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1.
J Laryngol Otol ; 121(2): 143-8, 2007 Feb.
Article in English | MEDLINE | ID: mdl-17005065

ABSTRACT

AIMS: To evaluate the results of chemotherapy alone in patients with invasive squamous cell carcinoma of the larynx who have achieved a complete clinical response after an induction chemotherapy protocol. METHODS: A comparison of results in a group of complete responders managed with a chemotherapy alone protocol, matched with those of an incomplete responder group managed with conventional modalities. RESULTS: The survival rate of the complete responder group was significantly higher than that of the incomplete responder group. No statistically significant difference was noted between the two groups in terms of local failure and nodal recurrence. CONCLUSION: Our results confirm the fact that chemotherapy alone is a viable option in selected patients with carcinoma of the larynx who have achieved a complete clinical response after an induction chemotherapy protocol. This therapeutic approach allows surgery and/or radiation therapy to be reserved for the management of metachronous second primary tumours.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Squamous Cell/drug therapy , Laryngeal Neoplasms/drug therapy , Female , Humans , Male , Middle Aged , Survival Rate
5.
J Otolaryngol ; 29(3): 135-8, 2000 Jun.
Article in English | MEDLINE | ID: mdl-10883824

ABSTRACT

Reconstruction of the oropharynx and the hypopharynx is difficult due to their wide diameters. We report eight cases of circumferential pharyngolaryngectomies for epidermoid carcinomas of the hypopharynx extended to the oropharynx and classified T4. Reconstruction was performed with a U-shaped free jejunal transplantation. This specific technique consists of a side to side anastomosis between two loops of jejunum. It facilitates reconstruction at the level of the oropharynx and diminishes postoperative complications.


Subject(s)
Carcinoma, Squamous Cell/surgery , Hypopharyngeal Neoplasms/surgery , Jejunum/transplantation , Oropharyngeal Neoplasms/surgery , Surgical Flaps , Aged , Anastomosis, Surgical , Carcinoma, Squamous Cell/radiotherapy , Combined Modality Therapy , Female , Humans , Hypopharyngeal Neoplasms/radiotherapy , Male , Microsurgery , Middle Aged , Oropharyngeal Neoplasms/radiotherapy
7.
Rev Laryngol Otol Rhinol (Bord) ; 120(5): 337-9, 1999.
Article in French | MEDLINE | ID: mdl-10769569

ABSTRACT

Sebaceous carcinoma is a rare tumor, from the adnexal epithélium of the sebaceous glands. Usually, lesions arise in meibonian glands of the eyelid. However, extraocular lesions within head and neck have been reported. We report a case of recurrent sebaceous carcinoma of the parotid gland without metastases.


Subject(s)
Carcinoma/pathology , Parotid Neoplasms/pathology , Sebaceous Gland Neoplasms/pathology , Adult , Carcinoma/surgery , Humans , Magnetic Resonance Imaging , Male , Parotid Neoplasms/surgery , Sebaceous Gland Neoplasms/surgery
8.
Ann Chir ; 52(10): 978-82, 1998.
Article in French | MEDLINE | ID: mdl-9951097

ABSTRACT

Reconstruction of the oro and hypopharynx has specific difficulties due to their wide diameters. Seven patients underwent reconstruction with a free U-shaped jejunal transplant, after circular pharyngolaryngectomy for hypopharyngeal cancer invading the oropharynx. This transplant included a side-to-side anastomosis between the two limbs of the jejunal loop. This transplant allowed reconstruction of the upper digestive tract after wide carcinologic resection of the pharynx. The U-shaped jejunal transplant facilitated the upper anastomosis, especially at the upper part where the resection involved the oropharynx. It formed a reservoir behind the tongue, and avoided nasal reflux. The best indications are large resections involving the oropharynx.


Subject(s)
Hypopharyngeal Neoplasms/surgery , Jejunum/transplantation , Adult , Anastomosis, Surgical/methods , Female , Graft Survival , Humans , Laryngectomy , Male , Middle Aged , Oropharynx/pathology , Oropharynx/surgery , Pharyngectomy , Plastic Surgery Procedures/methods , Treatment Outcome
9.
Ann Otolaryngol Chir Cervicofac ; 115(6): 332-7, 1998 Dec.
Article in French | MEDLINE | ID: mdl-9922829

ABSTRACT

A series of 23 patients with sphenoid disease were seen between 1992 and 1997. The most common symptom was headache. This headache was found to be nonspecific. Cranial nerve abnormalities were found in two patients. The different types of radiolographic images were analyzed, and compared with the surgical diagnosis. Twenty-one patients underwent surgical exploration by intranasal endoscopic sphenoidotomy. This approach allowed drainage and inspection of the sinus.


