[Extraskeletal pharyngolaryngeal Ewing's sarcoma. Apropos of a case]. / Sarcome d'Ewing extra-squelettique pharyngo-laryngé. A propos d'un cas.

The authors report on one case of pharyngolaryngeal extraosseous Ewing's sarcoma. This is a very rare tumor which preferentially has a paravertebral or retroperitoneal location. The difficult histological diagnosis is greatly facilitated by the use of tumoral markers. The treatment implemented consisted of a "conventional" Cisplatin 5 FU chemotherapy, which allowed an almost complete clinical recession after 3 courses, then of external radiation therapy. The evolution of these tumors still remains unpredictable. Regional metastases to the lymph nodes are rare, and they are usually remote and mainly pulmonary. Lastly, the merits of computed tomography for the follow-up of these intramural lesions of the larynx must be emphasized.

[The scapular osteocutaneous flap. Technic, indications in cervicofacial surgery]. / Le lambeau ostéocutané scapulaire. Technique--indications en chirurgie cervico-faciale.

The authors describe 10 cases of mandibular reconstruction following transmandibular buccopharyngectomy, using scapular osteocutaneous flaps. Repair of mandibular substance loss due to neoplastic surgery becomes a problem. Composite bone resections are associated with mucous and muscular defect formation. There is dual advantage in using this type of flap: on the one hand, reliability is great, independently of the case (revisions or other types of surgery) because of the presence of constant elements in the vascular pedicle; on the other hand, the cutaneous flap and the bone transplant are independent from each other, such plasticity affording equally successful symphyseal and lateral repair.

[A scapular osteo-cutaneous flap in mandibular reconstruction]. / Le lambeau ostéo-cutané scapulaire dans la reconstruction mandibulaire.

The authors report their experience with 6 cases involving the scapular T.O.L.V. technique described by Swartz et coll. They review the anatomy of the vascularisation of the flap together with the possible operative techniques. The 6 cases involved mandibular reconstruction following transmandibular bucco-pharyngectomy, either as first or second line surgery. In all cases the osteo-cutaneous flap gave a good quality reconstruction both in terms of oro-bucco-pharyngoplasty and in terms of repair of the horizontal portion of the mandible. The vascular pedicle was of satisfactory quality. Primary closure of the donor site was possible. No functional complications occurred at shoulder level. Combined reconstruction of the loss of bony and mucosal substance following this type of surgery considerably improves swallowing and phonation in these patients who previously had to undergo hemi-mandibulectomy.

[Otoendoscopy: application in the middle ear surgery]. / Otoendoscopie: application dans la chirurgie de l'orielle moyenne.

Oto-endoscopy is already of considerable value not only for the diagnosis of otological disorders, but also in peroperative use for access to areas that are difficult to see even under an operating microscope (sinus tympani, anterior attic, protympanum). The authors present an endoscopic operation, and report on their experience in cholesteatoma surgery using a closed technique.

[Laterocervical paraganglioma]. / Les para-gangliomes latéraux cervicaux.

Diagnostic and surgical features of lateral cervical chemodectomas are discussed in relation to a personal series of 16 patients with carotid body tumors and 10 with tumors of the intravagal glomus. Clinically, these affections are poor in symptomatology, those of the carotid glomus presenting as an isolated cervical tumor, intravagal glomus tumors as parapharyngeal masses of the restrostyloid type. Arteriographic findings are discussed in detail, as they constitute the only pathognomonic signs, enable differentiation between the two tumor sites, and supply essential pre-operative data: location of the pedicles, possible invasion of arterial walls, and the limits of the tumor. Surgical approach should be wide to enable control of the distal end of the internal carotid artery, if necessary under the base of the cranium, excision of the tumor usually being possible by employing the sub-adventitial resection technique.