[Rhinoplasty and reconstruction of the nasal dorsum: role of an autologous graft of the concha media]. / Rhinoplastie et chirurgie d'harmonisation du dorsum nasal: apport de la greffe autologue de cornet moyen.

BACKGROUND: Aesthetic and functional rhinoplasty can improve facial beauty. Surgical procedure may require autogenous grafts. These bone or cartilage grafts are harvested from different parts of the body. The objective of our study is to evaluate the use of nasal concha media as a new type of graft in rhinoplasty. MATERIALS AND METHODS: Patients consulted for aesthetic as well as for functional problems. They had dorsum deformities. The inclusion criteria had been the achievement of a harmonization surgery of the nasal dorsum, associated or not with another aesthetic or functional rhinoplastic intervention. The grafts are quickly and easily removed by endoscopic endonasal approach under optical control. The removed graft is then shaped and inserted by hidden approach during a rhinoplastic operation. Complications have been noticed for harvesting site and recipient site. RESULTS: Ten patients have benefited from this new technique from 2002 to 2007. They consulted for aesthetic as well as for functional problems in 9 cases. One person consulted for aesthetic matters only. The removal of these grafts has led to no complication. One case of infection has been noticed, and one dorsum irregularitie has been noticed. Aesthetic and functional results have been analysed over an average step back of two years and show at least comparable results to techniques already published. CONCLUSION: The concha media seems to serve well as graft material in some indications of rhinoplasty. The primary indication of this type of graft is in the harmonization surgery of the nasal dorsum. These grafts do not replace the other existent autologous grafts, but advantageously complete the technical arsenal of the rhinoplastician. A study involving a wider population should be done to validate the interest of this new type of filling graft in rhinoplasty.

[Endostenting using a Y-stent for hematoma after thoracic aorta surgery]. / Endostenting par prothèse en Y sur hématome après chirurgie de l'aorte thoracique.

OBJECTIVE: To describe the diagnostic and therapeutic management of extrinsic tracheobronchial compression after thoracic aorta surgery. PATIENT AND METHODS: We report the case of a female patient with Marfan syndrome. RESULTS: A 27-year-old woman with Marfan syndrome presented respiratory distress after type III dissecting aneurysm of the descending aorta from extrinsic compression (hematoma) of the lower third of the trachea and the left bronchial stump. We placed a Y-stent (Y-Tracheobronxane, Novatech SA, France), thus restoring a satisfactory channel. A few days later, the patient developed right congestive heart failure from compression of the left pulmonary artery secondary to the progression of the hematoma. Medical treatment for this cardiological complication and the progressive resorption of the hematoma made it possible to remove the stent after 21 days with no dyspneic recurrence. CONCLUSION: Placing a Y-stent is possible and effective and has few iatrogenic consequences in cases of extrinsic tracheobronchial compression from a hematoma occurring during heavy thoracic vascular surgery. With surgical revision impossible given the risks, stent placement allows progressive resorption of the hematoma, thus ending the compression of the bronchial tree.

[Inflammatory pseudotumor of the larynx in children]. / Tumeur pseudo-inflammatoire du larynx chez l'enfant.

OBJECTIVE: Describe the management of laryngeal pseudotumor in a young boy with exclusive endoscopic resection with laser CO2 resection. MATERIAL AND METHOD: Case report. RESULTS: We report a rare case of a laryngeal pseudotumor in a child that was successfully treated with endoscopic resection with laser CO2 vaporization. The last follow-up at 12 months revealed no evidence of recurrence and no voice sequelae. This is the first case reported that was successfully treated after a single procedure. It is the second one where tracheotomy was avoided. CONCLUSION: Endoscopic resection with laser CO2 vaporization is a safe and effective treatment in cases of limited laryngeal inflammatory pseudotumor in a pediatric population, but close follow-up is necessary because of the risk of local recurrence.

[Bilateral hypopharyngocele]. / Hypopharyngocèle bilatérale.

OBJECTIVE: Describe the management of bilateral hypopharyngocele in a trumpet player. MATERIAL AND METHOD: Case report of a professional trumpet player suffering from bilateral hypopharyngocele. RESULTS: A professional trumpet player was referred for an ORL consultation after he noticed that a bad sound was produced while he was playing associated with cervical pain. A CT scan demonstrated an asymmetric bilateral hypopharyngocele with no other abnormality. Because of the mild symptoms and the professional context, a successful conservative approach was used with antireflux medications. He was advised to seek professional instruction in order to improve his technique. On follow-up examination 6 months later, he had had no further problems since adopting the corrected techniques. CONCLUSION: Pharyngoceles are rare and easily misdiagnosed. Because of the mild symptoms and the professional context, a conservative medical approach should be proposed (antireflux medications) combined with specific orthophonic and physical therapy to modify breathing and trumpet playing techniques.

Coherent control of the effective susceptibility through wave mixing in a duplicated two-level system.

We theoretically demonstrate the coherent control of the effective susceptibility of a duplicated two-level system. The control is obtained for a linearly polarized weak field in the presence of a much stronger orthogonally polarized field. For small optical depths, the effective susceptibility chi(eff) behaves as chilin(e 2iphi) (chilin) is the linear susceptibility, phi the phase shift) allowing coherent control of the optical response. For large optical depths, chi(eff) approximately chi(lin), turning an absorber into an amplifier without affecting the dispersion.

