Otologic features and teachings of a bombing attempt.

The authors present 13 casualties observed after the bombing attempt in Djibouti (March 1987). All of them suffered blast injury to the ear. The scene and the circumstances of the explosion are described. A correlation is sought between the location and position of each casualty and the lesions he presented, with reference to animal experiment data, namely the shock waves propagation conditions. The otologic lesions are commented on with reference to acute acoustic trauma, and the need for a special study of vestibular outcome of blast injuries is emphasized.

[An uncommon localization of upper respiratory-digestive tract tuberculosis: the cavum]. / Une localisation peu fréquente de la tuberculose des voies aéro-digestives supérieures: le cavum.

On the basis of a personal case, the authors recall the features of tuberculosis in the cavum. These lesions can resemble malignant tumours of the rhino-pharynx and they are part of the differential diagnosis. In particular, the authors stress the existence of rhino-pharyngeal tuberculosis with very few symptoms, which need to be investigated routinely in the context of a survey of proven pulmonary tuberculosis.

[Mediofacial necrosis and malignant centrofacial granuloma. Apropos of 8 cases and 1 with atypical localizations]. / Nécroses médio-faciales et granulome malin centro-facial. A propos de 8 cas et d'une localisation atypique.

Since the first descriptions by McBride and then Stewart, and later reports by wegener, numerous publications have contained data emphasizing the diagnostic and classification difficulties of these affections, 450 cases having been documented up to the present times. Findings clearly demonstrate that mediofacial necrosis differs greatly by its pathological, etiopathogenic and out come features, and particularly the localization of the lesions. Eight case were investigated, and conclusions drawn that it was important to identify the different affections grouped under the term "mediofacial necrosis", in order to isolate cases of pure malignant centrofacial granuloma, which have no detectable etiology and cannot be integrated in another nosological framework.

[Nasal ciliary immobility and its otological consequences]. / L'immobilité ciliaire nasale et son retentissement otologique.

Ultrastructural anomalies were studied in vibratory cilia of middle ear mucosa and findings compared with those observed in pituitary and bronchial mucosae. Anomalies noted on electron microscopy are reported and commented.

[Otologic complications of water beds]. / Les complications otologiques des lits fluidisés.

Since the introduction of the use of water beds several cases of ear infections have been observed. These are due to the escape of microspheres and the prevention of these manifestations requires strict manipulation of these beds.

[Laryngeal lesions caused by explosions (laryngeal blasts)]. / Les lésions laryngées par explosion (blasts laryngés).

Laryngeal lesions due to explosions are termed laryngeal blast injuries when they result exclusively from the shock wave effects on laryngeal structures. Their experimental study is very recent and physical and physiopathologic bases for these lesions are discussed in relation to two cases. It is essential to identify these lesions early in all victims of an explosion since their presence may indicate the existence of pulmonary or abdominal blast injuries, detected at a later stage and affecting vital prognosis.

[Preservation of auditory function in the excision of acoustic neuroma]. / Conservation de l'audition dans l'exérèse des neurinomes de l'acoustique.

Selection criteria for the preservation of auditory function during excision of acoustic neurinoma have been defined for a long time, and the means for a successful achievement of such a goal are widely known. Recruitment of special patients, for whom maintenance of an even deeply altered hearing capacity constitutes a requisite for continuation of professional work has lead us to extend indications for the pre- and retrosigmoid approaches recommended by J.M. Sterkers. The authors present a series of 16 patients, in which a single case of cophosis was deplored.

[Tympanoplasty in the treatment of sequelae of blast injuries of the ear]. / Les tympanoplasties dans le traitement des séquelles des blasts auriculaires.

This study deals with 40 clinical files relating to auricular blast injury patients with ensuing eardrum perforation, managed either by tympanoplasty or by placement of a healing support. An analysis of the functional symptoms, the size and localization of the perforation; determination of the presence or lack of immediate post-injury infection, and of the degree and type of hearing loss suffered, permits to define the characteristics of postoperative ear status. A comparison of the study results with published data provides for specifying surgical indications and sheds light on the long-term evolution pattern in such patients.

[Effects of loud music on the Garde Républicaine musicians]. / Effets de la musique de forte intensité chez les musiciens de la Garde Républicaine.

The authors report their observations on the auditory status of 76 musicians belonging to a Republican Guard brass band, and give their interpretation of abnormal findings, as they compare percussion with wind instruments and make reference to literature data. Accompanying signs, such as ear fatigue, noise intolerance, tinnitus, ear-aches, disturbance of sleep, psychic disorders, and disturbances of equilibrium are also taken into account as predisposing factors. Lastly, an attempt is made to bring out some of the characteristics that are specific to each instrument.

