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J Pinsolle

Publications and source records attributed to J Pinsolle.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Mandibular reconstruction in oncology: discussion of indications].

The aim of the study was to assess the results of segmental mandibular resections and the validity of mandibular reconstructions. The medical records of 95 patients treated between January 1, 1987 and December 31, 1992 were reviewed. There were 82 (86%) carcinomas, 9 ameloblastomas and 4 sarcomas. Among the 82 patients treated for carcinoma, the overall 2- and 5-year survival rates were 70% and 33% respectively. The functional results evaluated one year after surgery showed no significant difference according to the reconstruction procedure: myocutaneous flap, osteomyocutaneous flap, titanium mandibular reconstruction plate or microsurgical transfer. The most important factor in functional rehabilitation is the amount of soft tissue resected. In head and neck oncology, aggressive surgical reconstruction of the mandible must only be used in patients with good general status and fair survival probability.

Adolescent↗
PubMed1994

[Treatment of primary soft tissue sarcoma of the head and neck].

Soft tissue sarcomas of the head and neck account for less than 1% of all malignant neoplasms in this region. A significantly increased risk of treatment failure is associated with high histologic grade, leading to an aggressive treatment. The medical records of 17 patients with soft tissue sarcomas of the head and neck were reviewed. They were divided into two groups according to age: 13 adults and 4 children. The former underwent wide surgical excision with postoperative radiotherapy in some cases and possibly chemotherapy. The 2 and 5 years survivals were 54% and 46% respectively. The latter, with rhabdomyosarcoma, underwent multimodality treatment (chemotherapy, surgery, radiotherapy). The 2 years survival was 50%. The mainstay of treatment of soft tissue sarcomas of the head and neck in adults remains surgery. Patients with incomplete resection or high grade tumour should receive more aggressive treatment (surgery and postoperative radiotherapy). The use of systemic chemotherapy has showed no statistically significant improvement in local control or survival. However, for rhabdomyosarcoma in children, chemotherapy is an essential part of treatment.

Adolescent↗
PubMed1994

[Results of the use of titanium mandibular reconstruction plates].

The aim of this study was to assess the use of titanium mandibular reconstruction plates after cancer surgery. The medical records of 36 patients were reviewed. The mean follow-up was 22 months. All patients had primary reconstruction of the mandible with Leibinger titanium plates. Thirty patients underwent postoperative radiotherapy with the plate in the field. The mean dose was 60 Grays over 6 weeks and the overdosage into tissues was reduced to 5%. Thirty patients (83%) had retained the plate at 6 months and no sign of osteomyelitis was found in any patient. Quality of speech and deglutition were satisfactory in 63% and 94% of the patients respectively; sixty-six p. cent of them found their cosmetic appearance good or excellent. The overall success rate of the technique was 74%. This technique did not excessively prolong operating time unlike microvascular transfer. Plates are an effective method of primary reconstruction in patients with advanced cancer and uncertain long-term survival. Tolerance of plates after radiotherapy is outstanding. Speech, deglutition and facial contour are immediately restored and further bone reconstruction is feasible.

Adult↗
PubMed1994

[Treatment of primary bone sarcoma of the jaws].

Head and neck bone sarcomas are very uncommon tumors. Therefore, treatment modalities are not clearly established. The medical record of 12 patients with bone sarcoma of the jaw were reviewed. Six patients with osteosarcoma underwent primary chemotherapy followed by wide surgical resection, radiation therapy or combined radiosurgical treatment. The 2 and 5 years survivals were 66% and 40% respectively. Five patients with chondrosarcoma were treated by wide surgical resection alone or combined with postoperative radiotherapy and possibly chemotherapy. All patients were alive; the mean follow-up was 9 years. One patient had Ewing's tumor. Osteosarcoma and chondrosarcoma in head and neck patients have a high rate of local recurrences. Surgery is the mainstay of treatment. Patients with voluminous tumors and high-grade lesions should receive postoperative radiotherapy. The role of chemotherapy has not been defined.

Adolescent↗
PubMed1993

[Dog bites on the face. Apropos of 200 cases].

