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P Bonfils

Publications and source records attributed to P Bonfils.

158 records · Page 9Linked to original sources
PubMed1983

[Difficult intubation in Pierre-Robin children, a new method: the retromolar route].

The Pierre-Robin-children show a micro- and retrognathia of the lower jaw with the consequence of dorsal and cranial displacement of the basioglossal. It is well known that this can lead to serious difficulties in endotracheal intubation. As far as we know intubation via retromolar route has never been described at length. It has never been mentioned in the case of Pierre-Robin-children as an alternative to the unsuccessful classical method. This paper describes the problems intubation in these children and deals with the corresponding prophylactic measures of most importance before intubating. It describes in detail the technique of homolateral retromolar intubation - axis straight and distance shorter - and gives helpful guidelines that lead to a straight intubation axis in spite of anatomical abnormalities: pressure on the cricoid, pushing the larynx to the side, hyperextending, adjusting the degree of flexion, pushing or rotating the head to the other side or appropriate bending the end of the tube with a stylet.

Anesthesiology↗
PubMed1983

[Preventive measures before a difficult intubation].

Difficult intubations occur frequently. Unfortunately they cannot always be recognized before intubating. This paper describes the most important prophylactical measures which can prevent risks during intubation. These are: examination (morphology, mobilization of the joints, laryngoscopy), optimal positioning of the patient, aspiration prophylaxis, choice and preparation of equipment and drugs, the repeated question of necessity of intubation, the oxygen supply and the attempt to ventilate the patient before giving muscle relaxants. Particularly the last two measures are of great importance in the majority of cases.

Emergencies↗
PubMed1982

[Nasal contralateral intubation: a new technique with a fiberoptic instrument].

Thirty adult patients were intubated with the help of a flexible fiberoptic instrument (FOI). The endotracheal tube was passed through the right nostril as in blind nasal intubation. At the same time the FOI was passed through the left nostril. This allowed an exact exploration for possible obstruction and an atraumatic and safe endotracheal intubation. By this means, it was also possible to alter exactly the position of the tube visually. This procedure presents distinct didactic advantages and helps to prevent false positioning of the tube and subsequent injuries. Indications, in particular its potential use in paediatric anesthesia, as well as its disadvantages, are discussed in the conclusion of this paper.

Adult↗
PubMed1976

[Changes in serum concentrations of calcium and inorganic phosphates and alkaline phosphatase activity due to anti-ipileptic treatment].

1. In a retrospective study the serum concentrations of calcium and phosphate and the activity of serum alkaline phosphatase in 54 epileptic patients treated by a variety of antiepileptic drugs (group A) were compared with those in 54 non-epileptic control patients (group B). Group B was chosen by computer to assign to each epileptic one control patient of identical sex and age. Patients affected by kidney or liver diseases were excluded from the study. 2. The data showed significantly lower calcium and phosphate concentrations and a higher activity of alkaline phosphatase in group A. Serum phosphate, but not calcium, was inversely correlated to the activity of serum alkaline phosphatase. 3. A minority of the epileptic patients were treated either by diphenylhydantoin or phenobarbital. The serum calcium tended to be lower under the former drug. The combined intake of both drugs produced no further hypocalcemic effect.

Adolescent↗
PubMedDate not supplied

Evoked oto-acoustic emissions from adults and infants: clinical applications.

Evoked oto-acoustic emissions (EOAEs), i.e. sounds emitted by the cochlea in response to a click, are recordable in the ear canal by a miniature microphone. They reflect an active cochlear biomechanism based upon OHC function, which accounts for the exquisite properties of sensitivity and frequency selectivity of the cochlea. EOAE recordings can therefore be considered an objective, easy, rapid and non-invasive audiological procedure which can be used to investigate the most sensitive part of the cochlea. From our experience of more than 300 recordings, we propose several clinical applications of EOAEs: 1) objective assessment of sensorineural hearing loss; 2) staging Meniere's disease by recording glycerol-induced changes; 3) diagnosis of retrocochlear pathology, and 4) screening of auditory function in infants.

