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16 results on '"Fuchsmann, A."'

1. Functional outcomes of soft palate free flap reconstruction following oropharyngeal cancer surgery

Author

Jean-Baptiste Melan, Carine Fuchsmann, Jacques Blanc, Pierre Pradat, Philippe Ceruse, Nazim Benzerdjeb, and Pierre Philouze

Subjects
Male, medicine.medical_specialty, Voice Quality, Free flap, Intelligibility (communication), Surgical Flaps, 03 medical and health sciences, 0302 clinical medicine, Swallowing, Quality of life, Surveys and Questionnaires, otorhinolaryngologic diseases, medicine, Humans, Voice Handicap Index, 030223 otorhinolaryngology, Aged, Soft palate, Squamous Cell Carcinoma of Head and Neck, business.industry, Speech Intelligibility, General Medicine, Middle Aged, Plastic Surgery Procedures, Deglutition, Surgery, Oropharyngeal Neoplasms, medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, Quality of Life, Free flap reconstruction, Female, Palate, Soft, Nasalance, business, Follow-Up Studies
Abstract

Introduction The objective of this study was to assess the impact of surgical resection and free flap reconstruction of soft palate cancer on speech, swallowing and quality of life, and to identify the factors influencing functional outcomes and quality of life. Material and methods Patients treated with surgical resection of squamous cell carcinoma and free-flap reconstruction of the soft palate were reviewed at least 12 months after surgery. Speech was assessed using the Hirose intelligibility scoring system, nasalance scoring, GRBAS scoring and the Voice Handicap Index 30 (VHI30) questionnaire. Swallowing was assessed by fiberoptic endoscopy and the Deglutition Handicap Index (DHI). Quality of life was assessed using EORTC QLQ-C30 and QLQ-H&N35 questionnaires. Results 29 patients were included. Speech outcomes were satisfactory, demonstrating normal or slightly below normal speech intelligibility in 75.9% of the patients, moderate or no rhinolalia in 72.4% of the patients and mean overall VHI30 scores indicative of slight or no handicap in 86.2% of the patients. Swallowing outcomes were satisfactory, with mean overall DHI scores indicative of slight or no handicap in 82.8% of the patients. Patient quality of life was preserved as demonstrated by mean quality of life and functioning scales scores all superior to 80%. Conclusion The sequelae arising from surgical resection and free-flap reconstruction of soft palate cancer are tolerable, involving slight handicap in terms of speech and swallowing and relatively little impact on quality of life.

Published
2021

2. Free flap head and neck reconstruction: Feasibility in older patients

Author

Pierre Pradat, Aurélie Parsemain, Carine Fuchsmann, Philippe Ceruse, and Pierre Philouze

Subjects
Male, Comorbidity, Postoperative Complications, 0302 clinical medicine, 030212 general & internal medicine, Aged, 80 and over, Bone Transplantation, Smoking, Age Factors, Middle Aged, Neoadjuvant Therapy, Survival Rate, Forearm, Oropharyngeal Neoplasms, Oncology, Head and Neck Neoplasms, 030220 oncology & carcinogenesis, Cohort, Female, Mouth Neoplasms, medicine.medical_specialty, Reconstructive surgery, Free flap, Free Tissue Flaps, Disease-Free Survival, 03 medical and health sciences, medicine, Humans, Laryngeal Neoplasms, Contraindication, Aged, Neoplasm Staging, Retrospective Studies, Radiotherapy, Squamous Cell Carcinoma of Head and Neck, business.industry, Pharyngeal Neoplasms, Retrospective cohort study, Perioperative, Length of Stay, Plastic Surgery Procedures, medicine.disease, Surgery, Case-Control Studies, Feasibility Studies, Tracheotomy, Geriatrics and Gerontology, Complication, business
Abstract

Objectives The main purpose of this study was to evaluate the perioperative morbidity of free flap head and neck reconstructive surgery in patients aged 70 years and over (Group A) by comparison with a cohort of younger patients (Group B). Secondary objectives included assessment of survival rates and functional outcomes in these older patients, likewise by comparison with a cohort of younger patients. Methods A retrospective study was conducted on all patients aged 70 years and over who underwent free flap reconstruction between 2012 and 2017. They were compared to a control group of younger patients to investigate hospital length of stay, postoperative complications and survival rates, and functional outcomes. Results No significant difference was observed between the two groups in terms of variables such as hospital length of stay and medical/surgical complications. In multivariate analysis, comorbidity was the only predictive factor for postoperative medical complications, and pharyngolaryngeal location the only significant predictive factor for surgical complications. Factors significantly associated with hospital length of stay were older age, active smoking, pharyngolaryngeal location and the Charlson Comorbidity Index (CCI). Overall survival was the only factor that was substantially lower in the over 70 group, while disease-specific and relapse-free survival were comparable in both groups. Conclusion Old age per se should not be considered a contraindication to major surgery combined with free flap reconstruction in older patients.

