Biomedical subjects

R Peynegre

Publications and source records attributed to R Peynegre.

At least 19 recordsLinked to original sources

PubMed2005

[Efficacy of Derinox assessed with one PNIF (Peak Nasal Inspiratory Flow) in patients suffering from common cold].

OBJECTIVES: The aim of this study was to compare the efficacy and tolerance of Dérinox (D) to Rhinofluimucil (R) and placebo (P) in the treatment of common cold, using an objective measure of nasal obstruction, the Peak Nasal Inspiratory Flow (PNIF--Clement Clarke International, Harlow, Angleterre). PATIENTS AND METHODS: This randomized, double-blind, double-dummy, parallel group study enrolled 354 patients (34 P, 165 D et 155 R) included by 85 general practitioners. The treatment duration was 5 days at usual recommended dosage regimens. PNIF measures were done before drug administration (T0) as well as 15 min and 3 h after each intake. Moreover, nasal obstruction, rhinorrhea and global discomfort were subjectively assessed. RESULTS: The efficacy of D was superior to that of P and R when comparing PNIF from T0 to T3 h after the first intake. At T15 min, rhinorrhea was significantly improved with both active treatments and global discomfort was significantly improved with D only. Treatment tolerance was satisfactory and comparable between the 3 groups. CONCLUSION: Efficacy of Dérinox(R) was superior to that of P and R for the improvement of the nasal obstruction (PNIF) between T0 and T3h (main criteria) after the first intake in patients suffering from common cold.

Acetylcysteine↗

PubMed2002

[Sinusal penetration of amoxicillin-clavulanic acid. Formulation 1 g./125 mg., twice daily versus formulation 500 mg./125 mg., three times daily].

INTRODUCTION: In order to meet the evolution of pneumococcus resistance to beta-lactam antibiotics, a new formulation of amoxicillin (AMX) and clavulanic acid (CA), with twice as much AMX (1 g/125 mg vs. 500 mg/125 mg) was developed for the treatment of acute pneumonia in patients at risk. This formulation can also be used in the treatment of acute maxillary sinusitis using a 1 g/125 mg regimen twice-daily. OBJECTIVES: Compare the sinusal penetration of AMX and CA (1 g/125 mg twice-daily vs. 500 mg/125 mg three times a day) when administered at both regimens to demonstrate equivalent pharmacokinetic and pharmacodynamic behaviour of the former when compared to the latter. METHODS: Concentrations of AMX and CA were measured in the anterior ethmoid, maxillary, posterior ethmoid sinus and in the middle nasa concha in 62 patients undergoing surgery for nasosinusal polyps. Patients randomised in two groups corresponding to 2 oral regimens, received either 1 g/125 mg twice a day or 500 mg/125 mg three times a day for 4 days. The last dose in both groups was administered 1 h 30, 3, 5 or 8 hrs prior to surgery. Serum samples were taken simultaneously to tissue samples. AMX and CA were measured by high performance liquid chromatography. Exogenous and above all endogenous blood contamination were taken into account with the hematocrit as well as blood and tissue haemoglobin concentrations. Comparisons of tissue concentrations were made for each sampling time, according to values obtained for a specific tissue with both doses on one hand, and on the other to values obtained with a specific dose in different tissues. The calculated pharmacodynamic parameters, which are considered to be predictive for bacteriological and clinical efficacy, result directly from tissue concentrations of AMX. tissue inhibitory quotients (IQtissue = Tissue concentration/MIC). time above MICs for serum and tissue concentrations (T > MIC). RESULTS: As regards AMX, whatever the dose, at 1 h 30 and at 3 hrs, tissue concentrations did not differ significantly whatever the tissue studied (from 1.1 to 2.5 micrograms/g). Conversely, at 5 and 8 hrs, they were greater than after the 1 g/125 mg regimen given twice-daily (0.06-0.7 vs. 0.7-1.8 micrograms/g). If we consider a given dose, the comparison between the various tissues showed identical concentrations in the four tissues studied at each sampling time, except in two cases with the dose of 500 mg/125 mg 3 times a day. T > MIC for serum and tissue showed higher values than those required for AMX/pneumococcus association (40-50%) with, nevertheless, greater tissue values for the 1 g/125 mg dose given twice-daily when MIC was of 1 microgram/ml (40-52% vs. 50-66%). The maximum tissue inhibitory quotients were also greater with the twice-daily 1 g/125 mg dose, when calculated with MIC 50 or 90 of S. Pneumoniae, H. influenzae, M. catarrhalis or S. pyogenes. As for CA, concentrations were equivalent for both doses at each sampling time and greater than those required in vitro during respectively 4 and 5 hours for beta-lactamases H. influenzae and M. catarrhalis. DISCUSSION-CONCLUSION: A least an equivalence between both dose regimens was observed, with occasionally a superiority of the twice-daily 1 g/125 mg dose, in terms of pharmacokinetics, tissue penetration and pharmacodynamics for both AMX and CA. This new regimen therefore appears more appropriate for the treatment of acute maxillary sinusitis in adults.