Acoustic Stimulation↗
PubMedDate not supplied

Frequency-specific information from click evoked otoacoustic emissions in noise-induced hearing loss.

Click evoked otoacoustic emissions (CEOAEs), pure-tone audiograms (PTAs), and Bekesy sweep frequency audiograms were recorded from 15 ears of 11 subjects with noise-induced hearing loss. For all ears, hearing threshold levels > or = 30 dB HL were found at the high frequencies. The aims of the study were to examine whether the decomposition of CEOAEs into narrow band components could identify hearing loss in a frequency-specific manner and to what extent audiometric thresholds could be predicted. CEOAEs were parcelled into 0.5-kHz-wide components by means of the wavelet transform. Reproducibility of CEOAE components was compared with audiometric threshold at corresponding frequencies. A general trend of low reproducibility for increasing audiometric thresholds was found. A reproducibility value of 60 per cent was found to best separate normal and elevated thresholds. The presence of a CEOAE component at a given frequency was always associated with audiometric thresholds < or = 20-25 dB HL. On the other hand, the absence of a component was equally associated either with normal or abnormal hearing levels. Large inter-subject variability was observed. A weak linear relationship was found between reproducibility and audiometric thresholds at corresponding frequencies, indicating that analysis of narrow band CEOAE components is valuable for separating normal from hearing-impaired ears but cannot replace the audiogram.

Acoustic Stimulation↗
PubMedDate not supplied

Fine alterations of distortion-product otoacoustic emissions after moderate acoustic overexposure in guinea pigs.

Guinea pigs were exposed to a pure tone at 6 kHz and 80 dB SPL for 30 minutes in order to induce mild reversible auditory fatigue over the 4 hours following exposure. Cochlear monitoring aimed to compare the shifts in round-window compound action potentials (CAP) thresholds to those of 2f1-f2 distortion-product otoacoustic emissions (DPOAE, frequency of stimuli f1 and f2). Both responses were evaluated every 1/10th octave between 6 and 12 kHz for CAP thresholds, and from 4 to about 14 kHz for DPOAEs in response to 50- and 70-dB SPL stimuli. The auditory fatigue turned out to be sufficiently mild that DPOAEs remained present, so that their microstructure could be followed up while the stimulus frequency ratio f2/f1 was swept from 1.06 to 1.30 (fixed f2) so as to derive DPOAE level profiles against f2/f1 and group latencies. CAP thresholds decreased by about 10 dB above 7.2 kHz, whereas DPOAE amplitudes decreased at most f2 frequencies from 6.6 kHz to 15.2 kHz, with the range of decrease being slightly narrower at higher stimulus intensities. While the mean DPOAE shift after 1 hour was around 5 dB irrespective of stimulus intensity, it tended to increase slightly after 2 hours despite stable CAP thresholds. DPOAE profiles against f2/f1 were slightly modified by the auditory fatigue, so that the maximum tended to be reached at lower ratio. No significant variation of DPOAE latencies was found after acoustic overstimulation. These experiments show that complex DPOAE changes were induced by auditory fatigue and their relationship to CAP threshold changes does not seem to be straight-forward. Nonetheless, fine DPOAE recordings might be useful to detect early changes in cochlear mechanics.

Acoustic Stimulation↗
PubMedDate not supplied

[Reoperation of tumors of the parotid gland, surgical approach and consequences for the 7th cranial nerve. Apropos of 42 cases].

Second or more surgical procedures on parotid are usually difficult and may induce injury on the facial nerve. The authors report their experience about 42 patients. The choice between a total parotidectomy or a surgical excision of a tumor depends on the number of surgical procedure, the type of initial procedure and the histological type of the tumor. Second surgical procedures for a wrong initial diagnosis (11 cases) were always a total parotidectomy with facial nerve preservation. The risk of a partial or total facial palsy is higher after several recurrences (3 of 8 cases). The facial nerve had to be resected in 3 of 9 cases of malignant tumors recurrences. The initial treatment of a tumor of the parotid must be radical so it can prevent for further surgical procedures and then avoid a facial nerve injury.

Adenocarcinoma↗