[Acute acoustic trauma, a retrospective analysis about 225 military cases]. / Traumatismes sonores aigus: analyse rétrospective de 225 cas militaires.

OBJECTIVES: Studying the epidemiology, the evolutionary audiometric profile and the after-effects of acute acoustic trauma managed in military environment. Assessing the influence beyond the audiometric recovery of earplugs, precocity of the treatment and hyperbaric oxygen therapy. MATERIALS AND METHODS: This retrospective cohort gathered 225 military cases of acute acoustic trauma hospitalized between 2003 and 2008. The cochlear supportive therapy associated intravenous methyl-prednisolone and pentoxyfilline, completed sometimes with hyperbaric oxygen therapy. The evolution was appreciated with pure-tone audiometry at the admission, at the end of hospitalization and one month after. Perceptive deafness and recovery shifts were statically calculated on 109 ears. RESULTS: On the 225 cases, 90% were males, middle-aged of 23 years. Initially 95% of the patients complained about tinnitus, associated with hearing loss felt for 71%. The left ear was more frequently affected. The initial audiometric loss was average of 34 dB HL, concentrated on 4000 and 6000 Hz frequencies. The therapy allowed an average recovery of +18,3 dB in a month. The audiometric sequela concerned 40% of the cases, and residual tinnitus a third. These rates were significantly higher with people whose initial hearing loss average exceeded 40 dB HL. Concerning the audiometric recovery and the after-effects, no significantly difference was found between the groups treated before or after 12 hours. There were either no difference with the earplugs and hyperbaric oxygen groups. CONCLUSION: Despite the effectiveness of early corticotherapy, after-effects of acute acoustic trauma remain frequent and invalidating. Its prevention suffers from non-observance and malposition of earplugs.

[Primary non-Hodgkin lymphoma of the nasal fossae and sinuses. Apropos of 8 cases]. / Les lymphomes non hodgkiniens primitifs des fosses nasales et des sinus. A propos de 8 cas.

The authors report their experience about 8 cases of nasal lymphomas diagnosed and treated between 1987 and 1993. Behind ordinary symptoms, a very bad forecast lymphoma may be hidden. Histological diagnosis is sometimes difficult and needs voluminous fresh fragments. During the evolution of this affection, local temporary nasal and paranasal remissions are often noted after chimiotherapy and/or radiotherapy, but rapidly appear visceras secondary localisations, suggesting an underestimation of the nasal and paranasal sinuses localisations among the treated non-Hodgkin's lymphomas population.

[Analysis of results of pharyngotomy in the surgical treatment of sleep apnea syndrome. Apropos of 150 cases]. / Analyse des résultats de la pharyngotomie dans le traitement chirurgical du syndrome d'apnée du sommeil. A propos de 150 cas.

The indications and limitations of simple veloamygdalotomy as surgical cure for sleep apnoea were analyzed on the basis of results obtained in the first 150 cases treated prospectively by pharyngotomy. Clinical and polysomnographic results were analyzed as possible factors predicting success or failure. With a success rate of 80%, pharyngotomy is a simple and effective treatment for patients with minor forms of sleep apnoea (initial apnoea/hypopnoea index < 20) and no severe obesity. It appears unreasonable to propose isolated pharyngotomy if the initial index is < 30 since the success rate in the cases is only 27%. Nasal repermeation does not improve overall results significantly. The lack of patient compliance to diagnostic and therapeutic modalities is an unavoidable reality due to human, social and economic implications.

[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.

[Laser CO2 arytenoidectomy by endoscopic approach in bilateral laryngeal paralysis. Apropos of 45 cases]. / Aryténoïdectomie par voie endoscopique au laser CO2 dans les paralysies récurrentielles bilatérales. A propos de 45 cas.

Between 1980 and 1993, 45 patients with bilateral cord abductor paralysis were treated by carbon dioxide endoscopic laser arytenoidectomy. Thyroid surgery was the main cause of bilateral laryngeal palsy (67%). Seven patients, who were tracheotomised before treatment, were decanulated. Ninety-one percent of the patients recovered physiologic respiration. The follow up period lasted from one month to thirteen one-half years. Advantages and disadvantages of laser arytenoidectomy are compared with other techniques.

[French military dental surgeons during World War I]. / Les chirurgiens dentistes français aux armées pendant la Grande Guerre.

A statute of dental surgeon of the Navy and later of the Army was created in February 1916 among the corresponding French military Health Departments. Under the pressure of the military events, after two years of "shifty" acting of the soldier-dental surgeons on the front line and irresolution of the Government, Justin Godart created at last a Corps of military dental surgeons and stomatologists. Problems of bucco-dental health raised as soon as the autumn 1914 by the trench war and the repair of "broken Jaws" (gueules cassées) induced by the new weapons of this war will be brilliantly and economically solved by this Corps suppressed after Armistice. A permanent Corps foreseen in 1945 seems revived in France with the 15 December 1993 decree amid the already provided new European Union.

