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J P Bessède

Publications and source records attributed to J P Bessède.

At least 19 recordsLinked to original sources
PubMed2004

[Adult laryngeal cavernous hemangioma: a case report].

We describe a case of laryngeal venous malformation, discovered by dysphonia. This malformation has a different histology and evolution compared to infant laryngeal hemangioma. The histological exam shows large and multiple vessels lined by regular endothelium. There is no spontaneous regression; this malformation can be stable or increase and induce a laryngeal obstruction. Although inconstant, a bluish colour, seen at endoscopy, suggests the presence of venous malformation. The diagnostic is confirmed by MRI, which shows local extension. We propose regular clinical and radiological supervision for asymptomatic venous malformations. Treatment is recommended only for symptomatic patients usually by laryngeal microsurgery or cervicotomy. Per cutaneous sclerosis is an interesting alternative therapy alone or prior to surgery. Regular follow-up is essential in order to detect frequent recurrences.

Adult↗
PubMed2004

[Induction chemotherapy and laryngeal preservation in pharyngolaryngeal carcinomas. Study of a 124 serie's patients and patient's follow up with laryngeal preservation].

OBJECTIVE: To try and determine the value of chemotherapy and its subsequent effect on laryngeal preservation in patients presenting with laryngeal and pharyngeal carcinomas. One group was initially treated with surgery and radiotherapy. The second group was treated with chemotherapy and subsequent salvage surgery and/or radiotherapy. Their survival rates and laryngeal preservation rates were compared. PATIENTS AND METHODS: From 251 patients the authors have retrospectively studied 124 patients with induction chemotherapy. The survival rate has been compared with a control group of 127 patients who was treated by initial surgery and radiotherapy. RESULTS: The survival rate at 5 years for the patients initially treated by surgery and radiotherapy was 64.1%. The survival for patients with a total clinical response following chemotherapy was 49.8% at 5 years. Survival with no total clinical response following chemotherapy treated by secondary radiotherapy was 25.7% at 3 years. The initial rate of laryngeal preservation is 32.2% but this rate fell to 22% after local recurrencies. CONCLUSION: The group with total clinical response after induction chemotherapy with laryngeal preservation have a non significantly difference in their survival compared with the group initially treated by surgery and radiotherapy. In contrary patients with non complete clinical response have a survival of 25.7% at 3 years. The rate of local recurrency of patients with laryngeal preservation is 32.5% and gives a finally rate of laryngeal preservation of 21%. These recurrencies decrease the survival rate.

Adult↗
PubMed2001

[Lymph node metastasis of cutaneous epidermoid carcinomas of the head and neck: prognostic factors and therapeutic strategies. Apropos of a series of 13 cases].

UNLABELLED: Squamous cell skin carcinoma has a relatively low rate of metastasis (0.5 to 16%), but the prognosis of these metastases is poor (22% of survival at 5 years). PATIENTS AND METHODS: from a series of 243 patients, we studied 13 patients who were found initially to have metastases or who developed metastases later. Fifty-four percent (54%) of the patients presented initially with regional lymph node and parotid involvement in 54%. RESULTS: All patients underwent surgery with removal of the skin cancer and a neck dissection. Radiotherapy was performed later in 92% of the cases. The 2 years survival rate was 62% and mean survival by Kaplan Meier curve was 47 months. DISCUSSION: Poor criteria of these cutaneous tumors are defined: tumor size, histologic differentiation, perineural spread. Patients with severe criteria must have a neck dissection to control the first lymph node. Along the anatomic area of the cutaneous tumor, a parotidectomy, a submaxillary control or a neck dissection will be performed. Its involvement will be followed by a neck dissection. A comparative study of the literature is made. Poor prognostic criteria of these cutaneous tumors are defined, in addition to the initial management of the cervical and parotid lymph nodes.

Aged↗
PubMed1998

[A voluminous exteriorized odontogenic keratocyst].

