Nasal cavity lobular capillary hemangioma due to insect sting.

INTRODUCTION: Lobular capillary hemangioma is a frequent benign vascular inflammatory lesion of the skin tissue. It rarely reaches the mucous membrane, and the nasal fossa involvement is exceptional. CASE REPORT: A 68-year-old woman presented with an ulcerous hemorrhagic mass blocking the left nasal fossa, which had appeared a few weeks after a wasp sting in the nose. The insect was evacuated only three weeks after the sting. The clinical and radiological data suggested malignancy. Biopsy under local anesthesia proved non-contributory and was complicated by 1 week's hospitalization for severe nosebleed. Surgical excision under video-endoscopy confirmed diagnosis. At 31 months' follow-up, the patient was free of recurrence. DISCUSSION/CONCLUSION: The pathogeny of lobular capillary hemangioma is uncertain. No previous cases affecting the mucous membrane after insect sting have been reported. Except in the typical contexts of long-term packing or pregnancy, diagnosis can be difficult and misleading. It can mimic a malignant pathology. Its rich vascularization requires caution during biopsy, and the risk of recurrence requires excision to be complete.

Temporary off-frequency listening after noise trauma.

Hearing loss is routinely estimated from the audiogram, even though this measure gives only a rough approximation of hearing. Indeed, cochlear regions functioning poorly, if at all, called dead regions, are not detected by a simple audiogram. To detect cochlear dead regions, additional measurements of psychophysical tuning curves or thresholds in background noise (TEN test) are required. A first aim of this study was to assess the presence of dead regions after impulse noise trauma using psychophysical tuning curves. The procedure we used was based on a compromise between the need to collect reliable estimates of psychophysical tuning curves and the limited time available to obtain these estimates in a hospital setting. Psychophysical tuning curves were measured using simultaneous masking with a 2-alternative forced choice paradigm, where the target was randomly placed in one of the two masker presentations. It is well known that some components of noise-induced hearing loss are reversible. A second aim of this study was to examine the potential recovery of dead regions after acoustic trauma. A third issue addressed in this article was the relationship between noise-induced dead regions and tinnitus. We found that 70% of the subjects had dead regions after noise trauma, while 88% reported tinnitus. Moreover, we found that the extent of dead regions probably diminished in about 50% of subjects, which highlights the ability of the human auditory system to recover from noise-induced hearing loss.

[Parathyroïd adenoma induced by long term lithium therapy: case report and review]. / Adénome parathyroïdien induit par le traitement au long cours par lithium: cas clinique et revue.

UNLABELLED: We report a case of a parathyroid adenoma during a long term lithium treatment without therapeutic overdose. CASE REPORT: A 73-years-old woman presented a demonstrative biological syndrome with hypercalcemia, elevated parathormone, normal urinary cyclic AMP, normocalciuria. CONCLUSION: This lithium induced hyperparathyroidism differs from the classic primary hyperparathyroidism with parthyroid adenoma where urinary cyclic AMP excretion is elevated and where there is hypercalciuria. Lithium is blocking the negative feedback of calcium on parathormone secretion and stimulates the growth of parathyroid adenoma. Treatment is surgical and consists in adenoma ablation. Calcemia follow up is indicated in patients with long term lithium therapy

[Fractures of the nose: simplified diagnosis and management]. / Fractures du nez: diagnostic et prise en charge simplifiée.

Fracture of the nose is a frequent injury. Careful management is necessary to avoid not only cosmetic but also functional sequels. Therapeutic modalities are simple and can easily be carried out under local anesthesia.

[Sinus lift with autogenous bone graft: surgical technique]. / Greffe de comblement sous sinusien (GCSS ou sinus lift) par os autologue : technique chirurgicale.

Insufficient maxillar bone crest does not allow dental implant placement. The sinus lift technique with an autogenous bone graft compensates this deficiency. This technique is performed in two steps: iliac autogenous bone harvesting and sinus graft. After describing the possible complications, the various approaches of this technique are presented. This pre-implant surgery must be performed by experienced surgeons.

[Reconstruction of a transfixing partial loss of substance from the wing of nose with the upper pedicled nasolabial flap]. / Reconstruction d'une perte de substance transfixiante partielle de l'aile du nez par lambeau naso-génien a pedicule supérieur.

The reconstruction of the wing of the nose is a surgical challenge. The aim of the reconstruction is both aesthetic and functional. The nasolabial flap with upper pedicule returned, described by Préaux in 1994, appears to be successful for this challenge. The advantages of this flap include simplicity, reliability, one-step procedure and good results. Nevertheless it presents functional and aesthetic disadvantages. We present a variant which allows to correct these disadvantages.

[Betel quid and oral cancer: case report]. / Chique de Bétel et cancers oraux: à propos d'une observation.

Betel quid chewing is a major cause of oral cancers in Asia. Practitioners must be able to recognize premalignant lesions. Cessation of betel quid use and preventive treatment must be recommended. Primary prevention will be difficult because of the traditional nature and commercial importance of this old habit.