Acute Disease↗

PubMed2002

Epidemiological and clinical aspects of nasal polyposis in France; the ORLI group experience.

Nasal polyposis (NP) is a common condition in patients consulting ENT practitioners in France. A multicenter prospective study was performed to evaluate symptoms, demography, environmental factors, personal and family history and associated conditions like asthma, and food or drugs sensitivity (FDS) in patients suffering from NP. In each investigation center assessments were performed at the moment of the initial consultation by the same investigator, then updated with complementary exploration results required by the protocol. The chi 2 test and the Fisher test were used for statistical analysis. In this study 224 patients were included. Males were predominant at 63%. Asthma was found in 45% of cases without relevant sex difference. However, FDS, positive in 31% of the patients, was statistically higher in females than in males (42.9% vs. 24.4%). Severe and major symptoms were more frequently found in the female population. Environment and habitat factors did not appear to be relevant. High rates of NP (52.66%) and asthma (43.58%) were found in the family history. Hereditary factors were suggested and lead us to further study the genetic factors potentially involved in this pathology.

Asthma↗

PubMed2001

Efficacy and tolerance of intranasal insulin administered during 4 months in severely hyperglycaemic Type 2 diabetic patients with oral drug failure: a cross-over study.

AIMS: We have evaluated the local tolerance and the metabolic efficacy of a lyophilized nasal insulin preparation in 10 severely hyperglycaemic Type 2 diabetic patients. METHODS: The study included two 4-month randomized periods: (A) three preprandial doses of nasal insulin secondarily combined with one evening subcutaneous NPH if the desired glycaemic control was not achieved; (B) two NPH injections daily. We assessed: (i) diabetes control on monthly HbA1c levels and occurrence of hypoglycaemic events; (ii) local tolerance on clinical symptoms, rhinoscopy, nasal muco-ciliary clearance and nasal biopsies; (iii) insulin absorption at months 0 and 4. RESULTS: One patient was withdrawn because of cough and dizziness after each nasal application. HbA1c was not significantly different at month 4 (9.4 +/- 0.5% vs. 8.8 +/- 0.2%, A vs. B). Blood glucose control remained only fair in the majority of our patients. Nasal insulin was able to replace the daytime fraction of the subcutaneous insulin with a 18% efficacy. Side-effects included transient nasal hyperactivity (pruritus, sneezing and rhinorrhoea) and chronic persistence of nasal crusts. Plasma insulin profiles were not significantly different between months 0 and 4. CONCLUSIONS: The utilization of nasal insulin (with or without NPH) was associated with similar diabetes control compared with NPH twice daily. Nasal insulin alone was able to achieve an adequate glycaemic control in three of the 10 patients.

Administration, Intranasal↗

PubMed2001

Six month administration of gelified intranasal insulin in 16 type 1 diabetic patients under multiple injections: efficacy vs subcutaneous injections and local tolerance.

OBJECTIVE: Nasal insulin administration is a potential route for intensive insulin management, less invasive and more rapid than subcutaneous injections. Previous studies have shown poor bioavailability (less than 15%) with nasal insulin administration with various absorption enhancers. The aim of the study was to evaluate in type 1 diabetic patients, the metabolic efficacy and local tolerance of a new gelified sprayed nasal insulin containing glychocolate and methylcellulose as absorption promoters. MATERIAL AND METHODS: The study was conducted in 16 type 1 diabetic patients (HbA1c 8.6+/-0.2%) in a cross-over trial including 2 six month randomized periods: a) NPH twice daily + 3 pre-prandial nasal insulin doses + nasal supplementation in case of unexpected hyperglycaemia; b) NPH twice daily + 3 pre-prandial regular insulin injections. End points were HbA1c levels, hypoglycaemic episodes and tolerance evaluated at month 0, 2, 6 and 8 on clinical symptoms and objective nasal assessments. RESULTS: Four patients were withdrawn because of nasal burning (3 cases) and persistent sinusitis (1 case), and one patient had purulent sinusitis at the month 6 examination. At month 6, HbA1c levels were comparable (8.3 +/- 0.1 vs 8.6 +/- 0.1%, m +/- SEM, NS) for nasal and subcutaneous period respectively. The number of hypoglycaemic events was identical during the 2 periods (88 episodes). Nasal tolerance with the gelified form was better than with the already reported lyophilized form but, when present, symptoms were more marked, suggesting a potentiating additional role of methylcellulose excipient on nasal intolerance. CONCLUSIONS: 1) Gelified nasal insulin is as efficient as subcutaneous regular insulin in type 1 diabetic patients. 2) Other galenic forms should be investigated to improve nasal tolerance and bioavailability.