A series of 200 patients bitten on the face by a dog between January 1979 and December 1990 was reviewed. The aim of the study was to assess our attitude of delayed sutures and to determine the origin of the dogs, their behaviour, and the circumstances of the bites. In this series, 146/200 patients (73%) were less than 15 years old and 85/200 (43%) less than 5 years old; most adults bitten had a job at risk. The rate of infectious complications was 2.5%. There were 70% (105/150) dogs from an identifiable breed (25% (38/150) pedigree) and 30% (45/150) mongrels. In 70% of the cases the victim did not know or hardly knew the dog. The study of our series and others previously published clearly demonstrates that a dog bite must never be sutured directly. By calculating the incidence of dog bite for each particular breed in France, we conclude that, with very few exceptions, no breed is more aggressive than another. Reducing the rate of dog bites implies better knowledge of dogs and respect for some common sense rules, both on the part of children and dog owners.

Adolescent↗
PubMed1993

[Transfrontonasal approach: development of a mixed approach to ethmoid tumors. Experience of 12 cases].

Our experience in approaching ethmoid tumors through a combined pathway is currently based on 81 patients. 69 of them were malignant tumors treated by the neurosurgical subfrontal and paralateronasal transfacial rhinological approach. For the past two years, we have adopted the technical modification described in Bordeaux by Pinsolle and San-Galli enabling the approach of the ethmoid bone by means of a unique (Unterberger's scalp) incision and a unical frontonasal flap. 12 patients benefitted from this transfrontofacial access. The advantages and disadvantages of the technique are discussed.

Ethmoid Bone↗
PubMed1993

[Titanium plates for mandibular reconstruction and radiotherapy].

Mandibular reconstruction plates are now used after cancer surgery in particular patients. This study assesses the irradiation of Titanium mandibular reconstruction plates in terms of both dosimetry and mid-term tolerance. Twenty patients with mandibular plates underwent radiotherapy (mean dose 60 Gy). The radiation dose on the patient itself was calculated with 3-dimensional treatment planning. A clinical and radiological evaluation of tolerance was made 6 months after the end of the treatment: intraoral and cutaneous healing and possible osteomyelitis. Mid-term tolerance was very satisfactory with only two failures at 6 months. When using parallel opposing fields, the overdosage into tissues was reduced to approximately 5 p. cent; and radiotherapy has probably no effect on titanium plate tolerance.

Adult↗
PubMed1993

[Adenoid cystic carcinoma of the salivary glands. The value of postoperative radiotherapy].

The study of adenoid cystic carcinoma of the salivary glands is limited by the paucity of series described and the lack of prospective reports. The medical records of 21 patients with histologically proven adenoid cystic carcinoma seen between January 1975 and December 1991 were reviewed. The efficiency of postoperative radiotherapy both on locoregional control and overall survival was assessed. Seventeen patients underwent extensive surgery and postoperative radiotherapy. Three patients had recurrences in the surgery and postoperative radiotherapy group. Two patients who underwent surgery alone presented tumor recurrences. For the complex series the overall five and ten-year survival rates were 83% and 67% respectively. For the 17 patients in the surgery and postoperative radiotherapy group, five and ten-year survival rates were 87% and 77% respectively. These results show postoperative radiotherapy to be effective in decreasing the recurrence rate which is largely reported elsewhere.

Adult↗
PubMed1992

Results of surgical treatment of T3 and T4 tumors of the oral cavity and oropharynx.

The combined use of surgery and radiotherapy is commonly accepted as the most effective treatment for locally advanced head and neck cancers. T3 and T4 tumors of the oral cavity and oropharynx often necessitate extensive local surgery. From 1981 to 1988, 199 patients with T3 and T4 tumors of the oral cavity and oropharynx were treated. One hundred seventeen patients underwent surgery plus postoperative radiotherapy; 78 had flap reconstructions. This series is extremely homogeneous because surgery was always performed by two surgeons, whereas radiotherapy was the responsibility of the same physician. The results of this study show a 96% local control rate at the end of treatment among the patients with combined treatment. The average time by which hospitalization was prolonged due to surgery was 29 days. The type and delay of recurrences and survival in relation with node involvement are also discussed. Extensive surgery in association with radiotherapy remains a reliable treatment in such patients.

Adult↗
PubMed1991

Modified approach for ethmoid and anterior skull base surgery.

