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Biomedical subjects

J Soudant

Publications and source records attributed to J Soudant.

At least 73 records · Page 4Linked to original sources

[Frontal and ethmoidal mucoceles. Apropos of 17 cases].

We have been studying 17 cases for operated mucoceles over a period of 4 years. Usual predisposing factors are often present, however we found no underlying malignant tumor revealed by a mucocele. Surgical treatment always included exclusion and filling with bone grafts in case of frontal involvement. Small ethmoidal lesions without symptom found on the CT scan are worrying because of their potential deterioration; in such cases, our attitude has been surgical.

Adolescent↗

[Value of the administration of trimetazidine associated with hemodilution in the treatment of sudden deafness. Report of a multicenter study].

Sudden deafness is a medical emergency, for which etiopathology is ill-known and no therapeutic consensus exists. This study is aimed at demonstrating that a greater audiometric gain can be achieved if trimetazidine, a major cellular anti-ischemia agent, is associated with hemodilution, than when the treatment is based on hemodilution only. 42 patients suffering from sudden deafness were all treated with hemodilution before their 7th day of deafness, half of them being given 3 tablets of trimetazidine daily in addition and the other half placebo, during one month. The results of this double-blind trial demonstrate an additional audiometric gain of 10% in the trimetazidine group for all frequencies, as well as a higher percentage of total recovery, ie. 63% vs. 47% in the placebo group. No particular sensitivity to treatment was noted according to the shape of the audiometric curve or in the case of initial cophosis, known to be of poor prognosis. The statistic significance was not established due to the small number of cases. The association of trimetazidine and hemodilution therefore seems to be an interesting therapeutic approach for sudden deafness, owing to the clinically appreciable audiometric improvement we have noted.

Adult↗

[Decompression of the optic nerve through the trans-ethmoid-sphenoidal approach in orbital injuries. Technic and results apropos of a new series].

An orbital injury can be responsible for compressing the optic nerve in the optic canal. This compression leads to a syndrome of physiological division with homo-lateral blindness and absence of pupillary reaction of light during stimulation of the injured eye, whereas the light reflex is present with contralateral stimulation. Computed tomography studies show the compression site directly: optic canal fracture, or indirectly: hematoma of posterior ethmoidal cells and sphenoidal sinus, fracture of the posterior part of the orbit. This type of injury can be improved by surgical decompression of the optic nerve via a trans-ethmoid-sphenoidal approach. The surgical technique will be first described. Then, the authors will report a series of 13 cases. In 6 cases, surgical decompression allowed recovery of visual acuity. The authors emphasize the uncomplicated post-operative course. Indeed, no complication was recorded and the hospitalization time was very short.

Adolescent↗

[Undifferentiated epithelioma of the parotid and cystadenolymphoma. Apropos of a case].

A case of undifferentiated epithelioma of the left parotid gland occurred 2 years after the removal of a cystadenolymphoma in the right parotid gland. The relationship of these two tumours was supported by several statements: the immunohistochemical study demonstrated in the epithelial cells of the 2 neoplasms the existence of ACE, usually thought as characteristic of cystadenolymphoma. Besides, it showed a high number of plasma cells secreting IgA in the stroma of the 2 tumours, the ultrastructural study performed on the epithelioma also demonstrated some similarities between epitheliomatous cells and epithelial cells of cystadenolymphomas (outlined epidermoid or glandular differentiation, numerous mitochondria). A peculiar, perhaps immunological mechanism could induce the cancerization, according to the theories used to explain the histogenesis of cystadenolymphoma.

Adenolymphoma↗

[Anatomic considerations on the pyramid and nasal septum. Quantitative data apropos of 33 dissections on fresh corpses].

The authors have dissected a series of nasal pyramids and septum. The various a anatomical structures have been measured and their relations with surgical landmarks have been recorded. Histograms show their findings. Surgical interest was emphasized for each stage of dissection. Some important points have been noticed during this study. They could bring some explanations to certain failures encountered after a septorhinoplasty.

