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P Roulleau

Publications and source records attributed to P Roulleau.

At least 19 recordsLinked to original sources
PubMed1996

[Acute epiglottitis in adults. A series of 41 cases].

Acute epiglottis is not strictly a childhood disease. We report our experience with acute epiglottis in adults with a retrospective series of 41 patients seen from 1986 to 1994. The main complaint was painful dysphagia. The diagnosis was confirmed a examination of the larynx. Therapeutic management in a hospital setting is required due to the risk of ventilatory obstruction (therapy to be adapted to the patient's ventilatory status).

Acute Disease↗
PubMed1994

[Contribution of x-ray computed tomography in the diagnosis of cervical suppuration].

The authors report their experience with computed tomography (CT) in 27 cases of cervical suppurations. The diagnosis was confirmed surgically in 24 cases and by the improvement of clinical signs and CT after antibiotics in 3. Two types of CT features were identified: collected abscesses (n = 22) visualized as encapsulated heterogeneous hypodense formations and extensive suppurative cellulitis (n = 5) formed by large diffuse hypodense collections without a clearly visible peripheral wall. The extension of the suppurative process could be evaluated precisely with CT, especially in certain anatomic areas where physical examination is difficult including mediastinal suppurations (n = 2), extension of parapharyngeal suppurations to the retrostyleal area (n = 1), and pterygo-maxillary and epidural collections (1 each) the latter in combination with a tuberculous abscess. Computed tomography is also useful in the etiological diagnosis (search for foreign body, cystic malformations, tuberculosis) and in post-treatment follow-up to visualize the absence of collections after cure in cases of favourable outcome and to determine the extent of the suppurative process in case of complications.

Adult↗
PubMed1994

[Otosclerosis: study of the postoperative course of hearing during the first 5 years and research of some prognostic factors. Apropos of a series of 67 cases].

Post-operative air conduction and bone conduction thresholds at 3 months, 1 year and 5 years after stapedectomy or stapedotomy in 67 patients were studied. Bone conduction thresholds improved in the first year postoperatively, then decreased progressively, less than in the non-operated ear but more than in a normal population. The air-bone gap was closed in 75% of the patients. The air-bone gap stayed at the same level during the studied period. Air conduction and bone conduction thresholds are better in the stapedotomy group than in the stapedectomy group only in the 4000 Hz frequency, and are similar for both groups in the 500-2000 Hz range.

Adult↗
PubMed1994

[Tympanoplasty using chondro-perichondral graft. Indications, techniques and results. Apropos of a series of 127 cases].

In an attempt to avoid recurrence, the authors have used chondro-perichondral grafts for more than 10 years for tympanoplasty of retraction pouches. Early results were published in 1987. This new retrospective series of 127 tympanoplasties, performed from 1987 to 1991 reports the anatomic and functional results obtained and the technical modalities used. After a mean follow-up of 18 months, the results appear encouraging. Indications of this chondro-perichondral graft have been widened to cases of unsuccessful first intention myringoplasty and to certain cases of progressive perforations occurring in a setting of inflammation or tubal dysfunction. The results must be confirmed on the basis of long term outcomes.

Adolescent↗
PubMed1993

[Oropharyngeal origin of septic thrombophlebitis of the internal jugular vein. Apropos of 3 cases].

While before antibiotics cases of septic thrombophlebitis of the internal jugular vein secondary to oropharyngeal infection were frequent and had a poor prognosis, today they are exceptional and often have a favourable course under antibiotic therapy. The clinical features are often limited to fever and a painful tumefaction of the anterior border of the sterno-cleido-mastoidian muscle, symptoms may be more pronounced in the Lemierre syndrome in which the anaerobic septicaemia is associated with secondary, especially pleuro-pulmonary, localizations. The diagnosis can be confirmed with a cervical CT-scan showing an enlarged, thrombosed vein which does not opacify and has a hyperdense periphery. Treatment is based on parenteral antibiotics adapted to anaerobic germs.

Adult↗
PubMed1993

[Kikuchi's disease. Apropos of a case. Review of the literature].

Kikuchi's disease is rare necrotic histiocytosis of the lymph nodes. Since the first description in Japan in 1972 by Kikuchi, several cases have been reported. The disease occurs most frequently in young women. Manifestations include enlargement of the cervical lymph nodes, sometimes with fever, and often associated with other non-specific clinical signs. Blood chemistry, including immunologic tests, are often normal but neutropenia and raised erythrocyte sedimentation rate have been reported. Diagnosis relies on the histological examination of lymph node biopsies. Generally the clinical course is favourable in 3-4 months. Secondary systemic lupus erythomatosus may develop and require regular follow-up. The aetiology of this rare disease is still unclear although certain observations would favour an immunological process. Very rare in France, we report a case of Kikuchi's disease in a pregnant woman and present a review of the literature.

Adult↗
PubMed1993

[Development of the surgery of chronic otitis].

For on a strictly conceptual level, today as well as yesterday we find the two main streams of thoughts shared by otologists. Some put the emphasis on the exeresis of lesions which are mainly cholesteatoma, at the agreed expense of hearing. Others are anxious to conciliate lesion exeresis and conservation, even restoration of hearing. The first streams of thoughts outnumbered the others during the first half of the century. Thus that was the triumph of the radical mastoïdectomy, due to the works of Kurster, Laufal and Stacke, then those of Bergman, Barany, Bondy, Beyer and Voss. Today the heirs to that philosophy have converted this surgery, in open technique tympanoplasty. In the second streams of the ... there was Heath in 1904, then Bondy in 1908, and especially Sourdille in France, who in his thesis, described antro-atticotomy with conservation of the ossicular chain. The state of mind he was in as early as 1918 makes him one of the fathers of tympanoplasty, at least so we think. Unfortunately for him, he was ahead of his time and it wasn't until the second half of the century that the heirs to his philosophy could fulfill the vow which was to conciliate lesion exeresis and restoration of hearing. To be frank, they enjoyed the use of antibiotics and surgery microscope, without which tympanoplasty whose initiators were Zollner and Wullstein would have never been possible. A lot of improvement remains to be done as far as chronic otitis surgery is concerned.(ABSTRACT TRUNCATED AT 250 WORDS)

Cholesteatoma↗
PubMed1991

[Bone anchored hearing aid. Results of bilateral applications].

