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Biomedical subjects

P Bordure

Publications and source records attributed to P Bordure.

At least 19 recordsLinked to original sources
PubMed1999

Cerebellar encephalomalacia on magnetic resonance imaging after removal of acoustic tumor.

MRI is widely used for postoperative surveillance of patients undergoing surgery for removal of acoustic neuroma. The purpose of this study was to investigate the frequency and pattern of postoperative changes in the cerebellum and brain stem on MRI after removal of acoustic neuroma. A retrospective study was conducted in 30 consecutive patients who underwent postoperative MRI between 1994 and 1995. The timing of the scans after surgery ranged from 12 months to 10 years. T2 -weighted turbo spin-echo images revealed cerebellar encephalomalacia in 17 of 30 cases. Cerebellar encephalomalacia was found more consistently in patients who had large tumors and was more frequent after the suboccipital approach. Encephalomalacia is largely caused by gliotic changes in the adjacent cerebellar tissues after tumor removal.

Adolescent↗
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↗
PubMed1998

[The value of beta-2 transferrin analysis and MR cisternography for the diagnosis of cerebrospinal fluid fistulas].

The diagnosis of cerebrospinal fluid (CSF) fistula may require invasive techniques. Detection of CSF and perilymph-specific beta 2 transferrin and MR cisternography which greatly enhances the CSF signal are sensitive and noninvasive techniques which allowed a precise diagnosis in seven patients with suspected CSF fistula. We review the different diagnostic techniques used for CSF fistula, beta 2 transferrin analysis and MR cisternography appear to provide accurate and noninvasive methods for investigating CSF fistulae. They should replace invasive techniques such as CT cisternography.

Adult↗
PubMed1997

[Bacteriological study in acute otitis media].

AIM: A prospective study on bacteriological epidemiology in acute otitis media was conducted in a pediatric hospital emergency service from January 1993 to October 1995. PATIENTS: One hundred and fifty-eight children, aged 6 months to 6 years, with an acute otitis media were included. Culturing and cleansing of the ear canal and tympanocentesis for aspiration and culture of the secretions were performed in 118 children (46 of whom had received antibiotics before for 48 hours). MAIN RESULTS: Middle ear aspirates were sterile in 35% of the children who had not received antibiotics and in 64% of those already treated. Bacteria in middle ear were predominantly Haemophilus influenzae and Streptococcus pneumoniae. Fifty-nine percent of S pneumoniae strains were penicillin-resistant; however, they were responsible for clinical failure in only 8% of cases. No Staphylococcus strains, commensal of the ear canal, could be considered as pathogenic for the middle ear. CONCLUSION: The preciseness with which secretions of middle ear are aspirated reduces the risk of contamination and comparison of ear canal and middle ear cultures allows to identify them. The high ratio of sterile middle ear aspirates after antibiotic treatment raises the question if other factors are responsible for persistent symptoms. The existence of penicillin-resistant S pneumoniae must be known to adjust treatment.

Acute Disease↗
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↗
PubMed1996

Perilymph detection by beta 2-transferrin immunoblotting assay. Application to the diagnosis of perilymphatic fistulae.

beta 2-Transferrin, the asialotransferrin, is found in cerebrospinal fluid (CSF) and inner ear perilymph, but is absent from serum and other body fluids or secretions except the aqueous humor. The detection of this asialo-fraction of the transferrin in ear fluid microsamples with an immunoblotting technique is of great interest when a perilymphatic fistula (PLF) is suspected. beta 2-Transferrin was detected on microsamples collected by syringe or on micro-collagen sponges from 30 patients undergoing ear surgery. The problem is reviewed, the technique and sample preparation are explained and the results discussed. beta 2-Transferrin detection in the ear fluid allows the identification of perilymph, except in the CSF oto- or rhinorrheal context, and is proposed as a promising test to confirm perilymphatic fistula.

Blotting, Western↗
PubMed1996

[Restoration of the mandible after trans-mandibular approach of invasive tumors of the oropharynx (43 cases)].

Preservation of the mandible is often possible in surgery of invasive malignant tumors of the oropharynx. From 1983 to 1993, we operated 158 T3 of the oropharynx: 73% with mandibulectomy and 27% with osteotomy (43 cases). Now, the osteotomy of the mandible is performed in more than 90% of the patients. The osteosynthesis needs two titanium plates; the pharyngoplasty is made with a pectoralis major myocutaneous flap. Followup: 36 cases of 43 gave satisfactory results. The osteotomy complication rate was 5 (12%): 5 osteitis (2 after radiotherapy).

