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Biomedical subjects

A Bequignon

Publications and source records attributed to A Bequignon.

8 recordsLinked to original sources

[Otogenic cavernous sinus thrombophlebitis. A case report].

OBJECTIVES: Acquire knowledge concerning the diagnosis and treatment of otogenic cavernous sinus thrombophlebitis. PATIENT AND METHODS: We report a case of otogenic cavernous sinus thrombophlebitis (CST) in a 6-year-old boy. RESULTS: CST diagnosis was based on clinical signs (septic illness, ocular nerve palsy and chemosis), and neuro-imaging confirmed the diagnosis. Contrast-enhanced CT scan demonstrates different signs: (i) filling defect or heterogeneous enhancement of cavernous sinus, (ii) cavernous sinus enlargement with bulging of the lateral wall, (iii) intensive enhancement of lateral wall corresponding to enhancement of a collateral network replacing the thrombosed cavernous veins, (iiii) and sometimes indirect orbital signs (exophthalmus, densification of the retro-orbital fat, superior ophthalmic dilatation with partial or no enhancement in case of thrombosis extension). The bacteria most frequently found are Streptococci, Streptococcus pneumoniae, Staphylococcus aureus, Gram-negative rods and anaerobes combined. The therapeutic management of CST consists of intravenous administration of appropriate antibiotics combined radical mastoidectomy if medical therapy has failed. Anticoagulant therapy is controversial. CONCLUSION: Knowledge of early diagnosis of otogenic cavernous sinus is important because prior to the antibiotic era, CST was almost always fatal. Currently, therapeutic outcome is not always favorable due to high morbidity after aggressive treatment.

Cavernous Sinus Thrombosis↗

[Surgery for hyperthyroidism on 43 patients].

UNLABELLED: Treatment of hyperthyroidy uses surgery as well radioactive iodine and antithyroid agents. OBJECTIVES: The study analyses the modalities of hyperthyroidy surgery, describes its complications and the population undergoing surgical treatment. POPULATION AND METHODS: It is a retrospective study on 43 patients with hyperthyroidy treated by thyroidectomy from January first 1998 until 31 January 2002. RESULTS: The mean age is 48 years. The sex ratio showed a predominance of women (with 36 women and 7 men). The most frequent aetiology is Graves' disease and toxic multinodular goiter. Total thyroidectomy is applied to Graves' disease and toxic multinodular goiter while single toxic nodules are treated by loboisthmectomy. Surgery for hyperthyroidy have a low morbidity (1/43 haematoma, 0/43 hypoparathyoidy, 1/43 palsy of recurrent nerve). CONCLUSIONS: In this conditions, the hyperthyroidy surgery is fast, effective and does not need a heavy follow-up. Surgery seems to be a good alternative to antithyroid agents, which are constraining and often ineffective in the long term, and to radioactive iodine who leads to a long follow-up because of induced hypothyroidy.

Adult↗

[Bronchial foreign bodies in children].

BACKGROUND: Tracheobronchial aspiration of foreign bodies in children is a rare event that can be serious. We report a 10-year retrospective study of tracheobronchial foreign body aspiration in children. METHOD: This retrospective analysis involved 87 patients who underwent endoscopy at the ENT unit of the Caen University Hospital. RESULTS: Foreign bodies were found in 34 of the 87 patients. Average age was 3 years, with a male predominance. Peanuts were the most common foreign bodies observed (16/34). Most of the foreign bodies were removed via the right main bronchus (17/34). Clinical and radiological signs depended on delay to admission and were found to be normal in 15% and 37.5% of the cases respectively. Twenty-four children out of 34 had a positive history of foreign body inhalation. All foreign bodies were removed during the endoscopy procedure. CONCLUSION: This work underlines the much-debated function of chest x-ray, the need for a rigorous technically correct endoscopy procedure and the importance of close cooperation between the anesthesiologist and the endoscopist.

Bronchi↗

[Chondromas and low-grade chondrosarcomas of the larynx: a case report].

