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Biomedical subjects

O Laccourreye

Publications and source records attributed to O Laccourreye.

At least 19 recordsLinked to original sources
PubMed2006

Clinicopathological significance of mitochondrial D-Loop mutations in head and neck carcinoma.

Mitochondrial DNA mutations have been reported in several types of tumours, including head and neck squamous cell carcinoma (HNSCC). The noncoding region of the Displacement-Loop (D-Loop) has emerged as a mutational hotspot and we recently found that they were associated with prognosis and response to 5 fluorouracil (5FU) in colon cancers. In order to evaluate the frequence of D-Loop mutations in a large series of HNSCC and establish correlations with clinicopathologic parameters, we sequenced the D-Loop of 109 HNSCC before a treatment by neoadjuvant 5FU-cisplatin-based chemotherapy and surgery. Then, we correlated these mutations with prognosis and response to chemotherapy. A D-Loop mutation was identified in 21% of the tumors, the majority of them were located in a C-tract (D310). The prevalence of D310 mutations increased significantly with the number of cytosines in the matched normal tissue sequence (P=0.02). Hypopharyngeal cancer was significantly more frequent (P=0.03) and tobacco consumption more important (P=0.01) in the group of patients with D-Loop mutation. The presence of D-Loop mutation was not associated with prognosis or with response to neoadjuvant chemotherapy. These results suggest that D-Loop mutations should be considered as a cancer biomarker that may be useful for the early detection of HNSCC in individuals at risk of this cancer.

Carcinoma, Squamous Cell↗
PubMed2006

[Who am I: A...].

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Famous Persons↗
PubMed2006

[Nonotologic osteomyelitis of the middle skull base].

OBJECTIVES: The study goals were to determine the patient demographics, identify predisposing factors, and determine efficacy of treatment for nonotologic osteomyelitis of the middle skull base. MATERIAL AND METHODS: Symptoms and treatment of five patients (sex ratio: 3/1; mean age: 57,1 ans) with osteomyelitis of the middle skull base treated from 1991 to 2005 are analyzed. All patients with a biopsy-proven diagnosis of osteomyelitis of the skull base were retrospectively evaluated. RESULTS: Four patients presented with asthenia, weight loss, headache, and fever. No patient presented with neurologic deficits associated with a destructive lesion of the osseous skull base. Three patients had an underlying immunocompromising condition (diabetes mellitus, steroid and immunosuppressor use). CT scan and MRI demonstrated central skull base abnormality, mainly at the level of the clivus. Systemic antibacterial/antifungal therapy, aggressive debridement of involved bone, and medical optimization remain important in the treatment of this group of patients. CONCLUSION: The interpretation of the results is performed after an analysis of the literature.

Adult↗
PubMed2006

[Pain when removing a silicon Blake drain].

OBJECTIVES: A prospective analysis of pain intensity and related factors observed when removing a Blake suction drain after head and neck surgery. MATERIALS AND METHODS: An inception cohort of 100 patients managed at a single institution (university teaching and tertiary referral center), by 10 surgeons, during the months of March-July 2004. Two different scales were used to evaluate pain (see and ). The variables under analysis were: age, gender, comorbidity, overall pain and psychological status, anti-pain treatment, type of disease (benign vs malignant), type of surgery performed, location of the drain, number of drains removed and delay from surgery. RESULTS: No complications were noted at the time of drain removal. The volume drained varied from 10 to 450 cc (mean value 90 cc). At the time of drain removal no pain was noted in 50% to 60% of patients according to the scale used. Minimal pain and strong pain were noted in 45% - 36% and 5% - 4% of patients, respectively. Among the variables under analysis, the age of the patient was the only variable significantly related to the intensity of pain noted at the time of removal of the drain whatewer scale was used for analysis. Pain was statistically more pronounced as age declined (p=0.011 and p=0.04 according to the scales used). CONCLUSION: At our department, due to its very good drainage ability, its facility of use and the very low intensity of pain noted at the time of removal, the Blake drain has replaced the time honoured Redon-Jost drain conventionally used after head and neck surgery.

Adolescent↗
PubMed2006

[Who am I: B...].

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Clinical Medicine↗
PubMed2006

[Who am I? E...].

