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O Malard

Publications and source records attributed to O Malard.

16 recordsLinked to original sources
PubMed2007

Engineering cartilage with human nasal chondrocytes and a silanized hydroxypropyl methylcellulose hydrogel.

Tissue engineering strategies, based on developing three-dimensional scaffolds capable of transferring autologous chondrogenic cells, holds promise for the restoration of damaged cartilage. In this study, the authors aimed at determining whether a recently developed silanized hydroxypropyl methylcellulose (Si-HPMC) hydrogel can be a suitable scaffold for human nasal chondrocytes (HNC)-based cartilage engineering. Methyltetrazolium salt assay and cell counting experiments first revealed that Si-HPMC enabled the proliferation of HNC. Cell tracker green staining further demonstrated that HNC were able to form nodular structures in this three-dimensional scaffold. HNC phenotype was then assessed by RT-PCR analysis of type II collagen and aggrecan expression as well as alcian blue staining of extracellular matrix. Our data indicated that Si-HPMC allowed the maintenance and the recovery of a chondrocytic phenotype. The ability of constructs HNC/Si-HPMC to form a cartilaginous tissue in vivo was finally investigated after 3 weeks of implantation in subcutaneous pockets of nude mice. Histological examination of the engineered constructs revealed the formation of a cartilage-like tissue with an extracellular matrix containing glycosaminoglycans and type II collagen. The whole of these results demonstrate that Si-HPMC hydrogel associated to HNC is a convenient approach for cartilage tissue engineering.

Aggrecans↗
PubMed2006

Reconstruction of circumferential pharyngolaryngectomy using a 'horseshoe-shaped' pectoralis major myocutaneous flap.

Eighteen patients underwent a circumferential pharyngolaryngectomy reconstruction post pharyngolaryngectomy. All tumours showed pharyngo-oesophageal junction invasion or circular involvement of the hypopharynx, requiring total, circumferential pharyngolaryngectomy. A pectoralis major myocutaneous flap was directly sutured to the pre-vertebral fascia. A Montgomery salivary bypass tube was introduced into the oesophagus, and a nasogastric tube was placed within it. No post-operative complications occurred for 14 patients and only minor ones for the other four. Average post-operative stay was 12 days. For 15 patients, feeding returned to normal throughout the follow-up period. No fistulae were noted and neopharyngeal stenosis occurred in three patients (16 per cent). Thirteen had complete resection with normal margins. Thirteen were still alive after one to three years of follow up. The local recurrence rate was 16 per cent. The use of a pectoralis major myocutaneous flap with Spriano's technique provides a simple, reliable method for circumferential hypopharyngeal resection. It has been applied to a wide range of patients, especially elderly ones and those with poor general status, as well as to cases in which widespread involvement was detected during surgery.

Aged↗
PubMed2006

Small cell neuroendocrine carcinoma of the nasal cavity and paranasal sinuses.

INTRODUCTION: Small cell neuroendocrine carcinoma (SNEC) of the sinonasal tract is a rare disease. OBJECTIVE: Report a descriptive study of a relatively large cohort of SNEC of the nasal cavity and paranasal sinuses. METHOD: The medical records of 21 patients presenting with nasal and paranasal SNEC to various French hospitals, from 1989 to 2003, were analysed to determine the clinical features and current treatment of the disease. RESULTS: Patient data were obtained from eight French hospitals. Twelve of the patients were male and nine were female, with a mean age at presentation of 55 years (range: 27 to 79 years). Patients' staging for nasal cavity malignancy was: T1, four; T2, three; T3, one; T4, 13; N0, 18; N2, three; M0, 20; and M1, one. None of the patients suffered from SNEC of the sinonasal tract with ectopic hormone production. Immunohistochemistry proved useful for diagnosis in 20 cases. Twelve cases were positive for cytokeratin, 14 for chromogranin, eight for neuron-specific enolase and 11 for neuron-specific synaptophysin. One patient had an adenocarcinoma and an inverted papilloma associated with neuroendocrine carcinoma. Patients underwent surgery (11 cases), radiotherapy (14 cases) and chemotherapy (12 cases). Recurrence occurred in 10 cases. Five patients had visceral metastases or cervical lymph node involvement. Nine of the patients died within four years of onset of the disease. CONCLUSION: Small cell neuroendocrine carcinoma of the sinonasal tract is an uncommon neoplasm with aggressive clinical behaviour. Recurrence is frequent and the prognosis is poor. However, the current treatment of these neuroendocrine neoplasms varies widely.

Adult↗
PubMed2006

[Maxillary sinus cancers: Prognosis and quality of life: a retrospective study of 22 cases].

