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Biomedical subjects

M Ferjaoui

Publications and source records attributed to M Ferjaoui.

At least 19 recordsLinked to original sources

[Imaging of rhinocerebral mucormycosis].

PURPOSE: Rhinocerebal mucormycosis is a rare life threatening fungal infection observed in immunocompromised patients. We report six cases of patients with rhinocerebral mucormycosis confirmed histologically. Our study confirms the necessity of early diagnosis when clinical and CT findings are suggestive. MATERIALS AND METHODS: This is a retrospective study including 6 diabetic patients (3 women and 3 men) aged from 28 and 63 years. Five patients had ethmoiditis evolving for a few days (3 to 5 days), and one patient was in an ketoacidotic coma and had a severe infectious syndrome with purulent rhinorrhea evolving for 4 days. All of our patients underwent computed tomography (CT) scan of the paranasal sinuses. MRI was performed in two patients with neurological findings. RESULTS: Unilateral ethmoido-maxillary sinusitis was noted in 5 cases. Only one case of pansinusitis was found. All patients presented orbital involvement. Cerebral involvement was noted in 4 cases (cerebral venous thrombosis: 2 cases; abscess: 2 cases; cerebral ischemia: 2 cases). The diagnosis of mucormycosis was based on endonasal biopsy. When available, MRI allowed a more precise evaluation of the orbital and cerebral extension. CONCLUSION: Mucormycosis is an opportunist mycosis due to mucoralis fungus. It is very invasive with a highly aggressive potential in diabetic or immunocompromised patients. Imaging study particularly CT scan, plays an important role in diagnosis especially to evaluate cerebral extension.

Adult↗

[Ectopic thyroid: two cases].

Ectopic thyroid is a rare condition (1/4000 to 1/8000 among patients with hypothyroidism). The underlying etiological pathogenic mechanisms remain unknown. Diagnosis is established on the basis of imaging findings. We report two cases of hypothyroidism in adult females who had ectopic sublingual thyroid glands. The first patient was a 20-Year-old woman who had been treated for hypothyroidism since the age of 13 Years before the diagnosis of ectopic thyroid 7 Years later. In both patients, the thyroid gland was palpable. In the first patient the physical examination revealed an ectopic sublingual gland. Scintigraphy confirmed the diagnosis in both patients. The CT-scan and MRI were positive in the second patient. Hormonal substitution therapy using L-thyroixine was given.

Adult↗

[Cold parapharyngeal abscess in spondylodiscitis].

BACKGROUND: The principle danger of pharyngeal abscess is the risk of rupture overflow into the upper respiratory track. Pyogenic abscesses are the most frequent and tuberculosis is rare. We report two cases of retro and parapharyngeal abscesses with tuberculous spondylodiscitis. CASE REPORTS: The first case occurred in a 54-year-old woman, the second in a 19-year-old man. Both had a laterocervical swelling associated with a oropharyneal bulge that progressed over several months. Computed tomography showed abscess formation and spinal disease in both cases. Drainage of the abscess led to the distological diagnosis of tuberculosis. Medical management was successful with resolution of the abscess and spinal lesions. DISCUSSION: Spinal tuberculosis should be suspected in patients with a parapharyngeal abscess without detectable portal that progresses slowly. A biopsy specimen is required for diagnosis. Magnetic resonance imaging can provide early evidence of spondylodiscities. Medical treatment is indicated.

Adult↗

[Primary sino-nasal lymphomas. Apropos of 25 cases].

PURPOSE: To report on the epidemiological and therapeutic features of a series of Tunisian patients treated for primitive sinonasal lymphoma. PATIENTS AND METHODS: Our retrospective study concerns patients with histologically proven primitive sinonasal lymphoma diagnosed and treated at our institution from 1975 to 1997. Initial work-up included: clinical plus ENT examination, WBC, ESR, LDH, abdominal ultrasonography, bone marrow biopsy and facial CT-scan taken since 1985. All slides are reviewed and reclassified using the Kiel system. Treatment is based on radiotherapy with or without chemotherapy (mainly with the CHOP protocol). RESULTS: We collected 25 patients (22 males and three females, sex-ratio = 7) with a mean age of 48 years (18 to 78). Mean delay of consultation is 4 months and patients consulted mainly for nasal obstruction (65%), more rarely epistaxis (40%) or rhinorrhea. ENT examination showed a fungating nasal fossa tumor in 20% of cases, predominantly unilateral (80%), associated to cervical nodes in 25% of cases. High-grade lymphomas represented 60% of the cases, and 60% of the patients were stage IE. All stage IEs have been treated by exclusive radiotherapy while more advanced stages received combined chemo- and radiotherapy (eight patients). The five-year actuarial survival rate was 69% for the whole population, with a better prognosis for localized stage and low-grade lymphomas. DISCUSSION: Radiotherapy remains a standard treatment for sinonasal lymphomas, permitting us to cure localized stages. In extended stages (more than IE), combined chemoradiotherapy seems to be a good option, especially in case of bulky tumors as observed for the other nodal and extra-nodal head and neck lymphomas.