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Academic Medical Centers↗
PubMed2005

[Octylcyanoacrylate (Dermabond) for skin closure at the time of head and neck surgery: a longitudinal prospective study].

OBJECTIVES: A prospective non-randomised evaluation of the octyl-2-cyanoacrylate (Dermabond) for skin closure in head and neck surgery. MATERIALS AND METHODS: An inception cohort of 52 patients managed by six otorhinolaryngologists head and neck surgeons at a single institution (university teaching and tertiary referral center) during the months of May-July 2004. The length of the skin incision varied from 3 to 30 cm (mean: 7 cm). Morbidity evaluation, longitudinal analysis of the evolution of the scar, and analysis of the degree of satisfaction. RESULTS: Postoperative death was not encountered. The overall morbidity rate was 3.8% (2/52). There was no instances of wound dehiscence's. A subcutaneous abscess was noted in one patient. From an aesthetic point of view, the scar appearance was considered to be slightly retracted during the first postoperative month and to be very good 2 to 4 months from initial surgery. Only one patient developed a minimal cheloid scar. Among the 47 patients who expressed an opinion postoperatively regarding the use of the octyl-2-cyanoacrylate (Dermabond) for skin closure, the degree of satisfaction was very high due to the ability to take an early shower (40 patients) followed by the lack of skin sutures (5 patients) and the lack of any allergic skin reaction (2 patients). CONCLUSION: At our department, the octyl-2-cyanoacrylate (Dermabond) for skin closure at the time of head and neck surgery is becoming more and more utilized due to the completion of a solid and aesthetic suture, the ability to take an early shower and the high degree of satisfaction expressed by the patients.

Adult↗
PubMed2005

[Preoperative oral information prior to planned thyroid surgery: the surgeon, physician, lawyer and judge's point of view].

OBJECTIVE: Analysis of the consequence of the preoperative information delivered orally to patients requiring surgery for benign pathology of the thyroid gland from various perspective (head and neck surgeon, physician, judge, lawyer). METHODS: Prospective study conducted in an academic tertiary care referral center. Inception cohort of 123 patients with benign pathology of the thyroid gland consecutively informed orally and by the same surgeon during the years 2003-2004. Analysis of the consequences of the preoperative information, degree of memorization regarding the surgical related risks as well as the patient's opinion regarding this information. RESULTS: Due to the information regarding the risks related to surgery 14.6% of patients refused to undergo surgery. None of the patients remembered more than 4 out of the 6 main surgical risks. 68.8% of patients remembered only one or two surgical related risks. 12.2% of patients did not remember a single surgical related risk, 85.5% of patients remembered the risk of a unilateral laryngeal nerve paralysis, 41.1% the risk of death related to the completion of a general anesthesia and 21.1% the risk of a bilateral laryngeal nerve paralysis. Less than 11% of patients remembered the other risks (general risks related to any open field surgical approach, hypocalcemia and loss of breast feeding) Among the patients who had an opinion postoperatively, 87.6% had a positive opinion and 41.9% a negative opinion regarding the preoperative information related to the surgical related risks. Also, 28.4% of patients expressed simultaneously a positive and a negative opinion. CONCLUSION: Oral information of the patient regarding the surgical risks resulted in an important stress for the patient and modified the relation patient-surgeon. Due to the information, a non-neglectable group of patients elicited not to follow the advice of the surgeon. Various measures are discussed since the information on the surgical related risks is a must from a legal point of view but is also highly appreciated and requested by most of the patients.

Adult↗
PubMed2005

[Dysphonia: current methods of evaluation].

OBJECTIVES: The aim of this review article was to provide an update on current techniques for evaluation of dysphonia in routine clinical practice. MATERIALS AND METHODS: Recent medical and other scientific literature was reviewed and pertinent current theories concerning the physiology of laryngeal function described. RESULTS: Perceptual voice quality evaluation by a professional jury of listeners is still considered to be the most reliable and complete means of evaluating pathologic voice, even though it is difficult to perform in routine and the results lack reproducibility. The objective evaluation of the vocal fundamental frequency and its variations and the spectral characteristics of voice has the advantage of being simple to perform, reproducible and quantifiable. However, automatic measurements need to be analyzed with precaution for severe dysphonia, the computer algorithms being designed for voices retaining a certain periodicity. Aerodynamic measurements are quantifiable and reproducible and provide information as to the quality of laryngeal function as a transducer of aerodynamic energy into acoustic energy. Videostroboscopy and electroglottography provide information as to the quality of the laryngeal vibrations, the source of sound production. CONCLUSIONS: All of these types of analysis are complementary, informing as to different aspects of vocal quality and laryngeal function. No one measurement alone can diagnose or characterize dysphonia.

