D Chevalier

CHRU de Strasbourg, Strasburg, Alsace, France

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Publications (138)202.45 Total impact

  • Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale. 11/2014;
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    ABSTRACT: Objective The study was designed to assess the prevalence, management and survival of patients with simultaneous squamous cell carcinomas of the oral cavity and hypopharynx (OC/HP). Material and methods A multicenter, retrospective study (2 university hospitals) was conducted between 2003 and 2007 on a series of 96 patients with simultaneous squamous cell cancers of the OC/HP. Results A total of 88 men and 8 women were included in the study: 81 patients presented double sites, 14 presented triple sites and one presented quadruple sites. The tumour sites most frequently observed were: hypopharynx in 61% of cases (involving the pyriform sinus in 42% of cases) and the oropharynx in 59% of cases (involving the palatine tonsil in 30% of cases). Upper aerodigestive tract endoscopy under general anaesthesia revealed a simultaneous lesion not suspected on clinical examination in 45% of patients: the site discovered on endoscopy was hypopharyngeal in 2 out of 3 cases; the tumour was classified T1 or T2 in 95.5% of cases. Patients treated simultaneously for all sites had a better prognosis than patients in whom each tumour was treated separately. The 5-year specific survival was 34% and the 5-year overall survival was 28%. Conclusion The prevalence of simultaneous squamous cell carcinomas of the oral cavity and hypopharynx ranges between 1 to 7.4% in the literature and was 4.6% in the present series. A common treatment strategy for each of the patient's tumours appears to be superior to the current theoretical approach that consists of considering each tumour separately.
    European Annals of Otorhinolaryngology, Head and Neck Diseases 10/2014;
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    ABSTRACT: We present herein the proposal of the European Laryngological Society working committee on nomenclature for a systematic classification of open partial horizontal laryngectomies (OPHL). This is based on the cranio-caudal extent of laryngeal structures resected, instead of a number of different and heterogeneous variables present in existing nomenclatures, usually referring to eponyms, types of pexy, or inferior limit of resection. According to the proposed classification system, we have defined three types of OPHLs: Type I (formerly defined horizontal supraglottic laryngectomy), Type II (previously called supracricoid laryngectomy), and Type III (also named supratracheal laryngectomy). Use of suffixes "a" and "b" in Type II and III OPHLs reflects sparing or not of the suprahyoid epiglottis. Various extensions to one arytenoid, base of tongue, piriform sinus, and crico-arytenoid unit are indicated by abbreviations (ARY, BOT, PIR, and CAU, respectively). Our proposal is not intended to give a comprehensive algorithm of application of different OPHLs to specific clinical situations, but to serve as the basis for obtaining a common language among the head and neck surgical community. We therefore intend to present this classification system as a simple and intuitive teaching instrument, and a tool to be able to compare surgical series with each other and with non-surgical data.
    Archives of Oto-Rhino-Laryngology 04/2014; · 1.29 Impact Factor
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    ABSTRACT: It is accepted that the follow-up of patients who had treatment for laryngeal cancer is a fundamental part of their care. The reasons of post-treatment follow-up include evaluation of treatment response, early identification of recurrence, early detection of new primary tumours, monitoring and management of complications, optimisation of rehabilitation, promotion smoking and excessive alcohol cessation, provision of support to patients and their families, patient counselling and education. Controversies exist in how these aims are achieved. Increasing efforts are being made to rationalise the structure and timing of head and neck cancer follow-up clinics. The aim of this document is to analyse the current evidence for the need to follow up patients who have been treated for LC and provide an up to date, evidence-based statement which is meaningful and applicable to all European Health Care Systems. A working group of the Head and Neck Cancer Committee of the ELS was constituted in 2009. A review of the current published literature on the management and follow-up of laryngeal cancer was undertaken and statements are made based on critical appraisal of the literature and best current evidence. Category recommendations were based on the Oxford Centre for Evidence-Based Medicine. Statements include: length, frequency, setting, type of health professional, clinical assessment, screening investigations, patient's education, second primary tumours, and mode of treatment considerations including radiotherapy, chemo-radiation therapy, transoral surgery and open surgery. It also addresses specific recommendations regarding patients with persistent pain, new imaging techniques, tumour markers and narrow band imaging.