[An anatomical curiosity: a miniature cranium in marble, pathological evidence?]. / Une curiosité anatomique: un crâne miniature en marbre, témoin pathologique?

After a detailed historical review of the representation of the human skull in art, the authors present a rare example of a reduced marble skull representing as they suggest it, cranio-facial lesions of which they try to explain the etiopathology.

[Gustave Ginestet (1897-1966), doctor general. Life and work of a pioneer of cosmetic and reconstructive maxillofacial surgery]. / Le médecin général Gustave Ginestet (1897-1966). Vie et oeuvre d'un pionnier de la chirurgie maxillo-faciale esthétique et réparatrice.

Gustave Ginestet, pratician and surgeon of two world wars in Europe, military medical in Lebanon and Syrian French Protectorat (1925-1931), countries where his works are not forgotten, was an admired and respectable master, pioneer of the maxillo facial and stomatologic French school of surgery, chief, between 1936 and 1966, and now, spiritual father of the referent services for head and neck surgery in France.

[Dr. Samuel Serge Voronoff (1866-1951) or "the quest for eternal youth"]. / Le Docteur Samuel Serge Voronoff (1866-1951) ou "la quête de l'éternelle jeunesse".

Samuel Serge Voronoff, a French physician and surgeon of Russian origin was the Khédive's personal physician from 1896 to 1910 and the instigator of modern medicine in Egypt. He was later a student and friend of Alexis Carrel as soon as 1910 and directed a service of bone grafts during World War I. Between 1912 and 1949 he published the results of his experimental work at his Voronoff Foundation of the Collège de France and at Grimaldi where he performed homografts of endocrine glands of cattle and corresponding heterografts between great primates and man. Contested since 1922 by his colleagues for his results however histologically confirmed and improved durable, Voronoff who had an audience in the Académie des Sciences will proceed his research with success during the period preceding World War II. He grafted old people in senior homes and Government cattle in Algeria, training followers in Italy and California. In 1939 he gave all his research facilities at the Collège de France to René Leriche (1879-1955) and remained on the American continent until 1945. At that time his theories became obsolete in view of the progress in endocrinology and his laboratories were destroyed during the war. He died in Lausanne in 1951 at 85. The recent epidemics caused by HIV suggests to study the work he performed in the Collège de France.

Acute severe neck pain and dysphagia following cervical maneuver: diagnostic approach.

INTRODUCTION: Overlooking an etiologic hypothesis in acute neck pain with dysphagia may lead to misdiagnosis. CASE REPORT: A 51-year-old man who had received cervical manipulation came to the emergency unit with evolutive acute neck pain, cervical spine stiffness and odynophagia, without fever or other signs of identified pathology. Cervical X-ray and CT angiography of the supra-aortic vessels ruled out traumatic etiology (fracture or arterial dissection) and revealed an accessory bone, orienting diagnosis toward retropharyngeal abscess, which was, however, belied by endoscopy performed under general anesthesia. A second CT scan with contrast injection and tissue phase ruled out infection, revealing a retropharyngeal calcification inducing retropharyngeal edema. Evolution under analgesics was favorable within 13 days. DISCUSSION: Given a clinical triad associating acute neck pain, cervical spine stiffness and odynophagia, traumatic or infectious etiology was initially suspected. Cervical CT diagnosed calcific tendinitis of the longus colli, revealing a pathognomic retropharyngeal calcification. Secondary to hydroxyapatite deposits anterior to the odontoid process of the axis, this is a rare form of tendinopathy, usually showing favorable evolution in 10-15 days under analgesic and anti-inflammatory treatment.

[Petrous surgical approaches in tumors of the cerebellopontine angle]. / Les voies d'abord pétreuses des tumeurs de l'angle ponto-cérébelleux.

Three petrous incisions, performed by an ENT-neurosurgery team, can be used for the resection of tumours of the cerebellopontine angle: transpetrosal incisions (posterior translabyrinthine and transcochlear) which provide large access to the IAM and the posterior surface of the petrous bone, but they sacrifice hearing. The suprapetrosal incision (reserved for tumours in the meatus) and the mastoidoretrosigmoid incision (for tumours less than or equal to 20 mm) preserve the labyrinth in an attempt to preserve hearing. The principal objectives of surgical resection of tumours of the cerebellopontine angle (85% of which are acoustic neuromas) are total resection (to preserve the vital prognosis) and preservation of facial nerve function. Attempts to preserve hearing must be confined to cases selected by a complete clinical otological and audiometric examination.