Electrodiagnosis↗
PubMed2004

[Long term results of exclusive chemotherapy for glottic squamous cell carcinoma complete clinical responders after induction chemotherapy].

OBJECTIVES: To evaluate the long-term results of exclusive chemotherapy for T1-T3N0M0 glottic squamous cell carcinoma complete clinical responders after induction chemotherapy. MATERIAL AND METHODS: Between 1985 and 2000, 69 patients with glottic squamous cell carcinoma complete clinical responders after induction chemotherapy were managed with exclusive chemotherapy at our department. Chemotherapy associated platinum and fluorouracil. This retrospective analysis evaluated actuarial survival, treatment morbidity, oncologic events and laryngeal preservation. Various independent factors were tested for potential correlation with survival and local recurrence. RESULTS: The 5-year Kaplan-Meier actuarial survival, local control, lymph node control estimate were 83,6%, 64,8%, 98,6% respectively. Chemotherapy never resulted in death. The 10-year actuarial metachronous second primary tumors estimate was 32%. The overall laryngeal preservation rate was 98,6%. CONCLUSION: Altogether our data and the review of the literature suggest that in patients achieving a complete clinical response after and induction based chemotherapy regimen, the completion of an exclusive chemotherapy regimen appears to be a valid alternative to the conventional use of radiotherapy or chemo-radiation protocols.

Adult↗
PubMed2004

[Mitomycin C: prevention and treatment of anterior glottic synechia].

OBJECTIVES: Topical applications of mitomycin C to the anterior glottis may prevent anterior glottic synechia (prevention group) or restenosis (treatment group). METHODS: In the prevention group, six patients with glottic carcinoma involving the anterior commissure were treated by transoral laser surgery. Repeated procedures were performed in one patient. For the six patients in the treatment group, the anterior glottic synechia was secondary to frontolateral laryngectomy (three patients), transoral laser therapy for laryngeal papillomatosis (two patients) or bilateral glottic carcinoma (one patient). Mitomycin C (0.4 mg/ml) was used as a topical application on the anterior commissure for a duration of 4 minutes. Outcome was assessed clinically at three months using a visual scale: no synechia (success), micro-synechia (partial failure), and synechia (failure). RESULTS: In the prevention group, there were six successes and one partial failure. In the treatment group, there were two successes, three partial failures, and one failure. No side effects were noted. CONCLUSION: Topical application of mitomycin C was effective to prevent anterior glottic synechia after transoral laser surgery for glottic carcinoma involving the anterior commissure. It is an alternative to endolaryngeal keel in patients with sequellar synechia. These preliminary results should be further evaluated in a larger series.

Adult↗
PubMed2004

[Quality of life before and after thyroplasty for vocal fold paralysis].

OBJECTIVES: The aim of our prospective study was to evaluate the vocal handicap in relation with the quality of life in patients with unilateral vocal fold paralysis (UVFP), before and after thyroplasty with Montgomery implant (type I). METHODS: Ten patients had to file the VHI questioner before and three months after thyroplasty. The 30 items of the Voice Handicap Index scale are sub-divided in 3 categories referring to "Functional", "Physical" and "Emotional" dimensions. RESULTS: Before thyroplasty, the global score and the 3 sub-scales rating are high reflecting severe impairment in speech communication (VHI total = 65,9/120, F = 25.7/40, E = 19.9/40, P = 20.8/40). Three months after thyroplasty, a significant improvement is found predominantly in the field of functional and emotional evaluation, corresponding to an improved quality of social life (VHI total = 20,9/120, F = 6.3/40, E = 3.6/40, P = 10.6/40). CONCLUSION: These results show the interest in using the autoevaluation VHI scale as a complementary evaluation associated to perceptual, acoustic and aerodynamic evaluation to objectify the functional improvement in voice quality after thyroplasty.

Aged↗