Administration, Intranasal↗

PubMed1999

Protruding the tongue improves posterior rhinomanometry in obstructive sleep apnoea syndrome.

In posterior rhinomanometry (PRM), oropharyngeal pressure is measured using a tube placed between the tongue and the hard palate. For valid results the patient must position the tongue and soft palate so that both the oropharynx and nasopharynx remain open. A high rate of failure of conventional PRM has been reported in normal individuals. In patients with obstructive sleep apnoea syndrome (OSAS), upper airway abnormalities may further increase the failure rate. This study proposes a modification of the technique in which protrusion of the tongue enhances pressure transmission between the nasopharynx and the mouth. In eight normal subjects, resistance was similar when measured by both methods. Of 24 OSAS patients, conventional PRM was unsuccessful in 11. In the remaining 13 patients, a significant correlation between the two methods was found, but resistance was lower by "tongue-out" than by conventional PRM, consistent with a decrease, during tongue protrusion, in retropalatal resistance, which is a component of the "nasal" resistance measured by PRM. In 26 OSAS patients, unilateral nasal resistance values measured by "tongue-out" PRM were similar to those measured by anterior rhinomanometry. When the "tongue-out" method was used routinely in 541 snorers, failure rates were 1.1% in the 272 non-OSAS patients and 3.7% in the 269 OSAS patients. These results indicate that posterior rhinomanometry with tongue protrusion is a highly effective tool for measuring nasal resistance in snorers.

Adolescent↗

PubMed1999

[Sinus mucoceles and surgery in iatrogenic diseases].

The increasing number of mucocele cases treated by the authors during the past ten years coincide with the expansion of functional endoscopic sinus surgery (FESS). The aim of this study is to evaluate the iatrogenic characteristics of this surgery by analysing the locations, time of development and the potential pathogenic factors of sinus mucoceles. Forty-two sinus mucoceles were operated in our department. These mucoceles were most frequently found in the anterior ethmoido-frontal system. Eleven patients had a history of endonasal ethmoidectomy mainly due to nasal polyposis. The time of mucocele formation after initial FESS (< 22 months) seems to be shorter than after exonasal sinus surgery or trauma (< 10 years). Endoscopic and CT-scan revealed different types of sinus obstruction findings: nasofrontal duct occlusion due to a fibrosis and osteogenic scar tissue process, or anterior ethmoid synechia in the case of ethmoido-frontal sinus mucocele, uncinate process fragment or scar tissue duct occlusion as far as maxillary sinus mucocele were concerned. We conclude that there seems to be a correlation between the expansion of FESS and the increasing number of mucocele cases. However, in this context it has to taken into consideration, that our department treats a considerable number of sinus pathology. Anterior ethmoid seems to be a favourable area for sinus mucocele formation. In order to prevent mucocele, it is essential to carry out FESS with great precaution. If endonasal surgery is performed, particularly in the anterior ethmoid, a close endoscopic follow-up, completed by radiological examinations, where necessary, must be ensured.

Adolescent↗

PubMed1998

Expression of the transforming growth factor beta isoforms in inflammatory cells of nasal polyps.