Published
2019

3. Population pharmacokinetics of daptomycin in patients with bone and joint infection: minimal effect of rifampicin co-administration and confirmation of a sex difference

Author

Garreau, Romain, Bricca, Romain, Gagnieu, Marie-Claude, Roux, Sandrine, Conrad, Anne, Bourguignon, Laurent, Ferry, Tristan, Goutelle, Sylvain, Valour, Florent, Perpoint, Thomas, Miailhes, Patrick, Ader, Florence, Becker, Agathe, Triffault-Fillit, Claire, Pouderoux, Cécile, Benech, Nicolas, Chauvelot, Pierre, Perry, Marielle, Daoud, Fatiha, Lippman, Johanna, Braun, Evelyne, Chidiac, Christian, Servien, Elvire, Lustig, Sébastien, Batailler, Cécile, Gunst, Stanislas, Schmidt, Axel, Malatray, Matthieu, Sappey-Marinier, Elliot, Fessy, Michel-Henry, Viste, Anthony, Besse, Jean-Luc, Chaudier, Philippe, Louboutin, Lucie, Ode, Quentin, van Haecke, Adrien, Mercier, Marcelle, Belgaid, Vincent, Walch, Arnaud, Martres, Sébastien, Trouillet, Franck, Barrey, Cédric, Mojallal, Ali, Brosset, Sophie, Hanriat, Camille, Person, Hélène, Sigaux, Nicolas, Céruse, Philippe, Fuchsmann, Carine, Aubrun, Frédéric, Dziadzko, Mikhail, Macabéo, Caroline, Laurent, Frederic, Beraud, Laetitia, Roussel-Gaillard, Tiphaine, Dupieux, Céline, Kolenda, Camille, Josse, Jérôme, Brevet, Marie, Trecourt, Alexis, Craighero, Fabien, Boussel, Loic, Pialat, Jean-Baptiste, Morelec, Isabelle, Tod, Michel, Mabrut, Eugénie, Hospices Civils de Lyon (HCL), Lyon Bone and Joint Infection Study Group (BJI), Hôpital Nord-Ouest de Villefranche-sur-Saône, Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre interrégional de référence Rhône-Alpes - Auvergne des infections ostéo-articulaires complexes, Institut des Sciences Pharmaceutiques et Biologiques (ISPB), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Modeling & analysis for medical imaging and Diagnosis (MYRIAD), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL)

Subjects
Male, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, 030106 microbiology, Population, MESH: Daptomycin, 03 medical and health sciences, 0302 clinical medicine, Daptomycin, Pharmacokinetics, MESH: Drug Monitoring, Internal medicine, MESH: Anti-Bacterial Agents, medicine, polycyclic compounds, Humans, Pharmacology (medical), 030212 general & internal medicine, Dosing, education, Pharmacology, Volume of distribution, Sex Characteristics, education.field_of_study, MESH: Humans, medicine.diagnostic_test, business.industry, Drug interaction, [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences, bacterial infections and mycoses, MESH: Rifampin, MESH: Male, Anti-Bacterial Agents, Infectious Diseases, Therapeutic drug monitoring, Female, Drug Monitoring, Rifampin, business, MESH: Female, Rifampicin, medicine.drug, MESH: Sex Characteristics
Abstract

Background Daptomycin is increasingly used in the treatment of bone and joint infection (BJI), but its pharmacokinetics (PK) and dosage requirements have not been thoroughly investigated in this indication. Daptomycin may be co-administered with rifampicin, which raises questions about a potential drug interaction. Objectives To investigate the population PK and dosage requirements of daptomycin in patients with BJI, and examine the influence of rifampicin co-administration. Methods A population approach was used to analyse PK data from patients who received daptomycin in our regional reference for BJI. We examined the influence of available covariates, including rifampicin co-administration on daptomycin PK. Simulations performed with the final model investigated the influence of dosages and covariates on PTA for both efficacy and safety. Results A total of 1303 daptomycin concentrations from 183 patients were analysed. A two-compartment model best described the data. Significant intra-individual variability was observed. Daptomycin clearance was influenced by renal function and sex, with females having a 26% lower typical clearance than males. Central volume of distribution (V1) was influenced by body weight, age, sex and rifampicin co-administration. Typical V1 was 11% lower in patients who were co-administered rifampicin. In PK/PD simulations, sex influenced the probability of AUC24/MIC target attainment, while rifampicin had a marginal effect. Conclusions A daptomycin dosage of 8 mg/kg/24 h in women and 10 mg/kg/24 h in men should optimize efficacy but may lead to excessive trough concentrations in many patients, especially in women. Therapeutic drug monitoring appears necessary for precision dosing of daptomycin.

Published
2021

4. Evaluation of virtual surgical planning systems and customized devices in fibula free flap mandibular reconstruction

Author

Jacques Blanc, Pierre Jacquenot, Veronica Nistiriuc-Muntean, Carine Fuchsmann, Pierre Philouze, and Philippe Ceruse

Subjects
Adult, Male, medicine.medical_specialty, Cephalometry, Conventional surgery, Operative Time, Free flap, Mandible, Surgical planning, Free Tissue Flaps, 03 medical and health sciences, User-Computer Interface, 0302 clinical medicine, Ischemia, medicine, Humans, Mandibular reconstruction, Fibula, 030223 otorhinolaryngology, Orthodontics, business.industry, General Medicine, Middle Aged, Plastic Surgery Procedures, Surgical Instruments, Otorhinolaryngology, Virtual planning, Surgery, Computer-Assisted, 030220 oncology & carcinogenesis, Operative time, Female, Mandibular Reconstruction, business
Abstract

The purpose of this study was to evaluate the accuracy of virtual planning using customized surgical devices (VP3D) in fibula free flap mandibular reconstruction. Fourteen patients received VP3D and 16 patients underwent conventional surgery (CS). Virtual planning was compared to postoperative scans using cephalometric and three-dimensional (3D) measurements. Operative times of both VP3D and CS groups were compared. Comparisons of cephalometric measurements revealed no significant difference between virtual planning and postoperative scans. 3D analysis demonstrated a high level of virtual planning accuracy. In the VP3D group, total operative time gain was 88 min (p