Adult↗

[A controversial procedure: rhinoplasty in children].

Confronted with nose malformations in children, surgeons experience at the same time a legitimate desire to rapidly attend to the altered anatomical structures, and a fear to aggravate the lesions existing initially by operating during a period of growth. Numerous animal experiments have not been conclusive as far as these two contradictory theses are concerned. In all cases, prudence remains mandatory, that is prudence towards the operational indications (important functional impairment), the date of the intervention (risk minimization with age), assessment of expected results (secondary malformations occurring even very late postoperatively).

Adolescent↗

[Treatment of acquired stenosis of the external auditory canal].

Often difficult surgical problems are encountered during treatment of acquired stenosis of external auditory canal. Theses stenoses can be of tumoral, inflammatory or traumatic origin and are the cause of infectious complications related to epidermal retention. Even with the assistance of modern imaging procedures, preoperative investigation is not simple, precise details of lesions being obtained in greater detail during surgical exploration. Four stages are involved in surgical treatment: excision of lesion, reaming of bony canal and enlargement of auditory meatus, providing cover and maintaining graft in place. The CO2 laser can be useful for excision of lesion or possible postoperative recurrence, and adjacent pedicle flaps are best for covering site. Postoperative inflammatory episodes can be treated by infiltration of local corticoids. Whatever the result of these different techniques, long-term surveillance of these patients is essential.

Constriction, Pathologic↗

[Treatment of sequelae of basedowian exophthalmos].

Treatment of sequelae of ophthalmopathy of Basedow's disease, essentially exophthalmos, oculomotor disorders and upper eyelid retraction, is of particular importance because of the functional and esthetic problems presented. Improvement in the different symptoms can be obtained by surgical treatment, but patients must have been perfectly stable with respect to both the thyroid and ophthalmologic plan for at least 6 months. It marked exophthalmos exists this is treated initially by orbital enlargement. Oculomotor problems are then resolved and finally treatment is terminated by surgery to eyelids. Very satisfactory functional and esthetic results are obtained.

Exophthalmos↗

[Surgical treatment of temporomandibular joint dysfunctions by Myrhaug's technic. Apropos 60 interventions].

The treatment of the chronic diseases of the temporomandibular joint is always difficult. At one moment or another, surgical treatment is discussed, proposed and performed. Many operations have been described to make the temporo-mandibular joint recovering its normal movements. Both joints are involved in those movements, because the joint is symmetrical. Myrhaug's technique, described in 1951, consists in the resection of all the temporal condyle. This technique which respects the meniscus and all the chondro-fibrous system of the joint creates a permanent and reducible chronic dislocation of the joint. This paper is made to show that under an experience of more than 60 operations the authors can give all the details they use, with some modifications of the original Myrhaug's technique. The authors give their own results over 60 operations: there are more than 70% of good or excellent results, without any complication. For all the cases they have operated and they present, the follow-up is more than one year and some times more than ten years. They have not seen any late complication and the results have not been modified after all that time. The main indication of this technique is the temporomandibular joint dysfunction syndrome which affects more the female population. This syndrome is made of an association of pain, cracking, abnormal movements and subdislocations, but pain is only one of the symptoms. The same operation is very efficient to treat chronic subdislocations affecting one or both joints. This Myrhaug's technique operation is very simple without any complication in the post-operative days and give very good results.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Bleomycin and cis-platinum with or without mitomycin C in 110 previously untreated patients with head and neck cancer.

