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Biomedical subjects

M Hamoir

Publications and source records attributed to M Hamoir.

At least 73 records · Page 4Linked to original sources
PubMed1990

Combined CO2-laser and alfa recombinant interferon treatment in five children with juvenile laryngeal papillomatosis.

Juvenile laryngeal papillomatosis is a rare and benign tumoral disease of childhood characterized by numerous relapses despite complete resection. The ENT treatment of choice is to vaporize the papillomas with a CO2 laser. Since the discovery of a viral etiology (Human Papilloma Virus), resection has been followed by medical attempts to control the disease by using various antiviral treatments. Among the latter, alfa interferon has proved effective during the first six months of treatment. In this article, we report on five cases of refractory juvenile laryngeal papillomatosis treated by excision (CO2 laser in four children, surgical resections in one child) and alpha-r IFN 1.5 x 10(5) U/kg daily. With this strategy, three of the five children are currently disease-free for periods ranging from 22 to 68 months. This series includes one remarkable observation of one child who responded only to double doses of alpha-r IFN, after initial failure at conventional doses. This therapeutic scheme reduced the frequency of relapses in a fourth child. In only one child the treatment did fail to modify the natural course of the disease. Side effects were tolerable and included anorexia (one case), palmar erythema (one case), a flu-like syndrome (two cases) and mild transient transaminase rise (three cases) not precluding further treatment. CO2-laser caused one laryngeal oedema and synechia of the anterior commisure of the vocal laryngeal cords in one other case.

Carbon Dioxide↗
PubMed1990

Correction of glottic insufficiency by collagen injection.

Thirty-nine patients were treated with GAX collagen for vocal fold augmentation. The objective results were evaluated by measurement of the maximum phonation time, the phonatory quotient, vocal frequency analysis, and laryngostroboscopy. These results are as good as those with Zyderm Collagen II (ZCI). Avoidance of useless overcorrection, better resistance to collagenase, and less induced hypersensitivity differentiate GAX from ZCI.

Adolescent↗
PubMed1989

Initial long-term results of collagen injection for vocal and laryngeal rehabilitation.

The records of 14 patients who have benefited from intralaryngeal injections of ZCI collagen for at least 3-4 years were reviewed. All patients still living were evaluated. Qualitative phonatory measurements included laryngostroboscopy and frequency voice analysis, while quantitative studies included maximum phonation times and phonatory quotients. The absence of both local and general inflammatory reactions was observed in these patients, confirming the excellent host tolerance of ZCI collagen and the stability of the functional results achieved.

Adult↗
PubMed1989

[CO2 laser treatment of the glottic sulcus and of epidermoid cyst. Technic and results].

The CO2-lasers of the new generation are equipped with milliwatts, super-pulse, small spot size (700 U or less). These technical improvements safe permit in resection of vocal fold benign lesions like polyps, nodules, or even sulcus glottidis. Our resection technique for sulcus glottidis and epidermoïd cysts is presented in 18 cases. If very strict rules of microsurgical treatment are respected, the functional results are as good as those with conventional techniques (93% of good results).

Adult↗
PubMed1989

[Preservation of the external branch of the superior laryngeal nerve in thyroid surgery. An anatomic study of 30 dissections].

The authors stress the importance of the external branch of the superior laryngeal nerve in laryngeal physiology, by noting the consequences of its section during thyroid surgery. A rigorous anatomical study carried out on 15 fresh cadavers, i.e. 30 superior laryngeal nerves, reproducing the conditions of thyroid surgery, allowed precision of the time during surgery when the external branch is at risk of being damaged, especially during sectioning of the vascular pedicle of the upper pole and at the time of separation of the thyroid pole from the laryngeal axis. The study considers the anatomical variations of the territory of the superior thyroid artery and the various technical problems that are posed in preserving the external branch of the nerve. In the light of their findings, the authors advise that this nerve axis should be identified before ligature of the upper thyroid pedicle; if the advice is not followed then the external branch of the superior laryngeal nerve may be damaged or sectioned in approximately 15% of cases.

Female↗
PubMed1989

Failure of tonsil and nose surgery in adults with long-standing severe sleep apnea syndrome.

Seven adult patients with a severe form of sleep apnea syndrome (mean apnea index, 47) underwent surgery for significant structural abnormalities at nose and/or throat level (septal deviation, turbinal hypertrophy, enlarged tonsils, long uvula, pharyngeal tumor). Although a subjective benefit was claimed by most patients, the polygraphic data showed no improvement or only a modest improvement in breathing pattern, oxyhemoglobin saturation, or general sleep architecture except in one patient. In this patient the evolution of the syndrome was recent (3 years) and surgical management of a parapharyngeal tumor resulted in a cure. We conclude that in adults with sleep apnea syndrome of long-standing, surgical correction of nasal or pharyngeal abnormalities should not be expected to normalize sleep and breathing. This contrasts with the known benefits achieved by the same type of surgery in children. Surgery might nevertheless be necessary in some adults to permit the application of other therapeutic means (ie, nasal continuous positive airway pressure).

