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Biomedical subjects

P Klap

Publications and source records attributed to P Klap.

At least 19 recordsLinked to original sources
PubMed1995

[Botulinum toxin in the treatment of frontoglabellar and periorbital wrinkles. An initial study].

Glabellar frown lines and crow's feet are wrinkles of facial expression related to an underlying muscular activity, which is particularly strong during facial expression. Classic treatments of these wrinkles only give partially satisfactory are associated with results, and secondary effects, whether they involve skin and muscle lifting, surgical section of muscles, dermal stimulation by thread or injectable fillers, chemical or mechanical abrasion, transient or permanent soft tissue augmentation with various materials. The authors studied the efficacy and safety of intramuscular injections botulinum A Exotoxin in glabellar and crow's feet areas in 19 well-informed and consenting patients. Botulinum toxin injections have been used since 1980 in the treatment of focal dystonia (blepharospasm, oromandibular dystonia, spasmodic torticollis, spasmodic dysphonia and writer's cramp) and safety hemifacial spasm. Their wide use in these indications has highlighted their excellent and efficacy, and the need to repeat injections every 3 to 4 months. The dose required was progressively adjusted around glabellar and orbital areas, while injections of the peri-buccal and forehead areas are still being evaluated. The 19 patients were examined clinically, filmed and photographed every month over a period of 12 to 24 months, and skin prints were performed. Evaluation criteria included the percentage improvement as assessed by the patients themselves, and also evaluation by the investigators of the data of clinical examination, and blind comparison of photographic, videoscopic, and prints. The authors obtained a significant decrease of wrinkles of the areas studied, with a "smoothing" effect during the period of activity of the toxin, which lased an average of 3 to 4 months at the beginning, and 6 to 9 months after several injections. No secondary effects, either general or local, were observed. The product's specificity means that the operator must have a complete mastery of the injection technique and a thorough knowledge of its pharmacology.

Adult↗
PubMed1992

Stridor and focal laryngeal dystonia.

Fibreoptic laryngoscopy in 6 patients with laryngeal stridor showed immobile vocal cords in a paramedian position but no other local cause. Thus a diagnosis of Gerhardt's syndrome, usually ascribed to paralysis of vocal-cord abductor muscles, was made in 3 patients who had no other signs or symptoms of dystonia, and in 3 patients who had multifocal dystonia. Electromyography (EMG) showed evidence of overactivity of vocal-cord adductors, with no evidence of denervation in the abductor muscles. Botulinum toxin injection of the overactive thyroarytenoid muscles abolished stridor. These clinical and EMG findings indicate that Gerhardt's syndrome is not caused by paralysis of vocal-cord abductors, but represents a focal laryngeal dystonia which may be treatable by botulinum toxin injections of vocal-cord adductor muscles rather than by arytenoidopexy or tracheostomy.

Aged↗
PubMed1992

[Spasmodic dysphonia. Investigation and therapeutic methods].

We report the successful treatment of three patients with adduction spasmodic dysphonia by direct injection of botulinum toxin into the vocal cord(s). This was achieved under electromyographic control, and this and other otolaryngeal techniques were used to monitor treatment and study this often puzzling condition.

Adult↗
PubMed1991

[Treatment of spasmodic dysphonia with botulinum toxin].

Spasmodic dysphonia is a focal laryngeal dystonia, a rare form of dystonia. Videostroboscopy, acoustic analysis, computerized voice analysis and over all electrophysiological analysis allow for the study of the different muscles involved in this dysphonia. There are two types of spasmodic dysphonia: adductor spasmodic dysphonia and abductor spasmodic dysphonia. The most efficient therapy nowadays is the injection of botulinum toxin into the thyroarytenoid muscle under fiberoptic visualization. We report 6 patient's cases of spasmodic dysphonia that we have been treating for about 2 years by direct injection of botulinum toxin in the vocal cords.

Adult↗
PubMed1989

[High frequency audiometry].

The authors have performed a series of high frequency audiograms in order to assess its value in routine otological practice. Initially, they conducted a statistical study on subjects with so-called normal hearing in order to establish standardised normal values. As in the earlier studies, a physiological alteration was observed in the high frequencies which was progressively accentuated with age. Audiometric results should therefore always be considered in relation to the patient's age. A standard graph is proposed for the presentation of the results. The authors subsequently performed high frequency audiometry in patients with internal ear disorders. High frequency audiometry allowed early detection of an alteration in the internal ear, when conventional audiometry was normal. The authors believe that high frequency audiometry should be part of the otological assessment as its allows early detection of internal ear disease.

Adult↗
PubMed1987

[Capillary-venous angioma of the temporo-masseteric region].

