[Clinical and therapeutic features of herpes zoster oticus: a case report]. / Zona otitique, aspects cliniques et thérapeutiques: à propos d'un cas.

Ear shingles, also called herpes zoster oticus, are a viral infection of the outer, middle and/or inner ear due to varicella zoster virus (VZV). Patients with ear involvement associated with facial palsy are clinically diagnosed with Ramsay-Hunt´s syndrome. We here report the case of a 25-year-old patient with herpes zoster oticus associated with peripheral facial palsy, without other associated signs. This study and literature review investigate the various clinical, para-clinical and evolutionary features of herpes zoster oticus and the therapeutic approaches.

[Voluminous parotid cyst of the first branchial arch: a case report]. / Enorme kyste parotidien du premier arc branchial: à propos d´un cas.

Parotid branchial cysts are rare and poorly known congenital malformations of the first branchial cleft. They are characterized by three types of manifestations which may be associated to it or isolated, including inflammatory swelling of the subauricular and inferior portion of the parotid with or without cervico-cutaneous fistula projecting into the cervico-mandibular area and a fistula in the floor of the external auditory canal with or without otorrhea, with or without pretimpanic bridle on otoscopy. They often go unnoticed, except for superinfections. Diagnosis is based on interview, the occurrence of recurrent abscesses or superinfections. No complementary imaging examination should be systematically performed. In atypical forms, ultrasound as well as magnetic resonance imaging (MRI) could be necessary, particularly in patients with parotid swellings, in order to confirm cystic structure. Abscesses and recurrent superinfections are the most common complications. Treatment is based on surgical resection. We report the case of a patient with voluminous parotid cyst of the pharyngeal arch.

[The inferior laryngeal nerve: anatomical and surgical considerations about 60 thyroidectomy]. / Le nerf laryngé inférieur: considérations anatomiques et chirurgicales à propos de 60 thyroïdectomies.

Thyroid surgery requires a thorough knowledge of cervical anatomy and anatomical variations, in particular of the lower laryngeal nerve, in order to avoid iatrogenic lesions. The objective of our study was to analyze the relationships of the lower laryngeal nerve, the existence of branches of nerve division and a subjective appreciation of the size of the nerve. This is a prospective study of 1 year including 60 patients who underwent thyroidectomy. Sixty patients underwent surgery on the thyroid gland between February 2014 and January 2015 by the same principal operator (10 men and 50 women). The average age of our patients was 51 years. For men were performed 6 total thyroidectomies, 2 left lobo-isthmectomies and 2 right lobo-isthmectomies. For women were performed 33 total thyroidectomies, 8 left lobo-isthmectomies and 9 right lobo-isthmectomies. On the right, the nerve was superficial relative to the artery in 71.6% of cases; it was divided in 33.3% of cases and was abnormally thin in 16.6% of cases. On the left, the nerve was deep in relation to the artery in 83.3% of cases; it was divided in 15% of cases and was abnormally thin in 11.6% of cases. Knowledge of the anatomical variations of the lower laryngeal nerve is essential in thyroid surgery, the risk is particularly important on the right side given the sometimes very small caliber and the existence of branches of division more frequent than on the left side.

Medial migration of the tympanostomy tube: what is the optimal management option?

The tympanostomy tube insertion is the gold standard of treatment for secretory otitis media. Complications are associated with this surgery in 17% of cases. One of the rare but real complications is the medial migration of the tympanostomy tube. To our knowledge, this is the 14th case reported in childhood. Considering this rarity, there is no consensus for the management of this phenomenon. Some authors propose a surgical removal, while others prefer to observe whether the patient is asymptomatic. We reported a case of migration of the tympanostomy tube and described the detailed clinical features and management options. This case report and mini-review will broaden readers the knowledge of medial migration of the tympanostomy tube and may guide the relative treatment of this complication in the future.

[Voluminous cervical amygdaloid cyst: about a case]. / Enorme kyste amygdaloïde cervical: à propos d'un cas.