OBJECTIVE: To determine the expression and the potential role of transforming growth factor beta (TGF-beta) in nasal polyposis. DESIGN: Comparison of TGF-beta expression between normal and inflammatory nasal mucosa and polyps; in inflammatory nasal polyps, characterization of the TGF-beta isoforms expression and their potential location in macrophages and eosinophils. SETTING: Patients and samples were selected at the Hôpital Intercommunal, Créteil, France, and immunohistochemistry and immunoblots were performed at the Institut National de la Sante et de la Recherche Medicale U296 (Universite Paris XII, France). SUBJECTS: Nasal polyps and nasal mucosa were sampled in 21 patients during ethmoidectomy, and muscosa was sampled in 6 healthy patients during rhinoplasty. METHODS: Immunohistochemistry and Western blot analysis were performed using specific antibodies to TGF-beta1-3, TGF-beta1, TGF-beta2, and TGF-beta3 isoforms. Double labeling was also performed using anti-TGF-beta1 antibody together with macrophages or eosinophil-specific antibodies. RESULTS: The expression of TGF-beta(1-3) was significantly higher in inflammatory nasal polyps than in inflammatory nasal mucosa and higher in inflammatory nasal mucosa than in nasal mucosa from healthy patients. Transforming growth factor beta1 was the main isoform detected in inflammatory nasal polyps, and it was present in numerous macrophages and in some eosinophils. CONCLUSIONS: Transforming growth factor beta, mainly TGF-beta1, is strongly expressed in inflammatory nasal mucosa, where it could be produced by macrophages and eosinophils. Transforming growth factor beta could induce epithelium and connective tissue modifications and therefore be involved in the pathogenesis of nasal polyposis.

Adult↗

PubMed1998

[Endonasal endoscopic surgery in the treatment of spontaneous or post-traumatic cerebrospinal fluid (csf) leaks].

The incidence and the risk of meningitidis justify treatment in all cases of cerebrospinal fluid rhinorrhea with spontaneous etiology or after traumatic injury. Endonasal surgery with endoscopic instruments provides many advantages compared with transcranial or transfacial approach used by neurosurgeons. We report our experience and our surgical technique in the treatment of CSF leaks in 5 patients. Intrathecal injection of fluoresceine was very useful in all cases for detecting the CSF leak. Total or selected ethmoidectomy depended on the localization of the leakage. Wide sphenoidotomy enables detection and repair of CSF leaks from the sphenoid cavity. A free graft of inferior turbinal mucosal was used to repair the breache. This rapid low morbidity surgery offered secure closure of rhinorrhea in 4 cases after one procedure and in 1 case after two procedures with an average follow up of 22 months. Cerebrospinal fluid rhinorrhea can be managed in first line therapy with endoscopic intranasal surgical techniques when they are localized in the anterior ethmoid or in the sphenoid cavity.

Adult↗

PubMed1997

Nasal cavity geometry measured by acoustic rhinometry and computed tomography.

OBJECTIVE: To determine the significance of cross-sectional areas obtained by acoustic rhinometry. DESIGN: Comparison of data obtained by acoustic rhinometry and computed tomography (CT). SETTING: Outpatient clinic. PATIENTS: Nine adults with nasal obstruction due to turbinate hypertrophy. MAIN OUTCOME MEASURES: Acoustic rhinometry and CT were performed after nasal decongestion. The acoustic area-distance curve was analyzed based on 3 notches (A1, A2, and A3) corresponding to 3 local minimal areas. Computed tomographic measurements were made in the coronal plane at 0.5-cm intervals, and the narrowest sections in the anterior (S1), middle (S2), and posterior (S3) parts of the nasal cavity were selected. Mean specific section areas and volumes were computed by integration of the acoustic area-distance curves using the same procedure for the 2 methods. RESULTS: Significant correlations were found between acoustic and CT areas in the anterior nasal cavity (A1 vs S1, P < .001; A2 vs S2, P < .005). Acoustic and CT anterior volumes from A1 to A2 and from S1 to S2 were significantly correlated with each other (P < .005). No correlation was found between acoustic and CT areas measured at the posterior part of the nose (A3 vs S3). A weak correlation was evidenced between acoustic and CT posterior volumes from A2 to A3 and from S2 to S3 (P < .05). CONCLUSIONS: Acoustic rhinometry may be particularly well suited to the evaluation of anterior nasal geometry during clinical studies. At the posterior part of the nose, acoustic measurements may be of limited clinical relevance.

Acoustics↗

PubMed1997

Myofibroblast accumulation induced by transforming growth factor-beta is involved in the pathogenesis of nasal polyps.