Angioma of temporomasseteric region is a capillariovenous malformation in the temporomasseteric groove which can extend into adjacent facial zones. It forms a well defined clinicopathological entity. Clinically these angiomas present typical signs of a slow output capillariovenous angioma. Several patients were investigated by standard radiology, tomography and scan imaging, allowing detection of bony, particularly maxillary deformities, and by preoperative laboratory examinations. Treatment is by first stage embolization in situ of the angioma using sclerosing agents to reduce risk of perioperative bleeding and disseminated intravascular coagulation. The second surgical stage varies with the size and site of the lesion. Treatment should be carried out fairly early in childhood to avoid facial skeletal and muscular deformities. This hopefully allows harmonious growth of face with preservation of functions that risk alteration by the temporomasseteric angioma.

Adolescent↗
PubMed1987

[Value of Gore Tex in the reconstruction of the nasofrontal canal].

Surgical technic used in treatment of chronic frontal sinusitis is described, and the interest emphasized of the employ of fragments of Gore Tex prosthetic fragments for calibration and maintenance of permeability of the newly formed nasofrontal canal. Their perfect tolerance allows them to be left in place and their permeability can be surveilled by CT scan imaging or fibroscopy.

Blood Vessel Prosthesis↗
PubMed1985

[The transfacial flap in surgery of tumors of the middle and posterior 3d of the face and base of the skull. Its use as a means of approach and reconstruction].

A transfacial approach and the use of a bone flap allows exeresis of large tumors of middle and posterior third of face and of base of skull. The procedure can be used alone or associated with a neurosurgical approach to the lesions. This wide surgical approach increases the possibility of a complete excision under conditions of strict hemostasis. Replacement of the bone flap at the end of surgery restores skeletal reliefs ad integrum with excellent esthetic results. The technique is described in detail and several examples of its use outtined.

Adenocarcinoma↗
PubMed1985

[Approach to the pterygomaxillary region by the Lefort I osteotomy].

Approach to the pterygomaxillary fossa under the base of skull, a difficult operation, has been facilitated by the use of a technique derived from the Lefort I osteotomy. Satisfactory access to the fossa and to the posterior-base region is obtained and esthetic or functional sequelae avoided.

Arteriovenous Malformations↗
PubMed1985

[Mucoceles of the maxillary sinus. Diagnostic and therapeutic problems. Apropos of 5 cases].

Five cases of the rarely observed maxillary sinus mucocele are reported, one patient with bilateral lesions presenting primary dilatation of the bronchi. A previous history of surgery or injury to sinuses was obtained in all cases, the diagnosis being confirmed by computed tomography imaging. Recovery is usually complete after the Caldwell-Luc operation. One case with exclusion of the sinus is described and the literature reviewed.

Adult↗
PubMed1984

[Diagnostic problems of tuberculoid cervical adenitis. Apropos of 70 cases].

Pathologic criteria in tuberculoid adenitis enable differentiation between follicular adenitis with or without caseous necrosis and that involving suppurative necrosis. The absence of specific etiology is emphasized. Seventy cases of tuberculoid adenitis are analyzed. Of the 62 cases of adenitis labelled tuberculous, bacterial confirmation was obtained in only 22 (35%), suggesting probable diagnosis by excess for the remaining 40 cases. Related bacteriologic problems concern isolation of B.K. of the 3 cases classified as sarcoidosis, it was important to obtain data from broncho-alveolar lavage and serum conversion enzyme assay. Four patients with adenitis were diagnosed as having cat-scratch disease from positive specific intradermal reactions, the probable discovery of the responsible agent thus providing a bacteriologic diagnosis.

Adolescent↗
PubMed1984

[Tumors and vascular malformations of the larynx. Angiographic aspects and therapeutic indications].

Satisfactory results were obtained in a case of laryngeal paraganglioma following surgery preceded by angiography and embolization. Clinical, arteriographic and histologic features of vascular malformations of the larynx are discussed, localized and isolated laryngeal angiomas being distinguished from those classified among cervicofacial angiodysplasias. Laryngeal vascular malformations are all capillarovenous angiomas. Treatment has been facilitated by the availability of arteriography and embolization methods, and consists of injections of a sclerosing agent (such as "ethybloc") together with surgery in some cases.

Adult↗
PubMed1983

[Mandibular reconstruction by composite musculocutaneous flap in glossopelvimandibular excisions].

Results of 14 mandibular reconstruction by a composite muscular flap of the pectoralis major and trapezium muscles during widespread glossopelvimandibular excisions are described. The technique employed is outlined, emphasis being placed on the need to observe strict precautions during removal and application of the bone component, to avoid accidental avulsion during reconstruction which could compromise the musculoperiosteal vascularization of the graft. Results are sufficiently encouraging for this type of reconstructive surgery to be proposed in all cases where mandibular repair is necessary after interruption of continuity.

Glossectomy↗