Revue de laryngologie - otologie - rhinologie最新文献

{"title":"[Treatment of head and neck squamous cell carcinoma of an unknown primary (HNCCUP): oncologic analysis of 35 cases].","authors":"E Berta,&nbsp;I Atallah,&nbsp;J L Quesada,&nbsp;E Reyt,&nbsp;J Villa,&nbsp;C A Righini","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>The aim of our study was to perform an oncologic analysis of patients treated for head and neck squamous cell carcinoma of an unknown primary (HNCCUP).</p><p><strong>Patients and methods: </strong>35 cases were included in our monocentric restrospective study (1999-2010). All patients had a complete clinical exam as well as head, neck and chest CT scans. The primary tumour remained undetected after panendoscopy 25 patients underwent a routine tonsillar biopsy ipsilateral to the lymphadenopathy. In 9 cases (36%), an invasive squamous cell carcinoma was detected on pathological examination. These patients were excluded from further study. Kaplan-Meier method was used for survival analysis. Univariate and multivariate analysis were also performed using Cox's regression model.</p><p><strong>Results: </strong>The therapeutic management of patients' majority (73%) consisted of lymphadenectomy with frozen section examination which confirmed the presence of an invasive squamous carcinoma in the resected lymph node(s). This was followed by ipsilateral neck dissection and radiotherapy or radiochemotherapy. Patients with unresectable lymph node(s) underwent exclusive radiochemotherapy. Specific survival rates at 1, 3 and 5 years were respectively 77%, 52% and 47%. The median survival time was 3 years. The comparison of univariate and multivariate survival curves confirmed that the lymph node status is an important factor for survival (HR 8.3 [2.03-33.96]).</p><p><strong>Conclusion: </strong>Our results are consistent with those found in the medical literature. HNCCUP has a poor prognosis which correlates with the lymph node status.</p>","PeriodicalId":76469,"journal":{"name":"Revue de laryngologie - otologie - rhinologie","volume":"134 3","pages":"131-8"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32461743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PET/CT in the management of metastatic cervical lymphadenopathy from unknown primary site: a seven years retrospective study.","authors":"M Barbosa,&nbsp;H Duarte,&nbsp;E Breda,&nbsp;E Monteiro","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the accuracy of PET/CT for the diagnostic evaluation of patients presenting cervical node metastasis of suspected unknown primary; furthermore to understand its relative clinical utility and relevance when compared to classic endoscopic investigation approach.</p><p><strong>Materials & methods: </strong>A retrospective study was pursued, collecting information from clinical files of all patients who presented to the Portuguese Institute of Oncology - Oporto, from January 2005 to December 2011, with cervical node metastases whose primary hadn't been found, despite clinical examination and standard imaging (CT scan or MRI) and therefore were submitted to a PET/CT. Among those presenting with non-supraclavicular metastasis patients were subsequently analyzed according to: histopathology; those who performed examination under anaesthesia (EUA) for biopsies either before of after PET/CT.</p><p><strong>Results: </strong>Eighty nine patients were included in the study. Detection rate was 32.6% with no statistically difference between those with supraclavicular metastases and those with metastases in higher cervical levels (p = 0.24). In this last group (n = 76), 43% patients had had PET/CT and an endoscopy associated with biopsies of the upper aerodigestive tract in different orders, to complete diagnostic workup in cases where the first performed was inconclusive. No statistically difference was found between these two methods (p = 0.25). Most of noticed false negatives were microscopic lesions located deep in the palatine tonsils.</p><p><strong>Conclusions: </strong>PET/CT showed to be an useful tool when searching for primary tumours whether metastasis were supraclavicular or located in higher levels of the neck. Despite its good accuracy and detection of tumours previously undetected by EUA with biopsies (missed mainly due to sampling error), up-front negative scan shouldn't preclude performing endoscopies. Being evident that both tools are helpful. It was not possible in this study to find any evidence that could show which one of these two exams should be performed first.</p>","PeriodicalId":76469,"journal":{"name":"Revue de laryngologie - otologie - rhinologie","volume":"134 2","pages":"89-94"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32221228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laryngeal paraganglioma mimicking a laryngeal haemangioma.","authors":"L Plisson,&nbsp;V Patron,&nbsp;Azoulay B Luna,&nbsp;E Babin,&nbsp;M Hitier","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Paraganglioma are uncommon neuroendocrine tumours arising from extra-adrenal chromaffin cells of the autonomic nervous system. In the head and neck region, these neoplasms most commonly arise from the carotid body, the vagus nerve, and the jugulotympanic area. We present the case of a 69-year-old woman who suffered from dyspnoea and dysphonia for six months. A biopsy diagnosed a laryngeal haemangioma and a resection of the tumour was performed using supraglottic pharyngolaryngectomy. Definitive histopathological examination revealed a laryngeal paraganglioma. Laryngeal paraganglioma and haemangioma must be evoked when confronted with a submucosal vascular laryngeal tumour. In such cases biopsies should be avoided. Exhaustive imaging is a key factor in the diagnosis and should include an MRI and an arteriography in order to rule out other differential diagnoses. To our knowledge this is the first case focusing on this issue.