Adult↗
PubMed1996

[Electrophysiologic and other objective tests in pediatric cochlear implantation].

Various electrophysiological procedures have been developed and utilized in pediatric cochlear implant patients. During surgery and just before implantation, recording of Electrically-Evoked Auditory Brainstem Responses (EABR) by electrical stimulation via a promontory needle electrode is a useful tool to select the suitable ear for implantation in the absence of other criteria. After implantation, peroperative assessment of the Electrically-Evoked Stapedius Reflex thresholds allows an estimation of the comfort levels not to be exceeded during the first tuning sessions. Recording of Averaged Electrode Voltages (AEV) provides assurance against general device failure, and can localize defectives electrodes which will be disactivated. Finally EABR obtained by electrical stimulation via the implant is the last control showing objective auditory responses. Furthermore there is a strong correlation between EABR thresholds and behavioral thresholds which will be obtained during the first tuning session. When a device malfunction is suspected after implantation, recording of AEV and EABR are performed, and the results are compared with the preoperative data.

Age Factors↗
PubMed1995

Usefulness of the galea flap in treatment of extensive frontal bone defects: a study of 14 patients.

We present a technique for treating extensive frontal bone loss after chronic osteitis and subsequent treatment. Unlike the technique usually performed in such cases (exclusion and filling), the frontal sinuses were conserved by isolating them from the reconstructed frontal vault. Isolation was achieved by means of a temporal galea and periosteum flap with a pedicle arising from the superficial temporal vessels. The study concerned 14 patients operated on from two to seven times for osteitis, which persisted in many patients for more than 10 years.

Adolescent↗
PubMed1994

[Vertigo and middle ear pathology].

The association of vertigo and diseases of the middle ear is not uncommon. It occurs especially during the course of chronic or acute otitis but can also occur as a sequela. Vestibular involvement is due to several pathophysiological mechanisms that influence the choice of treatment. The same is true for expansive processes of the tympanic cavity. When associated to otospongiosis, vertigo occurring during Ménière's disease can transiently contraindicate an operation on the tapes. On the contrary, vertigo resulting from traumatic lesion of the middle ear can suggest surgical intervention. Surgery of the middle ear can itself cause severe vertigo which sometimes requires a new operation. Lastly, the fortuitous association of disease of the middle ear with labyrinth disease, especially retrolabyrinthic such as eighth cranial nerve neurinome, is not uncommon, but can be long overlooked if it is not routinely suggested in the presence of labyrinth type symptoms.

Acute Disease↗
PubMed1994

A double-blind comparison of ciprofloxacin and amoxycillin/clavulanic acid in the treatment of chronic sinusitis.

A total of 251 adults with chronic sinusitis were enrolled into this prospective multicentre, double-blind, double-placebo comparison of ciprofloxacin (500 mg twice daily) with amoxycillin/clavulanic acid (500 mg three times daily). The diagnosis of chronic sinusitis (persistence of clinical symptoms for at least 3 months) was confirmed by computerized tomography scan and/or sinusoscopy prior to therapy. Patients at inclusion had purulent or muco-purulent rhinorrhoea. Staphylococcus aureus (n = 45), Haemophilus influenzae (n = 35), Streptococcus pneumoniae (n = 32) and enterobacteriaceae (n = 31) were isolated from pre-treatment aspirates of the middle meatus. Treatment lasted 9 days, at the end of which nasal discharge disappeared in 71/118 (60.2%) patients of the ciprofloxacin group and 69/123 (56.1%) of those in the amoxycillin/clavulanic acid group. The clinical cure and bacteriological eradication rates were 58.6% versus 51.2% and 88.9% versus 90.5% for ciprofloxacin and amoxycillin/clavulanic acid, respectively. These differences were not significant, however, amongst patients who had a positive initial culture and who were evaluated 40 days after treatment. Ciprofloxacin recipients had a significantly higher cure rate than those treated with amoxycillin/clavulanic acid (83.3% vs. 67.6%, p = 0.043). Clinical tolerance was significantly better with ciprofloxacin (p = 0.012), essentially due to a large number of gastro-intestinal related side-effects in the amoxycillin/clavulanic acid group (n = 35). Ciprofloxacin proved to be at least as effective as amoxycillin/clavulanic acid. The superior safety profile, a twice daily dosage regimen, suggests that ciprofloxacin may be a useful therapeutic alternative for the treatment of chronic sinusitis.

