[A post-styloid mass revealing a parapharyngeal schwannoma]. / Une masse rétro-stylienne révéatrice d'un schwannome parapharyngé.

INTRODUCTION: The schwannoma of the glossopharyngeal nerve is a rare etiology among the tumor masses developed in the parapharyngeal space. CASE REPORT: We report the case of a 33 years old woman in whom a large schwannoma of the left glossopharyngeal nerve was discovered incidentally on a brain MRI. Respiratory evolutionary prognosis imposed trans-oral surgical treatment. DISCUSSION: We discuss the diagnostic and therapeutic strategy for the benign tumors of the parapharyngeal space. CONCLUSION: The schwannoma of the glossopharyngeal nerve is a benign rare lesion. The difficulty lies on the surgical strategy and the choice of the approach. The functional suites are marked by difficulty swallowing and require intensive speech therapy.

[Salivary stones and stenosis. A comprehensive classification]. / Lithiases et sténoses salivaires. Une classification pratique des pathologies non tumorales.

INTRODUCTION: Sialendoscopy and sialo-MRI enable diagnosis of salivary gland obstructive pathologies, such as lithiasis, stenosis and dilatations. Therefore, a classification of these pathologies is needed, allowing large series comparisons, for better diagnosis and treatment of salivary pathologies. MATERIAL AND METHODS: With help from people from the European Sialendoscopy Training Center (ESTC), the results of sialographies, sialoMRI and sialendoscopies, a comprehensive classification of obstructive salivary pathologies is described, based on the absence or presence of lithiasis (L), stenosis (S) and dilatation (D) ("LSD" classification). DISCUSSION: It appears that a classification of salivary gland obstructive pathologies should be described. We hope it will be widely used and of course criticized to be improved and to compare the results of salivary gland diagnostic methods, such as sialography and sialendoscopy and also the results and indications for salivary gland therapeutic methods, such as lithotripsy, sialendoscopy and/or open surgery.

Salivary stones and stenosis. A comprehensive classification.

INTRODUCTION: Sialendoscopy and sialoMRI enables diagnosis of salivary gland obstructive pathologies, such as lithiasis, stenosis, and dilatations. Therefore, a classification of these pathologies is needed, allowing large series comparisons, for better diagnosis and treatment of salivary pathologies. MATERIAL AND METHODS: With help from people from the European Sialendoscopy Training Center (ESTC), the results of sialographies, sialoMRI and sialendoscopies, a comprehensive classification of obstructive salivary pathologies is described, based on the absence or presence of lithiasis (L), stenosis (S), and dilatation (D) ("LSD" classification). DISCUSSION: It appears that a classification of salivary gland obstructive pathologies should be described. We hope it will be widely used and of course criticized to be improved and to compare the results of salivary gland diagnostic methods, such as sialography and sialendoscopy, and also the results and indications for salivary gland therapeutic methods, such as lithotripsy, sialendoscopy, and/or open surgery.

Endoscopic endonasal surgery complication: new methods of intracavernous internal carotid artery injury treatment.

OBJECTIVES: To present new interventional neuroradiology methods of management of an ICA injury during functional endoscopic sinus surgery (FESS). CASE: The authors report the case of a patient who presented an ICA injury during a FESS and who could undergo an embolization. This embolization stopped the epistaxis and saved the patient from a lethal issue without any aftereffect. DISCUSSION: After a review of the literature the authors describe the circumstances of occurrence, the urgent management and the modern treatment of an ICA injury. Along with the progress in neuroradiology, the embolization represents a top grade treatment of this complication. Embolization with stent keeps permeable the ICA axis which represents a major progress in the management. CONCLUSION: The success of the management of an ICA injury relies on the close collaboration between anesthesist, otorhinolaryngologist surgeon and interventional neuroradiologist. Since 2004, modern techniques of interventional neuroradiology using new stents allow to keep permeable the ICA axis.

