[Ankylosis of the temporomandibular joint: a rare manifestation of ankylosing spondylitis]. / Ankylose de l'articulation temporo-mandibulaire: rare manifestation de la spondylarthrite ankylosante.

INTRODUCTION: The ankylosing spondylitis is a chronic inflammatory rheumatoid disease with predilection in the axial structures. The temporomandibular joint (TMJ) is involved in 10 to 24% of cases. Ankylosis of the TMJ is exceptional, only 11 cases being reported to date. OBSERVATION: A 48-year-old patient had been followed since 1987 for severe ankylosing spondylitis. The patient, known to be positive for tissue antigen HLA B27, was admitted for limitation of mouth opening. At physical examination, mouth opening was reduced to 1cm with no mandibular movements and a stiffness of the cervical spine in flexion. Computed tomography of the TMJs highlighted a bilateral lesion with ankylosis of the left joint and of C1-C2. Surgical treatment consisted in block resection of the two TMJs using a cartilaginous rib. With a follow up of 9 months, results have been satisfactory. DISCUSSION: Complementary explorations should be undertaken in ankylosing spondylitis patients with clinical symptoms suggestive of TMJ lesions in order to establish the diagnosis and initiate treatment and avoid the development of ankylosic forms.

[Laryngeal neuroendocrine carcinoma: a case report]. / Carcinome neuroendocrine du larynx: a propos d'un cas.

Laryngeal neuroendocrine carcinomas are uncommon and not well known tumors. Three histological subtypes, each of them with a different prognosis and treatment, can be identified. We report a case of a large cell laryngeal neuroendocrine carcinoma in 32 old-year boy who presented a right glotto-subglottic tumoral process. The patient was treated by total laryngectomy associated with bilateral functional neck dissection but without postoperative chemotherapy. A disease recurrence occured three months after surgery consisting on a massive involvment of laterocervical and sus clavicular lymph nodes. The authors discussed the clinical features, the histological and immunohistochemical characteristics, the treatment and the prognosis of laryngeal neuroendocrine carcinoma, according to literature. (full article translated in English available on www.ent-review.com).

[Superficial vascular anomalies of the face: apropos of six cases]. / Malformations vasculaires superficielles de la face. A propos de 6 cas.

The classification of superficial vascular anomalies of the face recognizes two major categories: hemangiomas and vascular malformations. A multidisciplinary approach to these malformations is necessary. MRI of venous vascular malformations, pulsed Doppler and arteriography of arteriovenous malformations are key examinations in the exploration strategy for superficial vascular malformations. Hemangiomas always regress. Surgery is generally needed only for late sequelae although in some cases early surgery is beneficial. Percutaneous sclerotherapy and surgery are indicated for venous malformations in order to minimize or improve skin, muscle and bone distorsions. Arteriovenous malformations are the most dangerous vascular anomalies of the face. Superselective arterial embolization prepares the surgical excision of the nidus, complete resection is essential. We review 6 cases of superficial vascular malformations of the face treated surgically and discuss the diagnosis features and the treatment modalities of these vascular anomalies.

[Primary hyperparathyroidism presenting as a brown tumor of the maxilla and hard palate. Apropos of a case]. / Hyperparathyroïdie primaire révélée par des tumeurs brunes des maxillaires et du palais osseux. A propos d'un cas.

Significant controversy persists in the classification of giant cell lesions of the maxillofacial skeleton. Multifocal giant cell lesions are strongly suggestive of hyperparathyroidism brown tumors. Maxillary localization is extremely rare. We report a case of primary hyperparathyroidism manifesting in the form of giant cell tumors of the maxilla, the hard palate and long bones. Biochemistry confirmed the diagnosis. Computed tomography localized the parathyroid tumor at the cervicothoracic junction in the retrosternal area. We discuss the clinical features of skeletal involvement in primary hyperparathyroidism and stress the need for ionized serum calcium assay in case of giant cell tumors of the cranial bones.

[Thyroid tuberculosis associated with papillary microcarcinoma of the thyroid gland: a case report]. / Tuberculose thyroïdienne associée à un microcarcinome papillaire thyroïdien: à propos d'un cas.