Between November 1979 and October 1981, 110 consecutive patients with previously untreated, biopsy-proven squamous cell carcinoma of the head and neck, were treated by chemotherapy prior to scheduled surgery and/or radiotherapy. Two regimens of chemotherapy were used. The first 57 patients received cis-platinum, 20 mg/m2/day for 5 consecutive days and bleomycin 5 mg/m2/day as a continuous infusion over the same 5 days every 3 weeks (Regimen A). The next 53 patients received the same schedule and dose of cis-platinum, bleomycin 2.5 mg/m2 every 12 hours for the same 5 consecutive days and mitomycin C6 mg/m2 on day 1 of each cycle every 3 weeks (Regimen B). The number of courses administered prior to surgery and/or radiotherapy ranged from 1-4 depending on the otorhinolaryngologist's assessment of the optimal time for locoregional treatment. The overall response rate in regimen A was 78% (45/57) compared to 90% for regimen B (48/53). Complete responses were seen in 10/57 (18%) and 13/53 (25%) patients in regimens A and B, respectively. Eight of 57 patients in regimen A and 6/53 in regimen B refused further treatment and follow-up, and 7/53 patients in regimen B chose to pursue chemotherapy (in which methotrexate replaced bleomycin) rather than undergo surgery and/or radiotherapy. Five of these seven patients are surviving disease-free from 7-12 months. In regimen A, 31/57 patients are surviving with a median survival exceeding 15 months. In regimen B, 46/53 patients are surviving up to 14 months. Nausea and vomiting induced by cis-platinum were the major side effects, seen to a variable degree in all patients. No cis-platinum-induced renal toxicity was observed with the 5-day regimen and none of the patients had symptomatic bleomycin-induced pneumonitis. One patient had a bleomycin-induced skin rash which did not require discontinuation of therapy.

Adult↗

[Results of several times daily treatment by cisdiamine-platinum and bleomycin. Therapeutical considerations (author's transl)].

Seventy two head and neck cancers have been treated with a combination of Cis-DDP (20 mg/m2/day) and bleomycin (6 mg/m2/day, 24 hours infusion) given for 5 days 3 courses every 3 weeks in preoperative cases and for 6 days (4 courses every 3 weeks) in non preoperative cases. Fifteen patients treated for local recurrence after irradiation experienced no significant response and their actual survival at 12 months is 22%. For the other patients the objective response rate was 78% with 10 complete responses and the projected survival at 12 months varies from 62% to 92% according to the subsequent treatment (irradiation or surgery followed by irradiation). These results are in agreement with a few reports using similar combinations; but it needs to answer new questions about possibility of surgical strategy variations in the cases of good or complete responses with such a chemotherapy.

Bleomycin↗

[Pharyngolaryngectomy without nasogastric feeding tube nor tracheal cannula (author's transl)].

Thirty three patients have been operated with total laryngectomy (LT) or pharyngolaryngectomy (PLT) with or without Zadical neck dissection, without nasogastric feeding to be and in five cases without tracheal cannula (but connection of a large tracheostomy). The authors demonstrated that there is no increasement of pharyngeal fistua. The beginning of oral alimentation has been made between the 4th and the 6th postoperative day. Such a procedure is more comfortable for the patients and decrease the hospitalisation duration.

Adult↗

[Actinomycoses in ORL].

Diagnosis in a suspected case of laryngeal pseudo-actinomycosis was confirmed by examinations conducted in the Pasteur Institute. This capricious and misleading affection is reviewed, its treatment requiring only simple but prolonged antibiotic therapy.

Actinomycosis↗

[Diagnostic contribution of 2 electrophysiological methods in a case of central pontine myelinolysis. Early auditory evoked potentials and blink reflex].

A case of central point myelinolysis is described in a heavy beer drinker who was found to have severe water and electrolyte disturbances on admission. The patient subsequently developed quadriparesis with pseudobulbar symptoms. The authors stress the diagnostic value of brain stem auditory-evoked responses and of blink-reflex, which were restored to normal as the patient recovered.

Adult↗

[Actuality of ambulatory anaesthesia in oto-rhino-laryngologic surgery (author's transl)].

The ambulatory intervention in ORL surgery presents a certain amount of constraint : anaesthetic, surgical, medicolegal and socio-economic. In spite of the lack of medicolegal definition for ambulatory anaesthesia, these anaesthetic intervention may take place in conditions approaching the other anaesthetic intervention provided that some rules are respected. The authors propose a practical treaty for the ambulatory intervention ORL surgery and as an illustration to this presentation propose a sample of a hundred ambulatory interventions.

Ambulatory Surgical Procedures↗