Biomedical subjects
S Bobin
Publications and source records attributed to S Bobin.
[Serous otitis in children].
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[Intubation or tracheotomy in severe subglottic laryngitis].
A retrospective study to assess safety of nasotracheal intubation for subglottic laryngitis in children was conducted in 44 cases treated in the Intensive Care Unit of Hôpital Bretonneau, France between 1971 and 1981. Intubation had been performed in 40 children, and immediate tracheotomy in the other 4. The course of the affection was favorable in 37 (92,5%) of intubated children, secondary tracheotomy being necessary in only 3 cases. A mean duration of 84 hours of intubation was sufficient in 24 children, a total mean duration of 180 hours being required in the 13 other cases. The catheter employed in the 3 tracheotomized children with morbilous laryngitis was too large, and laryngeal stenosis developed in 2 of them. These findings demonstrate that when a catheter of correct size (1/2 size below that indicated by the weight and age of the child) is employed, nasotracheal intubation for severe subglottic laryngitis is a safe procedure.
[Ethmoidal mucocele in a nursing infant. Apropos of 1 case].
Characteristic features of mucoceles of the paranasal sinuses in infants are their extreme rarity, their localization exclusively in the ethmoidal sinuses, and the specific nature of their clinical expression. Partial explanation of these specific features is provided form knowledge of the embryology of the facial sinuses and the various pathogenic theories developed concerning these mucocele lesions. Two out of four cases observed were associated with viscidosis, and a sweat test must be routinely performed in all cases.
[Choanal imperforation in children. Value of the transpalatine approach. Apropos of 30 cases].
Two routes of approach, the transnasal and the transpalatine, are used with equal frequency to treat choanal imperforations in infants, the transpalatine approach being traditionally reserved for children over 1 year of age. A retrospective study of 30 children treated between 1974 and 1981 demonstrated that results were insufficient when the transnasal approach was used (80 p. cent failures) when compared with those obtained with the transpalatine approach (90 p. cent successful). A suggested explanation for the superiority of the transpalatine approach is advanced, and this approach route proposed for initial surgery during the neonatal period based on the results of recent experimental studies showing its safety with regard to maxillary growth.
[Cat scratch disease. Apropos of a misleading case].
An unusual case of cat scratch disease was reported. A pharyngeal form of the disease, with a primary site of inoculation in the nasopharynx was observed. The histology showing pseudo-tubercular follicules was misleading the diagnosis finally made by a strongly positive Hanger Rose reaction. From this case we are reviewing the main caracteristics of this disease and especially forms with mucosal inoculation.
[Therapeutic indications in facial paralysis of the newborn infant. Apropos of 9 cases].
Neither clinical examination nor electrical or radiological investigations were able to predict, pre-operatively, the malformatory or traumatic etiology in 9 cases of neonatal facial paralysis. Surgical exploration demonstrated that the paralysis was due to trauma in 3 cases and to malformations in the other 6. Exploration of the intrapetrous portion of the facial nerve in these 9 cases was not satisfactory, as in 6 patients nerve agencies was detected. Simultaneous investigation of the parotid region in 5 of these 6 infants demonstrated absence of the intraparotid part of the facial nerve. When confronted with a spontaneously non-regressive facial paralysis in a neonate, and when doubt persists after radiological and electrical examinations, the intraparotid portion of the facial nerve should be explored in the stylomastoid region. Its absence suggests agenesis of the nerve, and makes intramastoid exploration of no value.
[Bacteriological study in acute otitis media].
A retrospective study was conducted of 587 bacteriological samples collected from 387 children with acute otitis media treated as outpatients over a period of 30 months, to determine relative frequency of the causative germs and their resistance to antibiotics. The most frequently involved bacteria were staphylococci (16 p.cent) of which 70 p.cent were Staph. Epidermidis, and Haemophilus (17 p.cent), résistance to ampicillin being present in 19 p.cent. These results, which differ from those in the published literature, suggest that paracentesis with systematic bacteriological typing is the treatment of choice in acute otitis media.
[Laryngeal stenosis in the child].
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[Therapy of subglottic angiomas in infancy. 32 case reports (author's transl)].
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[Treatment of laryngeal paralysis in the new born (author's transl)].
In a retrospective study of 108 cases of laryngeal paralysis in new born infants (49 bilaterals and 59 unilaterals) seen during a 6 years period, the authors have analysed the evolution according to the etiology in order to propose an adequate management. The spontaneous recovery or in case of definitive paralysis the good tolerance have led the authors to propose a temporary naso tracheal intubation and later in case of bad tolerance, a laryngeal plasty rather than a classical prolonged tracheotomy.