The use of combined craniofacial resection is well established for tumors of the ethmoid bone and the anterior aspect of the base of the skull. Mobilization of the medial fronto-orbital ridge improves the transbasal approach and can be performed with a monobloc bone flap. We describe an en bloc bifrontal craniotomy including the supraorbital ridges and the nasal bones. This provides a wider angle of approach to the anterior aspect of the base of the skull than any other method and avoids retraction of the frontal lobes. This type of bone flap procedure can be performed after a wide periosteal dissection in the coronal area of the scalp alone, without facial skin incision.

Adult↗
PubMed1991

[Oncocytic carcinoma of the parotid gland].

We report the case of an oncocytic carcinoma of the parotid gland affecting a sixty year old woman that was revealed by a right inferior facial paralysis. The histological features were observed in the parotid gland and in the right superior cervical nodes. The originality of this observation as compared to the other very rare cases of oncocytic carcinoma reported is the undoubtful malignant features present right away.

Carcinoma↗
PubMed1990

A comparative study of maxillo-facial trauma in Bristol and Bordeaux.

Consecutive patients with maxillofacial fractures who attended departments of maxillofacial surgery in Bristol and Bordeaux during 1985-1986 were surveyed prospectively to determine differences in demography and aetiology and patterns of injury. 1,652 patients were included: 1,146 in Bordeaux and 506 in Bristol. Significantly more patients with nasal complex fractures were treated in Bordeaux reflecting management of these injuries by oto-rhino-laryngologists in Bristol. Maxillary fractures were comparatively more frequent in Bordeaux, reflecting a higher incidence of road accidents. Significantly more assault victims were treated by maxillofacial surgeons in Bristol, though per capita alcohol consumption by age and sex matched individuals was greater in France than in the U.K. Incidence of fracture was 18/100,000 hospital catchment population/year in Bordeaux, compared to 32/100,000 population/year in Bristol; reflecting that in contrast to Bristol, specialists in private practice outside the regional centre treated patients with fractures in S. W. France. Differences in aetiology of injury could be explained by cultural factors. Formal twinning arrangements and EEC membership provide excellent opportunities for postgraduate education, training and collaborative clinical research.

Accidents, Traffic↗
PubMed1989

Approach to the pterygomaxillary space and posterior part of the tongue by lateral stair-step mandibulotomy.

Fifteen patients underwent surgery for retromandibular parotid, pharyngeal, or posterior tongue tumors. Surgical approach to the pterygomaxillary fossa, parapharyngeal space, and posterior tongue was performed by external cervical incision and lateral stair-step mandibulotomy. After resection of the tumors, the mandibular segments were replaced and secured with miniplates. The plates were removed after six weeks whenever postoperative radiation therapy was planned. By reflecting the ascending ramus, this method provides excellent exposure of the concerned areas. It makes unnecessary both incision of the lower lip and intermaxillary fixation with arch bars, thus allowing a quick resumption of oral feeding. A review of 15 patients demonstrated satisfactory results for mandibular function and morphologic appearance, with minimal complications.

Adolescent↗
PubMed1987

[Craniofacial injuries and osteomeningeal ruptures. When should the anterior fossa be approached?].

A retrospective analysis was carried out of 142 cases of craniofacial traumas divided into 5 types according to the Fain classification. The incidence of cerebrospinal fistula of fronto-basal skull is very high in types III and IV traumas (60% of the cases). It is less important in type II2 traumas representing severe naso-orbital lesions (40% of the cases). It is only of 20% in type II1 traumas (Lefort II and III). Uncontrollable rhinorrhea and late meningitis are mainly due to types II and IV traumas. From these findings surgical indications and technique of the approach of the fronto basal skull are discussed.

Adolescent↗
PubMed1985

[The amount of maxillofacial risk in playing rugby].

123 cases of maxillo-facial injuries due to rugby and treated in the Department of Maxillo-Facial Surgery at the University Teachers Hospital (C.H.U.) of Bordeaux between 1981 and 1984 are analyzed. The high rate of injuries decreases considerably if accidents caused by intentional brutality are excluded. This then approaches the rate for other team sports. Rugby is not basically a violent sport but can be made so by the unfairness of certain players. It would be most advisable to educate players along these lines.

Adolescent↗