Subject(s)
Paranasal Sinus Diseases , Sphenoid Sinus , Adult , Aged , Cysts/diagnosis , Cysts/surgery , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Mucocele/diagnosis , Mucocele/surgery , Mycetoma/diagnosis , Mycetoma/surgery , Papilloma, Inverted/diagnosis , Papilloma, Inverted/surgery , Paranasal Sinus Diseases/diagnosis , Paranasal Sinus Diseases/surgery , Paranasal Sinus Neoplasms/diagnosis , Paranasal Sinus Neoplasms/surgery , Sphenoid Sinusitis/diagnosis , Sphenoid Sinusitis/surgery , Tomography, X-Ray Computed
10.
Ann Otolaryngol Chir Cervicofac ; 113(5): 285-8, 1996.
Article in French | MEDLINE | ID: mdl-9124769

ABSTRACT

The histological examination of the salivary gland tumors is a very important step in the diagnostic approach of the lesions, on which depends the success of therapeutic outcome. Some surprises may occur; four examples were reported. In one case the lesion was not a tumor but a tuberculous lymphadenitis; another showed a Destombes Rosai Dorfman syndrome. Two other cases were found to be unusual tumors: a carcinosarcoma of the submandibular gland and a metastasis of a Merkel carcinoma in the submandibular gland.


Subject(s)
Carcinoma, Merkel Cell/secondary , Carcinosarcoma/diagnosis , Histiocytosis, Sinus/diagnosis , Submandibular Gland Neoplasms/diagnosis , Adult , Aged , Carcinosarcoma/pathology , Diagnosis, Differential , Female , Histiocytosis, Sinus/pathology , Humans , Lymphatic Metastasis , Male , Middle Aged , Submandibular Gland Neoplasms/pathology , Submandibular Gland Neoplasms/secondary , Tuberculosis, Lymph Node/diagnosis
11.
Ann Otolaryngol Chir Cervicofac ; 113(7-8): 419-24, 1996.
Article in French | MEDLINE | ID: mdl-9207976

ABSTRACT

Among a series of 520 parotidectomies performed between 1975 and 1995, we observed 88 cases of malignancy (17%). For this study, we excluded skin cancers which had invaded the parotid and glandular metastases of squamous cell carcinoma, malignant melanoma or kidney cancers, retaining only tumors with a glandular origin and lymphomas. Thus defined, our series comprised 60 patients, i.e. 12% of the operated parodids (31 confirmed cancers, 18 tumors with intermediary malignancy, including several in which the pathology report confirmed malignancy, and 11 lymphomas). We examined therapeutic management by histology and compared the outcomes. Relation with the facial nerve are discussed. Prognosis depends on histology, tumor stage and treatment.


Subject(s)
Parotid Neoplasms/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Facial Nerve/surgery , Female , Humans , Lymph Node Excision , Male , Middle Aged , Parotid Neoplasms/mortality , Parotid Neoplasms/pathology
12.
Bull Acad Natl Med ; 179(1): 147-56; discussion 156-7, 1995 Jan.
Article in French | MEDLINE | ID: mdl-7788441

ABSTRACT

One hundred and ninety seven patients with cancer of the hypopharynx underwent after circular resection, reconstruction with a free jejunal graft. The quality of free jejunal grafts is controlled by many investigations: clinical examination, radiography, electromyography, fibroscopy with biopsy. These investigations show that technically jejunal grafts must be short and linear to give the best functional results. Average resumption of oral intake was 14 days. Oral feeding was possible in 92% of cases. The free jejunal grafts with microsurgery are one of the more reliable procedures for reconstruction of pharynx and cervical esophagus after resection for cancer. (2 post-operative deaths and 8 grafts necrosis on 197 cases). The cumulative survival rate of 5 years was 35% for free jejunal graft. Survival depends on selection of the patients for local and nodes invasion. The quality of survival has improved. This operation must be reserved for the hypopharyngeal cancers which need a circular resection and do not invade the esophagus. The surgery is performed for a curative aim. The distant follow up of the patients is imperative: consultation every four months and then every six months: clinical examination, endoscopic, E.N.T., bronchial, and esophageal investigation. Chemotherapy and radiotherapy have specific indications.


