Endotype of Chronic Rhinosinusitis with Nasal Polyps in Morocco.

BACKGROUND: With the advent of biotherapies, endotyping of chronic rhinosinusitis with nasal polyps (CRSwNP) is becoming more and more important to optimize therapeutic management. While the majority of CRSwNPs in the United States, Europe, and Japan exhibit type 2 eosinophil-dominant inflammation response, other parts of Asia display mixed patterns including neutrophil-dominant inflammation. Until now, no study has focused on the proportion of inflammation patterns in Morocco or anywhere on the African continent. We aim to fill this gap by studying tissue inflammatory response in our operated patients. MATERIAL AND METHODS: After searching the database of the pathology department, we retrieved from the archives the stained pathology slides of all our patients who underwent surgery for CRSwNP over 5 years from 2017 to 2021. We counted then the number of eosinophils in the lamina propria at high-power magnification to determine the predominant inflammatory pattern. RESULTS: A total of 35 reports were collected. We found that eosinophilic inflammation was predominant, accounting for 97% of the cases. CONCLUSIONS: The CRSwNP endotype in our region would mainly be type 2. However, our results must be confirmed by multicenter studies involving a large number of patients.

The impact of the ultrasound classification on the rate of thyroid surgery indications: a 577 cases series.

OBJECTIVES: Nodules of the thyroid gland are common but rarely malignant. Their management can range from simple monitoring to surgery. The use of ultrasound and fine needle aspiration can reduce the rate of unnecessary surgeries. However, there is a risk of false positives and false negatives of malignancy that only pathology can avoid. The objective of this study is to assess the impact of ultrasound classification on the rate of surgical indications. MATERIAL AND METHODS: Between 2013 and 2017, the ultrasound classification was gradually adopted in our daily practice to become now routine. During this period, we conducted a retrospective study of all the patients who presented to our department for one or more thyroid nodules. RESULTS: A total of 577 patients were included in the study. We compared two groups, a first where the ultrasound classification was used and a second where this classification was not used. In the end, we found that this classification significantly reduced the surgical indication by 19% while increasing the malignancy detection rate in operated patients by 21%. CONCLUSIONS: The use of ultrasound classification reduces the indications for surgery while increasing the rate of malignancy in operated patients. The generalization of the use of the ultrasound classification score is strongly recommended in daily practice.

Prognostic factors of myringoplasty: study of a 140 cases series and review of the literature.

Myringoplasty is one of the most frequent interventions in otology. It aims to restore the eardrum in order to protect against extrinsic contamination by water and to improve hearing. Our study aimed to analyze the factors that may affect anatomical and functional results of myringoplasty or type I tympanoplasty. A retrospective study was performed of a series of 140 cases of myringoplasty over a 6-years period from 2010 to 2015. The approach was post-auricular in 69% of cases and all the patients underwent an underlay technique. Temporal fascia was used in 90.71% of the cases. After an average follow-up of 13 months, the anatomical and functional results were acceptable, with a tympanic closure rate of 88% and an average audiometric gain of 14.22 dB. Several factors affected our results, including the location of the perforation, the active or inactive status of the chronic otitis media, the condition of the opposite ear and the graft material. In light of our results and those of the literature, we believe that the middle ear should be dry at least two months prior to surgery, use of cartilaginous graft material and underlay technique should be preferred and special precautions should be taken in case of anterior or contralateral perforation.

Nasopharyngeal tuberculosis: report of four cases and review of the literature.

Even if tuberculosis is a major cause of morbidity and mortality, nasopharyngeal location is unusual and extremely rare. We report four new cases observed with short time interval suggesting a trend towards increased frequency. The diagnosis was confirmed by histological analysis after a biopsy. The evolution was favorable after anti tuberculosis chemotherapy. In the light of those observations and a review of the literature, we will discuss different characteristics of this disease and we will highlight the need of a systematic biopsy in order to confirm diagnosis and exclude undifferentiated carcinoma especially in endemic regions for both diseases.

[Surgical management of hyperthyroidism: about 60 cases]. / Chirurgie des hyperthyroïdies: à propos de 60 cas.

Hyperthyroidism includes several diseases characterized by high level of circulating thyroid hormones. Thyroidectomy is one of the main treatment options. We conducted a retrospective study to evaluate the epidemiological, clinical, therapeutic, evolutionary features of patients who had undergone surgery for hyperthyroidism in the ENT Department at the Avicenne Military Hospital in Marrakech. Data were collected from medical records of 60 patients. There was a female predominance and the average age was 52 years. Clinical manifestations were dominated by thyrotoxicosis in all patients. Clinical examination allowed the identification of 47 cases of toxic or pretoxic multiheteronodular goitre (78.33% of cases), 5 cases of Graves disease (8.33% of cases) and 8 cases of toxic adenoma (13.33% of cases). All patients underwent medical preparation. Total thyroidectomy was performed in 50 patients (83.33%) and loboisthmectomy in 10 patients (16.33%). Postoperative complications were: transient laryngeal paralysis in one case (1.6%), transient hypoparathyroidism in nine cases (15%), definitive hypoparathyroidism in one case (1.6%) and compressive hematoma in one case (1.6% of cases). Surgical treatment of bleeding and adherent toxic goiters should be performed by an experienced surgeon who must remain vigilant to minimize morbidity mainly caused by laryngeal paralysis and hypoparathyroidism.