Published
2019

5. Subcutaneous suppressive antibiotic therapy for bone and joint infections: safety and outcome in a cohort of 10 patients

Author

Lippman, J., Braun, E., Servien, E., Batailler, C., Gaillard, R., Gunst, S., Roger, J., Fiquet, C., Viste, A., Chaudier, P., Besse, J. L., Louboutin, L., Gaudin, G., Ledru, T., Van Haecke, A., Ode, Q., Mercier, M., Alech-Tournier, F., Martres, S., Trouillet, F., Barrey, C., Jouanneau, E., Jacquesson, T., Gerenton, B., Mojallal, A., Boucher, F., Shipkov, H., Ceruse, P., Fuchsmann, C., Gleizal, A., Aubrun, F., Dziadzko, M., Macabeo, C., Beraut, L., Dupieux, C., Kolenda, C., JOSSE, J., Gustave, C. A., Craighero, F., Boussel, L., Pialat, J. B., Morelec, I., Tod, M., Gagnieu, M. C., Mabrut, E., Lyon Bone Joint Infection, Study, Goutelle, S., Lustig, S., Daoud, F., Fessy, M. H., Cohen, S., Laurent, F., Chidiac, C., Valour, F., Ferry, T., Perpoint, T., Miailhes, P., Ader, F., Becker, A., Roux, S., Triffault-Fillit, C., Conrad, A., Perry, M., Pouderoux, C., Service de Chirurgie Orthopédique [Centre Albert Trillat], Centre Albert Trillat [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Neuroimagerie cognitive (LCogn), Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service hospitalo-universitaire de santé mentale et de thérapeutique, CHU Paris, Service de chirurgie maxillo-faciale et stomatologie [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Hospices Civils de Lyon (HCL), RMN et optique : De la mesure au biomarqueur, Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Edouard Herriot [CHU - HCL], Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Physiologie cardio-Respiratoire Expérimentale Théorique et Appliquée (TIMC-IMAG-PRETA), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Unite de Microbiologie Alimentaire et Previsionnelle, Ecole Nationale Vétérinaire de Lyon (ENVL), Centre National de Référence Legionella, Imagerie et modélisation Vasculaires, Thoraciques et Cérébrales (MOTIVATE), Physiopathologie, diagnostic et traitements des maladies osseuses / Pathophysiology, Diagnosis & Treatments of Bone Diseases (LYOS), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Physics [Ioannina), University of Ioannina, ARVALIS - Institut du végétal [Paris], Service des Maladies Infectieuses, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France, parent, Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL], Equipe 15, Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hosp Civils Lyon, Serv Malad Infect, Lyon, France, Institut für Physik [Rostock], Universität Rostock, Laboratoire de Mécanique et Technologie (LMT), École normale supérieure - Cachan (ENS Cachan)-Centre National de la Recherche Scientifique (CNRS), Centre interrégional de référence Rhône-Alpes - Auvergne des infections ostéo-articulaires complexes, University of Arizona, Agence Nationale de la Recherche, Hospices Civils de Lyon, ANR-11-LABX-0048, LABEX ECOFECT, ANR-11-IDEX-0007, Investissements d'Avenir, Institut des Sciences Chimiques de Rennes (ISCR), Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Supérieure de Chimie de Rennes-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES), Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Centre de Recherche en Cancérologie de Lyon (CRCL), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-Ecole Nationale Supérieure de Chimie de Rennes-Centre National de la Recherche Scientifique (CNRS), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiologie cardio-Respiratoire Expérimentale Théorique et Appliquée (TIMC-PRETA), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and Modeling & analysis for medical imaging and Diagnosis (MYRIAD)

Subjects
0301 basic medicine, Microbiology (medical), Male, medicine.medical_specialty, medicine.medical_treatment, gram-negative bacilli, [SDV]Life Sciences [q-bio], 030106 microbiology, Salvage therapy, Arthritis, Prosthesis, Microbiology, Cohort Studies, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, ertapenem, medicine, Combined Modality Therapy, Humans, Pharmacology (medical), 030212 general & internal medicine, Pharmacology & Pharmacy, Prospective cohort study, risk-factors, carriage, Pharmacology, Arthritis, Infectious, business.industry, Drug Administration Routes, Osteomyelitis, medicine.disease, Prognosis, Magnetic Resonance Imaging, 3. Good health, Surgery, Anti-Bacterial Agents, Treatment Outcome, Infectious Diseases, chemistry, Ceftriaxone, Female, business, Tomography, X-Ray Computed, Ertapenem, pharmacokinetics, Cohort study, medicine.drug
Abstract

Background Optimal treatment of prosthetic joint infection and chronic osteomyelitis consists of surgical removal of biofilm-embedded bacteria, followed by a 6–12 week course of antimicrobial therapy. However, when optimal surgery is not feasible, oral prolonged suppressive antibiotic therapy (PSAT) is recommended to prevent prosthesis loosening and/or relapse of infection. Since 2010, we have used infection salvage therapy using off-label subcutaneous (sc) injection of a β-lactam as PSAT for patients in whom oral PSAT is not possible. Methods A single-centre prospective cohort study (2010–18) reporting treatment modalities, efficacy and safety in all patients receiving sc PSAT. NCT03403608. Results The 10 included patients (median age 79 years) had polymicrobial (n = 5) or MDR bacterial (n = 4) prosthetic joint infection (knee, n = 4; hip, n = 3) or chronic osteomyelitis (n = 3). After initial intensive therapy, seven patients received ertapenem, three patients received ceftriaxone and one patient received ceftazidime by sc injection (one patient received 8 days of ceftriaxone before receiving ertapenem). In one patient, sc PSAT failed with recurrent signs of infection under treatment. In three patients, sc PSAT had to be discontinued due to side effects; in only one of these was the sc route implicated (skin necrosis following direct sc injection and not gravity infusion). Median treatment duration was 433 days. In six patients, sc PSAT was successful with favourable outcome at the time of writing. Interestingly, three patients with MDR bacterial carriage at baseline lost this under PSAT during follow-up. Conclusions As salvage therapy, sc PSAT delivered by gravity infusion is a safe and interesting alternative when an optimal surgical strategy is not feasible and no oral treatment is available.