Adolescent↗

[Mucous malignant melanoma of the neck and face. Experience at the Salah Azaiz Institute (Tunis)].

The mucosal melanoma of the head and neck is rare and of late diagnosis. This retrospective study concerns 17 cases brought together in 30 years. Sex-ratio was of 1.1, the average age of 58 years. Tumoral seats were the following ones: nasal cavity and paranasal sinus (n = 10), nasopharyngeal cavity (n = 2), gingival seat (n = 2), palate (n = 1), laryngeal seat (n = 1), middle ear (n = 1). Tumoral extension was classified an follows: stage I: 52.9%, stage II: 17.6%, stage III: 29.4%. Melanomas were achromic in 23.5% of cases. On the therapeutic plan, 47.1% of the patients were treated in a purpose palliative because of the importance of the tumoral extension. Seven patients (41.2%) were treated surgically; three among them received an additional radiotherapy for an insufficient tumoral excision or adenopathy in break capsular. Two patients (11.8%) were treated by exclusive radiotherapy. The rates of survival were 17.6% in 2 years, and 5.9% in 5 years. The average duration of survival was of 18.1 months. The causes of failure were essentially local and metastatic.

Adult↗

[Histology of the larynx].

The mucous membrane lining the interior of the larynx was studied in autopsy specimens taken from 21 infant larynxes, with ages ranging from 1 to 15 years. Only those larynxes in which the epithelial mucosal structures were preserved were set aside for study. A standard histological technique was applied. Paraffin sections were stained with haematoxylin-eosin, PAS, Masson's triple stain and orcine. The epithelium of the ventricles, ventricular bands and subglottis was found to be of respiratory type. On the vocal folds, the lining was non-keratinising squamous epithelium. These findings are consistent with those found in the literature. Findings that differed were as follows: the laryngeal surface of the epiglottis is classically described as having a respiratory type of epithelium, whereas we found it to be of non-keratinising stratified squamous type. The literature describes the epithelium of the ventricular bands as respiratory. While in our series we found stratified squamous in 56% and respiratory in 44%. Other findings are imprecise in the literature, and need definition; the finding of taste papillae in six cases without age correlation; and the richness of follicles in the lymphoid tissue at the epiglottis and ventricles of children aged more than 3 months.

Adolescent↗

[Carotid body tumors: contribution of the various imaging techniques. A report of six cases].

INTRODUCTION: Carotid body tumors are rare hypervascular lesions arising from neural crest paraganglion cells. MATERIALS AND METHODS: We retrospectively analyzed the imaging features of six patients with carotid body tumors to precise their imaging characteristics in order to find specific signs and elaborate a strategy for diagnosis. RESULTS: Imaging features detect the vascular nature of these tumors of the carotid space causing characteristic widening of the carotid bifurcation. Two patients had multiple (two or more) localizations and one had a family history of glomus tumor. CONCLUSION: MRI with MRA is considered as the gold standard imaging technique for the evaluation of glomus tumors as it allows a multiplanar approach which is important in the preoperative study.

Adult↗

[Amniotic band syndrome. Case report].

Amniotic band syndrome is a rare fetal malformation involving limb ring strictions, cranio-facial and trunck abnormalities. The authors report a case of 5 months old infant with also facial cleft. The plastic reconstructive surgery leads to a better functional result. This affection represents a sporadic disease without genetic causes. The pregnancy ultrasonography visualise fetal abnormalities.

Adult↗

[Nasal localization of the Crohn's disease].

Crohn's diseases is a chronic granulomatous inflammatory disease of the gastrointestinal tract. Any part of the gastrointestinal tract may be affected, and 9% of cases have oral lesions (1). Nasal involvement is exceptionally rare. We report a case of nasal involvement revealed by chronic atrophic rhinitis in a patient with known Crohn's disease.

Adult↗

[Fistula of the 4th endobranchial pouch: a case report].

The congenital fistula of the 4th branchial pouch is rare. Clinical and therapeutic difficulties are often found. The authors describe a new case of fistula of the fourth endobronchial pouch and precise the embryogenesis, the clinical diagnosis and the surgical treatment.

Adult↗

[Cogan's syndrome. Apropos of a case].

The syndrome of Cogan associate a non syphilic interstitial keratitis and a bilateral deafness of perception. Referring to a case, the authors review the clinical pathogenic and the different immunological exams.

Adult↗

[Pharyngeal stenosis in a case of Behçet's disease].

A case of pharyngeal stenosis in Behcet's disease is reported. A parallelism is done with other systemic disorders such as lupus erythematosus and Wegener's disease. Vasculitis and localised myositis are incriminated in the mecanism of the pharyngeal stenosis.

Adolescent↗