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Biomedical subjects

J Percodani

Publications and source records attributed to J Percodani.

At least 19 recordsLinked to original sources
PubMed2002

[Allergic rhinitis in children].

The diagnosis of allergic rhinitis (AR) in children is mainly based upon history which leads to distinguish between seasonal (periodic or intermittent) pollinic AR and perrenial (permanent or chronic) AR. The consequences of an AR can be severe with major nasal discomfort, repercussion on quality of life and school attendance, and impact on facial bone growth. In addition it can be complicated by asthma. Specific desensitization is the only treatment which may modify the immune response towards allergens. However it must be compared with the other treatments including local or general antihistaminic drugs and intranasal corticosteroids, the choice resting upon the severity of the symptoms, the respiratory repercussion, and the age of the child.

Adrenal Cortex Hormones↗
PubMed2002

Endoscopic sinus surgery for sinonasal haemangiopericytomas.

Haemangiopericytomas are rare peri-vascular tumours with variable malignant potential. The nasal cavity and the paranasal sinuses are most often involved in the head and neck. Five cases of haemangiopericytomas treated by a strict endonasal endoscopic approach are presented. Bleeding and nasal obstruction are the most frequent symptoms. Computed tomography (CT) scan and magnetic resonance imaging (MRI) allowed pre-operative assessment. Angiography with embolization was needed in two of the five cases. None of our patients presented with malignant histology. Our five cases were operated on, and a total tumour excision was performed through the endoscopic endonasal approach. We had one recurrence with a mean follow-up of 4.5 years. We suggest that when the tumour is purely intranasal or strictly located in the ethmoid or sphenoid sinus, it can be removed via an endonasal approach under endoscopic guidance in experienced hands.

Aged↗
PubMed2001

Value of investigation in the diagnosis of allergic fungal rhinosinusitis: results of a prospective study.

The authors report a prospective study in which the aim was to analyse the usefulness of different criteria in optimizing the diagnosis of allergic fungal rhinosinusitis. From 1995 to 1998, 165 patients were operated on for chronic rhinosinusitis. Investigations used in this study for the diagnosis of allergic Aspergillus rhinosinusitis consisted of an analysis of clinical, radiological, immuno-allergic criteria. Fourteen patients presented with allergic Aspergillus rhinosinusitis. One hundred and fifty-one patients did not present any of the necessary criteria for the diagnosis of allergic Aspergillus rhinosinusitis. The results show that the characteristic macroscopic appearance, the maxillary sinus localization, and the presence of positive specific IgE to Aspergillus fumigatus are arguments that reinforce the diagnostic certitude of allergic fungal sinusitis. No specific clinical or radiological criteria orients a diagnosis of chronic rhinosinusitis toward that of allergic fungal rhinosinusitis. The other immuno-allergic tests do not contribute to the diagnosis of allergic fungal rhinosinusitis. pathological, mycological, and

Adolescent↗
PubMed2000

[Allergic rhinitis].

Allergic rhinitis is one of the commonest diseases. The main allergens responsible are respiratory allergens. Pollinic or seasonal allergic rhinitis is currently distinguished from perannual or nonseasonal rhinitis, generally related to sensitization to allergens of the home environment. The diagnostic approach of allergic rhinitis is based on a careful clinical examination, in order to eliminate other causes of nasal dysfunction, and on complementary investigations, most importantly allergic skin tests. Several types of drugs, topically or systemically administered are currently available to treat allergic rhinitis. Surgical techniques should be reserved to patients who resist to medical treatment or to correct nasal architectural abnormality.

Adolescent↗
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

[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↗
PubMed1998

Mucoceles of the paranasal sinuses: uncommon location.

Mucoceles are the most common lesions causing expansion of the paranasal sinuses. The sinuses most commonly involved are, in decreasing order of frequency, frontal sinus, ethmoid sinuses, maxillary sinus and sphenoid sinus. We reviewed 46 cases of surgically proven mucoceles and the purpose of this study was to report five cases of mucoceles in an uncommon location.

Adult↗
PubMed1998

Evaluation of some velar functions before and after surgical treatment of snoring.

The aim of this prospective study was to evaluate velar function before and after uvulopalatopharyngoplasty for isolated snoring and for sleep apnoea. It is based on the analysis of oral and nasal airflow during phonation by an EVA workstation of 24 patients before and after the surgical intervention. The results show (1) quantitative and qualitative airflow abnormalities before the operation, (2) an increase in the percentage of nasal airflow flow after the operation, and (3) a change in the airflow sequence, which is improved after the surgical procedure. In conclusion, this work confirms a modification of velar function after uvulopalatopharyngoplasty and raises the problem of contra-indications to this intervention.

Adult↗
PubMed1998

The holmium:YAG laser for treatment of inferior turbinate hypertrophy.

Chronic hypertrophic rhinitis is sometimes refractory to local, as well as general, medical treatment. Before undertaking surgical reduction of the inferior turbinates, there is indisputably a place for cauterization or laser vaporization of the inferior turbinate mucosa. The authors present a study of 46 patients treated by the holmium:YAG laser for chronic hypertrophic rhinitis. The results after only one laser session are satisfactory in 89.1% at 6 months' follow-up and in 52.2% with mean follow-up of 16.2 months. No major secondary effects were observed.

Adolescent↗
PubMed1998

[Bilateral closure of the nasal cavity. An original surgical technique of treatment of severe recurrent epistaxis in Rendu-Osler disease].