Subject(s)
Esophageal Neoplasms/surgery , Hypopharyngeal Neoplasms/surgery , Jejunum/transplantation , Laryngectomy , Pharyngectomy , Adult , Aged , Aged, 80 and over , Female , Humans , Laryngectomy/mortality , Male , Middle Aged , Pharyngectomy/mortality , Retrospective Studies
13.
Rev Prat ; 44(10): 1346-51, 1994 May 15.
Article in French | MEDLINE | ID: mdl-7939196

ABSTRACT

Partial or functional surgery for cancers of the upper aerodigestive tract essentially concerns the larynx and the pharyngolaryngeal area. The aim of this surgery is to preserve voice and deglutition. Therefore fundamental anatomical structures such as the cricoid cartilage or at least one arytenoid cartilage must be spared, pointing the limitations of the techniques. Based on these principles, many authors have divided partial surgical procedures ranging from the simplest (cordectomy) to reconstruction on near-total laryngectomy. Cancers of the hypopharynx can benefit from similar techniques always founded on reconstruction by muscle and aponeurosis or by a free flap. Carcinologic results after partial surgery for cancer of upper aerodigestive tract are better than those obtained after total laryngectomy. This fact could be explained by the nature of these cancers that are limited. The carcinologic and functional success of this surgery needs a precise clinical indication and a perfect approach of the various surgical techniques.


Subject(s)
Laryngeal Neoplasms/surgery , Laryngectomy/methods , Pharyngeal Neoplasms/surgery , Pharyngectomy/methods , Humans , Hypopharyngeal Neoplasms/surgery
14.
Presse Med ; 23(14): 649-52, 1994 Apr 09.
Article in French | MEDLINE | ID: mdl-8072961

ABSTRACT

OBJECTIVE: Implantable systems for venous access are widely used in cervicofacial cancer. We prospectively evaluated complications related to this type of venous access in our cancer patients. METHODS: From September 1991 to September 1993, an implantable system for venous access was installed in 164 patients with epidermoid carcinoma of the upper respiratory and digestive tracts. The systems were implanted in the subclavian vein by 20 different operators (mean number of implants per operator = 8.2). All catheters were tunnelized. Chemotherapy was a combination of 5 fluorouracil and cisplatinum. RESULTS: Immediate complications included impossible implantation (n = 12, 7.3%), pneumothorax (n = 5), false passage (n = 4), haematoma (n = 3), arterial puncture (n = 2) and abscess of the thoracic wall (n = 1). During use, complications included extravasation (n = 4), catheter thrombosis (n = 2), venous thrombosis (n = 2) and infection at the site of implantation, desinsertion of the catheter from the chamber, haematoma at the site of implantation and septicaemia (n = 1 each). The rate of complications was related to implantation (17% of the implantations) or to use (8%). CONCLUSIONS: The rate of complications due to implantable venous access systems is relatively low, suggesting that these systems are acceptable for ambulatory chemotherapy.


Subject(s)
Carcinoma, Squamous Cell/surgery , Catheterization, Peripheral/adverse effects , Catheters, Indwelling , Otorhinolaryngologic Neoplasms/surgery , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Squamous Cell/drug therapy , Catheterization, Peripheral/methods , Combined Modality Therapy , Hematoma/etiology , Humans , Otorhinolaryngologic Neoplasms/drug therapy , Pneumothorax/etiology , Postoperative Complications , Prospective Studies , Thrombosis/etiology
15.
Ann Otolaryngol Chir Cervicofac ; 111(1): 35-7, 1994.
Article in French | MEDLINE | ID: mdl-7998754

ABSTRACT

As noticed in our experience, cosmetic results, after total parotidectomy, were better if the patient presented an hematoma. The author got the idea to fill the retro-mandibular defect with a clot. The technique is presented in detail. Fifty four patients had a total parotidectomy between January 1992 and May 1993. A clot was used in 39 of these 54 cases. Were excluded malignant tumors, superficial parotidectomies or the presence of a general pathology (diabetes, cirrhosis). The result was excellent in 31 cases even if a local treatment was necessary due to a secondary hematoma. There was no infectious complication. The follow-up of this series is insufficient, but by analogy with spontaneous hematoma, the results should be persistent. This technique is simple, does not increased the time of the surgical procedure and does not induced injury on any donor site.


Subject(s)
Parotid Gland/surgery , Surgery, Plastic/methods , Clot Retraction , Esthetics , Humans , Intraoperative Period
16.
Ann Otolaryngol Chir Cervicofac ; 111(6): 353-4, 1994.
Article in French | MEDLINE | ID: mdl-7785936

ABSTRACT

We report a case of otomycosis due to Scopulariopsis brevicaulis in a patient who has undergone tympanoplasty 3 months before. Mycological finding led us to consider this fungus as the causative agent. Whereas in vitro studies show a better efficiency of azole derivatives, cure was obtained with nystatine after two treatment failures in our patient.


