Jean-Philippe Blancal | Université Paris Descartes (original) (raw)
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Papers by Jean-Philippe Blancal
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2012
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2012
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2012
International Journal of Pediatric Otorhinolaryngology, 2015
Trismus is a frequent complication occurring after treatment of tumors of the pterygomaxillary fo... more Trismus is a frequent complication occurring after treatment of tumors of the pterygomaxillary fossa. Local flaps and full-thickness skin grafts fail to release it because they usually lead to scar contracture in previously irradiated tissues. We propose to release it with a thoracodorsal artery perforator flap, which is feasible in children like other perforator flaps. It is interesting because it is thinner than the anterolateral thigh flap and its scar may be less disgraceful and easier to hide.
Annals of the Rheumatic Diseases
Background Heterotopic ossifications are lamellar bone formations within soft tissues. They can o... more Background Heterotopic ossifications are lamellar bone formations within soft tissues. They can occur after trauma, orthopedic surgery, neurologic injuries, burns, hematoma, necrosis or even spontaneously. They can have major functional consequences. Ossifications of head and neck have already been reported, but never after cervical fasciitis. We describe here 26 cases. Objectives To reported rare complication of cervical fasciitis Methods Retrospective study of cervical fasciitis occurring between January 2008 and May 2013, with post surgery CT scans. Tomography images have been read by a neuroradiologist with anatomic expertise of the cervical region. Features of infections (origin, microbiology), patient demographic and clinical data (age, sex, diabetes, immunodepression) and ossifications are described. Results Among 170 fasciitis cases, 98 had post surgery CT scan, 36 of which were performed more than 28 days after surgery. 26 cases of ossification were identified (6 women, 20 ...
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2013
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2013
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2013
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2013
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2012
Intensive Care Medicine, 2015
Cervical necrotizing fasciitis (CNF) is a severe and debilitating disease that requires intensive... more Cervical necrotizing fasciitis (CNF) is a severe and debilitating disease that requires intensive care unit (ICU) management and prompt surgical treatment to reduce morbidity and mortality. The aim of this study was to estimate the incidence and factors associated with severe complications of CNF. We reviewed the medical records of consecutive patients hospitalized in an ICU from 2007 to 2012. The data were collected retrospectively; initial cervical and thoracic computed tomography (CT) scans, performed on admission, were reviewed by an experienced and blinded radiologist to determine CNF complications. A cohort of 160 patients admitted for CNF was included. The following complications of CNF were found: bilateral extension of CNF (28 %), internal jugular vein thrombosis (21 %), descending necrotic effusion (14 %), mediastinitis (24 %), and mortality (4 %); 53 % had at least one complication, and 48 % had at least one cervical complication. On the basis of a univariate analysis, the significant independent factors are odynophagia, dyspnea, oral glucocorticoids intake before admission, and pharyngeal source. Oral nonsteroidal anti-inflammatory drug intake before admission does not have any impact. The initial CNF complications increased both the duration of mechanical ventilation and the length of stay in the ICU. On the basis of a multivariate analysis, the independent factors for severe complications are pharyngeal CNF and oral glucocorticoid intake before admission. Our study demonstrated that an initial cervico-thoracic CT scan revealed a high incidence of cervical and mediastinal CNF complications that all needed immediate management. Those severe complications might be avoidable as they were associated, at least partially, with prehospital oral glucocorticoid intake.
Annales Françaises d'Anesthésie et de Réanimation, 2014
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, Jan 18, 2015
To report on the presence of olfactory arachnoid dilatations (OAD), a previously undescribed radi... more To report on the presence of olfactory arachnoid dilatations (OAD), a previously undescribed radiologic feature of spontaneous cerebrospinal fluid (CSF) rhinorrhea originating from the cribriform plate of the ethmoid bone. The medical records of all patients treated between 2001 and 2011 at a tertiary care center for a spontaneous CSF rhinorrhea originating from the cribriform plate were retrospectively reviewed. The radiological work-up included high-resolution computed tomography and magnetic resonance imaging with at least the following sequences: T1, T2, and T2 with fast imaging employing steady state acquisition (FIESTA). Thirty cases were identified. The mean age at diagnosis was 49. Fourteen patients (47 %) had a body mass index (BMI) of 30 or more and 3 patients (10 %) had a BMI between 25 and 29.9. Five patients had a history of meningitis. The imaging work-up revealed a bone defect of the cribriform plate in 6 cases (20 %), associated to a typical meningocele in 14 cases (...
