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Biomedical subjects

M Zanaret

Publications and source records attributed to M Zanaret.

At least 91 records · Page 5Linked to original sources
PubMed1989

[Choice of surgical technic for correcting the nose tip].

The surgical approach should be adapted to the type of correction needed. There is no room of standard technics. The various selection criteria that have to be considered are: the structure of the alar cartilages and the infra-and suprastructural characteristics thereof, determining the upper triangle of the lobule; the relative incidence of the abnormalities encountered in rhinoplastic practice; an analysis of the failures leading to secondary rhinoplastic operations, among which the most frequent are lobule and/or irregularities and drooping apex or insufficient projection thereof. Currently, the authors' conclusions are that: Most of the times, the upper triangle of the lobule is overdeveloped: reduction is carried out by resecting a superior strip laterally, while additionally trimming the cupulae, if necessary. Much more rarely, a globally hypertrophied lobule will be found that requires management by section-reconstruction of the cupulae. In case of a "normal", excessively projected lobule, the technic of choice is apex retraction. Primary apex projection defects should be recognized and treated with molding grafts. The nose tip should be prevented from drooping by means of columellar supporting grafts.

Humans↗
PubMed1988

[Tissucol in septorhinoplasties].

There are two major indications for Tissucol: 1. Stabilization of structures separated by the operative procedure or of graphs, in particular cartilaginous, whether placed along the crest of the nose or at the level of the columella in sagittal position between the mesials, or frontal position under their lower edges. 2. The construction of grafts. a) Mixing of bone powder and Tissucol provides "laminated" graphs which, when placed laterally and below iliac bone grafts, avoid the grooves which all too often form along the edges of such grafts. b) Coherent moulding graphs can be obtained using Tissucol with crushed cartilage (from septum or auricular concha).

Aprotinin↗
PubMed1988

[Grafts in esthetic and functional corrective rhinoplasty].

Results of the use of grafts in primary and secondary rhinoplasty are reported, the grafts being either of cartilage (concha auriculae, nasal septum, alar cartilage), bone (mastoid, ilium) or connective tissue (temporal aponeurosis). The distinction is made between modelling grafts of softened cartilage, supporting grafts of non-softened cartilage and mastoid bone, of bone reconstruction and of cartilaginous filling grafts.

Bone Transplantation↗
PubMed1988

[The base of the nose in corrective rhinoplasty].

The authors describe a study of the labio-columellar region and of the alae of the nose in corrective rhinoplasty excluding malformations. Esthetic characteristics and the anatomical structure of this junctional area between the mobile nose and the facial plane are revealed. Surgical problems are analyzed with study in succession of surgical approaches, maxillo-septal angle, the columella, the maxilla, the muscular layer and the alo-jugal junction. Surgical techniques which can be divided into inferior septoplasties, columelloplasty and labio-columelloplasty have precise indications in accordance with the type of formation of the labio-columellar region. A technique of nostril resection with the absence of damage to and shortening plasty of the muscle layer is described.

Esthetics↗
PubMed1988

[Contribution of nuclear magnetic resonance in the neuro-otologic diagnosis of acoustic neuroma. Screening and evaluation of its extension].

Forty patients with suspected tumoral syndrome of ponto-cerebellar angle were investigated by NMR imaging. The method proved to be reliable, less invasive (lack of irritation and absence of iodized contrast) and as rapid as CT scan imaging for the diagnosis of presence and extension of an VIIIth nerve neurinoma. It also allowed avoidance of computerized gas meatography during screening for intracanal neurinomas.

Audiometry↗
PubMed1988

[Initial results of free bone transposition of the iliac crest in pelvi-mandibulectomy].

Mandibular reconstruction in 6 patients was by free flap from iliac crest in pelvi-mandibulectomies. The different technics proposed for mandibular reconstruction are described with emphasis on the specificity of repair surgery in cervicofacial oncology. In this precise indication stress is placed on the limitations of conventional graft and endoprosthesis procedures and the need to transfer a vascularized bone fragment. Among the technics for transfer of vascularized bone, preference is accorded to the composite flap from iliac crest as against the osteo-musculo-cutaneous flap, and details for removal of the former are given. The osteo-musculo-cutaneous flap from iliac crest appears to be the procedure of choice for reconstruction of bone in all cases where mandibular reconstruction is necessary after loss of continuity.

Humans↗
PubMed1987

[Spheno-ethmoidectomy in recurrent nasal polyposis. Technic, indications, results].

Spheno-ethmoidectomy can be legitimately included within the therapeutic schema for nasosinusal polyposis causing incapacity and resistant to medical treatment. Benefiting from recent technical progress, a very precise medical therapeutic framework and improved knowledge of ethmoid surgical anatomy, a marked reduction in complications of this operation has been observed. Results of a series of 175 ethmoidectomies performed in 90 patients confirm the good results reported in the literature, even though follow up is still insufficient.

Ethmoid Sinus↗
PubMed1986

[Tumors of the cerebellopontile angle, with the exception of acoustic neuromas].

Based on a review of 38 cases of tumors of pontocerebellar angle, excluding acoustic neurinoma, and a literature review, clinical, radiologic and therapeutic characteristics of these lesions are described. Diagnosis depends on accurate pre-operative identification of the type of tumor. Based on frequency data it can be estimated that tumors of pontocerebellar angle are nearly always acoustic neurinomas : this infers that these other tumors of the angle represent a differential diagnosis where major orientation signs are radiologic. This is fundamental, since when considering all tumors of pontocerebellar angle those requiring a totally different approach to treatment than that for acoustic neurinomas must be distinguished from those for which inability to identify them is not of marked importance since their operatibility is identical.