Published
2019

6. Genetic polymorphisms of ABCB1 (P-glycoprotein) as a covariate influencing daptomycin pharmacokinetics: a population analysis in patients with bone and joint infection

Author

Jacquesson, T., Mojallal, A., Braye, F., Boucher, F., Shipkov, H., Chateau, J., Ceruse, P., Fuchsmann, C., Gleizal, A., Aubrun, F., Dziadzko, M., Macabeo, C., Rasigade, J. P., Beraut, L., Dupieux, C., Kolenda, C., JOSSE, J., Craighero, F., Boussel, L., Pialat, J. B., Morelec, I., Janier, M., Giammarile, F., Tod, M., Mabrut, E., Lyon Bone Joint Infect Study, Grp, Bricca, R., Goutelle, S., Gagnieu, M. C., Laurent, F., Ferry, T., Valour, F., Perpoint, T., Boibieux, A., Biron, F., Miailhes, P., Ader, F., Becker, A., Roux, S., Triffault-Fillit, C., Conrad, A., Bosch, A., Daoud, F., Lippman, J., Braun, E., Chidiac, C., Lustig, S., Servien, E., Gaillard, R., Schneider, A., Gunst, S., Batailler, C., Fessy, M. H., Herry, Y., Viste, A., Chaudier, P., Courtin, C., Louboutin, L., Martres, S., Trouillet, F., Barrey, C., Jouanneau, E., RMN et optique : De la mesure au biomarqueur, Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de biologie et chimie des protéines [Lyon] (IBCP), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Institut universitaire des systèmes thermiques industriels (IUSTI), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Hôpital de la Croix-Rousse [CHU - HCL], Unite de Microbiologie Alimentaire et Previsionnelle, Ecole Nationale Vétérinaire de Lyon (ENVL), Centre National de Référence Legionella, Imagerie et modélisation Vasculaires, Thoraciques et Cérébrales (MOTIVATE), Physiopathologie, diagnostic et traitements des maladies osseuses / Pathophysiology, Diagnosis & Treatments of Bone Diseases (LYOS), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche et d'Application en Traitement de l'Image et du Signal (CREATIS), Université de Lyon-Université de Lyon-École Supérieure de Chimie Physique Électronique de Lyon (CPE)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Department of nuclear Imaging, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), ARVALIS - Institut du végétal [Paris], Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL], Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hosp Civils Lyon, Serv Malad Infect, Lyon, France, Institut für Physik [Rostock], Universität Rostock, Laboratoire de Mécanique et Technologie (LMT), École normale supérieure - Cachan (ENS Cachan)-Centre National de la Recherche Scientifique (CNRS), Centre interrégional de référence Rhône-Alpes - Auvergne des infections ostéo-articulaires complexes, University of Arizona, University of Barcelona, Service des Maladies Infectieuses, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France, parent, Service de Chirurgie Orthopédique [Centre Albert Trillat], Centre Albert Trillat [Hôpital de la Croix-Rousse - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse [CHU - HCL], Neuroimagerie cognitive (LCogn), Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service hospitalo-universitaire de santé mentale et de thérapeutique, CHU Paris, Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-École Supérieure Chimie Physique Électronique de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Equipe 15, Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Centre de Recherche en Cancérologie de Lyon (CRCL), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, 0301 basic medicine, Oncology, Pharmacogenomic Variants, [SDV]Life Sciences [q-bio], efficacy, 0302 clinical medicine, Genotype, Pharmacology (medical), 030212 general & internal medicine, Pharmacology & Pharmacy, mdr1, education.field_of_study, Middle Aged, Bone Diseases, Infectious, Anti-Bacterial Agents, 3. Good health, modulation, Infectious Diseases, Area Under Curve, Population Surveillance, Female, Drug Monitoring, Glomerular Filtration Rate, medicine.drug, Microbiology (medical), safety, medicine.medical_specialty, ATP Binding Cassette Transporter, Subfamily B, 030106 microbiology, Population, Polymorphism, Single Nucleotide, Microbiology, 03 medical and health sciences, Daptomycin, Pharmacokinetics, Internal medicine, medicine, Humans, high-dose daptomycin, education, Genotyping, Alleles, Aged, Pharmacology, Arthritis, Infectious, therapy, business.industry, variability, Haplotype, Pharmacogenetics, exposure, Pharmacodynamics, resistant staphylococcus-aureus, Gene polymorphism, business
Abstract

