Biomedical subjects
Publications and source records attributed to M Garcin.
The authors report a case of a solitary melanotic neurofibroma involving the temporomalar area in a 17-year-old man. Light-microscopic study reveals a benign neurofibroma including melanin deposits. Electron microscopy shows typical premelanosomes and melanosomes within Schwann cell cytoplasm. The literature is reviewed, and theories of histogenesis for this unusual tumor are discussed.
Controversy exists as to the presence of ruptures of the membranous labyrinth in patients with Meniere's disease, some authors considering the lesions reported to be artefacts only. Confirmation of the existence of healed labyrinthine tears was obtained in all cases of clinically and histopathologically confirmed Menière's disease studied by means of a protocol involving strict criteria. Lesions were observed mainly in Reissner's membrane and demonstrated three particular aspects. It is suggested that the images described by Out-Pouch in the posterior labyrinth are also the result of healed ruptures.
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Combined use of a microcomputer of sufficient capacity and a commercial program for data processing permits simple storage and exploitation of hospital case-records in an ENT department of moderate size. The principal advantages of the system reside in its permanent availability, the ease of communication with the computer due to the clear language employed, its large storage capacity (650 case-records per diskette), and the moderate cost involved. Programming time is reduced by the use of a particular nomenclature for questions and possible replies. The system is not static, and can be adapted to individual needs or modifications in pathology.
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156 cases of laryngeal stenosis in the child were seen over a 10 year period. 40 were congenital and 116 acquired, chiefly after intubation. Congenital stenosis improved spontaneously in 60 % of cases. When tracheotomy was necessary, treatment was similar to that of acquired stenosis. For post-intubation stenosis analysis of the underlying pathology revealed the existence of risk factors: coma, cardiac surgery with extracorporeal circulation, laryngaeal pathology being responsible in 75 % of cases. Awareness of these risk factors was felt to be one of the essential elements in the prevention of post-intubation stenosis. Treatment varied in accordance with the degree of progression of the stenosis. In recent progressive forms medical and endoscopic treatment (51 cures without treacheotomy, 11 after tracheotomy for 2 to 10 weeks). In forms with scar tissue, tracheotomy associated with endolaryngeal calibration (21 cases) or laryngotracheal enlargement surgery (21 cases). A number of precautions are suggested in order to improve the prevention of stenosis with scar tissue. Indications of the various therapeutic methods are discussed according to whether the stenosis is due to scar tissue or is congenital. With regard to procedures involving laryngotracheal widening (28 in all : 21 for stenosis after intubation and 7 for congenital stenosis), emphasis placed upon the need to select amongst several types of operation according to the site and extent of the lesions.
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On the basis of a study involving 21 children treated over a 10 year period, the authors describe a method for the management of a child following the ingestion of a caustic fluid: emergency oesophagoscopy to determine the extent and nature on the lesions, in severe forms, alimentation gastrostomy, which would seem to be preferable to parenteral alimentation, is carried out, on the 21st day, a new endoscopic and radiological assessment, permitting distinction between those cases which are cured and those progressing to stenosis. In this latter group, the choice is made between dilatations and oesophagoplasty on the basis on the lesions present and the development of complications during dilatation.
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