    Archives of Oto-Rhino-Laryngology 03/2014; · 1.29 Impact Factor
  • G Mortuaire, O Boute, P Y Hatron, D Chevalier
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    ABSTRACT: To assess the safety and efficacy of submucosal radiofrequency (RF) treatment for hereditary hemorrhagic telangiectasia (HHT) with mild or moderate epistaxis. We carried out a prospective pilot study of 16 consecutive patients with HHT-related epistaxis from June 2010 to April 2012. Under local anesthesia, RF was applied to one or both sides of the nose from the columella beneath the septal mucosal (50 joules per puncture). Patients were sent a questionnaire at least six months after the procedure. RF under local anesthesia was well tolerated, according to visual analog scale scores. Neither crusting nor pain was reported one week after the intervention. The frequency of epistaxis per day and per month was significantly lower after RF. The duration of bleeding also decreased from more than 10 minutes to less than 5 minutes in two thirds of patients. Thirteen of the 16 patients were satisfied with the technique and would request it for subsequent procedures to treat repeated bleeding. Submucosal RF treatment for HHT is a safe, well tolerated procedure with significant efficacy in the short term. It should be considered as an alternative technique for managing HHT-related epistaxis, although long-term results remain to be evaluated.
    Rhinology 12/2013; 51(4):355-360. · 1.72 Impact Factor
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    ABSTRACT: Head and Neck Squamous Cell Carcinoma (HNSCC) is the sixth most common cancer worldwide. The treatment of advanced stages HNSCC is based on surgical treatment combined with radiotherapy and chemotherapy or concomitant chemo-radiotherapy. However, the 5-year survival remains poor for advanced stages HNSCC and the development of new targeted therapies is eagerly awaited. F14512 combines an epipodophyllotoxin core-targeting topoisomerase II with a spermine moiety introduced as a cell delivery vector. This spermine moiety facilitates selective uptake by tumor cells via the Polyamine Transport System (PTS) and reinforces topoisomerase II poisoning. Here we report the evaluation of F14512 toward HNSCC. Four cell lines representative of head and neck cancer localizations were used: Fadu (pharynx), SQ20B (larynx), CAL33 and CAL27 (base of the tongue). PTS activity and specificity were evaluated by confocal microscopy and flow cytometry using the fluorescent probe F17073 which contains the same spermine moiety as F14512. Cytotoxicity, alone or in association with standard chemotherapeutic agents (cisplatin, 5FU), and radio-sensitizing effects were investigated using MTS and clonogenic assays, respectively. F14512 efficiency and PTS activity were also measured under hypoxic conditions (1% O2). In all 4 tested HNSCC lines, an active PTS was evidenced providing a specific and rapid transfer of spermine-coupled compounds into cell nuclei. Interestingly, F14512 presents a 1.6-11-fold higher cytotoxic effect than the reference compound etoposide (lacking the spermine chain). It appears also more cytotoxic than 5FU and cisplatin in all cell lines. Competition experiments with spermine confirmed the essential role of the PTS in the cell uptake and cytotoxicity of F14512. Hypoxia had almost no impact on the drug cytotoxicity. The combination of F14512 with cisplatin, but not 5FU, was found to be synergistic and, for the first time, we demonstrated the significant radio-sensitizing potential of F14512. The spermine moiety of F14512 confers a targeted effect and a much better efficacy than etoposide in HNSCC lines. The synergistic effect observed in association with cisplatin and radiotherapy augurs well for the potential development of F14512 in HNSCC.
    Oral Oncology 11/2013; · 2.70 Impact Factor
  • Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale. 10/2013; 130(4):A7.
  • Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale. 10/2013; 130(4):A6.