Coherent control of light shifts in an atomic system: modulation of the medium gain.

A sequence of two femtosecond coherent pulses--a strong pi-polarized pulse and a weak sigma-polarized pulse--excite the S1/2-P1/2 transition of atomic rubidium in an optically dense vapor. The sigma pulse induces transitions between the adiabatic states with a coupling strength that is different for identically and oppositely light-shifted coupled states, and that can be modified by tuning the relative phase between the pulses. An efficient control of the medium gain for the sigma pulse is experimentally demonstrated. It is shown to be the result of interference between the absorption and the stimulated emission paths for sigma photons.

[Predictive factors of facial palsy of the acoustic neurinoma after retrosigmoid surgery: 230 cases]. / Facteurs prédictifs de la survenue des paralysies faciales du neurinome de l'acoustique opéré par voie rétro-sigmoïde. A propos de 230 cas.

OBJECTIVES: To determine predictive factors influencing postoperative facial palsy during retro sigmoid approach in vestibular schwannoma surgery. MATERIAL AND METHODS: Retrospective study over 230 patients with vestibular schwannoma, mostly stade I and II, operated by retro sigmoid approach, by the same oto neuro chirurgical team between 1993 and 2004. Pre and post operative parameters taken into consideration: quantitative: age and sex, audiometric parameters, duration of clinical symptoms; qualitative: tumor anatomic factors and facial nerve function according to House Brackmann classification. RESULTS: 8 days after surgery, 92% of patients have a normal or subnormal facial nerve function, 5% a facial paresis and 3% a paralysis. After one year, only 4% of patients still have a grade III to VI paralysis. Latency of vertigo with facial nerve paralysis is 4.33 vs. 1.97 year in absence of paralysis. Hearing conservation is 85% without facial nerve paralysis vs. 58% with facial nerve paralysis; Wave III latency (PEAP) with facial nerve paralysis is 4.54 vs. 4.28 ms if not. CONCLUSION: Significant predictive factors of facial nerve palsy outcome are: age, post surgery hearing conservation, wave III latency, difficulty in tumor dissection, vertigo latency.

Experimental demonstration of phase control of dispersion effects for an ultrashort pulse train propagating in a resonant medium.

We present an experiment in which an ultrashort pulse train propagates resonantly through anoptically dense vapor of atomic rubidium. The sequence obtained from a Fabry-Perot interferometer comprises nearly 10 regularly time-delayed and mode-locked pulses. We show that a sequence with phase shift phi = 0[2pi] between two successive pulses propagates with important temporal distortion, whereas a sequence with phi = pi[2pi] experiences few propagation effects, thus leading for the first time to our knowledge to the possibility of phase control of dispersion effects for an ultrashort pulse train.

Interferences of ultrashort free electron wave packets.

Interferences of free electron wave packets generated by a pair of identical, time-delayed, femtosecond laser pulses which ionize excited atomic potassium have been observed. Two different schemes are investigated: threshold electrons produced by one-photon ionization with parallel laser polarization and above threshold ionization electrons produced by a two-photon transition with crossed laser polarization. Our results show that the temporal coherence of light pulses is transferred to free electron wave packets, thus opening the door to a whole variety of exciting experiments.

Observation of coherent transients in ultrashort chirped excitation of an undamped two-level system.

The effects of coherent excitation of a two-level system with a linearly chirped pulse are studied theoretically and experimentally [in Rb (5s-5p)] in the low field regime. The coherent transients are measured directly on the excited state population on an ultrashort time scale. A sharp step corresponds to the passage through resonance. It is followed by oscillations resulting from interferences between off-resonant and resonant contributions. We finally show the equivalence between this experiment and Fresnel diffraction by a sharp edge.

Extent of 14C incorporation into cholesterol of infant skin fibroblasts incubated with carboxyl-labeled oleic, -linoleic or -arachidonic acid.

In order to determine the incorporation of C1-14C derived from mono- and poly-unsaturated fatty acids into cholesterol of human cells cultured in exponential phase, infant skin fibroblasts (SF) were used at the 5th passage. On Day 6, the SF were preincubated 36 h in a medium containing 5 per cent lipoprotein-deficient serum, and thereafter [1-14C] oleic, -linoleic or -arachidonic acid-without (OL1, LI1 and AR1 group SF), or with the addition of 0.25 mM cold fatty acids (OL2), LI2 and AR2 group SF). Cholesterol specific radioactivity (SRA) peaked 1 h after, and leveled off afterwards in the OL1, LI1 and AR1 groups. Cholesterol-SRA was relatively low in the other groups, but increased progressively, giving a biphasic response: C1-14C derived from from linoleic and arachidonic acids was actively incorporated into cholesterol during the first hours, as compared to C1-14C derived from oleic acid, but stabilized between 6 and 12 h for the LI2 and AR2 group SF incubation. This result appears to be due to the stimulation of pyruvate decarboxylation, observed elsewhere, and consequently to the dilution of the radioactive units in a large pool of non-labeled acetyl-CoA units derived from glucose, when these SF were incubated with 0.25 mM polyunsaturated fatty acids.