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Biomedical subjects

P Bonfils

Publications and source records attributed to P Bonfils.

At least 19 recordsLinked to original sources
PubMed2006

[Choanal stenosis: a rare complication of radiotherapy for nasopharyngeal carcinoma].

Choanal stenosis is usually a congenital anomaly in children. Acquired choanal stenosis after radiotherapy for nasopharyngeal carcinoma is a very rare pathology; only two publications report seven cases in the literature. We describe the clinical history, preoperative evaluation, surgical treatment and outcome of a case of acquired choanal stenosis after radiotherapy. The patient, a 56-year-old woman, presented with a history of nasopharyngeal carcinoma (T2- NO-MO) one year before that had been successful treated with radiotherapy (68 Gy). At the end of radiotherapy, she complained of complete nasal obstruction, anosmia and hearing loss due to a bilateral serous otitis media. Bilateral complete choanal stenosis was confirmed by endoscopy and CT scan. Functional endoscopic surgery was performed, and nasal stents were left in place for 3 weeks. One year after, the patient have good airflow, and a patent nasopharynx without choanal stenosis. In conclusion, choanal stenosis is an unusual complication of radiotherapy that can be successfully treated with transnasal endoscopic resection.

Carcinoma↗
PubMed2006

Chemotherapy alone in laryngeal squamous cell carcinoma.

AIMS: To evaluate the results of chemotherapy alone in patients with invasive squamous cell carcinoma of the larynx who have achieved a complete clinical response after an induction chemotherapy protocol. METHODS: A comparison of results in a group of complete responders managed with a chemotherapy alone protocol, matched with those of an incomplete responder group managed with conventional modalities. RESULTS: The survival rate of the complete responder group was significantly higher than that of the incomplete responder group. No statistically significant difference was noted between the two groups in terms of local failure and nodal recurrence. CONCLUSION: Our results confirm the fact that chemotherapy alone is a viable option in selected patients with carcinoma of the larynx who have achieved a complete clinical response after an induction chemotherapy protocol. This therapeutic approach allows surgery and/or radiation therapy to be reserved for the management of metachronous second primary tumours.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2006

Repetitive transcranial magnetic stimulation (rTMS): a new therapeutic approach in subjective tinnitus?

Subjective (non-recordable) tinnitus is the conscious perception of a phantom sound, and a very frequent, sometimes disabling, condition. Even if subjective tinnitus is often related to peripheral hearing loss, neurophysiological and functional imaging studies provide increasing evidence for an involvement both auditory and non-auditory central nervous pathways in the generation of tinnitus and related distress. Repetitive transcranial magnetic stimulation (rTMS) has been proposed to relieve tinnitus by reducing auditory cortex hyperexcitability associated with this condition. This paper will review the first clinical results reported in auditory cortex rTMS studies, with special reference to the pathophysiology of tinnitus processing and the mechanisms of action of rTMS. Although rTMS appears to be a very promising tool for the diagnosis and the treatment of tinnitus patients, available knowledge is still very limited at the moment. Further basic research and clinical studies are needed in order to optimize the parameters of stimulation (stimulus frequency, cortical target definition) and to validate the application of this technique in the management of patients with disabling tinnitus.

Chronic Disease↗
PubMed2006

[The cochlea in Fabry disease: a sensorineural hearing loss model of vascular origin?].

PURPOSE: Fabry disease is an inborn error of metabolism due to a deficient activity of the lysosomal enzyme alpha-galactosidase A. The enzyme defect leads to the systemic accumulation of neutral glycosphingolipids in tissues, mainly in the vascular endothelium. STRONG POINT: The aim of this paper is to present a review of the auditory manifestations in Fabry disease, and to discuss hypothesis on the vascular origin of deafness. PERSPECTIVES: Sensorineural hearing loss in Fabry disease could be the first documented vascular pathology of the inner ear.

Cochlea↗
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

[Granular cell tumours (Abrikossoff's tumour) of the parotid region].

BACKGROUND: Granular cell tumour (Abrikossoff's tumour) was first described by Abrikossoff in 1926. These tumours are rare and usually presents as a solitary lesion, located mainly in the subcutaneous tissue of the head and neck, and in the oral cavity (tongue). CASE REPORT: We report a rare case of a granular cell tumor of the parotid gland, in a 55-year old woman, who was referred with a left preauricular mass that had rapidly increased in size over 2 months. There was no cervical lymph adenopathy. RMI demonstrated a solitary lesion of the parotid gland. Surgical resection was performed. CONCLUSION: We discuss the classification, pathophysiology and the treatment of granular cell tumours through a review of the literature.

Female↗
PubMed2005

[Cognitive-behavioral therapy in the burning mouth syndrome--a new approach].

