Biomedical subjects

P Bonfils

Publications and source records attributed to P Bonfils.

At least 19 recordsLinked to original sources

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

[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↗

PubMed2004

[Osteoid osteomas in the frontal sinus].

Explore the source record for details and available documents.

Bone Neoplasms↗

PubMed2003

[Adrenal insufficiency after treatment of nasal polyposis].

OBJECTIVE: Assessment of hypothalamic-pituitary-adrenal (HPA) axis after long term and uncontrolled corticosteroid treatment in nasal polyposis. PATIENTS AND METHODS: A short synacthen test was performed in ten patients who received uncontrolled doses of corticosteroids in a population of 128 patients treated for nasal polyposis. RESULTS: Mean yearly dose of oral prednisone administered in short-term treatment varied between 1280 and 7300 mg. Mean daily dose of inhaled beclomethasone varied between zéro and 2000 microg. Morning plasmatic cortisol was abnormal in seven the patients before and after the stimulation (respectively 140 nmole/l and 359 nmole/l). DISCUSSION: High and uncontrolled doses of corticosteroids in nasal polyposis affect HPA axis.

Adrenal Insufficiency↗

PubMed2002

[Normative data of the Biolfa(R) olfactory test].

OBJECTIVES: To evaluate the feasibility of the Biolfa(R) olfaction test and establish normative values. PATIENTS AND METHODS: The new Biolfa(R) olfaction test includes a quantitative test to measure the olfactory threshold of three substances in a concentration range from 1 to 9 and a semi-quantitative test to assess olfactory "acuteness" for eight substances. Substances used for this test entail non-significant trigeminal stimulation. A population of 28 women and 24 men without olfactory dysfunction were tested. RESULTS: The olfactory threshold obtained with the quantitative test ranged from 5.86 to 9.54 for women, and from 6.4 to 9.6 for men. Analysis of the thresholds identified with the semi-quantitative test enabled establishing normative values for recognition of the eight substances. These values were reported on a diagram to allow partial translation of each subject's olfactory "acuteness". Olfactory threshold and smell identification ability were statistically superior for women. CONCLUSION: The Biolfa(R) olfaction test is the first allowing determination of both the olfactory threshold and quantification of smell identification ability. Normative values were obtained in this study to detect disease states.

Feasibility Studies↗

PubMed2001

Efficacy and tolerability of budesonide aqueous nasal spray treatment in patients with nasal polyps.

OBJECTIVE: To assess the efficacy and tolerability of once-daily treatment with budesonide aqueous nasal spray in patients with nasal polyps. DESIGN: Randomized, double-blind, placebo-controlled, parallel-group study. SETTING: Sixteen hospital clinics. PATIENTS: One hundred eighty-three patients with moderate-sized nasal polyps causing clinically significant symptoms during a 1-week run-in period. INTERVENTIONS: Patients were randomized to receive 1 of the following 4 budesonide aqueous nasal spray treatments: 128 microg once daily in the morning and placebo in the evening, 128 microg twice daily, 256 microg once daily in the morning and placebo in the evening, or placebo for 8 weeks. Nasal polyp size was scored and peak nasal inspiratory flow was measured at clinic visits at the beginning and end of the run-in period and after 4 and 8 weeks' treatment. Patients recorded daily peak nasal inspiratory flow, symptom scores (ie, blocked nose, runny nose, and sneezing) and sense of smell on diary cards. MAIN OUTCOME MEASURES: Mean change in nasal polyp size at the end of treatment; mean changes in combined and individual symptom scores. RESULTS: All doses of budesonide aqueous nasal spray significantly (P<.01) reduced polyp size; no significant differences were noted between the 4 treatment groups. The mean improvement in clinic peak nasal inspiratory flow at 8 weeks was 65.9 L/min with budesonide aqueous nasal spray, 128 microg twice daily; 71.6 L/min with budesonide aqueous nasal spray, 256 microg once daily; and 54.6 L/min with budesonide aqueous nasal spray, 128 microg once daily (all P<.001 vs placebo). Combined and individual symptom scores and sense of smell improved significantly in all budesonide-treated groups; the effect on symptoms became apparent within 1 to 2 days of the first dose. Budesonide aqueous nasal spray was well tolerated. CONCLUSIONS: Doses of budesonide aqueous nasal spray, 128 microg once daily, were found to be effective in the treatment of nasal polyps, and doses of budesonide aqueous nasal spray, 256 microg once daily, did not show any significant additional efficacy.