Myofibroblasts that express alpha-smooth muscle actin (alpha-SMA) are detected in many chronic inflammatory diseases. Transforming growth factor-beta (TGF-beta) is a potent inducer of myofibroblast accumulation in tissues. In this study, scattered myofibroblasts and TGF-beta were quantified and localized in nasal polyps (NPs) and normal nasal mucosa (NM). NPs were sampled in 16 patients during ethmoidectomy and NM was obtained from 10 control subjects during rhinoplasty. alpha-SMA and TGF-beta were detected using immunohistochemistry and the numbers of labeled cells were quantified (alpha-SMA and TGF-beta indices) and compared between NPs and NM. In eight NPs, in which the pedicle was preserved, alpha-SMA and TGF-beta were evaluated and compared in the pedicle, central, and tip areas. Finally, TGF-beta expression was compared between low (zone 1), moderate (zone 2), and high (zone 3) zones of alpha-SMA positivity. alpha-SMA and TGF-beta indices were significantly higher in NPs than in NM. In the eight selected NPs, alpha-SMA-positive cells were significantly more abundant in the pedicle than in the central and tip areas, whereas TGF-beta-positive cells were significantly more numerous in the pedicle than in the tip area. The number of TGF-beta-positive cells was significantly higher in zone 3 than in zone 1 of alpha-SMA positivity. Myofibroblasts, which are abundant in NPs but rare in NM, could be involved in the growth of NPs by inducing extracellular matrix accumulation. The local development of myofibroblasts in NPs could be controlled by TGF-beta, locally produced by inflammatory cells.

Actins↗

PubMed1997

[Endoscopic endonasal ethmoidectomy in severe sinusitis of cystic fibrosis. Mid-term results in 12 patients].

UNLABELLED: Sinusitis, with sometimes severe symptoms, are frequent in cystic fibrosis (CF). The aim of this mild-term retrospective study was to evaluate the functional and anatomical results of functional endoscopic ethmoidectomy (FEE) in 12 patients with CF. Nasal polyposis (9 cases) and medialization of the nasomaxillary wall (3 cases) were detected during endoscopic examination. Bilateral and multifocal opacities of the paranasal sinuses were present on the CT-scan images in all cases. A FEE was performed in 11 cases and in 1 case, only the anterior ethmoid was opened. Symptoms improved or disappeared in 9/12 cases between 1 and 3 years of follow-up and in 5/7 cases after 3 years of follow-up. A good or mild anatomical result was recorded in 6/12 cases between 1 and 3 years of follow-up and in 5/7 cases after 3 years of follow-up. During follow-up, a new surgical procedure (limited in 8 patients and complete in 3 patients) was often necessary. CONCLUSION: It is reasonable to propose FEE in CF patients with chronic sinusitis presenting severe symptoms with the aim of a substantial functional but not anatomical improvement.

Adolescent↗

PubMed1996

Increased epithelial cell proliferation in nasal polyps.

OBJECTIVE: To detect, quantify, and compare respiratory epithelial cell proliferation in nasal mucosa and polyps from patients with nasal polyposis. DESIGN: Cohort study. SETTING: Patients and samples were selected at the Hôpital Intercommunal de Créteil (France). Flow cytofluorometry and immunohistochemistry were performed at Hôpitaux Tenon and Mondor (Université Paris [France] VI et XII). PATIENTS: Twenty-one patients undergoing endoscopic ethmoidectomy for treatment of nasal polyposis. METHODS: In 10 cases, epithelial cells were removed from frozen inferior turbinate mucosa and polyps by mechanical disaggregation and were then analyzed by flow cytofluorometry, providing the cell DNA content (propidium iodide labeling) and the percentage of S-phase cells. In 11 cases, inferior turbinate mucosa and polyps were fixed in formaldehyde and embedded in paraffin. Proliferating cell nuclear antigen expression in the epithelium was quantified by immunohistochemistry; a proliferating cell nuclear antigen index was calculated for each sample in the basal area, suprabasal area, and full height of the epithelium. RESULTS: All cell populations studied were diploid, and percentages of S-phrase cells were significantly higher in nasal polyps than in mucosa. Proliferating cell nuclear antigen indexes were significantly higher in nasal polyps than in the suprabasal area and full height of the mucosal epithelium. CONCLUSION: Cell proliferation is increased in epithelium from nasal polyps. Epithelial damage caused by inflammatory mediators could induce this increased cell proliferation via epithelial repair processes. Inflammatory cells could up-regulate epithelial cell proliferation by secreting growth factors.

Cell Division↗

PubMed1996

[Comparison of concomitant radiotherapy and chemotherapy with radiotherapy alone in advanced cancers of the head and neck: results of a randomized trial].