</p>","PeriodicalId":76469,"journal":{"name":"Revue de laryngologie - otologie - rhinologie","volume":"134 2","pages":"109-12"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32221232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Aesthetic profiloplasty: retrospective study of 101 cases].","authors":"M Achache,&nbsp;J-M Thomassin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>Aesthetic profiloplasty focuses on patients with normal dental occlusion and summarizes the association of a rhinoplasty and genioplasty. The aim of our study is to analyze the dysmorphoses overall profile, as well as different surgical techniques. This also allows to validate a method of analysis and construction of an aesthetic project based on a profile photograph.</p><p><strong>Materials and methods: </strong>This is a retrospective study of 101 adult patients undergoing profiloplasty at our institution over a period of 35 years.</p><p><strong>Results: </strong>18 patients (17.8%) had an abnormality of the nasofrontal angle, 62 (61.3%) abnormal and the nasolabial angle 101 a chin dysmorphia.</p><p><strong>Conclusion: </strong>We studied profiloplasty focusing on its borders, first of all the nasal profile and then the facial profile with the chin. Our profilometric building is simple, didactic and to obtain a good cosmetic result. The Marseilles School Pech and Cannoni was intended, regarding rhinoplasty, trying to get a natural result for a consistent look. Through profiloplasty we continued this teaching of \"natural reworked\" to achieve the most harmonious profile.</p>","PeriodicalId":76469,"journal":{"name":"Revue de laryngologie - otologie - rhinologie","volume":"134 4-5","pages":"241-9"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32694032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Transsexualism: from diagnosis to management].","authors":"G De Bonnecaze,&nbsp;J J Pessey,&nbsp;B Chaput,&nbsp;A Al Hawat,&nbsp;B Vairel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The transsexualism or gender dysphoria is a pathology during which an individual does not recognize himself in his sexual identity and wishes to change it: in that it must be differentiated from the sexual ambiguities (hermaphrodism, pseudohermaphroditism) in which the sexual phenotype is not clearly established. In France the number of transsexuals is estimated at approximately 50,000 people. Since 2009 the transsexualism is not any more considered as a mental illness, it remains regarded as a long term illness. The objective of this article is to present the recent evolutions concerning the management of transsexual patients seeking feminization.</p>","PeriodicalId":76469,"journal":{"name":"Revue de laryngologie - otologie - rhinologie","volume":"134 4-5","pages":"225-9"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32694107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late metastasis from renal cell carcinoma to the thyroid and nasal cavity: report of a case.","authors":"A Roux,&nbsp;A M Alzharani,&nbsp;C Rousselot,&nbsp;P Beutter,&nbsp;D Bakhos","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Multifocal cervico-facial metastases are very rare. Medical history of the patient and clinical context make easier the diagnosis. A 54-year-old woman presenting with a nasal obstruction, was referred to our department. She had a past medical history of an operated renal cancer 12 years ago and a right hemithyroidectomy 30 years ago. Clinical examination revealed a polypoid lesion obstructing the right nasal cavity and a thyroid goiter. Fine-needle aspiration was positive for a renal metastasis. Computed tomography confirmed the nasal lesion without bone destruction and a cervical cystic lesion into the left thyroid lobe. Completion thyroidectomy and polyp excision were performed. The final histologic examination revealed a metastasis from a renal cancer. The association of intra-thyroid and nasal cavity metastases is uncommon and not related in the literature, the practitioner must suspect the diagnosis if the patient had a thyroid tumor, a suspicious nasal lesion and a past history of cancer. The surgical management is recommended for isolated metastasis to the nasal cavity and the thyroid gland especially in renal cancer.