Administration, Intranasal↗

PubMed2001

[Esophagectomy for squamous cell carcinoma of the esophagus isolated or associated with head and neck cancer: long-term survival].

STUDY AIM: Esophageal squamous cell carcinomas are frequently associated with head and neck cancers. This retrospective study was conducted to compare the long-term outcome of the patients with a double cancer and of the patients with a solitary esophageal cancer after curative management. PATIENTS AND METHODS: From 1989 to 1999, 114 patients with an esophageal carcinoma were included in the study. Among them, 52 had an associated head and neck cancer (metachronous: n = 17 and synchronous: n = 35). Curative treatment was achieved in all patients. The patients were divided in "solitary" and "associated" group. RESULTS: Age, sex distribution, tumor location and histological findings were similar in the two groups. The esophageal resection was an esopharyngolaryngectomy (n = 13), a subtotal esophagectomy with cervical anastomosis (n = 92) and a Lewis-Santy esophagectomy with thoracic anastomosis (n = 9). Operative mortality (8 versus 7.7%), anastomotic leaks rate (14.5 versus 21%) and pneumonia rate (21 versus 9.6%) were not significantly different in the two groups. The mean hospital stay was 27 days. The mean follow-up was 85 +/- 50 months. Five-year survival rates were not significantly different in the two groups (p = 0.6411). In univariate survival analysis the only significant predictive factors were the depth of esophageal tumor invasion (p = 0.0002) and node involvement (p = 0.0373). The presence of head and neck cancer did not affect survival after esophagectomy. CONCLUSION: With an aggressive therapeutic plan, the survival of patients with an esophageal cancer associated to head and neck cancer was similar to the survival of patients with an isolated esophageal carcinoma. Long term esophageal survey seems to be useful to detect more superficial esophageal carcinomas in patients with head and neck cancer.

Aged↗

PubMed2001

Functional anatomy of auditory brainstem nuclei: application to the anatomical basis of brainstem auditory evoked potentials.

Brainstem auditory evoked potentials (BAEP) are used routinely in clinical practice to evaluate the normality of the lower auditory system. The objective of this review is to describe the functional anatomy of the structures implicated in BAEP generation (cochlear nerve and the auditory brainstem nuclei). Indications and results of BAEP in clinical practice are presented and correlated with auditory structures, which generate each waveform of BAEP.

Auditory Pathways↗

PubMed2001

Lymphocele of the thoracic duct presenting as a left supraclavicular mass: a case report and review of the literature.

Surgical injuries and blunt trauma are the main causes of thoracic duct lesions. Cervical chylous fistula and chylothorax occur frequently after lesions of the cervical portion of the thoracic duct. On the other hand, thoracic duct cyst is a very rare entity, especially in its cervical portion. The authors reported a case of thoracic duct cyst, presenting as an asymptomatic left cervical mass. Diagnosis was suggested by computerized axial tomography and confirmed by histological analysis, after surgical removal of the cyst. After review of the literature, the authors recommended surgical treatment of cervical thoracic duct cysts in order to prevent potential complications as traumatic or spontaneous rupture.

Clavicle↗

PubMed2001

Origin of cubic difference tones generated by high-intensity stimuli: effect of ischemia and auditory fatigue on the gerbil cochlea.