Head & neck, 2013
The purpose of this study was to evaluate the learning curve for minimally invasive video-assiste... more The purpose of this study was to evaluate the learning curve for minimally invasive video-assisted thyroidectomy (MIVAT). Fifty consecutive patients were prospectively included in groups corresponding to their surgical order (10 patients in each group). The mean operation times between 2 neighboring groups were 33.9 minutes longer in group 1 than in group 2 (p = .01) and 25.8 minutes longer in group 3 than in group 4 (p = .002). The conversion rate for technical difficulties in group 1 was 6% (3 of 50). The definitive complication rate was 2% (1 of 50). In terms of operative time, 10 patients represented the early stage of the learning curve, and 30 patients represented the number of procedures required to reach an advanced level of skill. Considering the low conversion and complication rates, improved aesthetic results and postoperative course, MIVAT should become a tool in the repertoire of high-volume thyroid surgeons.
Bulletin de l'Académie nationale de médecine, 2011
Cervical fasciitis is one of the most severe ENT emergencies, requiring immediate management by a... more Cervical fasciitis is one of the most severe ENT emergencies, requiring immediate management by a multidisciplinary team. Often due to a benign pharyngeal or dental infection, this life-threatening condition leads to extensive necrosis spreading along the fascia of the neck, possibly to the mediastinum. A retrospective analysis of 150 consecutive patients admitted to our institution between January 2001 and December 2006 showed:--a 7% mortality rate;--pulmonary involvement in one-third of cases and hemodynamic failure or mediastinitis in half the patients;--mechanical ventilation for an average of 10 days, intubation for 13 days, tracheostomy for 31 days, intensive care unit management for 17 days, and hospitalization for 26 days; and--functional and esthetic sequelae in about half the patients. These data underscore the extreme severity of cervicofacial fasciitis and the need to pay close attention to any general or functional signs of severe sepsis in patients with apparently mild...
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2013
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2013
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2013
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2014
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2012
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2012
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2012
International Journal of Pediatric Otorhinolaryngology, 2015
Trismus is a frequent complication occurring after treatment of tumors of the pterygomaxillary fo... more Trismus is a frequent complication occurring after treatment of tumors of the pterygomaxillary fossa. Local flaps and full-thickness skin grafts fail to release it because they usually lead to scar contracture in previously irradiated tissues. We propose to release it with a thoracodorsal artery perforator flap, which is feasible in children like other perforator flaps. It is interesting because it is thinner than the anterolateral thigh flap and its scar may be less disgraceful and easier to hide.
Annals of the Rheumatic Diseases
Background Heterotopic ossifications are lamellar bone formations within soft tissues. They can o... more Background Heterotopic ossifications are lamellar bone formations within soft tissues. They can occur after trauma, orthopedic surgery, neurologic injuries, burns, hematoma, necrosis or even spontaneously. They can have major functional consequences. Ossifications of head and neck have already been reported, but never after cervical fasciitis. We describe here 26 cases. Objectives To reported rare complication of cervical fasciitis Methods Retrospective study of cervical fasciitis occurring between January 2008 and May 2013, with post surgery CT scans. Tomography images have been read by a neuroradiologist with anatomic expertise of the cervical region. Features of infections (origin, microbiology), patient demographic and clinical data (age, sex, diabetes, immunodepression) and ossifications are described. Results Among 170 fasciitis cases, 98 had post surgery CT scan, 36 of which were performed more than 28 days after surgery. 26 cases of ossification were identified (6 women, 20 ...