In our experience B.A.H.A. (Bone Anchored Hearing Aid) with its direct bone conduction brings a better hearing rehabilitation for patients with draining ear and further more with major aplasia. 23 patients were tested, 12 have got a bilateral hearing aid, 5 unilateral. They reported a better comfort, a more natural sound and a better discrimination in noise. A bilateral application brought them a stereoacousy with a special directivity, we also note improvement of hearing by different hearing tests.

Audiometry↗
PubMed1991

[20 years of tympano-ossicular allografts].

As ossicular homografts have been readily used since 1965 and tympanic and tympano-ossicular grafts since 1970, we felt it would be interesting to analyse over 3000 cases taken from two centers (Paris and Bordeaux) and to consider the evolution and development of these grafts. The study concentrates on five main points: the indications for tympanic and tympano-ossicular homografts; the immediate and long-term anatomical results; the immediate and long-term functional results; the disadvantages and risks associated with their use; the evolution and development of homografts Looking at the whole study we consider the results to be very satisfactory especially when one considers the pathological context in which they are achieved. We comment on the problems encountered with these homografts. However these should not constitute a contra-indication to their use.

Ear Ossicles↗
PubMed1988

[The base of the piriform sinus in the surgical treatment of fistula of the 4th endobranchial pouch. Apropos of 8 cases].

Fistula of the fourth endobrachial pouch, a congenital malformation, can be defined as an abnormal persistence of the canal joining the base of the piriform sinus and the deep surface of the lateral lobe of the thyroid. These fistulae, which have been more clearly understood over the last ten years, still constitute a delicate surgical problem, which is rarely discussed in the literature, based on the detection of their tract at their origin, the piriform sinus. The 8 cases operated at Hôpital Necker since 1981 reveal the variability of their tract, which, according to the authors, warrants an anatomosurgical analysis.

Adolescent↗
PubMed1988

[Titanium osteo-integrated fixtures. Otologic applications].

The osteofixtures developed by P.I. Branemark are pure titanium screws implanted percutaneously and intraosseously in the mastoid region. The mechanical properties and biocompatibility towards bone and soft tissues of these titanium fixtures were studied after 80,000 cases of human application, essentially in the field of dentistry. The authors present their preliminary results in the otological field: firstly, the auditory prosthesis with a mean gain of 20 dB over classical prostheses via air and bone transmission and, secondly, the epiprosthesis of the external ear in cases of aplasia with scarred skin.

Adolescent↗
PubMed1988

[Functional results of ossiculoplasty. Apropos of 216 cases].

Results of 219 ossiculoplasties performed during closed technic tympanoplasties over a 7-year period are reviewed. Ossiculoplasty involved the implantation of ossiculo-tympanic plate homografts, ossicular auto- or homo-grafts or Klein type prostheses. Results are analyzed as a function of disease causing the ossicular lysis, types of mounting and number of operations required. From these are determined etiopathogenic factors and technics providing improved results. Absence of residual inflammation, stability of mounting and use of remaining ossicles are conditions that ensure best results. Contact between columella and tympanic membrane should be as wide as possible, with greater preference therefore for stapes-malleus or foot of stapes-malleus than stapes-tympanic plate or foot of stapes-tympanic plate mountings. These former mountings improve functional gain in a homogeneous manner throughout the frequency range.

Cholesteatoma↗
PubMed1987

[Solid cold thyroid nodule. Current data].

Attitudes adopted when confronted with a solid cold thyroid nodule are analyzed in the light of recent developments in paraclinical data represented essentially by results of immunological, ultrasound and fine needle cytopuncture examinations. The use of these new surveillance technics frequently allows surgery to be deferred, while if on the contrary operation is decided then it usually now involves both thyroid lobes to avoid nodular recurrence and repeat surgery. Postoperative follow up surveillance is essential to ensure individual adaptation of attitude: therapeutic abstention, suppressive or possibly compensatory treatment.

Biopsy, Needle↗
PubMed1987

[Tympanic retraction pockets. Evaluation after 3 years of our therapeutic regimen. Apropos of 106 cases].

A retrospective study of 106 retraction pockets has been achieved: Part of them was treated with ventilation tubes (23 cases) and an other part was treated by tympanoplasty (83 cases). Our purpose was to verify if our indications were wright. We concluded that it is correct to operate the fixed retraction pockets and it is not dangerous. Concerned the indication of ventilation tubes in non-fixed retraction pockets we do not concluded but propose a complementary study.

Adolescent↗
PubMed1987

[Long-term anatomic results of tympanic homografts. Apropos of 170 cases].

Long-term anatomic results of 170 tympanic homografts performed in the Necker-Enfants-Malades hospital, France between 1977 and 1983 showed high frequency of complications: early perforation (17.7%); late perforation (14%); myringitis (8.5%); recurrence of retraction (7.31%); lateralization (9.4%). These complications are of much higher frequency than after tympanoplasty with autograft, and indications for tympano-ossicular homografts are now limited to total tympanic destruction with absence of handle of malleus.

Adolescent↗