[Extracting a foreign body from the nasal fossa without an ENT specialist]. / Extraction d'un corps étranger de la fosse nasale sans recours au spécialiste.

Foreign bodies in the nasal fossa are frequent and generally occur in children. In developing countries, access to an ENT specialist can be difficult or impossible. The authors describe several extraction techniques with special emphasis on those best suited to areas with limited access to specialist facilities. Using illustrations, a step-by-step description of the so-called "hook" technique is given. This simple technique allows successful removal of a foreign body from the nasal fossa in almost all cases.

[Poly-L-lactic-acid filling of facial lipoatrophy in HIV+ patients under tritherapy]. / Comblement par l'acide L-polylactique des lipoatrophies faciales des patients VIH+ sous trithérapie.

Facial lipoatrophy is one of the complications of antiretroviral therapy in HIV+ patients. Poly-L-lactic-acid filling can compensate this atrophy. This treatment has been completely covered by social security since 2005. The filling technique is described in this article.

[Management of Grave's disease in the tropics (experience at Bouffard Army Hospital Center in Djibouti]. / Prise en charge de la maladie de Basedow en milieu tropical (expérience du cha Bouffard de Djibouti).

Based on their experience in managing Grave's disease at the Bouffard Army Hospital Center within the local health care context in Djibouti, the authors advocate surgery as the first line treatment. Medical and economical factors supporting this preference are discussed so that readers can adapt them to his own local context.

[Primary cancer of the parotid gland: an anatomoclinical approach]. / Cancers primitifs de la parotide: approche anatomo-clinique.

BACKGROUND: Carcinoma of the parotid gland presents a wide variety of clinical presentations, behaviors and prognoses. The aim of this study was to define the characteristic clinical presentations and the prognostic factors of these tumors. MATERIAL AND METHOD: Sixty-six patients with carcinoma of the parotid gland seeing during the 1985-2003 period were included in this study. Mean patient age was 55 years; the sex-ratio was 1. RESULTS: The most common histological types of this series were mucoepidermoid carcinoma and adenoid cystic carcinoma. Stage I tumors were reported in 59% the series while only 18% the patients of this series had stage III and IV disease. Pain was reported in 45% all patients. Facial nerve clinical involvement was reported in 11% all patients. DISCUSSION: Both tumoral stage and histological grading are independent prognostic factors influencing the therapeutic strategy. Clinical course and tumor growth distinguished between malignant tumors with benign clinical behavior and malignant tumors with malignant clinical behavior. A preoperative workup with physical examination, fine needle cytology and MRI helps to define the preoperative diagnostic and to adapt the therapeutic strategy.

[Venous malformations of the parotid in adults. Report of two cases and review of the literature]. / Les malformations veineuses de la parotide chez l'adulte. A propos de deux cas et revue de la littérature.

Parotid vascular malformation in the adult is a very rare and benign tumor; only 47 cases were described in the world literature. This vascular malformation, mostly of venous origin is, on the opposite of the clinical, histological and evolution features of parotid hemangiomas in children, which are more frequent. Some clinical and radiological elements are pathognomonic allowing preoperative diagnosis. We present 2 cases of intraparotid venous malformation in adults, and based on an exhaustive study of the world literature discuss frequency, diagnosis and treatment of this disease.

[Internal ear injuries in diving: apropos of 16 cases]. / Accidents d'oreille interne en plongée sous marine: a propos de 16 cas.

After the study of 16 observations of inner ear injuries in diving, the authors remind us to the different mechanisms of inner ear's lesions. The principle of treatment depends of these mechanisms. Emergency is to recognize a decompression injury. So, all vestibular disorders must be considered as a decompression injury, as soon as, it was a saturating diving. Hyperbaric oxygenotherapy must be undertaken immediately. Though the symptomatology suggestive of fistula for 4 patients, no surgical exploration was done. The follow-up was marked by spontaneous amelioration, that make think of possible spontaneous cicatrization.

[Incidence of vertigo in diving]. / Incidence des vertiges en plongée sous marine.

Vertigo is relatively common after diving. Although it may be the result of the changes in pressure, it can also be a feature of decompression accidents, of clinical toxicity, simply be a manifestation of altered physiology resulting from immersion in a weightless environment in which all the organs involved in maintaining equilibrium (vestibular system, proprioception and vision) are affected. It seemed to us to be of interest to study the incidence of vertigo in naval divers by means of an anonymous questionnaire. The responses were elicited over a 3 month period from 333 divers. 45 divers reported clinical sensations of vertigo, an incidence of 13.5%. If this figure is related to the number of dives, the incidence falls to 0.06%. No decompression accidents were reported. The main aetiology was barotrauma, 42% being of alternobaric and 36% of pressure type. The remaining aetiologies were sensory illusions in 6% of cases, and other non-ENT causes in 16%. After a review of the physiopatholgy and study of the case hisotries, there is a discussion of the features which allow the aetiology to be determined and treatment planned.