  • J.L. Lefebvre, D. Chevalier, A. Demaille
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    ABSTRACT: Los cánceres de las vías aerodigestivas superiores (VADS) son frecuentes l3,[23]: se estima que en el mundo aparecen aproximadamente 500 000 nuevos casos todos los años. La mayoría de estos cánceres (cavidad bucal, laringe, faringe) se dan en los países industrializados y se presentan esencialmente en el hombre adulto; en su génesis predominan ampliamente el alcoholismo y el tabaquismo crónicos, a pesar de que en la actualidad se conocen o se sospechan otros factores. Los demás cánceres (fosas nasales, cavidades sinusales y nasofaringe) son más raros, su predominio masculino es menos marcado, afectan también a los niños y no tienen relación con el alcohol o el tabaquismo. Su repartición es más difusa en el mundo, aunque los cánceres nasofaríngeos aparecen con preferencia en el sudeste asiático y en la región mediterránea. La gravedad de los cánceres de las VADS justifica la realización de encuestas epidemiológicas minuciosas para precisar por una parte, el conocimiento de la susceptibilidad individual a los agentes cancerígenos conocidos y, por la otra, investigar otros posibles factores, entre ellos los ambientales, con el fin de adaptar lo mejor posible las futuras campañas de información, de prevención y de detección.
    EMC - Otorrinolaringología. 07/2013; 29(1):1–10.
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    ABSTRACT: BACKGROUND: Sinonasal cancers are rare and associated with a poor prognosis. The aim of this study was to report our experience and analyze the risk factors for oncologic failures. METHODS: A retrospective review of 156 consecutive patients treated with curative intent for sinonasal malignancy between 1995 and 2005 at tertiary cancer center was performed. Demographic, clinical, morphological and pathological parameters were correlated with oncologic outcomes. RESULTS: Complete response was obtained for 134 patients. Sixty-eight patients relapsed among which 51 had local recurrence. Nine of these 51 patients (17.6%) underwent successful salvage therapy. Five years local failure and overall survival rates were 50.0% and 61.1%. Maxillary sinus tumors, intracranial invasion and N>0 stage at initial diagnosis were significantly and independently associated with local failure and survival in multivariant analysis. CONCLUSION: Local control following initial treatment is primordial to optimizing outcomes due to the poor results of salvage therapy. Head Neck, 2013.
    Head & Neck 04/2013; · 2.83 Impact Factor
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    ABSTRACT: Objectifs Ce travail présente les recommandations de la SFORL pour la recherche de métastases à distance et d’un second cancer synchrone lors du bilan initial des cancers épidermoïde des VADS. Matériels et méthodes Revue exhaustive de la littérature analysée par un groupe de travail multidisciplinaire. Résultats Le thorax constitue la localisation la plus fréquente des métastases à distance et des seconds cancers synchrones hors VADS. Le scanner thoracique est préconisé chez tous les patients en première intention (grade B). Une TEP-TDM au 18-FDG est préconisée en cas d’image thoracique douteuse ou de risque métastatique élevé pour la détection des métastases à distance non pulmonaires (grade B). Une exploration de l’œsophage est recommandée pour les patients à risque significatif de cancer synchrone de l’œsophage (tumeur de l’hypopharynx et de l’oropharynx, intoxication alcoolique chronique) (grade B). L’examen de référence est la fibroscopie digestive haute (grade B). Conclusions Ces recommandations de grade B permettent de rationnaliser la place des différents examens radiologiques et endoscopiques réalisés en première intention pour la recherche des métastases à distance et des seconds cancers synchrones. Cette rationalisation devrait permettre de limiter le nombre d’examens réalisés et ainsi réduire le temps nécessaire au bilan initial.
    Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale. 04/2013; 130(2):112–117.
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    ABSTRACT: Objectifs Les auteurs proposent d’exposer les recommandations de bonne pratique concernant le bilan d’extension locorégional des cancers épidermoïdes des voies aérodigestives supérieures (VADS) : cavum, fosses nasales et sinus exclus. Matériels et méthodes Lecture critique multidisciplinaire de la littérature concernant le bilan d’extension locorégional des cancers épidermoïdes des VADS selon les niveaux de preuve scientifique en accord avec le guide d’analyse de la littérature publié par l’HAS en janvier 2000. Conclusion À partir du niveau de preuve des articles sélectionnés et de façon collégiale au sein du groupe de travail, des recommandations ont été proposées et gradées concernant le bilan d’extension locorégional clinique, endoscopique et iconographique des cancers des VADS.
    Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale. 02/2013; 130(1):40–46.
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    ABSTRACT: PURPOSE: The present in vivo/in vitro study was undertaken in order to evaluate the importance of macrophage migration inhibitory factor (MIF) in the progression of head and neck squamous cell carcinoma (HNSCC). METHODS: Tumor tissue expression (MIF immunostaining) and plasma levels (ELISA) of MIF were determined in HNSCC patients and correlated with tumor recurrence and metastasis, and overall survival. Furthermore, the impact of MIF expression on cell proliferation and anticancer drug sensitivity was examined in murine squamous carcinoma cell line SCCVII after MIF knockdown (MIF-KD). RESULTS: As revealed by quantitative analysis of MIF immunostaining, tumor progression was accompanied by an increase in mean optical density (MOD) and labeling index (LI). Likewise, an elevation of MIF serum levels was noted in HNSCC patients (n = 66) versus healthy individuals (n = 16). Interestingly, comparison of laryngeal carcinoma patients on the basis of MIF tissue expression (high expression, LI ≥ 47, versus low expression, LI < 47) disclosed a significant difference between disease-free survival curves for local and nodal recurrence, and overall survival curve. In vitro, MIF knockdown in murine SCCVII cells resulted in reduced cell proliferation and a decrease in cell motility. In mice inoculated with SCCVII cells, MIF-KD tumors grew more slowly and also appeared more sensitive to chemotherapy. CONCLUSIONS: Both clinical observations and experimental data suggest that MIF plays a pivotal role in the progression of HNSCC.
    Journal of Cancer Research and Clinical Oncology 01/2013; · 2.91 Impact Factor
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    ABSTRACT: PURPOSETo compare the efficacy and safety of induction chemotherapy (ICT) followed by chemoradiotherapy (CRT) or bioradiotherapy (BRT) for larynx preservation (LP). PATIENTS AND METHODS Previously untreated patients with stage III to IV larynx/hypopharynx squamous cell carcinoma received three cycles of ICT-docetaxel and cisplatin 75 mg/m(2) each on day 1 and fluorouracil 750 mg/m(2) per day on days 1 through 5. Poor responders (< 50% response) underwent salvage surgery. Responders (≥ 50% response) were randomly assigned to conventional radiotherapy (RT; 70 Gy) with concurrent cisplatin 100 mg/m(2) per day on days 1, 22, and 43 of RT (arm A) or concurrent cetuximab 400 mg/m(2) loading dose and 250 mg/m(2) per week during RT (arm B). Primary end point was LP at 3 months. Secondary end points were larynx function preservation (LFP) and overall survival (OS) at 18 months.ResultsOf the 153 enrolled patients, 116 were randomly assigned after ICT (60, arm A; 56, arm B). Overall toxicity of both CRT and BRT was substantial following ICT. However, treatment compliance was higher in the BRT arm. In an intent-to-treat analysis, there was no significant difference in LP at 3 months between arms A and B (95% and 93%, respectively), LFP (87% and 82%, respectively), and OS at 18 months (92% and 89%, respectively). There were fewer local treatment failures in arm A than in arm B; salvage surgery was feasible in arm B only. CONCLUSION There is no evidence that one treatment was superior to the other or could improve the outcome reported with ICT followed by RT alone (French Groupe Oncologie Radiothérapie Tête et Cou [GORTEC] 2000-01 trial [Induction CT by Cisplatin, 5FU With or Without Docetaxel in Patients With T3 and T4 Larynx and Hypopharynx Carcinoma]). The protocol that can best compare with RT alone after ICT is still to be determined.