[Preventive treatment of laryngeal stenosis in children].
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[Etiology and treatment of laryngeal stenosis in infants (48 cases)].
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[Respiratory obstacle and gastro-oesophageal reflux. Pathogenic link (author's transl)].
The finding of the frequent association in the infant of endothoracic tracheal compression and of GOR leads to discussion of their pathogenic link. In cases of endothoracic compression, manometric recording demonstrates the presence of an inversion of intragastric pressures with expiratory hyperpressure and a decrease in anti-reflux gradient. These data represent an argument in favour of medical anti-reflux treatment following discovery during endoscopic investigations for chronic or recurrent bronchopneumonia of the association of tracheal compression and gastrooesophageal reflux. Manometry should make it possible, where medical treatment proves unsatisfactory, to differentiate those cases where anti-reflux surgery is justified and those requiring a decompression procedure.
[Laryngeal cysts in the newborn (9 cases) (author's transl)].
Nine cases of laryngeal cysts in the newborn were seen over a period of 8 years. After reviewing data from the literature, the authors emphasise treatment. Simple puncture aspiration was invariably followed by a recurrence. Marsupialisation or endoscopic resection was associated with 5 successful results. An external operative approach was necessary in 4 cases because of multiple recurrences. No tracheotomy was necessary.
[Two cases of laryngotracheal stenosis in children suffering from punctate epiphysis disease (author's transl)].
The authors report two cases of congenital laryngotracheal stenosis in children with punctate epiphysis disease. This rare condition manifests itself clinically by dwarfism of the extremities, saddle-shaped deformity of the nose, cataract and visceral lesions. The specific common feature is the presence of radiological calcifications in bones with chondral ossification. Laryngeal or tracheal localisations are rare. They may be associated with laryngotracheal stenosis. On the basis of these two cases and of eight other found in the recent literature, the authors attempt to define the relationship of such stenosis with the existence of laryngotracheal calcifications and to define their prognostic significance in the course.
Magnetic resonance findings in 92 acoustic neuromas.
A retrospective analysis of the MR findings in 92 cases of acoustic neuromas is presented. The method of examination included in all cases intravenous injection of Gadolinium (Gd-DTPA or DOTA) with realization of sections in the axial and coronal planes. In 21 cases native MR studies were performed in the axial plane, before Gadolinium injection, with T1WI (n = 21), and T2WI (n = 6) images. Tumors were strictly intracanalar in 19 cases (20.7%), only localized in the cerebellopontine angle (CPA) in 5 cases (5.4%), and in 68 cases (73.9%) the tumors had intra- and extracanalar components. In this last group of lesions, 63.2% completely filled the internal auditory canal (IAC), and 36.8% occupied the internal portion of the IAC. In most cases (85.3%) the mean diameter of the CPA component was less than or equal to 2.5 cm. Lesions were more frequently homogeneous (58.8%) after Gd i.v.-enhancement. Heterogeneity was noted mainly in large lesions (greater than 2.5 cm: 100%). In all cases but one, the tumors were round, or oval-shaped, well-delineated, and did not present significant contact with the petrous bone. In 80.9% of CPA lesions, the center of the tumor was posteriorly excentered in relation to the internal auditory canal, whereas it was centered in 16.2% of cases. Widening of the IAC was observed in 51.1% of cases. In 45.2% of tumors of the CPA, smoothing of the posterior edge of the porus was visible.
Chondromyxoid fibroma of the nasal bone with extension into the frontal and ethmoidal sinuses: report of one case and a review of the literature.
Chondromyxoid fibroma is a rare benign tumor that usually occurs in the long bones. A 50-year-old patient presented with chondromyxoid fibroma of the nasal bone with extension into the frontal and ethmoidal sinuses. This is the fourth case reported to date in the literature. The clinical manifestations of the tumor were very limited, and the appearance at rhinoscopy was misleading. Radiologic imaging showed a soft tissue lesion invading the adjacent bony structures and the dura mater. Surgery was performed by a combined team of otorhinolaryngologists and neurosurgeons, and total excision of the tumor was achieved. The histologic diagnosis of this tumor is difficult because of its similarities to chondrosarcoma. [Editorial comment: The authors concisely review management of this rare tumor, emphasizing that complete surgical excision, rather than curettage, is required for long term control.]