[Lightning injury of the ear]. / Fulguration d'oreille.

Three cases of auricular fulguration are described and used as a basis for a review of physical characteristics and histopathologic consequences of lightning strikes. Cases are presented and discussed in relation to these fundamental and experimental data.

[Survey on the harmfulness of listening to music with headphones]. / Enquête sur la nuisance de l'écoute de la musique au casque.

A survey conducted in 52,000 young male subjects evaluated the influence of listening to music with stereophonic headphones on perception hypacusis leading to exemption from National Service. Also investigated were noise level output from promenaders as well as temporary auditory loss two minutes after listening for one hour. Findings suggested relative innocuity of listening at moderate intensity for less than seven hours weekly. Users exceeding these optimal factors develop professional type deafness for which similar preventive measures are required. Particular mention is made of the effect of strolling listeners on vigilance and on sound pollution of industrialized countries.

[Nasopharyngeal perforation: an exceptional accident during digestive endoscopy]. / Perforation du cavum: un accident exceptionnel d'endoscopie digestive.

A case of an endoscopic nasopharynx perforation is reported. As we known, this accident has never been described. During introduction of a duodenal tube appeared a subcutaneous neck emphysema. Radios revealed pneumomediastinum, pneumoperitonitis and retropneumoperitonitis. Nasofibroscopy affirmed the diagnosis. The too fast death of this 92 years old patient didn't allow an adapted therapeutic.

[Major acoustic injuries caused by firearms]. / Les traumatismes sonores majeurs par arme à feu.

The appearance of new generations of firearms, very harmful for the hearing of the shooter, suggested the need for an updated review of data concerning detonations and their effect on hearing. Emphasis is given to the place of acoustic injuries among traumatic pressure-induced otopathies as well as the value and efficacy of current therapeutic measures.

[Blast injuries of the ear. Current status and study of 200 cases]. / Les lésions auriculaires par blast. Aspects actuels et étude de 200 cas.

Clinical case-reports of 200 patients with blast-induced lesions are used as a basis for a review of physical and physiopathologic factors. Otologic aspects of injuries due to high-intensity shock waves are discussed and clinical and histopathologic features described. The place of post-traumatic pressure induced injuries to ear in catastrophy medicine is emphasized.

[Cervical cystic lymphangioma in adults]. / Lymphangiomes kystiques cervicaux de l'adulte.

Cystic hygromas, infrequent in children, are even rarer in adults where they once were generally an unexpected operative findings. Now, with the progress in modern medical imaging the diagnosis can be suggested before operation. Analysis of the embryogenesis helps to explain the different anatomical and clinical forms and the relations of the cystic hygroma with neighboring tissues, particularly of renous origin, grases of cystic hygroma of the neck in adults are reported and discussed with 26 other well documented cases from the literature. The diagnosis can be confirmed only after operation and histological examination. Surgical removal is technically less difficulté in adults than in children and recurrences are rare.

[Thyroid teratoma in adults]. / Tératomes thyroïdiens de l'adulte.

A new case of thyroid teratoma is reported in an adult and the heighten other cases of the literature are reviewed. This pathology, rather frequent and always benign in infants, is distinguished in adults by a malignant metastatic course for 14 cases of 19. The reported case, the second one in a male adult, remains a benign one after 14 years.

[Isolated sphenoidal aspergillosis presenting as an optic neuropathy]. / Aspergillose sphénoïdale isolée révélée par une neuropathie optique.

Aspergillosis fixation in the sphenoidal sinus is an exceptional occurrence when isolated. The clinical feature is misleading and the diagnosis often difficult; local and regional complications are dreadful. The authors report a case, presenting as an optic neuropathy, and the literature data.

[Cervical cystic lymphangiomas in adults]. / Lymphangiomes kystiques cervicaux de l'adulte.

Cystic hygromas, infrequent in children, are even rarer in adults where they are generally unexpected operative findings. Now, with the progress in modern medical imaging, the diagnosis can be suggested before operation. Analysis of the embryogenesis helps to explain the different anatomical and clinical forms and the relations of the cystic hygroma with neighboring tissues, particularly of venous origin. 9 cases of cystic hygroma of the neck in adults are reported and discussed with 26 other well documented cases from the literature. The diagnosis can be confirmed only after operation and histological examination. Surgical removal is technically less difficult in adults than in children and recurrences are rare.