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Biomedical subjects

M Jomin

Publications and source records attributed to M Jomin.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Treatment of osteo-dural injuries of the anterior segment of the skull base through the trans-lesion approach. Apropos of 25 cases surgically treated by a dual neurosurgical and maxillofacial team].

The authors describe a technique of mobilisation of the frontal sinus using the fractures of anterior and posterior walls. The translesional approach is adapted to cranio-facial borders surgery of traumatisms. It's a skull base approach which minimizes the cerebral retraction and enables or perfect viewing of the top of the ethmoid. The advantages, drawbacks and indications are discussed about 25 cases.

Adolescent↗
PubMed1989

[Treatment of severe postoperative infections in head surgery. 20 cases].

The authors report the management and follow-up of 20 patients with severe postoperative intracranial infections, abscesses and/or empyemas. Clinical neurological diagnosis was difficult in patients with deficits resulting from the first operation but over half the cases had an inflammatory reaction in the operated zone. CT scan showed that the infection was not limited to a single site (e.g. the subdural area) but was more diffuse in the majority of cases. Antibiotics were given alone in 10 patients and in association with empyema aspiration or reoperation in the other 10 patients. There were two fatalities but the other patients made a generally good functional recovery.

Adult↗
PubMed1989

[Recurrent meningitis, hydrocephalus and tegmen tympani dehiscence].

Cerebrospinal fluid (CSF) otorrhea is the usual presenting symptom of spontaneous tegmen tympani defects. A case associated with recurrent meningitis and CSF rhinorrhea without otorrhea is described. The coexistence of an hydrocephalus had led initially to ventriculoperitoneal shunting, which did not prevent meningitis recurrence. Previously reported in cases of anterior fossa and sella defects, an aqueduct stenosis was here associated with the tegmen tympani defect.

Adult↗
PubMed1989

[Problem of the preservation of hearing in acoustic neuroma. Value of the mixed supra petrous and retrosigmoid approach].

The authors described their experience of the possibilities of preservation of hearing on the basis of a series including approximately 180 acoustic neurinomas. Whilst the initial experimental approach involving the use of a sub-occipital approach in seated position was abandoned, in view of the risk of complications inherent to the use of this approach, the authors progressively developed the possibility of the preservation of hearing by a retro-sigmoid approach in horizontal position as described in France by Bremond, Magnand and Garcin, and taken up subsequently by Sterkers. Currently, a retro-sigmoid approach is used combined with a classical supra petral approach which can be used in all cases to assess the tumour at the base of the internal auditory meatus and identify the position of the facial nerve. This surgery by mixed approach can safeguard hearing in small tumours (grades I, II and IIIa) in approximately 75% of cases. Functional hearing should nevertheless be differentiated (approximately one case out of two) in other cases where only residual auditory tissue remains. It is highly likely that improvement in radiological techniques (leading to earlier diagnosis) as well as surgical techniques will lead to the safeguard of hearing in even more cases, and hence the importance of evaluation of these techniques in terms of their relative indication in comparison with the translabyrinthine approach which the authors consider to remain the approach of choice in large tumours (grades IIIb and IV).

Audiometry↗
PubMed1989

[Secondary and late development of hematoma of the brain stem].

The functional and social outcome in 15 patients with brainstem hematomas surviving on the 15th day is reported. At the end of the first year post stroke, the main neurological deficits were sensory, postural and paresis of the 6th and 7th cranial nerves. This resulted from the preferential location of the lesions in the lateral and posterior pons. On a functional point of view, 8 patients were independent in daily living. Seven of them were regularly engaged in more elaborated activities, at home and outside: 1 had recovered his previous professional activities. Those functions evolved more slowly during the 2nd year and later on. A significant correlation was found between the initial neurological status and the functional outcome at 1 year, and also between the volume of the hematoma on C.T. scan and this outcome. In this series, the age of the patients was not correlated to the other variables.

Activities of Daily Living↗
PubMed1989

[Surgical treatment of lumbar foraminal disk herniation. Value and indications for an interlaminar and extra-articular combined approach].

From 62 foraminal herniations seen over 2 years, the authors present a series of 22 lumbar foraminal disc herniations operated on by a combined interlaminar and extra-articular approach. After describing the technique the results are analysed. The objective of the combined approach is to provide satisfactory foraminal liberation without damage to the articular structures. They also define the indications. These are based on precise analysis of the topography of the hernia, provided by CAT scan examination. Three major topographical types may thus be defined.

Adult↗
PubMed1988

[Screw fixation of the odontoid process].

Fractures of the odontoid process of the axis create problems of specific osteosynthesis. The different techniques described so far require an external support and limit the movements of the cranio-cervical joint. These 2 drawbacks are avoided by direct screw fixation of the odontoid process in cases where conditions are favourable to this procedure.

