[Comparison of results obtained by laser and conventional instrumentation in vocal surgery. Pseudomyxoma and nodules]. / Comparaison des résultats obtenus par le laser et l'instrumentation conventionnelle en phonochirurgie. Pseudomyxomes et nodules.

Surgery for pseudomyxoma or laryngeal nodules should always be as conservative as possible. This is obtained both by the use of the laser and conventional surgical techniques, results being analogous from the phoniatric point of view. From the technical aspect, however, the laser is a much simpler procedure.

[Repermeabilization of the laryngeal pathway using the laser]. / Reperméabilisation de la filière laryngée par le laser.

Based on results in 48 cases, the principal indications and the place of laser in the repermeabilization of the glottic tract are discussed. Results on the cord adhesions were fair, whereas they were more constant with respect to regain of function in stenosis, paralysis and laryngeal edema. Laser can be used as single therapy by the endoscopic route for ankylosis or diplegia of the larynx, but should also act as a complement to a surgical or radiotherapeutic action.

[Evaluation of 6 years of CO2 laser microsurgery in laryngology]. / Bilan de six années de microchirurgie au laser CO2 en laryngologie.

Laryngeal microsurgery has been performed using a CO2 laser since 1978. It is essential to conduct a strict phoniatric pre-operative examination and to ensure correct anesthesia. Results after 735 operations underline the advantages of this technique for the treatment of benign laryngeal lesions (diffuse papillomatosis, sessile polyps, granuloma), in phonosurgery (nodules, bundle edema, corditis) and in the repermeabilization of the laryngeal network (paralysis, stenosis, laryngeal edema).

Dificuldades para diagnostico de sarcoidose exclusivamente cutanea. / Difficulties in the diagnosis of exclu sively cutaneous sarcoidosis

Dez pacientes que receberam o diagnostico de sarcoidose, em sua forma estritamente cutanea, foram acompanhados e/ou revistos em um periodo de dois a cinco anos, apos o diagnostico inicial. Cinco pacientes tiveram seus diagnosticos confirmados e se mantem curados apos tratamento com corticosteroides. Um paciente, apos tres anos, evoluiu para uma forma ganglionar e pulmonar de sarcoidose. Tres pacientes tiveram seus diagnosticos reformulados para hanseniase tuberculoide e foram tratados com sulfona. Um paciente teve seu diagnostico retificado para paracoccidioidomicose,forma cutanea localizada. Os autores discutem o comportamento dos testes tuberculinico, leprominico e de Kveim, no grupo estudado.Concluem reconhecendo a existencia de formas cutaneas estritas de sarcoidose, mas chamam a atencao para a dificuldade do diagnostico diferencial, sobretudo com hanseniase tuberculoide

[Deep papillomatosis of the adult and laser (author's transl)]. / Papillomatose profonde de l'adulte et laser.

Adult papillomatosis may be similar to child's papillomatosis or have an exophytic presentation. We describe a third kind of papillomatosis where papillomas tend to grow deep inside the mucosa. Laser seems an effective treatment of this condition which used to lead to tracheostomy and even total laryngectomy.

[Laser and phonosurgery (author's transl)]. / Laser et phonochirurgie.

Six patients are presented as examples of investigation and treatment of dysphonic patients in the ENT Department of the Tenon hospital, Paris. Investigations include photography, recording and sometimes sonograms before and after treatment. The multiplication of similar records will eventually show whether laser surgery should be preferred to instrumental surgery.

[Midline congenital fistulas of the nose. Fourteen cases (author's transl)]. / Fistules congénitales médianes du nez. (à propos de quatorze observations).

The authors report 14 cases of midline congenital fistulas of the nose. Early diagnosis of the abnormality and its deep prolongations are necessary in order to avoid delayed presentation by infectious complications, which may be grave. Anteroposterior tomograms, in Gosserez view, in general provide precise information concerning the extent. In order to limit aesthetic problems, surgical treatment, without prejudice to total excision, should give preference to concealed transcolumellar incisions extended if necessary to the nostrils. This approach offers extensive manaeuvrability and makes it possible to perform a rhinoplasty if necessary.

[Petromastoid clearance using plastic surgery in the surveillance of large cavities. Re-suture of the ear canal (author's transl)]. / Plastiques d'évidements pétromastoïdiens dans la surveillance des grandes cavités. L'ourlet de la conque.

The lesions met with in chronic otitis media and especially in cholesteatoma, can be extremely widespread and, after petromastoid clearance there is a large resulting cavity which is impossible to survey by the usual route of the ear canal. A plastic surgical technique on the ear canal, is described which allows an easy surveillance without esthetic damage. It consists of a resection of a part of the cartilage of the ear canal with conservation of the skin of the inner and outer ear canal. This skin is used to re-suture the piece of cartilage which has been sectioned.

[Surgery for laryngeal stenosis in infants in liable in case of failure to produce a worse condition resulting on a definitive disability (author's transl)]. / Sténoses laryngées durables de l'enfant et méfaits des traitements chirurgicaux. Le calibrage évolutif.

The proper treatment for these stenosis is the "evolutive calibrage" which takes advantage of the normal growth of the larynx with no risk of aggravation.

[Apneic anesthesia in unventilated patients for various operations and explorations in laryngotracheal surgery]. / Anesthésie en apnée sur malade non ventilé pour certaines interventions et explorations en chirurgie larygno-trachéale

A technique of anesthesia is considered for laryngoscopy in suspension, and certain acts of surgery of the vocal cords, e.g. myxoma, and of the trachea, e.g. destruction of papillomatosis. The patient is in apnea, unventilated, a catheter brings down to the level of the carena a current of oxygen of 15 liters per minute, the gaseous acidosis is buffered by injections of a solution of molar sodium bicarbonate. After briefly recalling the notions which justify this technique, its repercussion on homeostasis is studied by arterial gasometry. General anaesthesia with apneic oxygenation may offer the ENT surgeon increased possibilities of exploration and operation at the level of the larynx and trachea, but owing to its biological consequences, it should be used only with circumspection and its indications should be totally justified, for acts of limited duration. The technique seems, at present, difficult to adapt to surgery with laser.

[Trials of controlled hypotension with sodium nitroprusside in ORL surgery. Resistance and tachyphylaxis]. / Essais d'hypotension controlée par nitroprussiate de sodium en chirurgie O.R.L. Résistance et tachyphylaxie

Sodium nitropusside has been used to lower blood pressure during surgical operations on the ear, nose and throat when an operative field without bleeding was desired, e.g. surgery of the inner ear under microscope in particular. In our experience, with the preparation used, sodium nitropusside proved to be a powerful hypotensive agent, the effect of which comes on early but it is difficult to use owing to frequent tachyphylaxis, the possible causes of which are considered. No undesirable side-effects were noted on the main functions. From this limited personal experience, the efficacy of this technique of per-operative hypotension did not appear greater in the surgical field under consideration to those of the anaesthetic techniques used commonly, e.g. neuroleptanalgesia under artificial ventilation, which proved sufficient for reduction in operative bleeding and which had already caused the authors to abandon, some time ago, the use of hypotensive ganglioplegic drugs.