OBJECTIVES: Maxillary sinus cancer is uncommon. We present a study of 22 cases of patients managed at the Nantes University Hospital for maxillary sinus cancer during the time period 1989-2002. MATERIALS AND METHODS: Clinical and oncological characteristics of the tumors were evaluated. Treatment and results were evaluated in association with the patients' quality of life, estimated with a questionnaire survey sent to surviving patients. RESULTS: Carcinomas predominated (68%). The TNM classification was: T2: 45.5%, T3: 45.5% and T4: 9%. 89% of necks were N0 and 9% were N1. Treatment course (determined after imaging) was surgical removal of the tumor by total maxillectomy: 77.5%; partial maxillectomy: 22.5%, associated with post-operative radiotherapy. Esthetic consequences and disabilities of patients assessed by the questionnaire pointed out that 68% of them were complaining of poor quality of life. Global survival at 12 months was 63%, 20% at 24 months and 9% at 5 years. There were no statistically significant differences between specific survivals according to T-stage nor according to histological features. The difference was significant when surgical removal of the tumour was large according to post-operative histology. CONCLUSION: Authors conclude that maxillary sinus cancers exhibit poor prognosis, and focus on the necessity of quality of life assessment.

Aged↗
PubMed2005

Hyrtl's fissure: a case of spontaneous cerebrospinal fluid otorrhea.

Spontaneous CSF otorrhea is a relatively rare entity. Adequate diagnosis and treatment are needed to avoid life-threatening complications such as meningitis. Because diagnosis is based on CT findings, identification of the different pathways of congenital fistulas requires detailed knowledge of embryology and anatomy. The facial canal, petromastoid canal, and tympanomeningeal (Hyrtl's) fissure can be responsible for CSF fluid otorrhea in the absence of any abnormality of the adjacent membranous labyrinth. We report the first documented and imaging case of Hyrtl's fissure and its treatment.

Cerebrospinal Fluid Otorrhea↗
PubMed2004

[Ethmoid adenocarcinoma: trans-facial approach for anterior skull base resection. a series of 80 cases].

OBJECTIVE: To present results of a retrospective analysis of eighty cases of ethmoid adenocarcinoma. Carcinologic and surgical results of anterior skull base resection via the transfacial approach are presented. METHODS: Tumors were classified as 5% T1, 23% T2, 31% T3, 21% T4a and 20% T4b. Thirty-four patients were treated via a paralateronasal approach without skull base resection. Anterior skull bas resections were performed via the transfacial approach for 26 patients and by combined neurosurgical approach for 21. RESULTS: Mean follow-up was 4.8 years. Survival rate was 63.4% at 5 years and 57.9% at 8 years. Forty-two patients were alive and disease-free at last follow-up. Three patients were alive with recurrence. The rate of local recurrence was 38.8%. Complications occurred in 20% of the patients who had a transfacial approach. Complications appeared to be less frequent than with the combined approach. CONCLUSION: Prognosis is related to local control and could be improved by using skull base resection more systematically. In our experience this can be managed by a transfacial approach with similar carcinological results and less complications than the combined approach.

Adenocarcinoma↗
PubMed2002

Radiation-induced cancers of the pharynx and larynx: a study of five clinical cases.

Radiation-induced cancer, a rare clinical entity, is often difficult to diagnose and manage. This study reports a series of five cases of radiocarcinogenesis of the pharynx and/or larynx that developed after external radiotherapy. The primary lesion was diagnosed at a mean age of 50 years (+/-12.9) and the radiation-induced cancer at a mean age of 59 years (+/-13.1), giving a latent period of 9 years (+/-3.7). Analysis of gammagraphic records indicated that four of the patients had developed a secondary tumour in the penumbra of irradiation fields. In these zones, the delivered dose was between 20 and 80% of the prescribed dose, corresponding to an estimated cumulative mean dose of 14.1-56.3 Gy. These results are compared with data in the literature to determine the diagnostic criteria for radiation-induced cancer, possible predisposition (genetic or acquired) and the dose effect.

Adult↗
PubMed2002

[Relapsing polychondritis revealed by ENT symptoms: clinical characteristics in three patients].

Relapsing polychondritis (RP) is a recurrent, chronic and rare disease of unknown etiology, considered as a systemic vasculitis. RP is characterized by inflammation of cartilaginous structures of the ears, nose, respiratory tract and joints. RP is likely initiated by ENT symptoms. Etiology is unknown but the association with HLA-DR4 and the occurrence of antibodies to type-II collagen suggest that an immunologic mechanism is involved in its pathogenesis. Diagnosis is difficult requiring identification of elastic cartilaginous injuries. Delay before diagnosis is usually important after the first attack. Neither serum investigation nor histological confirmation are necessary to establish the RP diagnosis, and ENT symptoms are generally sufficient to achieve the diagnosis. Prognosis is linked to laryngeal, tracheal and cardiovascular involvements. An association with myelodysplasia is acknowledged. Based on these three cases and data in the literature, we review classical diagnostic criteria (McAdam), prognosis and therapeutic outcome.

Adrenal Cortex Hormones↗
PubMed2001

[Autografts versus biomaterials for ossiculoplasty with normal stapes; a comparative analysis of functional outcome in 100 cases].