</p>","PeriodicalId":76469,"journal":{"name":"Revue de laryngologie - otologie - rhinologie","volume":"134 2","pages":"101-3"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32221230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"European review of ENT.","authors":"Stéphane Lacher-Fougere","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76469,"journal":{"name":"Revue de laryngologie - otologie - rhinologie","volume":"134 3","pages":"118"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32461740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Lysis of the incus long process and incudostapedial rebridging ossiculoplasty: comparative study of titanium-gold angle prosthesis Plester-type versus Martin Incudo prosthesis hydroxylapatite].","authors":"M B Faye,&nbsp;C Martin,&nbsp;S Schmerber","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>We report two surgical techniques devised to restore a disrupted incudostapedial joint.</p><p><strong>Material and methods: </strong>Thirty patients underwent rebridging of distal portion of incus long process in the ENT Department of University of Grenoble and Saint-Etienne, between October 1998 and September 2002. Two types of ossicular prostheses were used: A titanium-gold angle prosthesis according to Plester Winkel Kurz (n = 16 patients), and a hydroxylapatite prosthesis as Martin Incudo Prosthesis (n = 14 patients).</p><p><strong>Results: </strong>The average hearing gain in short term is of 8.30 dB for the Martin-Incudo group. It is of 5.23 dB in the Winkel group. Seven and three cases of failures (Residual Rinne > 20 dB) were noticed respectively in the groups Martin-Incudo and Winkel. Seven and four cases of labyrinthisation were observed respectively in the groups Martin-Incudo and Winkel. The average hearing gain in long term is 3.43 dB in the Martin-Incudo group; and 2.85 dB among patients with Winkel Kurz prosthesis. Average residual Rinne is higher than 20 dB in the Winkel group. The hearing gain is not statistically significant between the two groups (p > 0.05).</p><p><strong>Conclusion: </strong>The titanium partial prosthesis did not give good functional results. In the case of a limited lysis (< 2 mm) of the distal portion of incus, we use the cement or cartilage interposition. When ossicular chain cannot be preserved entirely, we privilege incus transposition or a titanium PORP. The Martin-Incudo prosthesis seems interesting in the event of lysis of 2 mm of the long process of incus, nevertheless engineering changes are necessary in order to make rigid the incudostapedial joint.</p>","PeriodicalId":76469,"journal":{"name":"Revue de laryngologie - otologie - rhinologie","volume":"134 3","pages":"125-30"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32461742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Fungal sinusitis: report of two cases of indolent form of fungus usually invasive, up treatment and care].","authors":"M Pénicaud,&nbsp;J Michel,&nbsp;P Belenotti,&nbsp;S Ranque,&nbsp;A Varoquaux,&nbsp;A Giovanni,&nbsp;P Dessi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>Unlike Aspergillus sinusitis, sinus infections by mucormycosis are often invasive and have a lethal potential. We report two cases of chronic sinusitis with unilateral uncomplicated diagnosis of mucormycosis confirmed by pathology or mycology and discuss the therapeutic strategy.</p><p><strong>Presentation: </strong>Case 1) An immunocompetent patient with a right chronically sphenoid sinusitis uncomplicated underwent endonasal surgery in our institution. Rhizopus Oryzae was found on the surgical mycological specimen. The patient received no adjuvant medical therapy after surgery, because there were no invasive clinical or radiological criteria and no histopathological confirmation. Clinical, radiological and mycological follow-up was done. Case 2) A patient with a chronic maxillary sinusitis underwent endonasal surgery in our institution. Histological analysis found filaments in favor of mucormycosis without vascular emboli. We decided in agreement with the national reference center for mycology not to treat medically.</p><p><strong>Conclusion: </strong>A follow up of more than 3 years for both cases tends to confirm this collective decision.</p>","PeriodicalId":76469,"journal":{"name":"Revue de laryngologie - otologie - rhinologie","volume":"134 3","pages":"149-52"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32463173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Migrant foreign body of the oesophagus: report of a case].","authors":"K Doumbia-Singare,&nbsp;S K Timbo,&nbsp;S Soumaoro,&nbsp;M Keita,&nbsp;B Guindo,&nbsp;L Traore,&nbsp;A Mohamed,&nbsp;M Diallo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate the risk brought by the traditional practice in the evolution of the foreign bodies of the aesophagus.</p><p><strong>Case report: </strong>30 years old male with migration from the oesophagus of a fish bone in soft tissue of the neck, which could have been favored by the traditional practice. The diagnosis of migration was suspected when a laterocervical mass appeared after a traditional processing. The rigid aesophagoscopy was negative and the scanner allowed to identify the foreign body in an extraluminal location. It was removed by cervicotomy. Postoperative was uneventful.</p>","PeriodicalId":76469,"journal":{"name":"Revue de laryngologie - otologie - rhinologie","volume":"134 3","pages":"169-71"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32463178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}