OBJECTIVE: We report a case of cricoid chondroma, underlining the difficulty in establishing a precise differential diagnosis between chondroma and low-grade chondrosarcoma of the larynx. MATERIAL AND METHODS: A 48-year-old woman developed inspiratory dyspnea. The final diagnosis was cricoid chondroma. We reviewed our case and data in the literature on these cartilaginous tumors. RESULTS: The patient was treated with conservative surgery. At 18 months follow-up, no recurrence has been detected. DISCUSSION: These tumors are rarely found in an ENT location and have similar histological features. According to many authors, the clinical course alone enables a distinction between chondroma and low-grade chondrosarcoma. Surgical treatment is indicated and provides good phonatory function in the vast majority of the cases.

Chondroma↗

[Utility and limitations of speech audiometry testing in the detection of occupational noise-induced hearing loss: a comparative study in two groups in the hospital setting].

OBJECTIVE: The objective of this study is the evaluation of the calculation of 100% intelligibility threshold and noise resistance index as a monitoring test in populations exposed to noise in their work environment. METHOD: This is a retrospective exposed-unexposed study as the exposure to the risk factors took place before the survey. The exposed subjects were chosen in principle on sonometric criteria and the unexposed subjects among employees whom we believe were not exposed. The exploration method included history taking, clinical examination, free field audiometry and speech audiometry with background noise. RESULTS: The exposed population has a 100% intelligibility threshold on average equal to 29.69 dB, significantly higher than in the unexposed population where it is calculated at 25.30 dB (p = 0.07). The noise resistance index varies with age (p = 0.04). CONCLUSION: Our study shows the existence of a significant hearing difference between two populations with different noise exposure. It demonstrates a relationship between a hearing loss risk factor such as noise and the occurrence of the "professional hearing loss" disorder. The calculation of the 100% intelligibility index and the noise resistance index advantageously complements tonal audiometry. These procedures provide a better approach to the social impact of hearing loss but were not useful in the detection of hearing loss.

Adult↗

[Intracranial complications of acute mastoiditis].

We report a case of extradural abscess after acute mastoiditis in an 8-years-old boy. The clinic diagnostic of an intracranial complication is difficult. The most common present symptoms are fever, otalgia and otorrhea but are not specific. Neurologic symptoms are suggestive signs of an intracranial complication. We believe that, in acute mastoiditis performance of a CT scan of the brain and temporal bones with intravenous contrast, contribues to the diagnostic of intracranial complication. The diagnostic of thrombosis sinus sigmoid is evoked with slight contrast enhanced sinus sigmoid and failure to opacify. The characterisation of an epidural empyema is a hypodense epidural collection in a contrast-enhanced CT scan. The most common isolated organism are Streptococcus Pneumoniae, Staphylococcus aureus and Pseudomonas aeuginosa. The therapeutic management includes combination of intraveinous antibiotics, mastoidectomy and surgery of the intracranial complication.

Acute Disease↗

[Temporal fibrous dysplasia with labyrinthine involvement. Apropos of a case and review of the literature].

Craniofacial fibrous dysplasia manifests clinically with dysmorphic syndrome, ophtalmologic or otologic signs. We report a case of temporal polyostotic fibrous dysplasia with vertigo and sensorineural hearing loss. Sensorineural hearing loss, with no cholesteatoma associated, as described in our case is rarely described. We review the literature concerning main clinical, diagnostic and therapeutic aspects of this disease.

Aged↗

[A case of Kikuchi disease. Review of the literature].

We report a case of Kikuchi's disease in a young man. It is a rare entity, described for the first time in 1972. It manifests clinically with cervical adenopathy and fever, often associated with other non-specific clinical signs. Laboratory tests are often normal. The diagnosis is established on the basis of histologic of lymph node excisional biopsy. Kikuchi's disease is likely to be misinterpreted as malignant lymphoma or systemic lupus erythematosus. It generally needs no treatment because it runs a spontaneously benign course with complete resolution of the symptoms within 6 months. Secondary systemic lupus erythematosus may develop. For this reason, regular follow-up of patients is recommended. The etiopathogenesis of this disease is still unknown, perhaps due to an immunologic phenomenon. It could be a hyperimmune reaction induced by various antigenic agents (infectious, neoplasic), or an autoimmune process.

Adult↗