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Biomedical subjects

J M Thomassin

Publications and source records attributed to J M Thomassin.

At least 73 records · Page 4Linked to original sources
PubMed1985

[Cholesteatoma of the ear. Experience with an eclectic therapeutic attitude].

In the light of 702 cases of cholesteatoma seen over a 20 year period, the authors report the experience of a hospital team based upon analysis of the last 517 cases. 322 patients were treated by a conservative attitude to the bony meatus, including 120 undergoing routine revision between 14 and 24 months. 195 cases were treated by an open technique, either primarily or following massive recurrences despite the use of closed techniques. In 33% of cases, patients had already undergone at least a tympanoplasty. The authors discuss the indications of the treatment of cholesteatoma. Each patient must be considered as an individual case and whilst our preference would be for conservation of the bony meatus, certain anatomical and functional conditions make a so-called open technique necessary in 1/3 of cases.

Adolescent↗
PubMed1985

[Rare cervicofacial cysts and fistulas in children].

Among the various congenital cervicofacial swellings observed in children, three types are rarely encountered in general practice: auriculobranchial cysts and fistulae, thymic cysts and cystic lymphangiomas. To resolve diagnostic and therapeutic problems related to these rare lesions it is essential that their etiopathogenic bases be understood. Auriculobranchial cysts and fistulae present clinical symptoms (cervical, parotid, auricular) that are only poorly evidenced and are related mainly to infection. Surgical excision requires a wide approach route of the parotidectomy type with preliminary isolation of the facial nerve. Thymic cysts result from embryogenic anomalies leading to remnants from the 3rd endobranchial pouch and/or degenerative disorders of Hassal's corpuscles. Of mainly perioperative detection their exeresis requires investigation of possible inferior mediastinal prolongations and preservation of healthy thymic parenchyma. Cystic lymphangiomas arise from dysembryoplasia of the lymphatic system, two opposing pathogenic theories existing to explain their origin. They are serious lesions because of their dissecting tendencies and their inexorable growth in the vast majority of cases. Two forms of lymphangioma, from the embryologic, diagnostic and therapeutic points of view, can be distinguished: those of extraparotid origin and those developing from the parotid.

Branchioma↗
PubMed1984

[Total circular pharyngolaryngectomy. A method of reconstruction with a free forearm skin flap].

The reconstruction of the digestive tube after total circular pharyngo-laryngectomy continues to pose a number of problems. Fistulae and delayed healing of the mucosa are common problems after musculo-cutaneous flaps. They are due, on the one hand, to a spring effect of the flap which interferes with tubulisation and, on the other hand, to the problematical suture of the thick thoracic wall skin to the fine oesophageal mucosa. Free visceral plasties give first intention repairs with rapid return of eating, but they carry a mortality of 10 to 15%. The free ante-brachial plasty with a radial pedicle seems to be a satisfactory alternative due to the quality of the oesophageal reconstruction and the absence of mortality. The technique of forming the flap and the operative procedure are described. Five cases are presented. There were no failures and oral feeding could be re-commenced by the 21st day, on average.

Colon, Sigmoid↗
PubMed1984

[Role of musculocutaneous flaps in pelvibuccopharyngectomy].

Musculocutaneous flaps were used for reconstruction after excision of large base of tongue or lateral oropharyngeal wall tumors in 50 patients, the most frequently employed flap in both regions being one from pectoralis major. Results showed marked reliability for these types of flaps for repair in these two areas, and they have now supplanted conventional single pedicle skin flaps. Various flaps supplying different useful surfaces are required, the platysma or sternocleidomastoid muscles being used for small areas, the pectoral or trapezius muscles for medium sized gaps and the latissimus dorsi for extensive repairs. Postoperative and functional results were improved both after initial or repeat operations. The possibility of more extensive excisions should improve prognosis of these tumors, their severity being partly related to local recurrence. It is too early to conclude definitely in their use in initial surgery, but they are valid procedures following failure of radiotherapy, enabling certain patients to be treated again after 3 years in the absence of any other therapy.

Follow-Up Studies↗
PubMed1984

[Glottic reconstruction with a flap of thyroid perichondrium].

Laryngoplasty was performed using the perichondrium of the thyroid cartilage or a sternohyoid muscle flap. Techniques and results are described using this method, applied for glottic reconstruction after vertical partial laryngectomy of the frontolateral type and after cordectomy. Anatomic and functional results in 15 cases are described, ultrasound imaging showing in all cases an improvement in basic laryngeal function, and in the timbre and strength of the voice.

