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This paper deals with breast and head phantoms fabricated from 3D-printed structures and liquid mixtures whose complex permittivities are close to that of the biological tissues within a large frequency band. The goal is to enable an easy and safe manufacturing of stable-in-time detailed anthropomorphic phantoms dedicated to the test of microwave imaging systems to assess the performances of the latter in realistic configurations before a possible clinical application to breast cancer imaging or brain stroke monitoring. The structure of the breast phantom has already been used by several laboratories to test their measurement systems in the framework of the COST (European Cooperation in Science and Technology) Action TD1301-MiMed. As for the tissue mimicking liquid mixtures, they are based upon Triton X-100 and salted water. It has been proven that such mixtures can dielectrically mimic the various breast tissues. It is shown herein that they can also accurately mimic most of the head tissues and that, given a binary fluid mixture model, the respective concentrations of the various constituents needed to mimic a particular tissue can be predetermined by means of a standard minimization method.

Upper digestive and respiratory tract cancers represent, in frequency, the fourth cancer in the general population. They are responsible of non-specific symptoms. Clinical examination of this anatomical region is difficult for a layman for whom the specific material is not available to diagnose a small tumour The objective of this paper was to make more sensitive the general practictioners about these type of cancers.

Introduction: Obstructive Sleep Apnea Syndrome (OSAS) is becoming an important public health problem because of its frequency and adverse health consequences. The objective of this prospective study was to evaluate the prevalence of and risk factors for OSA in a cohort of subjects working for the french Army., Subjects and Methods: This prospective study was carried out on a sample of volunteers working for the French army. The subjects were recruited at their annual work visit between November 2008 and September 2009. Subjects were asked to complete 2 screening questionnaires (Epworth and Berlin) and were given a medical examination. Subjects suspected of having OSAS (based on high questionnaire scores) were monitored by nocturnal ventilatory polygraphy. OSAS was diagnosed if the subject was found to have an apnea/hypopnea index (AHI) greater than or equal to 5., Results: In this healthy, young and active population (n = 1054), 4.20% of subjects were diagnosed with OSA. Comparing our two groups of subjects (OSA and non-OSA), several statistically significant (p < .05) differences emerged that may be associated with OSA: the individuals with OSA were older by an average of 7 years, they presented with an average BMI greater than 4.5 kg/m2, an average abdominal girth greater than 12.2 cm and an average cervical circumference greater than 2.6 cm. In addition, they consumed more tobacco when they were smokers and were more likely to present with permanent nasal obstruction. They were also more likely to suffer from gastroesophageal reflux and present with skeletal class II. Finally, they presented with a longer average soft palate as determined by the Mallampati scoring system., Conclusion: We found that the major risk factors for OSAS were age, BMI, abdominal girth and cervical circumference (linear correlations determined by bi-variate analysis).

Obstructive sleep apnea syndrome is a common disorder associated with potentially severe complications. Polysomnography is the gold standard diagnostic tool, while CPAP ventilation is recognized as the most efficient therapy. The numerous symptoms, even though little specific, should be rapidly detected to screen for the syndrome and transfer the patient to an adequate healthcare facility. The severity of the condition depends on the complications it causes.

Objective: The aim of this retrospective study was to determine the relevance of 5 different imaging signs in the evaluation of carotid artery invasion., Subjects and Methods: Between September 2001 and September 2008, 22 patients (20 men and 2 women) presented with lymph node metastasis of a head and neck squamous cell carcinoma that invaded the carotid artery. The patients received either carotid artery dissection (CAD, group 1 [n = 17]) or carotid resection (group 2 [n = 5]). Preoperative images using CT (n = 18) and/or MRI (n = 14) were analyzed., Results: In 1 of 17 cases in group 1 and in 5 of 5 cases in group 2, encasement of more than 180 degrees of the artery was present (P < .05). Segmental obliteration of the fat between the lymph node and the carotid artery was noted in 7 of 17 cases in group 1 and for all cases in group 2 (P < .05). Deformation of the carotid artery was reported in no cases in group 1 and in all cases in group 2 (P < .05)., Conclusion: The combination of deformation of the carotid artery, encasement of more than 180 degrees of the carotid perimeter, and segmental obliteration of the fat between the adenopathy and the carotid artery was highly predictive of massive invasion of the carotid artery, which would require a resection en bloc. In comparison, the isolated existence of encasement of more than 180 degrees or segmental obliteration of fat could not strictly indicate massive invasion of the carotid artery; thus, CAD could be planned., (Copyright (c) 2010 Mosby, Inc. All rights reserved.)