    Journal of Clinical Oncology 01/2013; · 18.04 Impact Factor
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    ABSTRACT: OBJECTIVES: To set out good practice guidelines for locoregional extension assessment of squamous cell carcinoma of the head and neck (excluding nasopharynx, nasal cavities and sinuses). MATERIALS AND METHODS: A critical multidisciplinary review of the literature on locoregional extension assessment of squamous cell carcinoma of the head and neck was conducted, applying levels of evidence in line with the French health authority's (HAS) literature analysis guide of January 2000. CONCLUSION: Based on the levels of evidence of the selected articles and on work-group consensus, graded guidelines are set out for clinical, endoscopic and imaging locoregional extension assessment of head and neck cancer.
    European Annals of Otorhinolaryngology, Head and Neck Diseases 01/2013;
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    ABSTRACT: OBJECTIVES: This report presents the French Society of ORL (SFORL) guidelines for exploration for remote metastasis and synchronous second cancer in initial staging of head and neck squamous cell carcinoma. MATERIALS AND METHODS: An exhaustive literature review was analyzed by a multidisciplinary work-group. RESULTS: The thorax is the most frequent location of remote metastases and synchronous second cancer outside of the upper aerodigestive tract. Thoracic CT is recommended as first-line examination in all cases (grade B). 18-FDG PET/CT is recommended when the thoracic CT image is doubtful or in case of high metastatic risk (grade B), for the detection of non-pulmonary remote metastasis. Esophageal exploration is recommended in case of significant risk of synchronous esophageal cancer (hypopharyngeal or oropharyngeal tumor, chronic alcohol intoxication) (grade B). The reference examination is flexible endoscopy of the upper digestive tract (grade B). CONCLUSION: The present grade B recommendations rationalize the roles of the various first-line radiological and endoscopic examinations for remote metastasis and synchronous second cancer, so as to limit the number of examinations performed, thereby reducing the time needed for initial staging.
    European Annals of Otorhinolaryngology, Head and Neck Diseases 12/2012;
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    ABSTRACT: To evaluate the long-term oncologic results of supracricoid laryngectomy with cricohyoidoepiglottopexy (CHEP) for laryngeal cancer. A 35-year retrospective study concerning 291 patients treated by supracricoid laryngectomy with CHEP for laryngeal cancer was performed. The following postoperative data were studied: recurrence rates (lymph node and laryngeal), distant metastases and second cancer. The mortality rate and overall survival were estimated by the Kaplan-Meier method. The postoperative mortality was 1.03 %. 23 patients were lost to follow-up. The 3-year survival rate was 84 % and the 5-year survival rate was 80 %. 12 patients developed distant metastasis. 31 patients developed a second cancer. The local (laryngeal) control rate was 93.94 % and the regional (cervical lymph node) control rate was 92.05 %. In multivariate analysis, the occurrence of a second non-ENT cancer and metastasis as well as margins involvement were reliable to mortality. Supracricoid laryngectomy with CHEP appears to be associated with very good long-term oncologic results and still has a place in the management of T1, T2 and selected T3 glottic cancers.
    Archives of Oto-Rhino-Laryngology 12/2012; · 1.29 Impact Factor
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    ABSTRACT: BACKGROUND: Sinonasal cancers are rare and no high-level evidence exists to determine their optimal management. Prophylactic neck treatment issue remains controversial. The aim of this study was to analyze the pattern of neck failure and to identify any prognostic factors that may influence neck control. METHODS: A retrospective review of 155 consecutive patients treated for sinonasal malignancy, without prophylactic neck treatment, between 1995 and 2005 at tertiary cancer center was performed. Demographic, clinical, morphological and pathological parameters were correlated with oncologic outcomes. RESULTS: Eight out of 155 patients (5%) presented initially with neck node metastasis. Complete remission was obtained for 133 patients after treatment completion. During follow up, 16 out of 133 patients (12%) were affected with regional recurrence. Neck failure occurred in 8 out of 51 patients with local failure and in 8 out of 82 patients locally controlled. Isolated nodal failure was observed in 5 patients initially cN0 out of 133 (3.8%) representing 7.3% of all recurrences and 3 of them underwent successful salvage therapy. None of the tested factors were significantly associated with neck control (p>0.05). Lymph node at diagnosis time was significantly and independently associated with poor survival (p=0.0012). CONCLUSION: Isolated neck relapse, when local control is achieved, is rare and salvage treatment is effective. Routine prophylactic neck treatment has little interest. However, this approach could be profitable to few selected patients, who remain to be defined. Further investigations are needed.