Adult↗
PubMed1986

[Venous and meningeal prolapse during enlarged trans-labyrinth approach].

One hundred consecutive operations using the enlarged trans-labyrinthic (ETL) approach for acoustic neurinoma performed by the same surgeon were analyzed to determine incidence of venous and/or meningeal prolapses. Findings showed that ETL approaches were normal in 51 cases : normal superficial sinusodural space--external auditory canal and on deep dissection a superior petrous sinus and jugular space separated from the internal auditory canal. Prolapse was observed in 49 approaches : 30 very narrow sinusodural spaces due usually to temporal meninges prolapse (76%) associated in 25% of cases with a prolapse of lateral sinus; 29 prolapses of jugular space and 10 of superior petrous sinus, detected mainly in the narrow sinusodural spaces. In these cases, superficial displacement of the temporal meninges and lateral sinus appears indispensable in order to recover normal operating conditions towards the labyrinth and pontocerebellar angle.

Ear, Inner↗
PubMed1986

[Requisite selection of surgical technics in the treatment of cancer of the larynx].

Rules for functional surgery of cancer of larynx are defined by means of a detaited analysis of results of 43 cases of reconstructive anterior frontal laryngectomy, 17 cases of crico-hyoide-epiglottopexy and 32 cases of crico-hyoidopexy. The carcinologic features of this surgery are discussed, and emphasis placed on the importance of the paraglottic space and its functional conditions in the light of recent physiologic data. Surgical procedures used are outlined with, for each of them, the neoplastic localization suitable for treatment and a critical analysis of postoperative functional results. Carcinologic follow up is still insufficient for several techniques used, preventing any precise conclusions to be drawn, but the authors consider it is justifiable to perform 66% of partial as against 34% of total laryngectomies.

Humans↗
PubMed1985

[The external fronto-ethmoidal approach].

A lateral fronto-ethmoidal approach simultaneously exposing the frontal sinus and the nasal fossae appears to be a necessity for the surgical treatment of fronto-ethmoidal pathology. It is possible to fashion an osteo-plastic flap in the fronto-naso-maxillary region. The technique of the approach is described. The operation leaves no ocular functional sequelae and the scar is minimal. Twenty one operations by fronto-nasal flap approach are described, 10 for benign tumours of the fronto-ethmoidal system and 11 with the aim of re-aerating the frontal sinus for cases of complicated or iatrogenic serious sinusitis. The results are studied. The indications of the fronto-nasal flap are described: In tumour pathology, this technique must be used for osteomas and mucoceles of the fronto-ethmoidal system as soon as the ethmoidal component reaches or goes beyond the middle ethmoid. If the fronto-ethmoidal lesion only involves the anterior ethmoid, it is then accessible via simple frontal flap. Inverted papillomas which require wide exposure should also be treated via this approach. In infectious pathology, the fronto-nasal flap offers the possibility, after eradication of fronto-ethmoidal lesions and calibration of the naso-frontal canal, of re-aeration of the frontal sinus which seems preferable to its exclusion. The possibility of re-aeration of the frontal sinus by an osteo-plastic procedure is progress in comparison with lost bone craniotomy procedures.

Craniotomy↗
PubMed1985

[Vestibular neurectomy in Ménière's disease. Results and comments apropos of 77 cases].

The authors report 77 cases of vestibular neurectomy performed between 1972 and 1984 (40 male and 37 female) for incapacitating Meniere's vertigo. Neurectomy was via a sub-petrous (S.P.) approach in 55 cases, by posterior trans-labyrinthine (P.T.L.) approach in 9 and anterior trans-labyrinthine (A.T.L.) in 13 cases. A.T.L. was abandoned because of the frequency of leaks of CSF and of meningitis. The P.T.L. approach did not result in any facial paralysis, even transient. There were 2 CSF leaks, without meningitis and one of which required reoperation. For the 55 S.P. cases, hearing worsened in 22.2% with 8 cases of deafness, including three appearing secondarily. There were two transient auditory improvements. Vertigo was cured in 73 cases (94.8%) with 25.9% instability after several months. The authors stress the frequent bilateralisation of the disease and the need to reserve vestibular neurectomy for cases of longstanding incapacitating vertigo, resistant to all other treatment, as well as the value of surgery on the endolymphatic surgery provided that the criteria of indication are complied with. Medical treatment remains the essential basis, including the analysis and, where applicable, treatment of psychosomatic factors by a trained psychiatrist. Finally, when vestibular neurectomy is indicated, the S.P. approach is otologically most suitable, the P.T.L. being reserved for deaf ears or the elderly.

Aged↗
PubMed1985

[Cholesteatoma of the ear. Experience with an eclectic therapeutic attitude].

In the light of 702 cases of cholesteatoma seen over a 20 year period, the authors report the experience of a hospital team based upon analysis of the last 517 cases. 322 patients were treated by a conservative attitude to the bony meatus, including 120 undergoing routine revision between 14 and 24 months. 195 cases were treated by an open technique, either primarily or following massive recurrences despite the use of closed techniques. In 33% of cases, patients had already undergone at least a tympanoplasty. The authors discuss the indications of the treatment of cholesteatoma. Each patient must be considered as an individual case and whilst our preference would be for conservation of the bony meatus, certain anatomical and functional conditions make a so-called open technique necessary in 1/3 of cases.

Adolescent↗