Ossicular graft is usually considered as the reference for surgical substitution in ossiculoplasties. Nevertheless, according to the infectious risks, nothing but autografts or synthetic prosthetic substitutes should be used nowadays. Authors compare hearing results for 100 patients after ossiculoplasty with either ossicular autograft or calcium-phospathe chain reconstruction. Audiometric results were retreived using both Glasgow Benefit Plot study and post-operative air-bone gap thresholds closure. Significant hearing improvement was statistically demonstrated in both conditions, and 60% of the patients had a post-operative hearing gain. Autograft ossicular reconstructions did not show to provide higher results. Biocompatibility and functionnal properties of calcium-phosphate materials retreived in this study, indicate that those ceramic substitutes should be considered as the best alternative to autografts.

Adolescent↗
PubMed2001

[Otomycosis].

Explore the source record for details and available documents.

Adult↗
PubMed1999

Influence of biphasic calcium phosphate granulometry on bone ingrowth, ceramic resorption, and inflammatory reactions: preliminary in vitro and in vivo study.

Calcium-phosphate ceramics used in surgery, as bone-bonding materials, are currently available in different forms (blocks, granules, etc.). However, progress in noninvasive surgery has favored the development of injectable composite materials associating a polymeric and a dusty mineral phase. The purpose of this study was the in vivo evaluation of biphasic calcium phosphate of various grains sizes, to elucidate the role of granulometries in ceramic degradation/resorption, bone ingrowth, and inflammatory reactions. Three particle sizes were compared: 10-20, 80-100, and 200-400 microm. The 10-20-microm powders provided the best bone ingrowth, with a higher resorption/degradation rate in conjunction with stronger early inflammatory reactions. The 200-400-microm powders showed higher bone ingrowth than 80-100-microm ones, indicating that properties of cell recruitment for osseous apposition and mechanical support for bone bonding may both play a role in both ingrowth mechanisms. Our results suggest that the strong inflammatory reaction in 10-20-microm granulated powders was due to a faster reversal of the resorption/apposition sequence in bone. This may have resulted from massive release of bone ingrowth factors, which implies that the brief inflammatory process observed in the early stages of implantation was favorable to the osteoconduction process.

Bone Development↗
PubMed1999

[The role of areolar tissue on otologic surgery].

Areolar tissue is a loose conjunctive tissue, located between the fascia temporalis superficialis and the temporal aponeurosis. It can be used in several circumstances during otologic surgery. First, in stapes surgery, it can be used as an interposition between the piston and the platinotomy. Its thickness has no equivalent in comparison with other temporal tissues, explaining in part its usefulness in this indication. In perilymphatic fistula surgery, the areolar tissue is especially recommended for round window and oval window grafting because of its spontaneous adhesive capacity. It can be useful in myringoplasty, to reenforce an atrophic tympanic membrane or to close a small perforation. Also areolar tissue can be used as a flap or as a free graft to reconstruction of the external acoustic meatus. It's a good conjunctive support, which can be covered by skin graft. Finally areolar tissue is an interesting and useful material for otologic surgery. Its qualities are complementary to those of the temporal aponeurosis.

Connective Tissue↗
PubMed1997

[Radio-anatomical study of the external auditory canal. Comparison between anatomical pieces and x-ray computed tomography].

Ear canal CT scan is widely used in addition to clinical examination, for diagnosis and evaluation of disease extension. Ear mouldings were performed on 11 cadavers (22 mouldings), 5 measurements were taken on each specimen and compared with CT scan measurement. Moulding measurements varied from side to side in one specimen, and moreover from one specimen on another one. Comparison between mouldings and CT scan showed that medial meatus measurements are identical. On the other hand, there are wide gaps for the lateral measurements. Biometrical disparity of the external auditory canal (EAC) was confirmed by this study. CT scan measurements in the lateral portion of the EAC are not reliable. Quantitative usefulness of CT scan is therefore limited to the study of the bony meatus.

Adult↗
PubMed1993

[Macroscopic vascularization of the adult sternum. Implications of removal of the internal thoracic arteries].

The most of the arterial vascularisation of the adult sternum is on the dependence of the internal thoracic arteries. The best results of the aorto-coronary by-pass starting from this arteries are however subjected to more infectious complications. The study of this arterial supply, in "surgical" conditions, after sternotomy and ablation of one or two internal thoracic arteries show this devascularization. The residual arterial supply is only constituted by thin branches coming from intercostal arteries.

Adult↗
PubMedDate not supplied

Computed tomography in TN stage evaluation of oral cavity and oropharyngeal cancers.

Oral and oropharyngeal carcinomas are characterized by a high incidence of node metastatic involvement and local extension. The study compared the TN stage of patients by clinical and computed tomography (CT) examination to postoperative histopathology. Sensitivity of CT for tumor extension was 82%, predictive value for bone involvement 67%. Clinical examination was poor in predicting the presence (54%) or absence (56%) of node involvement. Sensitivity of CT for assessment of node involvement was 80%, specificity 71%, positive predictive value 67%, and negative 83%. Node involvement was high (30%) in clinically NO necks versus only 9% for negative CT.

Adult↗