From April 1987 to October 1992, 67 patients with inoperable squamous cell carcinoma of the head and neck region were included in a randomized trial. All patients had induction chemotherapy with cisplatin (100 mg/m2, D1) and fluorouracil (1 g/m2, from D1 to D5) every three weeks for a total of three cycles. Patients were randomized to concurrent external radiation therapy (70 Gy/39 fractions/8 weeks) and chemotherapy with cisplatin (50 mg/m2 in short infusion, D1, D15, D29, D43) and fluorouracil (5 mg/kg, intra-muscular, every Monday, Wednesday and Friday) (experimental group) versus radiotherapy alone with the same modalities (control group). The followup for living patients was 14 to 60 months with a median of 42 months. Analysis of preliminary results has shown that: 1) early and late side effects are similar in both groups; 2) after completion of treatment, the percentage of patients in complete remission was 71% (20/28) in the experimental group and 43% (12/28) in the control group; this difference was statistically significant among non responders to induction chemotherapy (1/15 versus 13/20, P = 0.001), but non significant among responders (11/13 versus 7/8) and 3) there were no differences between both randomized groups in term of 3-year overall survival and of 3-year loco-regional control. Results are discussed taking into account a review of literature.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1996

[Osteoma of the naso-sinusal cavities. Surgical indications and role of endonasal endoscopic surgery].

Osteoma of the para-nasal sinuses is a rare and benign tumor that develops slowly. When therapy becomes mandatory, it is necessarily surgical and requires a standard external approach. This report analyses seven cases of operated osteomas, using different surgical techniques, adapted to different indications. Three patients underwent exclusive endonasal endoscopic surgery, and four patients had external surgery coupled with endonasal surgery. Results have proven successful with a four-year median follow-up. Epidemiological, clinical, histological and therapeutic considerations as well as the value of the endoscopic endonasal surgical approach are discussed. Endonasal endoscopic surgery can be used alone in naso-ethmoidal osteomas. It must, though, be associated with external standard procedure when the osteoma involves important extension to the frontal sinuses. In isolated frontal osteomas, external standard approach is mandatory for resection, endonasal technique being in this case contributive to the repermeabilisation of the infundibulum.

Adult↗

PubMed1996

[Treatment of antro-choanal polyp by enlarged endoscopic meatotomy. Apropos of 19 cases].

Antro-choanal polyp (ACP) is traditionally removed by performing Caldwell-Luc operation. The aim of this study was to evaluate the interest of removing ACP via enlarged middle meatotomy performed under endoscopic control (EMM). The cases of 19 patients who underwent EMM for ACP removal between 1991 and 1993 were retrospectively analyzed. The main symptom was nasal obstruction and ACP was diagnosed according to endoscopy, CT-scan and pathological examination. The usual technique for EMM included coagulation of the mucosal area of implantation of the ACP pedicle. The pedicle was localized on the external maxillary wall in 68.5% of cases. No complications was reported while ACP recurred in only one case. Using EMM to remove ACP appears therefore to be a safe and non-invasive method. The localization and removal of the ACP pedicle with coagulation of its mucosal area of implantation is recommended.

Adolescent↗

PubMed1995

Endoscopic and CT-scan evaluation of rhinosinusitis in cystic fibrosis.

In order to obtain an accurate evaluation of nasal and paranasal sinus disease in cystic fibrosis patients, 75 patients with a proven cystic fibrosis diagnosis have been investigated using the following standard techniques: questionnaire, ENT examination, endoscopical examination, sinus X-rays, and in 31% of the cases a CT scan. The analysis of results shows that nasal obstruction is the most frequent symptom (32%) and that nasal polyps are present in 43% of the cases. Endoscopic examination seems to be of great interest in giving a more accurate picture of nasal and paranasal sinus disease. Analysis of CT scan images leads the authors to describe a new and specific entity in nasal and paranasal sinus disease in cystic fibrosis patients: the pseudomucocele. In this report, the authors discuss the various aspects of pseudomucocele, attaching particular importance to the CT scan results.

Adolescent↗

PubMed1994

[Current aspects of laryngeal tuberculosis. Apropos of 4 cases and review of the literature].

After the discovery of streptomycin 1944, laryngeal tuberculosis became a rare complication of advanced pulmonary tuberculosis. Since that time the clinical aspects of the disease have changed. We analyzed these changes by reviewing 65 papers in English and in French published from 1965 to 1991 involving 738 cases and added our 4 new personal cases. To our knowledge, we report the first two well-documented cases of laryngeal tuberculosis in HIV positive patients. We propose a therapeutic and follow-up protocol for laryngeal and chest specialists treating such patients.

Adult↗