Biomedical subjects
Publications and source records attributed to M Detsouli.
Although thyroid cancer is not the first cause of bone metastases, this diagnosis must be always entertained because when it is found to be the cause of the metastasis, the survival is good. Bone metastases can take on different appearances and thyroid cancer discovered secondarily. We report two cases of mandibular metastases revealing a thyroid cancer and we stress on diagnosis and therapeutic difficulties.
Based on a retrospective study over a six year period, we report 15 cases of tuberculosis of the larynx, confirmed histologically. Dysphonia was the main symptom. The diagnosis rests on direct laryngoscopy and biopsy, with histology. Medical treatment achieves a good outcome.
Rare benign tumours of the larynx (RBTL) form a heterogeneous group. The clinical picture is non-specific. Based on a series of 17 cases of RBTL treated in our department, we wish to draw attention to the diagnosis, treatment and clinical course of these tumours. The mean age of the patients was 37 years, with the male sex predominating. The presenting symptom was most commonly progressive dysphonia, while 5 patients were admitted in respiratory distress. Examination and special investigations revealed 8 cases of laryngocoele, 6 cases of angioma, 2 cases of schwannoma, and one of chondroma. Treatment was surgical, by an external approach in 10 cases and endoscopically in 7. The postoperative course was satisfactory. No long-term recurrences were encountered. Conservative surgery by an external or endoscopic approach has revolutionised the functional outcome in these benign tumours.
The antrochoanal polyp is a particular pathology of nasal fossae and sinuses. Since the first description made by Killian, several pathogenic mechanisms and surgical techniques have been reported. The polyp exeresis is classically made using the Caldwell-Luc approach. The aim of our study is to lay stress on the interest of endonasal surgery compared to other surgical procedures. Between 1996 and 1998, we operated on 12 cases by endonasal approach. Diagnosis is made upon clinical, CT-scan and pathological data. In all cases, an extended middle meatotomy is performed. In 3 cases, it is associated with an inferior meatotomy. The polyp pedicle is systematically coagulated at level of its maxillary implantation area. No recurrence, nor operative complication are noted. The average follow-up is 12 months.
The intranasal approach for mucoceles of the sinuses represents an advance in the techniques of sinus surgery. The object of our study is to show the value of this type of surgery by reviewing 16 cases of fronto-ethmoidal mucoceles undergoing surgery in our department. The approach was purely intranasal. Surgery consisted of wide marsupialisation of the nasal cavities. The immediate postoperative progress was good. There were no complication in this series; neither was there any recurrence. The follow up period was from 3 months to 5 years. As the follow-up period was too short in some of the cases, no firm conclusions can be drawn. Yet despite this limitation, it seems that the intranasal approach is to be preferred in dealing with mucoceles of the sinuses.
The treatment of the parotid tumors was clarified for a majority of the tumors, in spite of her histology diversity. The authors report in a retrospective study 120 cases of a parotid gland tumors during ten years over. They insist on the difficult of therapeutics, the histological diversity and the complications and sequelles of the surgery. The diagnosis was especially clinical and completed by scan and or a sialography. The superficial or total parotidectomy with preservation of facial nerve was realized in eighty-nine percent. The functional courage and the radiotherapy were associated respectively in eleven and seventeen patients. The histology was dominated by the benign tumors. The complications and sequelles were a facial paralysis definitive and a Frey's syndrome respectively in three percent cases. The ninety-seven percent patients were controlled with a mean follow up of three years. After results we must know every histologic type for to adapt his treatment. And the same complications and the sequelles were noted in all surgery type.
The authors report a case of a rare first branchial cranio facial malformation, combined with a posterieur maxilla cleft, and macrostomia. The authors insist on the clinical aspect, and the difficult classification of this malformations.
The retrolabyrinthine approach was described several years ago, however its use was restricted to functional surgery of the cerebellopontine angle. Its detractors reproach its narrowness. But a large approach to the cerbellopontine angle can be performed after an extended exposure of the posterior and middle fossa dura, and section of the endolymphatic sac. This approach was used in 5 cases of acoustic neurinomas stage I and II, with normal hearing. Hearing preservation was obtained in 2 cases. We had deafness in 2 cases who had extensive tumor in the bottom of the internal auditory canal.
The authors report on a case of a cervical hydatid cyst revealed by an isolated subangulomaxillary tumefaction. They stress the scarcity of this localization, the definitive diagnosis of which is obtained only with an exploratory and curative cervicotomy.
A retrospective study of 25 sinuses mucoceles over a ten year period is presented. The authors insist on epidemics and diagnostics characteristics of this pathology and discuss the various therapeutics means.
The authors report 10 cases of frontal sinus osteoma. The patient group consisted of 5 men and 5 women, ranging in age from 15 to 60 years. The most common revelating symptom was headache. Treatment depends on tumor size, its course, and complications. Transfacial incision was used in 3 cases and Cairns Unterberger approach in 5 cases. Post operatively anatomic and esthetic results were good, without recurrences.
The laryngopyocele is a rare complication of laryngocele. About one case of laryngopyocele and review of literature, the authors recall the main characteristics of this affection. Its clinical picture is often alarming. The CT scan, not often made emmergenceley, give a characteristic image. The treatment is mainly surgical but also endoscopic, then facilitated by the use of laser. The fact of thinking to this diagnosis toward a laryngeal dyspnea with fever permit sometimes to avoid tracheotomy then usually made emmergencely.
Laryngocele is usually benign affection of the larynx. But serious forms of clinical emergency necessitating tracheotomy are possible. We reported 3 cases. New methods of treatment are presented endoscopic resection and laser marsupialization.
Mucocele of the maxillary sinus is a rare affection his pathogenesis is still discussed, with a prevalence of the injury's and inflammatory's theories. The diagnosis being confirmed by computed tomography imaging ... We report in this study, 3 cases of maxillary sinus mucocele, with a review of literature.
Between 1985 and 1990, 15 ethmoid frontal mucoceles were collated. All our patients consulted us at the exteriorization stage. A CT-scan is the ideal examination, making it possible to assert the diagnosis and to individualize the bone destruction and the neighbouring tissue repression. Trans-ethmoid or trans-nasal marsupialization by an external or endonasal approach provided excellent results after a 1 to 5 year follow-up period.
The authors report the case of a 60 year old woman with synovial osteochondromatosis of the elbow treated by total synovectomy. The result was good for all symptoms. They discuss the etiology, pathogenesis, diagnosis and treatment.
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