International audience; Background Daptomycin has been recognized as a therapeutic option for the treatment of bone and joint infection (BJI). Gene polymorphism of ABCB1, the gene encoding P-glycoprotein (P-gp), may influence daptomycin pharmacokinetics (PK). Objectives We aimed to examine population PK of daptomycin and its determinants, including genetic factors, in patients with BJI. Patients and methods We analysed data from patients who received daptomycin for BJI between 2012 and 2016 in our regional reference centre and who had measured daptomycin concentrations and P-gp genotyping. A population approach was used to analyse PK data. In covariate analysis, we examined the influence of three single nucleotide variations (SNVs) of ABCB1 (3435C\textgreaterT, 2677G\textgreaterT/A and 1236C\textgreaterT) and that of the corresponding haplotype on daptomycin PK parameters. Simulations performed with the final model examined the influence of covariates on the probability to achieve pharmacodynamic (PD) targets. Results Data from 81 patients were analysed. Daptomycin body CL (CLDAP) correlated with CLCR and was 23% greater in males than in females. Daptomycin central V (V1) was allometrically scaled to body weight and was 25% lower in patients with homozygous CGC ABCB1 haplotype than in patients with any other genotype. Simulations performed with the model showed that sex and P-gp haplotype may influence the PTA for high MIC values and that a dosage of 10mg/kg/24h would optimize efficacy. Conclusions Daptomycin dosages higher than currently recommended should be evaluated in patients with BJI. Gender and P-gp gene polymorphism should be further examined as determinants of dosage requirements.

Published
2019

7. Strategies of Active Middle Ear Implants for Hearing Rehabilitation in Congenital Aural Atresia

Author

Eric Truy, Nicolas Verhaert, Stéphane Tringali, Carine Fuchsmann, and Geneviève Lina-Granade

Subjects
Adult, Male, Hearing aid, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Hearing Loss, Conductive, Ear, Middle, Audiology, Hearing Loss, Unilateral, Hearing Loss, Bilateral, Hearing Aids, Bone conduction, Audiometry, otorhinolaryngologic diseases, medicine, Humans, Child, Stapes, Round window, medicine.diagnostic_test, business.industry, Auditory Threshold, medicine.disease, Sensory Systems, Conductive hearing loss, Surgery, Ossicular Prosthesis, Treatment Outcome, medicine.anatomical_structure, Otorhinolaryngology, Hearing level, Speech Perception, Middle ear, Audiometry, Pure-Tone, Female, Neurology (clinical), business, Bone Conduction
Abstract

OBJECTIVE: To describe our surgical and audiometric experience using different active middle ear implant strategies facing various anatomic situations in aural atresia. STUDY DESIGN: Retrospective case review. SETTING: Tertiary academic referral center. PATIENTS: Five patients with congenital aural atresia, (3 unilateral and 2 bilateral), with mean age of 22.4 years (range, 12-44 yr), referred for hearing rehabilitation. INTERVENTION: Active middle ear implant on stapes capitulum. MAIN OUTCOME MEASURES: Description of surgical implantation with different active middle ear implants. Preoperative and postoperative air conduction, bone conduction, and aided and unaided thresholds and speech scores were measured, at mid to long term. Subjective benefit analysis was determined through the Abbreviated Profile of Hearing Aid Benefit questionnaire. RESULTS: After activation and fitting of the devices, a mean functional gain of 32.5 dB hearing level was measured. Speech tests in quiet showed a mean functional gain of 20.2 dB. Patients had a mean follow-up period of 12 months. No intraoperative or postoperative complications were noted. Furthermore, we reflected on new coupling possibilities, especially in a difficult case with stapes-footplate fixation where no approach of the round window was feasible because of aberrant facial nerve course. CONCLUSION: Facing anatomic variations in congenital aural atresia, active middle ear implants can provide substantial hearing improvement in safe conditions and open new strategies for hearing rehabilitation.

Published
2011

8. Diffusion-weighted MR imaging for evaluation of pediatric recurrent cholesteatomas

Author

C. Fuchsmann, D. Bossard, S. Ayari-Khalfallah, Patrick Froehlich, and I. Plouin-Gaudon

Subjects
Male, Reoperation, medicine.medical_specialty, Adolescent, Severity of Illness Index, Predictive Value of Tests, Recurrence, Severity of illness, otorhinolaryngologic diseases, medicine, Humans, Prospective Studies, Child, Prospective cohort study, Cholesteatoma, Middle Ear, business.industry, Cholesteatoma, General Medicine, medicine.disease, Diffusion Magnetic Resonance Imaging, medicine.anatomical_structure, Otorhinolaryngology, Child, Preschool, Middle ear surgery, Predictive value of tests, Pediatrics, Perinatology and Child Health, Middle ear, Female, Radiology, Tomography, Tomography, X-Ray Computed, business, Diffusion MRI
Abstract

Objective To compare the efficiency of diffusion-weighted MR imaging (MRI) vs. high resolution CT in predicting recurrent or residual cholesteatoma in children who underwent prior middle ear surgery. Design Prospective study. Setting Tertiary care university hospital. Patients Seventeen patients (4 with 2 recurrences) aged 5–17 years (mean 11.4) previously surgically treated for a cholesteatoma of the middle ear, were included for follow-up with systematic CT scan and MRI, between 2005 and 2007. Methodology CT scan was performed on a Siemens Somaton 64 (0.5/0.2 mm slices reformatted in 0.5/0.3 mm images), parallel and perpendicular to the lateral semi-circular canal for each ear (100 mm × 100 mm FOV). MRI was undertaken on a Siemens Avanto 1.5 T unit, with an adapted protocol for young children. Diagnosis of recurrent cholesteatoma was based on the evidence of a hyperintense image at B1000 on diffusion-weighted images. Results of CT scan and MRI were compared with operative diagnosis. Results Nine patients had a positive MRI, among which 8 had cholesteatoma confirmed during revision surgery. In the 12 negative MRI cases, 5 were positive on revision surgery. None of these lesions was over 3 mm. Two of them were diagnosed on the CT scan. CT scan alone had a positive predictive value of 75%, and a negative predictive value of 58%. Conclusion Diffusion-weighted MRI is associated with a high positive predictive value for the detection of recurrent cholesteatoma. CT scan remains the first choice imaging technique. In case of doubtful CT scan, diffusion-weighted MRI could confirm a recurrence or, when negative, avoid second-look surgery.