Cubic difference tone (CDT) otoacoustic emissions are thought to arise from the feedback loop allowing outer hair cells to enhance the sensitivity and tuning of the organ of Corti. The existence of residual CDTs during complete cochlear ischemia is therefore disturbing. That stimulus intensities must exceed 50-60 dB SPL for residual CDTs to be recorded and for level notches to be present in CDT growth functions is often cited as evidence for a two-component, "active/passive" model: one component, the residual one, would originate from a passive, hardly vulnerable mechanism and thus be unsuitable for hearing screening purposes. This model was probed in gerbil ears after complete interruption of the cochlear blood flow. Cochlear potentials and CDTs were controlled simultaneously through continuous monitoring of CDT level and phase for 50 and 60 dB SPL stimuli and group-delay measurements. After a clear initial decay, CDT levels elicited at 60 dB SPL plateaued for several minutes at about 20 dB below initial level, and when early level notches were observed, CDT phase changes remained minor. The CDT group delays decreased by less than 30%. Later CDT level notches were associated with sharp phase reversals but the similarity between CDT characteristics before and after a notch was hardly consistent with a two-component interpretation. When mild sound overexposure (pure tone, 90-95 dB SPL, 15-30 min) had been performed prior to ischemia, little or no ischemic CDT came from the frequency bands where auditory fatigue had been detected (within 1 kHz), irrespective of the stimulus intensity. It suggests that instead of being passive, residual ischemic CDTs were vulnerable and produced according to a near-normal tonotopy by the same mechanisms that were sensitive to auditory fatigue. All the results lined up with a simple feedback model of cochlear function assuming a single CDT source related to mechano-electrical transduction in outer hair cells. More parsimonious than a two-component model, it posits that although early stages of ischemia dramatically impair the overall performance of the cochlea, the nonlinear mechanical stages responsible for the existence of CDTs keep working albeit at higher intensities.

Acoustic Stimulation↗

PubMed2001

Catheter-related upper extremity deep venous thrombosis in cancer patients: a prospective study based on Doppler US.

PURPOSE: This prospective study extending for more than 3 years had two objectives: (a) to use Doppler ultrasonography (US) to estimate the incidence of asymptomatic catheter-related upper extremity deep venous thrombosis (DVT) in a large population and (b) to study the effect of the catheter position as an individual risk factor for catheter-related DVT. MATERIALS AND METHODS: Between October 1995 and June 1998, a total of 145 patients who had oropharyngeal tract cancer and who were fitted with the same totally implantable central venous catheters (CVCs) were included in the study. Follow-up included (a) estimation of the position of each catheter tip on a chest radiograph obtained immediately after surgery and (b) regular monthly Doppler US screening for catheter-related DVT. RESULTS: Seventeen patients developed catheter-related DVT; 13 of them were asymptomatic. The mean interval between CVC implantation and detection of thrombosis was 42.2 days. Correct positioning of the distal catheter tip was associated with a significantly lower rate of catheter-related DVT. Only five of 87 patients with a correctly positioned distal catheter tip (ie, either in the superior vena cava or at the junction between the right atrium and the superior vena cava) developed thrombosis, compared with 12 of 26 patients with a misplaced catheter (P <.001). The side on which the CVC was implanted did not influence the catheter-related DVT rate. CONCLUSION: The rate of asymptomatic catheter-related DVT is high and could be lowered with correct initial CVC positioning.

Adult↗

PubMed2001

[Smell dysfunction in nasal and paranasal sinus disease: a review of the literature (I)].

Substantial advances have been achieved during the last decade in our understanding of the biological bases of the sense of smell, as well as in the clinical identification, diagnosis, and management of dysosmia. Nasal obstruction can result from inflammatory, neoplastic, traumatic, and developmental alterations within the nasal cavity. All these processes, if they result in bilateral restriction of airflow to the olfactory neuroepithelium, presumably alter the ability to smell. Rhinitis, nasal polyposis, and rhinosinusitis are accompanied by decreased ability to smell. Benign and malignant neoplasms can obstruct the nasal chamber and thereby alter airflow to the olfactory receptors without damaging the olfactory neuroepithelium. The purpose of this synthesis is to provide an advanced review of the literature in order to describe the basis of smell alterations in nasal polyposis and chronic rhinosinusitis.

Anti-Inflammatory Agents↗

PubMed2001

[Smell dysfunction in nasal and paranasal sinus disease: a review of the literature (II)].