The authors report the case of a 63 years old man who presented a voluminous exteriorized keratocyst of the jaw. We have first made a punction of the cyst in order to facilitate the operation. Anatomopathological examination of the liquid found epithelial cells. We collected the keratocyst by a non interrupting mandibulotomy via cervical incision.

Humans↗
PubMed1998

[Proposal for a predictive clinical scale in dysphagia].

The compiling of a predictive clinical scoring system for the risk of a false passage (FP) has its origins in the limitations of tests which explore only the cough reflex, known to be absent or faulty in 40% of patients investigated for problems of deglutition. A raised clinical score is based on the results of an exhaustive prospective study of 140 patients tested for the first time by videofluoroscopy for FP, this being the reference investigation for false passages. Discriminant analysis allowed the most selective variables to be identified and retained. We have identified 2 categories of patients, according to whether or not they have had any ENT past history. The score is obtained by adding the weighted values for the selected clinical signs. For those patients with an ENT past history, 5 clinical variables were retained: the absence of adhesions = 14, the presence of a velar reflex = 8, the capacity for voluntary deglutition = 8, glottic obstruction = 6, the absence of primitive reflexes = 6, giving a total score for the variables of between 0 and 42. If the total exceeds 32 or is less than 26, there is no FP; for scores between 32 and 26, videofluoroscopy is required to give more precise evidence of the risk. When this scoring system was applied prospectively to a series of 105 patients, a correct predictive result was obtained in 54 patients (51.4%), an equivocal result in 42 patients (40%), and a false result in 9 patients (8.6%), 3 of which (2.8%) were false negatives. The predictive score for FP allows evaluation of the risks of FP in at-risk patients, and adaptation of the treatment strategy according to the type of disordered physiology expected from the cause; thus videofluoroscopy can then be reserved for cases where treatment fails, so that the precise deglutition problem can be pinpointed.

Adult↗
PubMed1998

[Nutritional status and clinical score of 95 patients examined by radiovideoscopy for deglutition].

Ninety five consecutive patients were examined. One performed swallowing videoradioscopy, swallowing clinical score calculation and nutritional assessment with four different methods: Body Mass Index (BMI), arm muscle circumference, dual frequency bioelectrical impedance analysis and serum albumin level. The easiest and the most reliable method for nutritional assessment, comparing to the others, was BMI, where only weight ant height were necessary to measure. So, the prevalence of protein-energy malnutrition was 24.2%, unlinked neither with the presence of videoradioscopy swallowing disorders nor with clinical swallowing score level. The score level was inversely correlated with the presence of videoradioscopy swallowing disorders, and correlated with feeding types: the highest for per os normal feeding, the lowest for patients with parenteral nutrition. The presence of videoradioscopy swallowing disorders was inversely correlated with feeding types. Swallowing clinical score was validated.

Aged↗
PubMed1997

[Is laryngeal papillomatosis always juvenile?].

After recording an increased frequency of adult-onset recurrent respiratory papillomatosis, the authors propose a multicentric investigation. The aim of the investigation is to determinate the frequency of the new cases and their clinical form. The preliminary results confirm the increased frequency of the adult-onset form and show the possibility of a clinical form change.

Adolescent↗
PubMed1993

Ewing's sarcoma of the mandible: a case report.

The authors report the case of an 8-year-old boy with a Ewing's sarcoma localized to the mandible. The therapeutic modalities consisting of induction chemotherapy, surgical removal of the involved portion of the mandible with reconstruction using a parascapular osteo-cutaneous free flap, and maintenance chemotherapy are described. Emphasis is placed on the importance of performing a wide resection and the use of a multidisciplinary team approach in the treatment of these unusual tumours.

Cell Nucleolus↗
PubMed1992

[RNA extraction, in vitro translation and two-dimensional analysis of oncoproteins in cancers of the upper respiratory and digestive tracts].

After a review of the literature concerning oncogenes expression of in head and neck carcinomas, the authors studied RAN extraction, in vitro transduction and two dimensional analysis of oncoproteins in head and neck carcinomas. The results between the tumoral tissue and normal tissue were compared significantly more oncoproteins spots were found in the tumoral tissue analysis.