Published
2010

9. Contribution of CT-assisted navigation and microdebriders to endoscopic sinus surgery in cystic fibrosis

Author

C. Fuchsmann, Patrick Froehlich, P. Reix, S. Ayari, M.P. Colreavy, I. Durieux, and Gabriel Bellon

Subjects
Adult, Male, Microsurgery, medicine.medical_specialty, Adolescent, Cystic Fibrosis, Cystic fibrosis, Quality of life, medicine, Humans, Major complication, Sinusitis, Child, PERIORBITAL PAIN, Retrospective Studies, business.industry, Endoscopy, Retrospective cohort study, Equipment Design, General Medicine, medicine.disease, Surgery, Endoscopic sinus surgery, Debridement, Otorhinolaryngology, Child, Preschool, Pediatrics, Perinatology and Child Health, Female, Tomography, X-Ray Computed, business, Bilateral surgery, Follow-Up Studies
Abstract

Summary Objective To demonstrate the interest of CT-assisted navigation and the microdebrider in rhino-sinus surgery for cystic fibrosis. Methods A retrospective study included 20 patients with cystic fibrosis who had undergone endoscopic sinus surgery using CT-assisted navigation and microdebrider between 1998 and 2006. Results Surgery was indicated for the following symptoms resistant to medical management: incapacitating nasal obstruction (n = 18, 90%) and headache or periorbital pain (n = 14, 70%). At 3 years follow-up, six patients (30%) were symptom-free, six (30%) had required re-operation, and symptoms were well controlled by medication in the other eight (40%). Mean initial bilateral surgery time was 61 min. There were no complications. Conclusion The advent of microdebriders and CT-based navigation has improved endoscopic sinus surgery in cystic fibrosis. It has permitted the control of medication-resistant symptoms, especially nasal obstruction and pain. Precision is satisfactory, with reduced surgery time. No major complications have been observed. Two- or three-step surgery is possible where endoscopic anatomic landmarks have suffered alteration. The resultant control of symptoms encourages extending indications, with repeat procedures, in view of improving patients’ quality of life. Further assessment on a larger series will be needed.

Published
2008

10. Thulium laser in airway diseases in children

Author

Patrick Froehlich, Sonia Ayari-Khalfallah, and Carine Fuchsmann

Subjects
Male, medicine.medical_specialty, Treatment outcome, Laryngoscopy, chemistry.chemical_element, Thulium laser, law.invention, Laryngeal Diseases, Tracheostomy, law, medicine, Humans, Medical physics, Child, Tracheal Diseases, medicine.diagnostic_test, business.industry, Infant, Newborn, Infant, Laser, Treatment Outcome, Thulium, Otorhinolaryngology, chemistry, Child, Preschool, Female, Surgery, Laser Therapy, Airway, business
Abstract

To specify the characteristics of the thulium laser and to evaluate the advantages and possibilities of treatment with this laser in laryngotracheal diseases in children.Fiber-based lasers have facilitated a new style of surgery. When performing therapeutic airways endoscopies there is the possibility of good control of lesions and adequate visualization of the surgical field using the telescope. Different types of laser may be used but the 2013-nm thulium laser shows promise as a laser that is efficient in soft tissues with the advantages of the other lasers without their problems. The thulium laser has been described in treating urinary tract abnormalities and recently airways diseases in adults, but there are no reports of other uses for this technique in the pediatric airway.The thulium laser appears to be an interesting tool in the management of laryngotracheal diseases such as subglottic stenosis, tracheal granuloma and laryngomalacia. The use of this laser in laryngotracheal diseases in children will probably progress in the future.

Published
2008

11. Curative treatment can be an option for patients with metastatic squamous cell cancer of the head and neck

Author

Philippe Ceruse, Clémence Guenne, Alain Cosmidis, Sophie Tartas, Jérôme Fayette, Carine Fuchsmann, and V. Favrel

Subjects
Oncology, Male, squamous cell carcinoma, medicine.medical_specialty, Pathology, TPF, Pharmaceutical Science, head and neck, Internal medicine, Drug Discovery, Antineoplastic Combined Chemotherapy Protocols, cetuximab, Recurrent disease, Medicine, Humans, Basal cell, Head and neck, metastases, Aged, Original Research, Pharmacology, Aged, 80 and over, Squamous cell cancer, Drug Design, Development and Therapy, Cetuximab, business.industry, Squamous Cell Carcinoma of Head and Neck, Induction chemotherapy, Middle Aged, stomatognathic diseases, Curative treatment, Head and Neck Neoplasms, Localized disease, Positron-Emission Tomography, Carcinoma, Squamous Cell, Female, business, medicine.drug
Abstract