Adult↗
PubMed1988

Interest in frozen section examination of margins and lymph nodes in laryngeal surgery.

One hundred and one patients presenting with a squamous cell carcinoma of the larynx underwent surgery in our department between January 1980 and May 1985. In most of these patients, nodes were removed from the main lymphatic drainage pathways and subjected to immediate frozen section examination. The results from frozen section examination of the nodes were then compared with those from the surgical specimens of cervical neck dissections performed on the patients according to the classic rules. In addition, margin resections were made and examined by frozen section after removal of the tumour. In the event of a positive finding, these resections were continued until healthy tissue was reached, the specimens being examined in addition by classic methods. Immediate frozen sections enable the margins of the resection to be verified correctly. In our series we were brought to extend the limits of resection in 10 cases out of 68 (15 per cent). It can also be seen that the accuracy of the pathologist's reading of the frozen sections is satisfactory. The overall level of error is three out of 68 (4.5 per cent). All the errors correspond to false negatives. The aim of avoiding neck dissections in the presence of N0, thanks to nodal selection with frozen section, is not attained. We find a 6/61 rate of false negatives for N0-N1 (10 per cent) when we compare the frozen sections of the selected nodes and the neck dissections. This is due to the fact that the surgeon may be led astray by a reactive hyperplastic node whilst other less inflammatory neighbouring nodes are in fact the site of metastasis.

Carcinoma, Squamous Cell↗
PubMed1987

[Correction of a glottis gap by injection of collagen. Apropos of 25 cases].

Results of treatment of patulous glottis by injection of collagen are discussed. The technique used differs little from that in which Teflon is employed, the difference being that the collagen paste is injected into Reinke's space. The quantity deposited varies between 1 and 1.5 cm3. Twenty-five patients had been treated in this way by April 1986, the longest follow up being for 19 months (mean: 9.5 months). The compound presents remarkable tolerance and no complication has been noted up to the present. Results were at least equal to those obtained using Teflon. Vocal quality was evaluated, apart from by vocal recordings, by analysis of vocal spectrum and objective measurements such as phonatory quotient and output. Results appear to be stable and although some reduction in quantity injected was noted most of the collagen becomes living tissue by colonization with host tissue. Availability of new generations of collagen such as that crosslinked at 35 mg/ml will probably resolve definitely the problem of persistence of results.

Adult↗
PubMed1986

The challenge of upper airway obstruction in pediatric intensive care.

Over a 5-year period, 75 patients were admitted to a pediatric intensive care unit because of acute upper airway obstruction (AUAO). Congenital abnormalities were demonstrated in 25 children; 9 of them died secondary to severe combined malformations or major central nervous system dysfunction. Acquired AUAOs were seen in 50 patients; 1 died in brain death secondary to anoxia. Obstructions were observed at all levels of the airways from the nose to the carina. In 28% of the patients, AUAO had remained undiagnosed until admission for complications such as acute respiratory failure, cardiac arrest, coma, seizures. With early diagnosis and prompt release of the obstruction the prognosis is good unless severe congenital abnormalities or major central nervous system damage are associated.

Airway Obstruction↗
PubMed1986

Tumor of the hypopharynx: free jejunal transfer with conservation of the larynx: a case report.

Resection of the hypopharynx or cervical esophagus for malignancy is always quite mutilating if reconstruction cannot be achieved with a one-stage procedure. Several techniques have been described, but they are often associated with laryngectomy. In the case reported, a free split jejunal segment transfer allowed reconstruction of the hypopharynx without laryngectomy, as the malignancy did not involve the larynx.

Humans↗
PubMed1986

Exploration of glottic function before and after injection of collagen for rehabilitation of the vocal cord.

After more than one year's use of injectable collagen for vocal and glottic rehabilitation, the subjective and objective results have been presented for a series of 18 patients, 17 of whom had paralysis of one vocal cord, while one patient had a post-traumatic atrophy of the left cord. The assessment is based on rigid and flexible fibroscopy, stroboscopy, the objective phonatory assessment with measurement of the phonatory quotient and mean flow rate, EMG of the vocal cords and frequential analysis of the voice. Apart from the improvement in the phonatory quotients and outputs after injection, the noteworthy results have been the persistence of flexibility and undulation in the cord injected, visible by stroboscopy, and also the reappearance of the fundamental and 2 or 3 first harmonics on frequential analysis of the voice. The mean follow-up was 6.5 months, with a maximum of 14 months and minimum of 1 month. At the medium term, injectable collagen would appear to be a worthwhile alternative to Teflon because of its simplicity of use, its very great tolerance and the quality of the functional results obtained.

Adult↗
PubMed1986

[Mannequin syndrome].

Describe since the beginning of the fifties, the mannequin syndrome consists of anorexia, amenorrhea and swelling of the parotid glands. This variety of symptoms is usually found in young female patients who want to remain thin. In fact, this syndrome has been several times diagnosed in fashion models or airhostesses;hence the term "mannequin syndrome".

Adult↗