[Exposure of the facial recess through the ear canal. Value in posterosuperior retraction pockets (initial results)]. / Mise à plat du recessus facial par voie du conduit. Intérêt dans les poches de rétraction tympaniques postéro-supérieures (résultats préliminaires).

19 patients had surgery for progressive [17] and/or symptomatic [2] posterior attic retraction pockets involving the facial recess. Exposition of the suprapyramidal region was obtained after endaural incision by thinning the posterior wall of the ear canal and removing the posterior-superior portion of the tympanic sulcus. This technique is less complicated than intact canal wall tympanoplasty with mastoidectomy. Yet gives similar functional results. After a mean follow-up of 20.3 months, we have observed no residual cholesteatoma and no recurrent retraction pockets. Unlike posterior tympanoplasty, this technique makes it possible to meticulously remove the osteitic bone invariably found in the facial recess when there is infection of the retraction pocket.

[Scanner-guided puncture biopsy of a lesion occupying the pterygo-maxillary fossa]. / Ponction biopsie guidée sous scanner d'un processus occupant la fosse ptérygo-maxillaire.

A 26-year old male patient was referred to us for impaired mouth opening. Actually, Mr. B. has been followed up for SADAM for 2 years at different hospital services. In view of the ineffectiveness of the treatments administered (occlusal releasing gutter, antiinflammatory agents) and due to occurrence of severe episodes of earache refractory to conventional analgesics, we request that a CT-scan be obtained to evidence the process invading the pterygopalatine fossa. ENT examination and scanner-guided needle biopsy are performed to enable anatomopathological analysis and diagnosis.

[Epithelioma of the lacrimal sac. Review of the literature and analysis of 8 cases]. / Les épithéliomas du sac lacrymal. Revue de la littiérature et analyse de huit observations.

Eight patients with lacrimal sac epitheliomas are reported and the published literature reviewed. Clinical signs of these very particular type of tumor are described, as well as their method of extension to the upper facial region which has now been perfectly documented by computed tomography images. Papillomatous forms are relatively frequent, progression of the tumors is slow, and the prognosis for recurrences is fairly good if extensive surgery has been applied.

[Radiological examination of the temporo-mandibular joint. Basic principles (author's transl)]. / L'examen radiologique de l'articulation temporo-mandibulaire. Principes fondamentaux.

Radiological examination of the temporo-mandibular joint remains technically difficult. Standard views using usual X-ray techniques are inadequate. Preference must be given to selective tomography (sagittal, frontal or even axial) after determination of the axis of the condyles on a Hirtz position film. In certain cases, arthrography may also make it possible to define the contours of joint surfaces not seen on plain films. Radiocinematography is little used.

[Facial paralysis during progressive chronic otitis. Reflections apropos of 32 cases]. / Paralysies faciales au cours d'otites chroniques en évolution. Réflexions à propos de 32 cas.

The authors report their experience of 32 cases of facial paralysis occurring during progressive chronic otitis. Twenty were pre-operative. The conclusions which may be drawn are as follows: 1) It occurs in general in cases of severe chronic otitis with large destructive cholesteatomatous and osteitic lesions. 2) Surgery is often difficult, long full of unexpected findings and risks. 3) The development of facial paralysis in a case of progressive chronic otitis is an indication for immediate surgery, on the same basis as a fistula of the H.S.C.C., which is, in fact, oftan present in association. 4) The lesions encountered are much more extensive at the time of secondary (11) rather than at primary surgery (9). 5) The extent of the lesions (13 cases of fistula or laybrinthine destruction) and auditory impairment (16 cophoses or sub-cophoses) are such that tympanoplasty is useless. The authors report their long term results: 13 cases of complete recovery, 4 nil, 3 partial (2 as a result of a superficial cervical plexus graft). They raise the problem of the management when a markedly contused nerve is discovered: simple liberation with incision of its sheath or immediate graft? The other twelve were postoperative. Five were cases operated upon by the autor. There was 100% recovery in all cases, but one patient, in whom the nerve followed an atypical course, required decompression surgery. In the other seven, the autors performed 3 decompressions followed by an excellent result, apart from in one case in which the nerve was markedly contused. In 2 cases a superficial cervical plexus graft and a XII-VII anastomosis proved necessary.