    Oral Oncology 10/2012; · 2.70 Impact Factor
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    ABSTRACT: INTRODUCTION: Micro-anastomosed free fibula flap is an attitude of choice in mandibular defect repair in oncology, enabling effective functional rehabilitation. The present study assessed donor and recipient site morphology and donor-site sequelae. PATIENTS AND METHODS: The study consecutively recruited patients undergoing mandibular resection with free fibula flap reconstruction in our centre between December 2003 and September 2008. Assessment on adapted scales was performed by two independent expert physicians and patient self-assessment. RESULTS: Out of 49 mandibular reconstructions performed in the centre over the 5-year study period, 23 patients free of recurrence were included. Satisfaction rates were 73% for the recipient site and 70% for the donor-site, with patient/expert agreement of 47% and 49.5% respectively. Donor-site impact was mainly in terms of reduced ankle range of motion (43% of cases) and flexion strength (39%) and discomfort in running (35%) and walking (26%). Risk factors for dissatisfaction were more than 5% weight loss at admission for recipient site dissatisfaction (patient, P=0.012; expert, P=0.046), and skin graft for donor-site dissatisfaction (patient, P=0.04; expert, P=0.035). CONCLUSION: Free fibula flap was associated with high satisfaction rates, but non-negligible donor-site impact.
    European Annals of Otorhinolaryngology, Head and Neck Diseases 10/2012;
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    ABSTRACT: Introduction Le lambeau libre micro-anastomosé de fibula a une place de choix dans la reconstruction des défects mandibulaires en cancérologie, permettant une bonne réhabilitation fonctionnelle. Notre étude est une évaluation morphologique du site donneur et receveur, et un enregistrement des séquelles sur site donneur. Patients et méthodes Il s’agissait de patients pris en charge consécutivement au Centre Oscar-Lambret pour mandibulectomie interruptrice avec reconstruction par lambeau libre de fibulaentre décembre 2003 et septembre 2008. Une évaluation par deux médecins examinateurs non opérateurs a été effectuée selon des échelles adaptées. Cette même évaluation-patient a été réalisée par auto-questionnaire. Résultats Vingt-trois patients, sans récidive, participant à l’étude, ont été inclus parmi les 49 reconstructions mandibulaires réalisées dans notre centre sur cinq ans. Le taux de satisfaction est de 73 % au niveau du site receveur et de 70 % sur le site donneur avec une concordance patient-expert de 47 % sur le site receveur et 49,5 % sur le site donneur. Les principales données perturbées au niveau du site donneur étaient une diminution d’amplitude de cheville (43 %), une baisse de la force en flexion (39 %), une gêne à la course (35 %), une gêne à la marche (26 %). Les facteurs de risque liés à l’insatisfaction étaient une perte de poids supérieure à 5 % à l’admission pour le site receveur (patient p = 0,012/expert p = 0,046), et la présence d’une greffe pour le site donneur (patient p = 0,04/expert p = 0,035). Conclusion Les patients opérés par lambeau libre de fibula présentent des taux de satisfaction élevés, mais avec un retentissement sur le site donneur non négligeable.
    Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale. 10/2012; 129(5):274–281.

Publication Stats

1k Citations
202.45 Total Impact Points

Institutions

  • 1994–2014
    • CHRU de Strasbourg
      Strasburg, Alsace, France
  • 2009–2013
    • Université de Mons
      • Faculty of Medicine and Pharmacy
      Mons, Walloon Region, Belgium
  • 1991–2012
    • Centre Hospitalier Régional Universitaire de Lille
      Lille, Nord-Pas-de-Calais, France
  • 2006–2010
    • Lille Catholic University
      Lille, Nord-Pas-de-Calais, France
  • 2003
    • CHU de Lyon - Hôpital de la Croix-Rousse
      Lyons, Rhône-Alpes, France
  • 1989–2000
    • University of Lille Nord de France
      Lille, Nord-Pas-de-Calais, France