Female↗
PubMed1984

[Translabyrinthine approach in the surgery of acoustic neurinoma. How to shorten the operative time].

A procedure was sought for shortening duration of operation through an enlarged translabyrinthine (ETL) approach in acoustic neurinoma surgery. Two factors appear to be of primary importance. First, the equipment used must be adapted for the purpose and of reliable quality: the 3 M craniotome for the extralabyrinthine phase, the Zimmer AMSCO ototome for the labyrinthine phase, and Yasargil's autostatic retractor to maintain retraction of the temporal lobe and lateral sinuses. Second, a precise operative methodology: wide exposure and retraction of the temporal lobe and lateral sinus in all cases to provide a panoramic view of the labyrinthine region; ablation of the incus and initiation of a posterior tympanotomy to assist dissection to expose the 2nd and 3rd portions of the facial nerve; labyrinthectomy and identification of the internal auditory canal (IAC) in the region of the small fossa of the hemisphere as an aid to continuation of the operation; identification of Limaçon's aqueduct, which is a barrier that must not be crossed when exposing the jugular bulb and mixed nerve regions; isolation of the facial nerve in the base of the IAC by reclining the superior restibular nerve, the facial nerve lying just behind the latter.

Ear, Inner↗
PubMed1984

[Value of thallium scintigraphy in thyroid pathology].

The value of thallium 201 (Tl 201) scintigraphy was investigated in 45 patients with thyroid affections. Scintigrams were performed with both technetium 99 m (Tc 99 m) and Tl 201. Of the 27 patients with 43 thyroid nodules confirmed histologically (16 patients were operated upon and needle puncture cytology conducted in 11 cases), all cold nodules to Tc 99 m and Tl 201 were found to be benign. Of the 28 hot nodules to Tl 201, cancer was demonstrated in 8 cases, equivalent to 72 p. 100 of false positives against the 47 p. 100 of all cases reported in the literature. In benign affections, thyroid topography to Tl 201 can now be obtained in patients with plummer's toxic nodules without the need for Quérido's test and without iodine saturation of the thyroid. Gonadal toxicity of Tl 201 prevents its routine use in patients under 35, who were excluded from this study.

Humans↗
PubMed1983

[Lateral cervical chemodectoma].

Diagnostic and surgical features of lateral cervical chemodectomas are discussed in relation to a personal series of 13 patients with carotid body tumors and 7 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 retrostyloid 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 subadventitial resection technique.

Adult↗
PubMed1982

[Results of rhinoplasties. A computer study of 351 medical records].

The authors studied the cosmetic results of 1380 rhinoplasties carried out over a period of 10 years by two surgeons, Professor A. Pech and Professor M. Cannoni. They used a classical reduction rhinoplasty technique. Different procedures were used for the tip of the nose depending on the individual indications, and the development of ideas over a period of time. Only 351 files, complete with pre- and post-operative photographs have been selected. The photographs have been analyzed on the basis of 70 criteria by an independent, young female ENT specialist, and the results of her analysis were fed to the computer. The study provides three types of answer. Firstly, the results were good in 69% of cases, and the greater the experience of the surgeon, the greater the success. Secondly, the different techniques for correcting the tip of the nose are analysed with good scores for Cinelli's technique (69%). The tip modeling procedures of Converse and of Lipsett have been abandoned owing to the high frequency of round tips. Finally, the different types of anomalies encountered are listed: 42% round tips, 20% asymmetrical tips, 17% residual humps, 11% of wide nasal bones, hooked noses and postoperative deviations. The authors then comment on the results, focusing on following points: the frequency of incomplete files (70%); the general improvement in the results with the gaining of experience, the decline in the proportion of hooked noses, also in line with experience, from 24% in the first 5 years to 7% after 10 years; the development of ideas concerning the techniques to be used in correcting the tip of the nose with an evergrowing place for those sacrificing the dome of the alar cartilages, such as the "Hockey stick" and a personal procedure derived from Pollot; wide nasal bones and failures in the tracing of the naso-frontal angle (64%) for which no solution is suggested; and, finally, postoperative nasal deviations. Since undertaking this study, the authors have successfully avoided this defect by using the external approach.

Computers↗
PubMed1982

[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↗