External or internal lateral osteotomy: why I choose the external percutaneous approach.

The authors present their surgical experience with the management of patients with dorsum deformities using a precise technique: the external percutaneous approach. The indications for this technique have still not been set out very clearly in the rhinological textbooks or manuals, and so novices (and not only novices) have difficulty in understanding and applying it. We therefore try to systematise and clarify these indications in brief, together with the technical details, providing a comparison with another technique that is in very widespread use at present: the internal lateral osteotomy. Although the external percutaneous approach is not used very often--in our experience in 30% of cases only--we find the results very satisfactory and we recommend it when it is required by the anatomic conditions.

Autologous costochondral cartilage implant in two cases of velopharyngeal insufficiency.

The velopharyngeal sphincter is critical in enabling the functions of speaking and swallowing. Velopharyngeal insufficiency (VPI) results in hypernasal speech and nasal regurgitation. A frequent cause of VPI is congenital cleft palate, but otolaryngologists sometimes encounter iatrogenic VPI after surgery. Treatment of VPI with prostheses is often successful but not always well tolerated. Many surgical procedures have been proposed to correct palatal length or to enlarge the posterior pharyngeal wall. We report two cases in which autologous costochondral cartilage was used as implant augmentation. This approach is indicated and efficient when the velopharyngeal deficit is less than 5 mm. An autologous costochondral cartilage implant procedure is safe and reversible and can be expected to incite minimal host reaction.

The antrochoanal polyp.

The different varieties of choanal polyps are reviewed by the authors according to their implantation pedicle. Their histology, possible pathogenesis, the various symptoms, steps in the diagnostic procedure and differential diagnoses are also described. Finally, the various modes of treatment are discussed, focussing in particular on the surgical methods and the new possibilities offered by developments in the field of endoscopy.

[Relations between vasculotensional disease, sudden deafness and benign paroxysmal postural vertigo: value of anticochlear antibodies]. / Relations entre la maladie vasculotensionnelle, la surdité brusque et le vertige positionnel paroxystique bénin: intérêt des anticorps anticochléaires.

Some vasculotensional diseases may be associated, at a certain point of their evolution, with occurrences of sudden deafness or of benign paroxysmal positional vertigo. It seems that the efficiency of the treatments of sudden deafness and benign paroxysmal positional vertigo is not modified by those associations of pathologies. On the other side, the search for anticochlear antibodies gives a positive result in 45% of the vasculotensional diseases. When the vasculotensional disease is associated with sudden deafness, this percentage increases. On the contrary, it is lower when the vasculotensional disease is associated with benign paroxysmal positional vertigo. The presence of anticochlear antibodies may lead to a corticotherapy in case of failure of the classical treatments.

[Techniques of uvulopharyngoplasty for snoring]. / Techniques d'uvulopharyngoplastie pour ronflement.

Snoring is considered abnormal even in children. Breathing difficulties can modify the development of the face and provoke upper respiratory dysfunction. Some surgical techniques are presented.

[Bacteremia and tonsillectomy]. / Bactériémie et amygdalectomie.

A comparative study on the course of bacteremia and the postoperative behavior in 132 patients requiring tonsillectomy and adenoidectomy has been conducted. A control group including 33 patients was compared to three groups of an even number of cases treated with either doxycycline or amoxycyllin, or receiving gamma globulin immunotheraphy. Choice was guided by (1) the occurrence of bacteremia during surgery and the search for the various microbial strains involved, and (2) the confirmation of the advantages of the drug used within the first week of treatment.