Amygdaloid cysts are benign dysembryologic cystic tumors developing in the anterolateral portion of the neck. They account for 2% of all neck tumors located in the laterocervical region. They mostly result from branchial cleft abnormalities, accounting for 6.1-85.2% of all second branchial cleft abnormalities. They are due to the persistence of the cervical sinus during the differentiation of the branchial apparatus. They manifest as a laterocervical swelling in the anterior edge of the sternocleidomastoid muscle. The diagnosis of cyst is confirmed by ultrasound and CT scan. Treatment is based on surgical resection. We here report the case of a 24-year old woman presenting with voluminous left laterocervical swelling evolving over the past 3 years without any associated symptoms. Exploratory cervicotomy with anatomopathological examination were performed. The histologic diagnosis of amygdaloid cyst with no sign of malignancy was retained. This study aims to analyze the anatomoclinical features and to discuss the therapeutic options for the management of this disease.

[Supracricoid partial laryngectomy (SCPL) with either cricohyoidoepiglottopexy (CHEP): our experience with 16 cases]. / Laryngectomies partielles supra-cricoïdiennes avec reconstruction par CHEP: notre expérience sur 16 cas.

Partial laryngectomy with either cricohyoidoepiglottopexy (CHEP) are mainly used to treat glottic cancers becuse they ensure a satisfactory preservation of physiological functions and satisfactory local carcinologic control. Our study aimed to analyze the functional and carcinologic results of this surgical technique. We conducted a retrospective study of patients undergoing partial laryngectomy with either cricohyoidoepiglottopexy in our Hospital between 2011 and 2014. We analyzed the epidemiological data, the surgical peculiarities, the functional outcomes and the carcinologic control of the disease. A total of 16 patients were included in this study. All our patients had T1 or T2 glottis squamous cell carcinoma. Functional outcomes were generally simple, especially in cases where the preservation of the 2 cricoarytenoid units was possible (75% of cases). However post-operative complications were reported in 31.25%. Carcinologic control was satisfactory, only one patient experienced local recurrence. Partial laryngectomy with either cricohyoidoepiglottopexy (CHEP) is a safe surgery preserving physiological functions and ensuring satisfactory quality of life. It also allows for good carcinologic control (it is subject of course to compliance with surgical indications).

[Giant parathyroid carcinoma: diagnostic difficulties and therapeutic strategies]. / Carcinome parathyroïdien géant: difficultés diagnostiques et stratégies thérapeutiques.

Parathyroid carcinoma is a very rare malignancy responsible for 0.4 to 5.2% of hyperparathyroidism. Clinical diagnosis is difficult and treatment should be codified. Surgery is the only curative treatment. We report the case of a female patient treated for malignancy-associated hypercalcemia revealing parathyroid carcinoma. The patient underwent surgery; after three months she developed lymphatic recurrence. Given the absence of other secondary involvement, bilateral lymph node dissection followed by chemotherapy was performed. Parathyroid carcinoma is often suspected on the basis of biological, radiological and especially intraoperative macroscopic criteria, but definitive diagnosis is made histopathologically. Surgery is currently the only curative treatment and the role of adjuvant therapy is to establish.

Intramedullary spinal cord metastasis from laryngeal carcinoma: case report and review of literature.

Laryngeal cancer metastases are relatively rare and mainly affect the lung. The medullary localization remains exceptional. We report the case of a patient followed for operated laryngeal cancer and whose oncologic control revealed a medullary localization. A patient followed for squamous cell carcinoma of the larynx, treated in 2010 by a partial surgery whose endoscopic control at 5 years revealed the presence of right arytenoid edema without suspicious lesions, multiple biopsies were made and which returned negative. A month later, the patient presented a rebel cervical spine pain and a feeling of heaviness of the upper limbs, for which a radiological assessment was done finally objectifying a right hypopharyngeal process and a suspicious right internal jugular lymphadenopathy (biopsy confirmed the squamous type), as well as an intramedullary metastasis. This case is an illustration of an exceptional evolution of this type of cancer and a are metastatic localization difficult to highlight, which leads us to ask the question on the need of simultaneous and systematic radiological and endoscopic control treatment for operated laryngeal cancer.

Quiste epiglótico gigante: ¿es imprescindible la traqueotomía? / Giant epiglottic cyst: is tracheostomy essential?

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Tuberculosis of the parotid gland: histology surprise.

The Parotid gland is rarely involved in tuberculosis, even in endemic countries. We report a case of a 26 year-old woman with no medical history, who presented with a swelling of the parotid lodge. Pathology performed after surgery found a tuberculous parotitis, and the patient received anti-tuberculous regimen with a satisfactory evolution. We discuss both diagnostic and therapeutic modalities for this infection.