[A rare cause of recurrent meningitis in children: cochleovestibular dysplasia]. / Une cause rare de méningite récurrente chez l'enfant: la dysplasie cochléovestibulaire.

Recurrent bacterial meningitis is an uncommon disease of childhood. It occurs most often in children who have an underlying predisposing disorder that can result from anatomic fistula or immunodeficiency. Cochleovestibular dysplasia is a rare malformation of the inner ear that is often associated with translabyrinthine cerebrospinal fistula and then can cause recurrent bacterial meningitis. We report an unusual case of recurrent meningitis revealing cochleovestibular dysplasia in a 9-year-old child. The malformation was confirmed by imaging and the child had surgery. The outcome was favourable with no recurrence of meningitis during the 3 years after the operation.

[Effectiveness of a consensus protocol for the prevention of chemotherapy-induced nausea and vomiting]. / Efectividad de un protocolo consensuado para la prevención de náuseas y vómitos inducidos por quimioterapia.

OBJECTIVE: To assess the effectiveness of a consensus protocol for the prevention of CINV at our institution and level of adherence to it. METHOD: Prospective observational study. Patients treated with chemotherapy (CT) in whom a 120-hour follow-up was made after the cycle were included. We assessed the response to the therapy, categorized as: complete response (CR) (absence of nausea and vomiting, without the need of additional treatment within the 120 hours following the cycle), acute response (AR) (within the first 24 hours) and delayed response (DR) (within 24 and 120 hours), depending on whether or not these were adjusted to the hospital protocol. A descriptive statistical analysis was performed analyzing the different risk factors and level of adherence to the hospital protocol. RESULTS: A total of 167 patients were included in whom CR was observed in 71.9% of the cases (88.9% AR and 73.7% DR), with absence of vomiting in 89.8%. Seven point two percent of the cases did not adhere to the protocol. There were no differences in treatment response between the patients adhering and adhering to the protocol (CR, AR o DR) but yes in vomiting occurrence (8.3% vs. 36.4%, p = 0.014). CONCLUSION: The effectiveness of our protocol is good specially for controlling the vomiting although nausea during the delayed phase still is a not resolved matter. Vomiting control is poorer in those patients not adjusting to the protocol.

[Congenital cholesteatoma in children]. / Cholestéatome congéntial.

OBJECTIVES: To report on two cases of congenital cholesteatoma in patients aged 1 month. To review the clinical and radiological features of congenital cholesteatoma and to clarify the contribution of the CT scan in the diagnosis and the preoperative workup. PATIENTS AND METHODS: The authors report two observations of congenital cholesteatoma. These children were investigated using high-resolution CT. The treatment was surgical in both cases. RESULTS: The children were 1 month old, presenting with facial paralysis. In the otoscopic exam, the tympanic membrane was normal in both cases, with a whitish retrotympanic soft mass. The diagnosis of congenital cholesteatoma was made based on the CT data. CONCLUSION: Congenital cholesteatoma is rare. Otoscopic examination must be undertaken during the physical exam of a child at a young age to establish an early diagnosis. CT scan allows positive diagnosis and a precise preoperative workup.

Benign osteoblastoma in an unusual mastoid location.

INTRODUCTION: Benign osteoblastoma (OB) is an unusual primary bone tumor. The preferred locations are the posterior arch of vertebrae and long bones. We report herein an extremely rare location of an OB in the mastoid process of the temporal bone. CASE REPORT: A 22-year-old woman presented with painful left retro-auricular swelling. Computed tomography features were suggestive of an aggressive osteolytic lesion of the left mastoid. The pathologic examination of bone curettage material revealed a benign OB. A complete resection of the tumor was performed later, with no evidence of recurrence at 1 year. DISCUSSION/CONCLUSION: To our knowledge, this is the 14th reported case of OB confined to the mastoid process of temporal bone. Its histological diagnosis can be difficult and osteosarcoma is its principal differential diagnosis. Although generally regarded as benign, OB has potential for recurrence and local invasion. As such, complete resection, whenever possible, is preferred over conventional curettage.

[What are the alternative criteria for fine needle aspiration biopsy of a thyroid nodule?]. / Quels critères alternatifs à la cytoponction d'un nodule thyroïdien ?

OBJECTIVES: To identify the clinical and paraclinical factors of thyroid nodule malignancy (in absence of ultrasound-guided fine needle aspiration biopsy data). PATIENTS AND METHODS: This retrospective study was conducted on a cohort of 282 patients admitted for management of a thyroid nodule disease. All patients had undergone surgery and the specimen had been analyzed anatomically and pathologically. Forty-four patients had malignant disease. Epidemiological, clinical, and paraclinical data, as well as the anatomical and pathological characteristics of the specimen were collected for each patient. RESULTS: We showed that the epidemiological data (sex and age), the nodule's characteristics (consistency, irregularities of the edges and fixity to underlying structures, and size), the presence of adenopathies, signs of compression, and the presence of calcifications were the predictability criteria of malignant disease. However, the scintigraphic aspect, the echostructure, and the hormonal status were not significant. CONCLUSION: This study underscores that a relevant clinical and paraclinical analysis remains highly contributive in the presurgical identification of factors predictive of malignancy of a thyroid nodule, notably in countries where technological tools are not always available.