OBJECTIVE: The aim of this study is to present a new approach of burning mouth syndrome treatment by cognitive and behavioral therapy. METHODS: Cognitive and behavioral therapy in a patient with severe and resistant burning mouth syndrome. RESULTS: Disappearing of the oral pain of the burning mouth syndrome. CONCLUSION: After a review of the literature, we propose the treatment of burning mouth syndrome by cognitive and behavioral therapy.

Aged↗
PubMed2005

[Non-traumatic cerebrospinal fluid rhinorrhea of sphenoid origin].

The posterior wall of the sphenoid sinus is rarely implicated as a site of spontaneous cerebrospinal fluid fistula. Presented here is a case of CSF rhinorrhea of this nature, including the diagnosis workup and endoscopic approach permitting closure of the fistula.

Aged, 80 and over↗
PubMed2004

[Surgical treatment of paraosmia secondary to an upper respiratory infection].

Many people experience some degree of olfactory dysfunction during the acute stages of an upper respiratory infection (URI). The olfactory function usually returns to the preinfection level in few days. In some cases, the dysosmia remains even after the reopening of the air passageways. The olfactory loss after URI associates an hyposmia and odor distortions. We report a rare case of odor distortions after URI treated by surgery.

Adult↗
PubMed2004

[Olfactory disorders].

Smell and taste problems are of major importance to those who suffer from olfactory disorders. The inability to determine the presence of odors in the home and the markedly reduced capacity or incapacity to appreciate food flavors are key reasons given for limited social interaction. Patients experiencing distorted smells and tastes may avoid food, which results in weight loss and possible malnutrition. We present an overview of smell disorders, based on physiological considerations, with specific attention to clinical characteristics of conditions most commonly causing smell disorders.

Adult↗
PubMed2004

[Cyst of the parapharyngeal space arising from the branchial arches].

OBJECTIVES: We describe a rare case of parapharyngeal space cyst arising from the branchial arches. CASE REPORT: We report the clinical and radiological (CT and MRI) findings. Surgical resection was performed via a transcervical approach. CONCLUSION: Branchial cysts arising from the second pouch are the most common benign neck tumors. A parapharyngeal location (type IV in Proctor's classification) is very rare, and only 24 cases have been reported. Based on our observations in this case and a review of the literature, we discuss the differential diagnoses and treatment options.

Adult↗
PubMed2004

[Contribution of cognitive and behavioral therapy for patients with tinnitus: implication in anxiety and depression].

OBJECTIVES: Tinnitus is a common otologic symptom but, despite important advances in the evaluation and management of such symptom, ENTs often fail to address tinnitus properly. Some tinnitus patients report that tinnitus interferes with activities of daily living, such as reading, social interactions, sleep, concentrating on complex tasks. Anxiety and depression are current major disorders associated with tinnitus. Many theories exist regarding mechanisms of tinnitus origin. A number of publications favors the theory of discordant dysfunction of inner or outer hair cells of the organ of Corti. Nevertheless, some authors insist on the possible role of the central auditory pathways. Multiple functional connections between auditory system, limbic system, autonomic nervous system seem crucial in the development of tinnitus. The aim of this paper is to present a new approach in France of tinnitus treatment by cognitive-behavioral therapy (CBT). MATERIAL AND METHODS: 96 patients with chronic and intense tinnitus were included in the study (38 females, 36 males, mean age 48 years). A CBT was developed after a clinical evaluation based on standardized questionnaires. RESULTS: The two main results are: (i) the importance of anxiety and depression in this population, (ii) the amelioration of tinnitus perception in 750f the included patients. CONCLUSION: CBT shows promise as a treatment of tinnitus-related distress.

Anxiety↗
PubMed2004

[Adenomatoid hamartoma of the ethmoid sinus: one case report].

INTRODUCTION: Hamartomas are non-malignant malformations or inborn errors of tissue development. In the head and neck region, especially in the nasal cavity and the ethmoid sinuses, they are relatively rare. PATIENTS AND METHODS: A case of respiratory epithelial adenomatoid hamartoma of the ethmoid sinus and a review of literature are reported in order to describe the diagnostic and therapeutic management of this tumour. RESULTS: A 74-year-old man complaining for unilateral nasal obstruction for years was referred to our institution. Clinical and radiological studies revealed a large intra-nasal tumour, osteolytic in nature, arising from the right ethmoidal sinus. Fifteen months after a complete excision of the tumour using an endoscopic procedure, the nasal cavity was free of tumour. DISCUSSION AND CONCLUSION: Very rare and classified as non-malignant tumours, hamartomas are composed of excessive proliferation of one or more cellular components specific to a given tissue. They can grow out of any part of the body for example the surface epithelium, seromucous glands and vessels. Hamartomas commonly originate from the lung, kidney and intestine. Their localisation in the nasal cavity, especially in the ethmoid sinus, is unusual, but it is really important to be known to distinguish hamartomas from papillomas and adenocarcinomas not to perform useless and destructive surgery.

Adenomatoid Tumor↗