Subject(s)
Ear Diseases/microbiology , Mycoses/etiology , Tympanoplasty/adverse effects , Administration, Topical , Adult , Antifungal Agents/therapeutic use , Ear Diseases/drug therapy , Ear, External , Humans , Male , Mycoses/drug therapy
17.
J Chir (Paris) ; 130(8-9): 349-57, 1993.
Article in French | MEDLINE | ID: mdl-8253882

ABSTRACT

Second or more surgical procedures on parotid are usually difficult and may induce injury on the facial nerve. The authors report their experience about 42 patients. The choice between a total parotidectomy or a surgical excision of a tumor depends on the number of surgical procedure, the type of initial procedure and the histological type of the tumor. Second surgical procedures for a wrong initial diagnosis (11 cases) were always a total parotidectomy with facial nerve preservation. The risk of a partial or total facial palsy is higher after several recurrences (3 of 8 cases). The facial nerve had to be resected in 3 of 9 cases of malignant tumors recurrences. The initial treatment of a tumor of the parotid must be radical so it can prevent for further surgical procedures and then avoid a facial nerve injury.


Subject(s)
Adenocarcinoma/surgery , Adenoma/surgery , Carcinoma, Adenoid Cystic/surgery , Carcinoma, Squamous Cell/surgery , Parotid Neoplasms/surgery , Adult , Aged , Facial Nerve Injuries , Facial Paralysis/prevention & control , Female , Humans , Intraoperative Complications , Male , Middle Aged , Neoplasm Recurrence, Local , Postoperative Complications/prevention & control , Reoperation
18.
Ann Otolaryngol Chir Cervicofac ; 110(3): 153-61, 1993.
Article in French | MEDLINE | ID: mdl-8239336

ABSTRACT

Second or more surgical procedures on parotid are usually difficult and may induce injury on the facial nerve. The authors report their experience about 42 patients. The choice between a total parotidectomy or a surgical excision of a tumor depends of the number of surgical procedure, the type of initial procedure and the histological type of the tumor. Second surgical procedures for a wrong initial histological diagnosis (11 cases) were always a total parotidectomy with facial nerve preservation. The risk of a partial or total facial palsy is higher after several recurrences (3 of 8 cases). The facial nerve had to be resected in 3 of 9 cases of malignant tumors recurrences. The initial treatment of a tumor of the parotid must be radical so it can prevent for further surgical procedures and then avoid a facial nerve injury.


Subject(s)
Facial Nerve Injuries , Neoplasm Recurrence, Local/surgery , Parotid Neoplasms/surgery , Adult , Aged , Facial Paralysis/etiology , Female , Humans , Male , Middle Aged , Parotid Neoplasms/pathology , Reoperation
19.
Ann Otolaryngol Chir Cervicofac ; 110(1): 3-8; discussion 8-9, 1993.
Article in French | MEDLINE | ID: mdl-8317861

ABSTRACT

Distortion-product otoacoustic emissions are otoacoustic emissions evoked by two pure tones called primaries and proposed in order to provide a frequency specific investigation of the cochlea. This paper first reports complete input-output functions of distortion-product otoacoustic emissions for conventional audiometric frequencies in a population of 35 neonates without any risk for cochlear function. Distortion-product otoacoustic emissions could be useful, in association with evoked otoacoustic emissions and comportemental audiometry, to precisely evaluate the peripheral auditory system in infants and neonates.


Subject(s)
Audiometry/methods , Deafness/diagnosis , Otoacoustic Emissions, Spontaneous , Auditory Threshold , Humans , Infant, Newborn
20.
Ann Otolaryngol Chir Cervicofac ; 110(5): 277-80, 1993.
Article in French | MEDLINE | ID: mdl-7508211

ABSTRACT

This study compared the results of the CT scan of the paranasal sinuses in nasal polyposis patients before and after a topical vasoconstrictor application on the nasal mucosa. No change have been observed either on the maxillary and ethmoidal sinuses, or the middle meatus. On the other hand, an important retraction was observed on the nasal mucosa, in particular on the inferior turbinate. Then, the application of a topical vasoconstrictor on the nasal mucosa does not seem necessary in order to explore the sinuses in patients with nasal polyposis.


Subject(s)
Nasal Decongestants , Nasal Polyps/diagnostic imaging , Paranasal Sinus Neoplasms/diagnostic imaging , Polyps/diagnostic imaging , Tomography, X-Ray Computed , Adult , Aged , Clinical Protocols , Female , Humans , Male , Middle Aged
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