Clémence Guenne,1 Jérôme Fayette,2 Alain Cosmidis,1 Carine Fuchsmann,1 Sophie Tartas,3 Véronique Favrel,4 Philippe Céruse1 1Head and Neck Surgery Department, Lyon-I University, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France; 2Medicine Department, Lyon-I University, Centre Léon Bérard, Lyon, France; 3Medical Oncology Department, Lyon-I University, Hospices Civils de Lyon, Lyon Sud Hospital, 4Radiotherapy Department, Lyon-I University, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France Background: No specific study has focused on patients with metastatic squamous cell carcinoma of the head and neck (SCCHN) at diagnosis. Due to high response rates of induction chemotherapy in chemo-naïve patients with localized disease, their prognosis should be better than patients with recurrent disease.Methods: From January 1, 2008 to July 1, 2012, we retrospectively collected all patients’ records with SCCHN diagnosed as metastatic. Patients, disease, treatment and its results were analyzed. Survival was calculated using the Kaplan–Meier method.Results: Of the 749 new patients treated for SCCHN in our institution, 16 (2.1%) were metastatic at diagnosis, of whom five had cytological results to prove it. Six patients died before treatment or had palliative care and ten received initial chemotherapy and then surgery and/or radiotherapy according to the primary response. Four patients treated with first-line chemotherapy with docetaxel-5FU-cisplatin (TPF) showed a complete response of metastatic lesions allowing locoregional treatment. The overall survival at 1 year and 3 years was 50% and 24%, respectively. The median survival was 7 months (1–72 months). Seven patients (43.7%) had a higher survival at 12 months, including five (31.5%) who are still alive without recurrence with a mean follow-up of 30 months. There was a significant difference in overall survival (P

Published
2014

12. A pyriform sinus cancer organ preservation strategy comprising induction chemotherapy with docetaxel, cisplatin, and 5-fluorouracil, followed by potentiated radiotherapy: a multicenter, retrospective study

Author

Antoine Ramade, Muriel Rabilloud, Sophie Tartas, Aurélien Belot, Jérôme Fayette, Carine Fuchsmann, Philippe Céruse, Marc Poupart, V. Favrel, Pascal Pommier, Philippe Zrounba, Alain Cosmidis, Biostatistiques santé, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), and Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Adult, Male, Cancer Research, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Urology, Docetaxel, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, Antineoplastic Combined Chemotherapy Protocols, otorhinolaryngologic diseases, medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Aged, Retrospective Studies, Pharmacology, Cetuximab, business.industry, Cancer, Induction chemotherapy, Hypopharyngeal cancer, Induction Chemotherapy, Middle Aged, medicine.disease, Combined Modality Therapy, 3. Good health, Surgery, Laryngectomy, Radiation therapy, Pyriform Sinus, Oncology, 030220 oncology & carcinogenesis, Carcinoma, Squamous Cell, Female, Taxoids, Fluorouracil, Cisplatin, Neoplasm Recurrence, Local, business, Organ Sparing Treatments, Paranasal Sinus Neoplasms, medicine.drug
Abstract

No specific study has evaluated the role of neoadjuvant DCF (docetaxel, cisplatin, 5-fluorouracil) followed by radiotherapy in pyriform sinus cancer, which are often included in studies focusing on laryngeal and hypopharyngeal cancer. We assessed the proportion of patients treated sequentially for a pyriform sinus cancer with a preserved larynx. Overall survival, event-free survival (EFS), survival with 'local control', and treatment tolerance were assessed as well. We retrospectively reviewed 88 patients with advanced pyriform sinus squamous cell carcinoma treated with DCF between 2005 and 2010. After induction, radiation could be potentiated with cetuximab or cisplatin. Most patients (82%) had been treated with organ preservation intent. The response rate to DCF was 85%, including 42% with complete response. Primary tumor was operated in 13 patients (eight with total laryngectomy). Radiotherapy had been delivered to 78 (89%) patients (30 with cisplatin, 39 with cetuximab). Potentiation had been achieved as planned in 52 and 79% of patients treated with cisplatin and cetuximab, respectively. Twenty-three local and three neck recurrences were found. Median overall survival was 16.8 months and 38.3% at 3 years. EFS at 3 years was 29.1% with a hazard ratio for partial responders versus nonresponders of 0.18 (P

Published
2014

13. Efficacy and safety of photodynamic therapy with temoporfin in curative treatment of recurrent carcinoma of the oral cavity and oropharynx

Author

A. Ramade, Philippe Ceruse, Carine Fuchsmann, M. Durbec, and Alain Cosmidis

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Photodynamic therapy, Antineoplastic Agents, Disease-Free Survival, Temoporfin, chemistry.chemical_compound, Quality of life, Medicine, Humans, Adverse effect, Hematoporphyrin Photoradiation, Aged, Aged, 80 and over, business.industry, Recurrent Carcinoma, General Medicine, Middle Aged, Surgery, Oropharyngeal Neoplasms, Treatment Outcome, Otorhinolaryngology, Oropharyngeal Carcinoma, chemistry, Mesoporphyrins, Female, Mouth Neoplasms, Radiology, Neurosurgery, Neoplasm Recurrence, Local, business
Abstract

Therapeutic options for recurrent carcinoma of the upper aérodigestive tract (UADT) are limited. The prognosis of these tumours remains poor with significant rate of recurrence and a lower median survival time. Photodynamic therapy (PDT) is a relatively new therapeutic alternative which combines the use of a photosensitising agent and light to induce a cytotoxic effect on the tissues. This is a retrospective single-centre study carried out in patients with a recurrence of an oral cavity or oropharyngeal carcinoma or a second appearance of tumour in a previously irradiated area. There were no metastases in lymph nodes or other organs. Laser treatment was carried out 96 h after temoporfin (Foscan(®)) injection. In our series we had 14 cases with a complete response, 1 partial response. Overall survival at 1 year was 72 % and 36 % at 5 years. Disease-specific survival at 1 year was 82 % and 45 % at 5 years. Recurrence-free survival at 1 year was 52 % and 34 % at 5 years. Side effects mainly described are pain in the area of illumination, well controlled. PDT with Foscan(®) gives useful results in terms of survival and improvement in quality of life with few adverse events or severe complications. The fact that it has low toxicity and that treatment sessions can be repeated mean it should be considered in the therapeutic armamentarium for recurrent carcinoma of the UADT.