Axis, Cervical Vertebra↗
PubMed1988

[Tomographical use of Tc hexamethylpropylene amine-oxime. First experience (78 studies)].

A new radiotracer of cerebral perfusion, 99mTc-labelled hexamethylpropylene amine-oxime, has been tried in 78 subjects: 6 controls and 72 patients. Qualitatively, the distribution of this tracer in healthy subjects was very much the same as that obtained with a reference method using 133xenon inhalation. Quantitatively, there was no correlation between the real blood flow rate and the normalized cerebral uptake rate. On the other hand, the asymmetry indices obtained in controls (but also in 16 patients) correlated very closely with those obtained with 133xenon. Our first results in acute ischaemic diseases as well as in the evaluation of vasospasm or Alzheimer-like presenile dementia point to wide fields of application for the new compound. Unlike its predecessors, it is always available and will probably be used, without any logistic investment, with the standard equipment of all Nuclear medicine departments.

Adult↗
PubMed1988

[Treatment of vasospasm in aneurysmal meningeal hemorrhage using intravenous nimodipine. Multicenter cooperative study].

We present a multicentric randomized double-blind study of the curative effect of intravenous Nimodipine on the post hemorrhagic vasospasm after aneurysmal rupture. On 122 validated cases out of 188 analyzed patients, the study demonstrates a significative effect on the mortality and severe morbidity related to vasospasm: the reduction of the risk is appreciated to 72%. The major effect is obtained on the mortality risk. A selective effect can be demonstrate on the isolated vasospasm.

Double-Blind Method↗
PubMed1988

[Choice of a technic of stabilization in surgical treatment of recent fractures of the odontoid process. 90 cases].

The objective of this study is to analyse the advantages and disadvantages of different surgical technics of odontoid process fracture stabilization. We try to find the best indications for each of them. We won't consider stable odontoid fractures which haven't treated by surgical therapy. A review of ninety acute dens fractures since 1979 has been analysed before 1985, the most of our injured person had a surgical stabilization by posterior approach. The analysis of our results had incited us, since that date, to vary our indications, by taking possibilities of anterior approach into consideration. So, have been realized 55 C1-C2 lacings, 20 of which with bone graft, 12 occipito-cervical arthrodesis, 10 screw fixations of odontoid process, 9 atlanto-axial arthrodesis by screw fixations, 2 posterior fixations by CD pediatric instrumentation, 1 Knodt instrumentation, 1 osteosynthesis by trans-oral exposure. Patients have been seen again, 1 month, 3 month, 6 month, 1 year later. Results have been estimated: Clinically by cervical mobility study in rotation and by local pain (16 excellent results, 24 good results, 27 middle results, and 23 bad results); Radiologically by analysis of specific complications of each technic (8 secondary removing, 6 incomplete deplacement corrections, 4 excessive corrections, 3 pseudarthrosis). We have regrouped global results technic by technic. We propose a therapeutic planning in which each technic can find the best result. The objective is to assure an effective retention by preserving movings of superior cervical spine.

Adolescent↗
PubMed1988

[Subacute extradural hematoma of the vertex. A case].

A patient suffers from a spasmodic triparesis 8 days after a cranial traumatism of the vertex. Ruptured superior sinus leads to development of an subacute extradural hematoma. The following course is uneventful after surgical cure. The localization, subacute evolution and clinical findings are rarely described in the literature.

Hematoma, Epidural, Cranial↗
PubMed1988

[Direct osteosynthesis of fractures of the odontoid process using a biodegradable implant (B.O.P.)].

The authors describe a new technique for treatment fractures of the dens. An anterior approach (technique of Boehler) is used. It provides for one-stage fusion and no additional disturbance of C1-C2 rotation. Under AP and lateral guidance the body of C2 is drilled medially, and so are the site of fracture. Then comes the gradual impaction of a conical implant of biocompatible resorbable implant [*], tip cephalad. The biopolymer is used for grafting purposes in all type of fractures of the odontoid process, which permits the latter to be fused without using screws or any other metal implant.

Adult↗
PubMed1988

[Pseudotumoral cerebellar infarction of venous origin].

A case of venous thrombosis with pseudo-tumoral cerebellar infarction is reported. Cerebello-vestibular symptoms and intracranial hypertension had a progressive course over one and half month. CT showed an unilateral cerebellar lesion, with contrast medium enhancement and hydrocephaly. Thrombosis of the cerebellar superficial veins was found at surgical operation. A thrombosis of the transverse sinus was likely. No cause was discovered. This case, together with a published one, shows that a venous thrombosis may determine a cerebellar infarct.

Cerebellar Diseases↗