Chronic Disease↗

PubMed2000

[Chemicals toxic to the olfactory system. Analysis and description].

AN IMPORTANT PROBLEM: Occupational exposure to chemical products can have toxic effects on the olfactory system. An important number of patients have experienced olfactory disorders subsequent to the development of the chemical industry and atmospheric pollution. EPIDEMIOLOGY DATA: Straightforward data are difficult to collect because several cofactors other than the toxic product are involved. Two lists of toxic products can be made. The first list includes products for which scientific data is available and the second products for which data is lacking. Olfactory tests also differ between authors and countries. TWO TYPES OF TOXICITY: Acute, accidental toxicity is evidenced by the lesions caused by inhalation of high-doses of strongly toxic agents. Chronic intoxication caused by lower concentrations of these inhaled agents does not produce a trigeminal reflex leading to a modified respiratory rate reducing the airborne aggression. APPROXIMATIONS: Clinical data describing the olfactory toxicity of certain industrial and chemical compounds are very significant but often cannot prove a cause and effect relationship. Data obtained with experimental models in rodents are difficult to extrapolate to humans.

Air Pollutants, Occupational↗

PubMed2000

[Evaluation of the hypothalamo-hypopituitary axis after long-term inhalation corticotherapy for nasal polyposis].

OBJECTIVE: To assess the hypothalamic-pituitary-adrenal (HPA) axis after long-term intranasal corticosteroid treatment in nasal polyposis. PATIENTS AND METHODS: A short synacthen test was performed in 24 patients who received the highest dose of inhaled beclomethasone among a population of 392 patients treated for nasal polyposis with inhaled corticosteroid therapy and short-term oral corticosteroids. RESULTS: Mean yearly dose of oral prednisone administered in short-term treatment was 371 mg/year. The amount of short-term oral prednisone decreased during the treatment. Mean daily dose of inhaled beclomethasone was 2861 micrograms/day, decreasing during treatment. Morning plasma cortisol was normal in all patients before and after stimulation (163 +/- 44 and 1 +/- 60 micrograms/ml respectively). Nolomethasone dose and plasma cortisol level before or after stimulation. DISCUSSION: The high dose of inhaled beclomethasone used to treat nasal polyposis does not affect the HPA axis. Some authors in the literature contest the validity of short synacthen test to detect HPA axis suppression. This test does however detect severe impairments of the HPA axis in outpatients.

Administration, Inhalation↗

PubMed2000

[Olfactory disorders due to medications: analysis and review of the literature].

INTRODUCTION: Olfactory disorders caused by medicinal drug intake are an uncommon occurrence. However, such an etiology should be systematically taken into account and investigated, as olfactory loss may be reversible once the particular treatment has been stopped. CURRENT KNOWLEDGE AND KEY POINTS: An analysis of the literature shows that of the large number of drugs that are apparently responsible for olfactory disorders, this adverse side effect has in fact only been observed in animal study populations, and no clinical case report has been made on the subject. The real toxicity to man is therefore only hypothetical. Of the 150,000 cases recorded in the pharmacovigilance centers in France, only 68 have reported olfactory complications (0.05% of cases), and only 22% of the medical files on this disorder reach a satisfactory level of plausibility. Cardiovascular drugs are mainly implicated in the development of olfactory disorders. Of these, certain drugs in particular should be mentioned: conversion enzyme (ACE) inhibitors which are responsible for taste disorders, some betablockers, and a calcium antagonist (a dihydropyridine derivative). Olfactory disorders have also been reported following administration of drugs used in anesthesia, in cancerology, endocrinology (carbimazole), in immunology (interferon), in the treatment of infectious diseases (ciprofloxacine, dioxycycline, terbinafine), and in rheumatology (D-penicillamine). FUTURE PROSPECTS AND PROJECTS: It is frequently difficult to establish a direct relationship between drug exposure and an olfactory disorder, and it is often not easy to determine with any certainty the causative role of the drug in the development of this disorder.

Animals↗