Published
2012

14. [Importance of a molding nasolabial flap in the reconstruction of mobile nose defects, a review of 25 cases]

Author

M, Durbec, D, Vertu-Ciolino, C, Fuchsmann, and F, Disant

Subjects
Adult, Aged, 80 and over, Male, Young Adult, Humans, Female, Middle Aged, Nose, Plastic Surgery Procedures, Surgical Flaps, Aged
Abstract

Mobile nose reconstruction, because of its location, its anatomy and its functional role is a surgical challenge. We describe throughout this article the surgical technique and the importance of the nasolabial flap in a single-step procedure for repairing mobile nose defects.We present 25 cases of mobile nose defects secondary to an oncologic etiology, affecting the supratip, the alar margin and the columella. Patients benefited from a superiorly pedicled molding nasolabial flap harvested in a one-step procedure under local anesthesia.Aesthetic result of each repair was evaluated according to 5 criteria and was considered as very satisfactory by the surgeons. No complication such as necrosis or infection was recorded.A molding nasolabial flap allows optimum repair of the mobile nose. It represents reliability, elasticity at the price of minimal scarring. We find it an important tool in the therapeutic armamentarium in patients with tissue loss in mobile nose.

Published
2011

15. Hearing preservation in retrosigmoid approach of small vestibular schwannomas: prognostic value of the degree of internal auditory canal filling

Author

Carine Fuchsmann, Christian Dubreuil, Guillaume Buiret, Stéphane Tringali, Sandra Zaouche, and Chantal Ferber-Viart

Subjects
Male, medicine.medical_specialty, Fundus (eye), Schwannoma, Postoperative Complications, Hearing, Predictive Value of Tests, otorhinolaryngologic diseases, medicine, Humans, Cranial Nerve Neoplasms, Retrospective Studies, Palsy, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, Retrospective cohort study, Neuroma, Acoustic, Middle Aged, Vestibulocochlear Nerve, Neuroma, medicine.disease, Prognosis, Magnetic Resonance Imaging, Sensory Systems, Surgery, Treatment Outcome, Otorhinolaryngology, Predictive value of tests, Ear, Inner, Audiometry, Pure-Tone, Female, Neurology (clinical), Audiometry, Facial Nerve Diseases, business
Abstract

OBJECTIVES To assess the contribution of preoperative radiologic appearance of vestibular schwannoma (VS) on the magnetic resonance imaging in constructive interference in steady-state sequences and demonstrate if the degree of the internal auditory canal (IAC) filling is correlated with hearing and facial preservation. PATIENTS A group of 278 patients who underwent VS surgery in a tertiary referral center. INTERVENTION Retrosigmoid approach surgery. MAIN OUTCOME MEASURES Patients were classified in 4 groups according to the percentage of IAC filling on the preoperative magnetic resonance imaging as Group IAC 1(IAC empty or filled

Published
2010

16. Hearing rehabilitation in congenital aural atresia using the bone-anchored hearing aid: audiological and satisfaction results

Author

Patrick Froehlich, Christian Dubreuil, Guillaume Buiret, Carine Fuchsmann, Eric Truy, F. Disant, and Stéphane Tringali

Subjects
Hearing aid, Adult, Male, Reoperation, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Hearing Loss, Conductive, Audiology, Prosthesis Design, Congenital Abnormalities, Prosthesis Implantation, Young Adult, Patient satisfaction, Bone conduction, Hearing Aids, Quality of life, Suture Anchors, otorhinolaryngologic diseases, Medicine, Humans, Ear, External, Child, Congenital Microtia, Rehabilitation, business.industry, Bone-anchored hearing aid, Auditory Threshold, Ear, General Medicine, Syndrome, Middle Aged, medicine.disease, Conductive hearing loss, Otorhinolaryngology, Atresia, Child, Preschool, Quality of Life, Female, business, Bone Conduction, Follow-Up Studies
Abstract

The BAHA (bone-anchored hearing aid) remains the most reliable method of auditory rehabilitation for patients with congenital aural atresia and improves hearing outcome and quality of life in these patients who are otherwise unable to benefit from traditional hearing aids. New techniques are being developed, such as fully implantable hearing devices, and will have to prove their efficacy and safety in this indication.To evaluate the audiological results and patient satisfaction after rehabilitation of congenital aural atresia using the BAHA.Sixteen patients suffering from bilateral congenital aural atresia were implanted with unilateral BAHA. Preoperative air- and bone-conduction thresholds and air-bone gap (ABG), preoperative sound reception threshold (SRT), postoperative aided thresholds, implantation complications, patient satisfaction, and the APHAB questionnaire were collected.After a mean follow-up period of 6.5 years, 15 patients were still using their device. Each patient had an average improvement of 33 ± 7 dB. Closure of the ABG within 15 dB of the preoperative bone-conduction thresholds occurred in 10 patients. Adverse skin reactions appeared in 50% of patients over 6.5 years of follow-up. Eleven of the 12 patients used their BAHA for more than 8 h per day.

Published
2010

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