Introduction: Facial palsy (FP) is a feared complication of parotidectomy. Facial nerve monitoring (FNM) has been poorly evaluated since it was created at the beginning of the 90's. The authors described a retrospective series and discussed it reviewing the literature data., Subjects and Method: From January 2002 to January 2009, 75 parotidectomies were performed in 72 patients (34 males, 38 females), without FNM in 28 cases (group 1) and with FNM in 47 cases (group 2)., Results: In group 1, 9 FP were noted, 5 were transient and 4 were definitive. In group 2, 12 FP were noted, 9 were transient and 3 were definitive. Both one month and six months after parotidectomy, the FP rate was significatively higher in group 1 than in group 2 for the reoperations., Conclusions: Facial nerve monitoring is an adjunctive method available to a surgeon during parotid surgery to assist with the functional preservation of the facial nerve. It did not allow to improve the facial prognosis in benign tumours removal but it improved the facial prognosis in reoperations. Its interest should be tested for malignant tumour removal.

Objective: The aim of the study was to compare the efficiency, safety, and cost of the different methods of hemostasis (conventional hemostasis versus LigaSure vessel sealing system [LVSS] versus harmonic scalpel) currently available for thyroid surgery., Study Design: Randomized, controlled trial., Setting: The study was conducted from September 2007 to December 2008 in a university hospital., Patients and Methods: Sixty patients (48 females and 12 males) underwent a total thyroidectomy for multinodular goiter. They were randomly assigned into three groups: group one (n = 20), conventional hemostasis; group two (n = 20), LigaSure; and group three (n = 20), harmonic scalpel., Results: For group three, the mean operative time was 37 minutes shorter than group one (P < 0.001) and eight minutes shorter than group two (P = 0.04). The complications rate was similar among the three groups. The mean postoperative paracetamol consummation in group one was 1.4 g greater than in group two (P = 0.016) and 1.3 g greater than in group three (P = 0.02). The overall average operative cost was 11 and 85 dollars cheaper for groups two and three than for group one, respectively (P < 0.001)., Conclusion: Total thyroidectomy using the harmonic scalpel was the fastest procedure because it was bloodless, and hemostasis and sectioning were controlled with a single instrument; it was, therefore, the most inexpensive procedure because of the reduction of operative time and staff cost. The operative safety was similar for all three procedures. In our series, the harmonic scalpel and the LVSS caused less pain than the conventional hemostasis.

Introduction: Partial glossectomy is the main treatment for tongue carcinoma. The resection of the tongue, which is a very vascularised tissue, requires a good hemostasis. The advantage of the harmonic scalpel is in combining sectioning and hemostasis in one single instrument, allowing a bloodless dissection of soft tissue. The aim of this prospective study was to evaluate the benefits and risks when using a harmonic scalpel in partial glossectomy., Subjects and Methods: In this prospective study conducted in a university hospital from march 2004 to December 2008, eighteen consecutive patients underwent a partial glossectomy with the use of harmonic scalpel. Results were compared with previous surgical procedures performed between September 2000 and February 2004 by monopolar hemostasis by our team (n = 12) when the harmonic scalpel was not available., Results: All 18 patients underwent partial glossectomy with the harmonic scalpel as the only instrument of section and hemostasis. The median blood loss was of 0 mL. The median operative time was 29 minutes (16 minutes less than partial glossectomies performed with conventional hemostasis. P < .001). No operative complications occurred. Two post-operative bleedings (5 days and 7 days after the glossectomy) occurred necessitating a new surgery to ligate the lingual artery. The margins of the resection were acceptable and no recurrence appeared., Conclusion: The harmonic scalpel makes it fast and easy to perform a partial glossectomy with no bleeding. Ligation of the lingual artery (when it is visualized during the dissection) should be performed because of the frequency (more than 10% in our series) and because of the potential gravity of a lingual post-operative bleeding.

Introduction: Managing advanced head and neck cancer is often a difficult task, particularly when massive invasion of the carotid artery is present. However, en bloc resection can be a curative procedure, and reconstruction of the carotid artery limits the risk for stroke. The aim of this study was to describe the interest, indication, potential risks, and methods by which we carried out resections as well as reconstructions of the carotid artery using superficial femoral artery transplantation., Subjects and Methods: We presented one case of en bloc resection of the carotid artery with reconstruction with superficial femoral artery transplantation., Results: Postoperative care was uneventful. The patient did not suffer from neurological deficiency. After three years of follow-up, the patient survived without any cancer recurrence., Conclusion: The occurrence of massive cancer invasion into the carotid artery should not be a contraindication for surgery. En bloc resection of the carotid artery with revascularization using the superficial femoral artery allows for appropriate control of the cancer, and carries an acceptable level of neurological risk.