Tuberculosis of the thyroid gland is extremely uncommon. The infection may present first in the thyroid gland or appear secondary to a tuberculous process elsewhere in the body. The diagnosis is rarely made clinically because the different presentations of the disease often mimick malignancy or euthyroid nodular goitre. It is of interest to report a case of tuberculosis of the thyroid associated with papillary microcarcinoma of the gland. No tuberculous process elsewhere in the body has been found. The frequency of MCP on thyroidectomy specimens suggest that this association is incidental.

[Osteosarcoma of the jaws. Apropos of 12 cases]. / Les ostéosarcomes des maxillaires. A propos de 12 cas.

We report 12 cases of osteosarcoma (10 located in the mandible and 2 in the maxilla). There were 8 men and 4 women who were older than usually observed in osteosarcoma at other sites (8 of 121 patients were over 30 and the average age was 34 years). Clinical signs were variable. Bone tumefaction was the most frequent sign, with a diameter greater than 5 cm in most cases (10 out of 12). Surgery alone was used for 8 patients and radiosurgery for 3. Follow-up is available for 8 patients. All presented local recurrence with extensive tumors progression. All died within an interval of 3 to 30 months despite palliative surgery and/or radiotherapy or chemotherapy.

Parameningeal rhabdomyosarcoma. Report of 19 cases.

Parameningeal rhabdomyosarcomas are associated with a poor long term survival. This is due to the fact that they are aggressive tumours with early involvement of the skull base. The authors report a series of 19 cases between 1984 and 1995 with a relative proportion of children, male patients and tumours of embryonal type. Three patients were operated on and only one of them was found with tumour free margins. Systemic chemotherapy using the VAC-VAd protocol was administered in 18 patients and intrathecal chemotherapy was delivered in 5 patients with involvement of the skull base. Nine patients were irradiated with doses varying from 45 to 55 Gy. Twelve patients died from 20 days to 4 years after initial treatment; 6 were lost to follow up and only one patient is living without any evidence of disease after 11 years.

[Cholesteatoma of the middle ear in children. Apropos of 160 cases]. / Le cholestéatome de l'oreille moyenne chez l'enfant. A propos de 160 cas.

Cholesteatoma of the middle ear in children is a current topic and authors are not yet unanimous as far as surgical treatment is concerned. We report our experience on 160 cases of cholesteatoma observed in 150 children aged from 4 to 15 years old. The first complications represent the reason for consulting in 36% and bilateral affection in 15% of the cases. We have practised the "open technique" in 62%, the "closed technique" in 38% of the cases. The "second look" operation for a residual cholesteatoma, or a recurrence constitute 26% of cases after the closed technique. Our choice of the open technique is explained by the social and economic standard of the patients, the state of the mastoid, the frequency of the complications mainly intracranial ones, and the types of lesions encountered during the operation. According to this serie, we can review the data of the literature, and analyse the different points of view.

[Malignant otitis externa: apropos of 19 cases]. / Les otites externes malignes: à propos de 19 cas.

In the Anglo-Saxon literature, necrotizing otitis in the diabetic patient, known as malignant otitis externa (MOE), represents a specific and in many ways serious entity. We report on our personal experience with 19 cases of MOE with hospitalization and a 9-year follow-up. Our diagnostic criteria are as follows: all our patients are diabetic (with diabetes revealed twice by the MOE). Otalgia is a predominant feature of the clinical picture, with facial palsy being recorded in practically all our patients. A pyocyanic germ was responsible in 16 cases. The use of CT instead of Tc99 scintigraphy enabled the assessment of the extent of the complaint. Surgical treatment (mastoidectomy), recommended for our first patients, is now considered pointless due to its lack of efficacy against an already extensive process, and with the arrival on the market of new families of ATB's, in particular the quinolones. It would appear that this general treatment, combined with local treatment, provides a better control of the evolution of the MOE, which nonetheless carries a high mortality rate estimated at 18%. On the basis of this series, we present the data in the literature, recalling the diagnostic criteria, the value of skull base imaging and the criteria of recovery.