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J Percodani

Publications and source records attributed to J Percodani.

25 records · Page 2Linked to original sources

[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↗

[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↗

[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↗

[The voice of the child, morphological evolution of the larynx and its acoustic consequences].

From a review of the literature, the authors analyze the role of laryngeal modifications in the evolution of a child's voice. The modifications found are topographic (laryngeal descent in the neck), morphologic (increase in volume modification of laryngeal shape), and histologic (lamina propria differentiation), each responsible for acoustic modifications. The chronological evolution of the voice integrates these modifications in a global context of development, where the central nervous system is of primary importance.

Adolescent↗

[Partial lower turbinectomy in children: indications, technique, results].

Inferior turbinate surgery has been proposed as a treatment modality in severe childhood hypertrophic rhinitis refractory to medical treatment. The authors present a series of 38 children treated in the otorhinolaryngology department of the Timone University Hospital, Marseille, and the Rangueil University Hospital, Toulouse. Thirty eight children between 9 and 16 years of age (27 males and 11 females) underwent a bilateral inferior turbinectomy, and followed-up for a period of 6 months to 4 years. Allergy was fund in 19 patients, asthma in 11 patients, and an underlying sinus pathology associated in 9 patients. Turbinate surgery was isolated in 16 cases, and in 22 cases, it was associated with an adenoidectomy, a septoplasty, and/or an ethmoidectomy. The authors discuss the operative indications, and describe the turbinectomy technique in children. Post-operative complications are rare (no crusting rhinitis, one non symptomatic synechia). One case of nasal bleeding was noted after nasal packing removal. Functional obstructive symptoms were improved in near 90% of cases. Asthma was improved or disappeared in 27.3% of cases, and no cases of worsening asthma was noted. The authors conclude that this type of turbinectomy is efficient and non-iatrogenic when a precise indication and a rigorous technique are applied.

Adolescent↗

[Efficacy of partial inferior turbinectomy in the treatment of nasal obstruction. Retrospective study apropos of 71 patients].

Longtime discredited, practiced with reticence even today, the inferior turbinectomy represents the treatment of choice in patients with persistent chronic nasal obstruction despite medical treatment or cauterization. Between January 1989 and December 1995, 81 patients underwent an isolated bilateral inferior turbinectomy (without an associated septal or sinus intervention). This retrospective study analyzes the short and long-term results in 71 patients with a one year minimum follow-up. Turbinectomy was in all cases always partial and managed under endoscopic guiding. Mean follow-up was 33 months, based on a patient's questionnaire. No cases of crusting rhinitis were observed. 81,7% of patients were improved by the surgical intervention. In asthmatic patients, no worsening of the asthma was noted, whereas in 28,5% of these cases, there was an improvement or disappearance. Non serious adverse effects appear after surgery as rhinorrhea (16%) and post nasal drip (18,4%). The surgical turbinate reduction represents an option in the care of patients with chronic nasal obstruction associated with inferior turbinate hypertrophy.

Adolescent↗

[Comparative study of cartilaginous and synthetic laryngotracheoplasty. An experimental study in rabbits].

The most significant advance in the treatment of laryngotracheal stenosis in children is the augmentative laryngotracheoplasty using a graft of autologous rib cartilage (ARC). In order to reduce the potential morbidity of this technique due to the additional surgical procedure, the use of a ceramic, hydroxyapatite (HA), implant was compared to ARC in a randomized experimental study in 99 New Zealand rabbits: 32 rabbits had ARC grafts, 33 had HA implants covered with a graft of perichondrium (HAP) and 33 had naked HA implants. At 3 months, immediately before necropsy, there was no significant clinical difference between the 3 groups of animals. Histological examination was performed in 81 animals. Implants were found in 54 specimens. More implants were found in the ARC group than in the HA groups (p < 0.003). No difference was noted between the 3 groups in the epithelial covering of the implant, the amount of inflammation, the analysis of the interface between the implant and the cricoid cartilage and in the viability of the graft. No implant was found in 27 animals. However, scar bands of approximately the same width as the implant were responsible for cricoid diastasis in 23 cases. Therefore, it seems that the missing implant played the role of spacer. While this experimental study does not eliminate HA as a augmentative implant in the subglottic region of the rabbit, the evolution of the scar bans must be followed for a longer period in rabbits before considering the clinical application of this technique.

Animals↗