[15 years experience with microvascular free tissue transfert for repair of head and neck cancer defects]. / Expérience de 15 ans d'utilisation des lambeaux libres en cancérologie cervico-faciale.

We present the modalities and results obtained with free flap reconstruction of head and neck cancers defects. This retrospective review of 165 free transfers performed between 1984 and 1999 included 89 radial forearm flaps (54%), 38 latissimus dorsi flaps (23%), 28 osteomyocutaneous flaps (17%), 6 omentum flaps (4%), 2 jejunum flaps, and 2 cutaneous scapular flaps. Indications were orobuccopharynx (34%), hypopharynx (24%), mandible (17%), craniofacial (15%) and skin (10%) defects. Flap failure rate was 9%. Reconstruction of a radiated site was a statistically significant indicator of flap failure. Four types of free flaps were preferred for reconstruction of head and neck cancer defects. The radial forearm flap was used as a lap flap for the orobuccopharynx, the tubuled radial forearm flap for reconstruction of the digestive tract after total pharyngolaryngectomy, the osteomyocutaneous free fibular flap for pelvimandibulectomy, especially for the anterior arch, the latissimus dorsi flap to fill craniofacial defects, and the free omentum flap for craniofacial complications after radiotherapy.

[Reconstruction of the palate vault by free forearm cutaneous flap in oncology]. / Reconstruction de la voûte palatine par lambeau cutané anté-brachial libre en cancérologie.

Surgical reconstruction after partial superior maxillectomy raises a major functional challenge and postoperative recovery implies difficult prosthetic rehabilitation. Between 1989 and 2000, 23 free radial forearm flap reconstruction were performed for palate defects. Twenty-two patients were treated for cancer-related defects and one patient for a non-malignant tumor. Immediate reconstruction was performed in 21 cases and delayed reconstruction in 2. Radiation therapy had been given prior to surgery in 7 patients, Flap necrosis occurred in 2 patients who had surgery alone. Deglutition and phonation outcome was satisfactory in all patients. Trismus was the most frequent complication (7 cases). The free radial forearm flap is the gold standard surgical treatment for superior maxillary defects. In these patients, and exclusive skin flap enables complete reconstruction.

[Hamartomatous adiposity of the thyroid]. / Adipose hamartomateuse de la thyroïde.

Report of one case of hamartomatous adiposity of the thyroid gland. Only eight cases have been reported. The lesion is composed of thyroid tissue and mature adipose elements. Previously reported cases are reviewed and the pathogenesis is discussed.

[Sensory illusions in hang-gliding]. / Illusion sensorielles en vol libre.

Sensory illusions in hang-gliding and para-gliding. Hang-gliding and para-gliding are at the moment booming sports. Sensory illusions are physiological phenomena sharing the wrong perception of the pilote's real position in space. These phenomena are very familiar to aeroplane pilotes, they can also be noticed on certain conditions with hang-gliding pilotes. There are many and various sensory illusions, but only illusions of vestibular origin will be dealt with in this article. Vestibular physiology is reminded with the working principle of a semicircular canal. Physiology and laws of physics explain several sensory illusions, especially when the pilote loses his visual landmarks: flying through a cloud, coriolis effect. Also some specific stages of hang-gliding foster those phenomena: spiraling downwards, self-rotation, following an asymetric closing of the parachute, spin on oneself. Therefore a previous briefing for the pilotes seems necessary.

[Cystic duplication of the esophagus, a rare etiology of dysphagia. Apropos of a case]. / La duplication kystique de l'oesophage, étiologie rare d'une dysphagie. A propos d'une observation.

A case of an upper oesophageal duplication in a 44 year old man was reported. Dysphagia was the only clinical signs and further examinations CT Scan, MRI performed for diagnosis. Surgical treatment (thoracotomy) was performed and postoperative complication was underlined. Cysts with oesophageal structure are unusual anomaly and surgery is difficult and dangerous.