Adult-onset woakes' syndrome: Report of two cases.

INTRODUCTION: Woakes' syndrome is a rare condition commonly defined as recurrent sinonasal polyposis with consecutive destruction of the nasal pyramid. Till now, only a few cases have been reported in the literature. The purpose of this paper is to present the features of woakes' syndrome through two new clinical cases, adding some valuable insight to the recently reported cases. CASE REPORT: We report a series of two consecutive adults male and female patients, aged 55 and 58 years, with Samter's triad, who presented recurrent nasal polyposis and progressive broadening of the nasal dorsum. Facial CT showed in both patients the same radiologic pattern of nasal and paranasal cavities obliteration with nasal bone deformation. Both patients underwent functional endoscopic sinus surgery and correction of the bony nasal vault deformity without osteotomies. At 3 months follow-up, the nasal air passage remained free and aesthetic outcomes were observed. DISCUSSION: having been described over 130 years ago, the etiology of woakes' syndrome remains unclear. Treatment includes topical treatment and sinonasal surgery. Surgical treatment of the nasal dorsum deformity is rarely addressed. CONCLUSION: These observations suggest that the external nose deformity may be successfully corrected by digital compression, in combination with endoscopic sinus surgery.

Rebellious headache revealing an extensive rhinoscleroma: A case report and review of the literature.

and importance: this case report aimed at an unusual case of extensive rhinoscleroma with a literature review, We report this case to bring attention to the patients with immunodeficiency problem regardless of presenting symptoms. Case presentation: a 70 -year-old patient with diabetes and hypertension, consulted for chronic median and posterior headaches have not improved with symptomatic treatment. She reported cacosmia without rhinorrhea and right otalgia. The examination of the nasal cavity showed a bleeding lesion on the lateral wall of the nasopharynx. CT-scan of the facial showed tissue lesion on the posterior and lateral walls of the nasopharynx, with infiltration of the parapharyngeal space and bone lysis right edge of the clivus. The biopsy confirmed the diagnosis of rhinoscleroma. The patient started the ciprofloxacin for 3 months, and the evolvement has noticed with the disappearance of the lesion during the first month of treatment. The patient started the ciprofloxacin for 3 months, and the evolvement was noticed with the disappearance of the lesion during the first month of treatment. Cilinical discussion: rhinoscleroma is a chronic and progressive granulomatous disease of the nasal cavities. The diagnosis is confirmed by the search for bacteria and an anatomopathological assessment of MIKULICZ cells. The medical treatment of choice has a high concentration in macrophages such as rifampicin and fluoroquinolone. Conclusion: rhinoscleroma is a granulomatous disease caused by klebsiella rhinoscleromatis, you must think about in front a nasopharyngeal lesion imitating a malignant pathology.

About an unusual penetrating cervical wound:Iron bar.

INTRODUCTION: The majority of cervical wounds are linked to aggressions and attempted autolysis by knives or firearms. CASE PRESENTATION: the story is about a 35 -year-old man admitted to the emergency room for a penetrating cervical wound following an accidental fall in the workplace. The extremely long iron bar (concrete)has penetrated its neck on the right side.upon admission, the patient was conscious,hemodynamically and respiratory stable without sensory-motor deficit.Surgical exploration is urgently decided under general anesthesia, from wich the foreign body is successfully removed.A follow -up examination at 4 months was without particularity. DISCUSSION: Penetrating neck injuries caused by objects such as rods or iron bars pose a significantly high risk of serious neurological damage.Penetrating neck injuries can be life-threatening and functional.the extent of the lesions must be assessed precisely before removing the foreign body. CONCLUSION: we report an exceptional case of a penetrating neck wound caused by a concrete iron bar.treatment should always be multidisciplinary and giving priority to vital structures and function.

A foreign body lodged in the ethmoid sinus 3 years previously: A case report.

INTRODUCTION AND IMPORTANCE: Ethmoid sinus foreign body is a rare condition. We describe an unusual case of an intra-ethmoid foreign body that was diagnosed late, we have reported this case to makeover fellow readers aware of the need to carefully examine the patient victim of a road traffic accident and the imaging performed. CASE PRESENTATION: A radio-opaque foreign body was detected at CT- scan of a 70- year-old man, who was the victim of a road traffic accident three years previously. The metallic foreign body was removed from the nasal cavity endoscopically without complications. DISCUSSION: The presence of foreign bodies in the paranasal sinuses is extremely rare, especially following a road traffic accident, and has a lower incidence compared to facial injuries. The Symptoms are vague, which Paranasal computed tomography is the examination of choice to locate the foreign body. The best ethmoidal sinus surgical approach is endoscopy. CONCLUSION: It is important to make a diagnosis and include foreign objects with a recurrence of symptoms especially from an accident on a public road and early removal with extensive debridement results in minimal tissue destruction.

An chronic otitis media with effusion complicated with paravertebral abscess: Case report and review of the literature.

INTRODUCTION: Chronic otitis media are still present and often overlooked. Our observation is interesting by the association of double purulent complications of chronic otitis media: paravertebral abscess and lateral sinus thrombosis. CASE: We report the case of a 54-year-old man with a long history of NPC, who presented to the hospital with severe right earache, associated with headache and 39°fever. CT scan and MRI assessed a complicated chronic otitis media of the middle ear by thrombophlebitis of the lateral sinus and posterior paravertebral abscess. He was put under antibiotic therapy and cortical mastoidectomy two weeks later. Nearly one-year follow up reveals a satisfactory recovery. CONCLUSION: The chronic otitis media with effusion deserves careful monitoring. The early diagnosis and adequate treatment of this life-threatening lesion may result in excellent prognosis. Especially for young people in developing countries.

[Frontal sinus barotrauma: about a case and review of the literature]. / Barotraumatisme du sinus frontal à propos d'un cas et revue de la littérature.

Sinus barotrauma is the second most frequently reported injury after middle ear barotrauma. The front sinus is the most common site affected. This is a rare and specific pathology. We here report the case of a 26-year-old patient having severe left frontal pain with ipsilateral epistaxis after a dive. CT scan showed left frontal hemosinus. Patient evolution was good after therapy. Frontal sinus barotraumas are accidents related to the variations in environmental pressure. Epistaxis is a sign of serious health condition, CT scanner plays a role in evaluating potential predisposing factors and establishing monitoring procedures. Patient treatment aims to relieve symptoms and to remove predisposing factors. Frontal sinus barotraumas are a rare injury ; orbital and encephalic complications are exceptional. Their treatment coincides with that of their causal pathology.