Autoradiography↗
PubMed1992

["Conservative" transmandibular buccopharyngectomy].

Tumors of the amygdaline region were up until now most often treated by transmandibular buccopharyngectomy (TMBP) with a systematic sacrifice of the mandibular angle. This exercise justified by wide carcinological imperatives, a larger surgical facility and simple immediate postoperative follow-up, in fact systematically shows a substantial esthetic and functional prejudice. This principle was reinforced by the occurrence of osteitis during the first attempts of osseous reconstruction using steel wires opposite the mandibular angle (Dargent, Charachon, 1963). In 1989, Gehanno and Beauvillain published a mandibular conservation technique by vertical paramedian osteotomy, right in front of the mental nerve, shifted from the future field of radiation, with osteosynthesis by titanium plates. This technique appeals to us because it is easy to use, reliable and carcinologically safe. We have currently adopted it with satisfaction for 8 of our patients over an 18-month period, without any case of osteitis and with both good esthetic and functional results.

Bone Plates↗
PubMed1990

[Naso-orbito-cerebral mucormycosis. A more & more common disease].

A typical case of naso-orbital-cerebral mucormycosis is described. This rare but serious disease mainly occurs in fragile patients, notably diabetics or those undergoing an immunosuppressant treatment. The cases recorded are therefore increasingly frequent. Mucorales, normally saprophytic, germinate in the nasal cavities due to an infection and then colonize the sinuses, the orbit, followed by the meninges. The diagnosis must be made before meningeal impairment when faced with a peri-orbital edema, the beginning of exophtalmy or oculomotor paralysis in high-risk patients with sinusal opacity. The diagnosis is based on the histology and the mucology which must be directed by the clinician: indeed, the histology of the naso-sinusal mucosa samples must be performed using special stains. The mycological samples must also be taken from special environments. Once the diagnosis is confirmed, the required treatment with high doses of intravenous Amphotericine B must be administered immediately, otherwise the evolution is fatal.

Brain Diseases↗
PubMed1990

[Transposition of the temporal muscle and surgery of the middle third of the face. Technic, indications and results].

The authors reemploy the technique using the temporal muscle to fill in large surgical cavities after tumoral surgery of the middle 1/3 of the face. The purpose of this technique is to prevent crust formation after radiotherapy, and to improve esthetic results by preventing further cutaneous retraction. They expose their own technique, the results and the indications from 8 cases.

Adult↗
PubMed1989

[New prospects in the treatment of vertigo].

Vertigo results from sensory conflicts that are usually intralabyrinthine or between two labyrinths. Symptomatic treatments rests on the reduction of these conflicts by vestibuloplegic drugs. However, this treatment should not last for more than 48 or 72 hours since in established vestibular lesions central compensation demands that the centres be informed. The use of sedative drugs in vertigo, therefore, should be reduced, and vestibular rehabilitation is recommended in most cases. Only Meniere's disease escapes this rule, being a self-limited process.

Acute Disease↗
PubMed1989

[Pitfalls of extracapsular thyroid surgery].

The usual landmarks of thyroid surgery are often altered with a goiter. The surrounding tissue may also be subject to variation. Different anomalies the surgeon may encounter are presented along with their management: the recurrent nerve, the external laryngeal nerve, the parathyroids and an intrathoracic goiter. Each case of thyroid surgery must be considered individually, and the ENT surgeon must devote particular attention to assure perfect postoperative vocal cord function.

Goiter, Substernal↗
PubMed1988

[Repair of deglutition troubles after partial surgery of the pharyngolarynx with injection of collage. Apropos of 9 cases].

The authors report their experience treating nine patients with swallowing disorders following partial surgery of the laryngo-pharynx. GAX collagen (Phonagel), resistant to collagenase was injected into the laryngeal structures to protect the trachea, yielding a satisfactory long term result. A description of the injection technique is given particularly with functional reconstructive laryngectomies and hemipharyngolaryngectomies. The results concerning functional improvement and weight gain are evaluated over a five month period.

Collagen↗