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2013
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2013
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2013
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2013
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2012
Intensive Care Medicine, 2015
Cervical necrotizing fasciitis (CNF) is a severe and debilitating disease that requires intensive... more Cervical necrotizing fasciitis (CNF) is a severe and debilitating disease that requires intensive care unit (ICU) management and prompt surgical treatment to reduce morbidity and mortality. The aim of this study was to estimate the incidence and factors associated with severe complications of CNF. We reviewed the medical records of consecutive patients hospitalized in an ICU from 2007 to 2012. The data were collected retrospectively; initial cervical and thoracic computed tomography (CT) scans, performed on admission, were reviewed by an experienced and blinded radiologist to determine CNF complications. A cohort of 160 patients admitted for CNF was included. The following complications of CNF were found: bilateral extension of CNF (28 %), internal jugular vein thrombosis (21 %), descending necrotic effusion (14 %), mediastinitis (24 %), and mortality (4 %); 53 % had at least one complication, and 48 % had at least one cervical complication. On the basis of a univariate analysis, the significant independent factors are odynophagia, dyspnea, oral glucocorticoids intake before admission, and pharyngeal source. Oral nonsteroidal anti-inflammatory drug intake before admission does not have any impact. The initial CNF complications increased both the duration of mechanical ventilation and the length of stay in the ICU. On the basis of a multivariate analysis, the independent factors for severe complications are pharyngeal CNF and oral glucocorticoid intake before admission. Our study demonstrated that an initial cervico-thoracic CT scan revealed a high incidence of cervical and mediastinal CNF complications that all needed immediate management. Those severe complications might be avoidable as they were associated, at least partially, with prehospital oral glucocorticoid intake.
Annales Françaises d'Anesthésie et de Réanimation, 2014
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, Jan 18, 2015
To report on the presence of olfactory arachnoid dilatations (OAD), a previously undescribed radi... more To report on the presence of olfactory arachnoid dilatations (OAD), a previously undescribed radiologic feature of spontaneous cerebrospinal fluid (CSF) rhinorrhea originating from the cribriform plate of the ethmoid bone. The medical records of all patients treated between 2001 and 2011 at a tertiary care center for a spontaneous CSF rhinorrhea originating from the cribriform plate were retrospectively reviewed. The radiological work-up included high-resolution computed tomography and magnetic resonance imaging with at least the following sequences: T1, T2, and T2 with fast imaging employing steady state acquisition (FIESTA). Thirty cases were identified. The mean age at diagnosis was 49. Fourteen patients (47 %) had a body mass index (BMI) of 30 or more and 3 patients (10 %) had a BMI between 25 and 29.9. Five patients had a history of meningitis. The imaging work-up revealed a bone defect of the cribriform plate in 6 cases (20 %), associated to a typical meningocele in 14 cases (...
Head & neck, 2013
The purpose of this study was to evaluate the learning curve for minimally invasive video-assiste... more The purpose of this study was to evaluate the learning curve for minimally invasive video-assisted thyroidectomy (MIVAT). Fifty consecutive patients were prospectively included in groups corresponding to their surgical order (10 patients in each group). The mean operation times between 2 neighboring groups were 33.9 minutes longer in group 1 than in group 2 (p = .01) and 25.8 minutes longer in group 3 than in group 4 (p = .002). The conversion rate for technical difficulties in group 1 was 6% (3 of 50). The definitive complication rate was 2% (1 of 50). In terms of operative time, 10 patients represented the early stage of the learning curve, and 30 patients represented the number of procedures required to reach an advanced level of skill. Considering the low conversion and complication rates, improved aesthetic results and postoperative course, MIVAT should become a tool in the repertoire of high-volume thyroid surgeons.
Bulletin de l'Académie nationale de médecine, 2011
Cervical fasciitis is one of the most severe ENT emergencies, requiring immediate management by a... more Cervical fasciitis is one of the most severe ENT emergencies, requiring immediate management by a multidisciplinary team. Often due to a benign pharyngeal or dental infection, this life-threatening condition leads to extensive necrosis spreading along the fascia of the neck, possibly to the mediastinum. A retrospective analysis of 150 consecutive patients admitted to our institution between January 2001 and December 2006 showed:--a 7% mortality rate;--pulmonary involvement in one-third of cases and hemodynamic failure or mediastinitis in half the patients;--mechanical ventilation for an average of 10 days, intubation for 13 days, tracheostomy for 31 days, intensive care unit management for 17 days, and hospitalization for 26 days; and--functional and esthetic sequelae in about half the patients. These data underscore the extreme severity of cervicofacial fasciitis and the need to pay close attention to any general or functional signs of severe sepsis in patients with apparently mild...
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2013
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2013
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2013
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2014