In the Rendu Osler disease, epistaxis are seen in 80 to 90% of patients, and the multiple treatments that have been proposed have each shown their failure to achieve satisfactory results. We propose, in the case of abundant epistaxis, a bilateral closure of the nasal cavity. This technique has been initially described by Young in 1967 in the treatment of chronic atrophic rhinitis. This operation was carried out in two patients who presented with serious daily epistaxis, poorly tolerated, and refractory to several treatments. Neither of these patients has presented a post-operative bleeding episode with a one year and six months follow-up respectively. Anatomically, the results are satisfactory in both patients, with total closure of the nasal cavity. Functionally, both patients are satisfied, with an appreciable improvement in the quality of life despite total nasal obstruction.

Aged↗
PubMed1998

[Adenoid cystic carcinoma of the larynx. A case report and review of the literature].

Laryngeal adenoïd cystic carcinoma (ACC) is a rare disease due to the poor distribution of the accessory salivary glands in this area. The authors describe a case of ACC arising from the sus glottic area and underline the difficulty of such a diagnosis, which is in fact an histologic finding. The signs of discovery of a laryngeal ACC are not different from other tumors of the area, except pain frequently evoked in these tumors. Laryngeal ACC arises exceptionally before the age of 20 years and no risk factor is known. The most frequent localization is in the sub-glottic area, but sus glottic and glottic localizations have been reported. Evolution is marked by the onset of cervical lymph adenopathies and systemic metastasis most often located in the lung. The treatment comprises wide surgical exerisis followed by radiotherapy. Other reports seem to indicate that the pronostic of the laryngeal location of this disease is worse than in other areas of the head and neck.

Aged↗
PubMed1997

Functional endoscopic sinus surgery and 109 mycetomas of paranasal sinuses.

Mycetomas of paranasal sinuses are more frequently diagnosed with the widespread use of nasal endoscopy and computed tomography (CT). We present a series of 109 cases treated by functional endoscopic sinus surgery (FESS) with a mean follow-up of 29 months. All localizations were seen, and contrary to what was initially thought, seven cases presented in multiple sites. Several clinical presentations were found, from a pansinusal involvement to a simple mycetoma hanging in a superior meatus. A heterogeneous sinus opacity with microcalcifications on CT scan is very suggestive of the diagnosis, but a homogeneous opacity may be encountered even with bone lysis. FESS was performed in all cases to obtain a wide opening of the affected sinuses, permitting a careful extraction of all fungal material. In the postoperative period, no medical treatment is prescribed. With a mean follow-up of 29 months, only four recurrences were seen. This study reinforces the interest in FESS for cases of mycetoma of the paranasal sinuses.

Adult↗
PubMed1996

[Introductory chemotherapy in epidermoid carcinoma of the head and neck. Apropos of a retrospective study of 293 patients].

The authors present a retrospective study of 293 patients treated by neoadjuvant chemotherapy for squamous cell carcinoma of the head and neck without metastases. The results are globally analyzed for all localizations, as well as separately for each localization (larynx, hypopharynx, oropharynx). The aims of this study are to evaluate the results of neoadjuvant chemotherapy in the different tumor sites of the upper aerodigestive tract, to identify the predictive factors of a complete response, and to ascertain if neoadjuvant chemotherapy allows to alleviate the locoregional treatment without compromising survival. In laryngeal cancers, the organ conservation rate was 20.8%. If chemotherapy does not improve survival in patients with laryngeal cancer, it should be noted that survival of patients who had a total response of their tumor to chemotherapy is better than that of non-responders. In hypopharyngeal cancers, the organ conservation rate was 30% and no statistically significant difference in survival was noted as a function of the different parameters studied. As for oropharyngeal cancers, chemotherapy obtained, in our series, a total clinical response, and thus avoiding oropharyngeal surgery, in 46.2% of cases. In this localization, the survival of totally-responding patients is greater in a statistically significant manner at 5 years than in non-responding patients. Globally, chemotherapy does not improve survival, but does allow for a gain in the quality of survival, permitting a non-negligible rate of organ preservation as a function of tumor site. The tumor stage, the lymph node status, as well as the initial performance index represent predictive factors of total response to neoadjuvant chemotherapy. Analysis of our results had led us to reserve neoadjuvant chemotherapy in T3 laryngeal and hypopharyngeal cancers, in T3 cancers of the tonsil and the tonsiloglossal fold, as well as T2-T3 tumors of base of the tongue and soft palate.

Adult↗
PubMed1996

[Paranasal sinus aspergilloma. A propos of 45 cases].

The authors report a retrospective study of 45 cases of paranasal sinus aspergillomas to justify the endonasal endoscopic approach and define its limitations. The maxillary form was found in 40 cases (89%). 61% of the patients had dental care in the past. Radiographically, calcifications were seen in 43% of the cases and heterogenous sinus opacification in 38% of the cases. Mycologic study was positive in 94% of the cases. Fungal hyphae were observed in 83% of the cases on pathologic examination. During the follow-up, 3 recurrences appeared. The following points are emphasized: predictive factors, diagnosis and the different surgical procedures and their respective indications.

Adolescent↗
PubMed1996

[Metastatic cervical adenopathies of unknown primary site. Long-term course].

We conducted a retrospective study of 34 patients treated by radical neck dissection followed by radiotherapy for one or several cervical adenopathies without a primary tumor. Mean follow-up was 48 months. During follow-up, 6 patients developed a presumed primary tumor, and 11 patients presented with recurrent lymph nodes. We found no statistically significant predictive factor, as to either clinical characteristics or the histological nature of the adenopathies. On the other hand, the number of metastatic lymph nodes found on the surgical specimen was correlated with the risk of lymph node recurrence. Among the prognostic factors with an unfavorable effect on survival, the dimensions of the adenopathy, its fixed characteristic and its TNM status, were identified. In this series, the appearance of a primary tumor did not seem to worsen the prognosis. On the other hand, the appearance of lymph node recurrence predicted poorer survival rates. The results are discussed and compared with those found in the literature.

Adult↗