferable to its exclusion. The possibility of re-aeration of the frontal sinus by an osteo-plastic procedure is progress in comparison with lost bone craniotomy procedures.

Craniotomy↗
PubMed1985

[Vestibular neurectomy in Ménière's disease. Results and comments apropos of 77 cases].

The authors report 77 cases of vestibular neurectomy performed between 1972 and 1984 (40 male and 37 female) for incapacitating Meniere's vertigo. Neurectomy was via a sub-petrous (S.P.) approach in 55 cases, by posterior trans-labyrinthine (P.T.L.) approach in 9 and anterior trans-labyrinthine (A.T.L.) in 13 cases. A.T.L. was abandoned because of the frequency of leaks of CSF and of meningitis. The P.T.L. approach did not result in any facial paralysis, even transient. There were 2 CSF leaks, without meningitis and one of which required reoperation. For the 55 S.P. cases, hearing worsened in 22.2% with 8 cases of deafness, including three appearing secondarily. There were two transient auditory improvements. Vertigo was cured in 73 cases (94.8%) with 25.9% instability after several months. The authors stress the frequent bilateralisation of the disease and the need to reserve vestibular neurectomy for cases of longstanding incapacitating vertigo, resistant to all other treatment, as well as the value of surgery on the endolymphatic surgery provided that the criteria of indication are complied with. Medical treatment remains the essential basis, including the analysis and, where applicable, treatment of psychosomatic factors by a trained psychiatrist. Finally, when vestibular neurectomy is indicated, the S.P. approach is otologically most suitable, the P.T.L. being reserved for deaf ears or the elderly.

Aged↗