Adolescent↗
PubMed1994

Controlled prospective study of oral ciprofloxacin versus amoxycillin/clavulanic acid in chronic suppurative otitis media in adults.

The efficacy and tolerability of ciprofloxacin (500 mg twice daily) was compared with that of amoxycillin/clavulanic acid (500 mg three times daily) in 76 patients with acute exacerbations of chronic non-cholesteatomatous suppurative otitis media enrolled in this open randomized multicentre trial. A total of 40 ciprofloxacin-treated patients and 35 amoxycillin/clavulanic acid-treated patients were evaluable for clinical efficacy following the 9-day treatment period. Pseudomonas aeruginosa was the main pathogen isolated prior to treatment. At the end of treatment, otorrhoea had disappeared in 57.5% of the ciprofloxacin group and 37.1% of the amoxycillin/clavulanic acid group (p = 0.04). Bacterial eradication rate was also significantly greater with ciprofloxacin (69.7%) than with amoxycillin/clavulanic acid (27.3%). Both treatments were well tolerated. Ciprofloxacin appears to be an effective treatment of chronic otitis media, and superior to amoxycillin/clavulanic acid.

Adult↗
PubMed1994

[Perilymph fistula: diagnosis by detection of perilymph in the middle ear by beta-2 transferrin immunofixation].

beta 2-transferrin is a specific protein found in the cerebrospinal fluid and in the perilymph. Detecting beta 2-transferrin in the middle ear is of great interest when a fistula of the perilymph is suspected. This protein can be detected on microsamples with an immunofixation technique. We searched for beta 2-transferrin in pure perilymph, cerebrospinal fluid and serum in 8 patients operated by translabyrinthine approach for acoustic tumor removal. Search for beta 2-transferrin was performed in liquid from the inner ear in 3 labyrinthectomies. Samples were taken on collagen sponges or with micro syringes. beta 2-transferrin was detected in the perilymph of patients operated for neurinoma and in 2 of the 3 labyrinthectomies. This protein was found in only one of the patients for which the diagnosis of perilymphatic fistula had been retained. Detection of beta 2-transferrin in the middle ear can be proposed as a specific diagnostic test for perilymphatic fistula when the clinical situation does not suggest a fistula involving cerebrospinal fluid.

Adolescent↗
PubMed1994

[Post-traumatic perilymphatic fistulas].

Perilymphatic fistulas (often secondary to trauma) are abnormal communications between the middle ear and the perilymphatic space involving a flow of perilymphatic fluid into the middle ear. The diagnosis is suggested by the association of cochleovestibular symptomatology in a traumatic context. The clinical context is of considerable importance in establishing the diagnosis. Thus, different etiological forms of post-traumatic fistula have been described, i.e., after stapedectomy (those initially reported), due to head trauma, resulting from direct ear injury, or by excessive pressure changes. Lesions are found at the level of round or oval windows, or between the two, at a fracture site of the typed noted after head trauma. Paraclinical explorations are of little value. Only caloric hypo-excitability or unexcitability associated with even partial conservation of cochlear function is a very good indicator. The diagnosis is determined during careful surgical exploration of the middle ear. Treatment requires closing the fistula with connective tissues such as temporal aponeurosis or stapedectomy with interposition in the event of marked dehiscence of the oval window. There are notable differences in the various therapeutic results reported. Vertigo was improved or cured in more than half the cases, whereas hearing was much less improved.

Fistula↗
PubMed1992

[Vestibular evoked potentials. Diagnostic trends].

The contribution of short-latency evoked potentials to the exploration of auditory, visual and somatosensory neurosensory pathways is capital. The determination of short-latency vestibular evoked potentials has encountered many difficulties, mainly due to the necessity to find a specific, very short stimulation in order to select and synchronize the vestibular nerve fibers. Recent studies in animals have demonstrated short-latency potentials evoked by angular accelerations, linear accelerations or electric shocks on the round window. The generators of these potentials seem to be located in the vestibular nerve and nuclei. Electric stimulations of the internal ear have the advantage of providing a study of the peripheral vestibular pathways separately on both sides, while accelerations involve both vestibula, which probably makes the interpretation of data very difficult.

Acoustic Stimulation↗