[Morganella morganii and early-onset neonatal infection]. / Morganella morganii et infection maternofoetale.

UNLABELLED: Morganella morganii is an opportunistic gram-negative bacterium, resistant to ampicillin, and scarcely involved in early-onset neonatal sepsis. CASE REPORT: After a premature rupture of the membranes, a pregnant patient received prophylactic amoxicillin per os. She developed chorioamnionitis. Her infant was diagnosed with early-onset sepsis. Maternal and baby's blood cultures grew M. morganii. Both the mother and the infant were successfully treated with a third-generation cephalosporin and an aminoglycoside. DISCUSSION: The influence of a prior antibiotherapy on the emergence of M. morganii vertical infections is discussed.

Postintubation interarytenoid adhesion.

Interarytenoid fibrous adhesion is a poorly recognized complication of intubation and is frequently confused with bilateral vocal cord paralysis. Early diagnosis and treatment is essential for optimal management. Otolaryngologists should constantly remain alert for interarytenoid fibrous scar to establish the diagnosis as early as possible, optimizing the probability of restoring normal breathing and quality of life and avoiding an unnecessary tracheotomy. Surgical laser reduction is appropriate in all cases when other miscellaneous laryngeal injury lesions are eliminated. Direct laryngoscopy with careful examination of the posterior commissure and laryngeal electromyography are the 2 main clinical diagnostic aids contributing to establish the diagnosis.

[Neuropeptides: their role in nasal physiology]. / Les neuropeptides: rôles en physiologie nasale.

In a review of the literature, the authors have studied the biochemical aspects of the sensory physiology of the nasal mucosa. In a previous publication, the abundant presence of neuropeptides in the afferent sensory nerves of the pituitary gland was studied. In this work, the authors have sought to determine the physiological role of these molecules in transmitting messages of aggression, and their implication in the defense mechanisms.

[Surgical treatment of pleomorphic adenoma of the parotid gland. Apropos of 192 cases]. / Traitement chirurgical des adénomes pléomorphes de la parotide. A propos de 192 cas.

Tumors of the salivary glands are exceptional, representing approximately 2% of head and neck tumors. The parotid gland is most often involved, at a frequency reaching 80%. Histology examination generally shows a pleomorphous adenoma. The choice of a surgical technique best adapted to curative treatment depends on the type of tumor and is widely debated. Our management strategy is based on simultaneous histology examination and superficial parotidectomy. Several pre and intra-operative factors determine the need for resection. We verified our strategy with a retrospective study.

Prognostic value of histologic findings in neck dissections for squamous cell carcinoma.

BACKGROUND: Cervical node involvement is the most significant prognostic factor in head and neck squamous cell carcinoma. When histologic findings show node invasion, the number of positive nodes and the presence of extracapsular spread are commonly accepted as prognostic factors. OBJECTIVE: To confirm the findings of recent reports that there is no significant difference in outcome associated with extracapsular spread. SETTING: Referral center. DESIGN: Retrospective study. PATIENTS: Three hundred thirty-seven patients under-going 487 neck dissections for carcinoma of the oral cavity, oropharynx, hypopharynx, and larynx from January 1, 1985, to December 31, 1992. For N3 node involvement, a radical neck dissection was performed; other patients underwent supraomohyoid or functional neck dissection. Two hundred forty-two patients underwent postoperative radiotherapy (mean dose, 59 Gy). OUTCOME MEASURES: Survival capabilities calculated by the Kaplan-Meier method and significance calculated by the log rank test. RESULTS: Overall 5-year survival was 50.8%. The study of prognostic factors showed no significance for extracapsular spread (P = 45). Conversely, the number of positive nodes had a significant value (P < .001). CONCLUSIONS: Extracapsular node spread per se might be considered as no longer having a definitive prognostic value. These results, consistent with those of previous reports, may be due to wider use of combined treatment modalities.

[Analysis of reconstruction procedures for defects of the mouth floor. Report of 96 cases]. / Analyse des procédés de reconstruction du plancher buccal. A propos de quatre-vingt seize cas.

The aim of this study was to assess the reconstruction of floor of the mouth defects after cancer surgery. The medical records of 140 patients treated between January 1st, 1987 and December 31st, 1995 were reviewed. Ninety-six patients had primary reconstruction: there were 82 cutaneous or osteomyocutaneous flaps and 14 microsurgical transfers. Among these patients 15 had titanium mandibular reconstruction plates. The reconstruction procedures and postoperative follow-up were evaluated. Healing by first intention is appropriate for superficial soft tissue defects. The nasolabial flap is used only for small mucosal defects. A forearm flap should be the first choice treatment for large soft tissue defects owing to its plasticity and reliable vessels. Segmental mandibular resections often imply mandibular reconstruction. Titanium plates may be used alone or with a cutaneous flap. Tolerance of plates after radiotherapy is very good and they are an effective method of reconstruction for fragile patients.

[Neuropeptides and nasal mucosa: a general review and update]. / Neuropeptides et muqueuse nasale: revue générale et mise au point.

Following a review of the literature, the authors focused their interest on the sensitive physiology of the biochemistry of the nasal mucosa. After a general presentation of the neurotransmitter molecules studied (the tachykinins), the authors have determined their presence in the sensitive afferent nerves of the pituitary gland, evidencing their co-existence with various other neuropeptides. The distribution of these molecules was studied, given their capacity of acting on peripheral tissular receptors. The widespread distribution and the considerable potential of such neuropeptides reveal the important they play in nasal physiology.

[Carcinoma of the oral cavity in adults less than 30 years of age]. / Carcinomes de la cavité buccale chez l'adulte de moins de 30 ans.

Carcinoma of the oral cavity in patients less than thirty years of age is quite uncommon. Moreover, the usual tobacco and alcohol exposure is not found in these patients. We reviewed retrospectively the medical files of 7 patients with squamous cell carcinoma of the oral cavity treated between 1980 and 1993. Six patients were male. Mean age was 26 years. The primary site was staged T1 in 2 patients, T2 in 3 patients, T3 in 1 patient and T4 in 1 patient. The results of treatment suggest that there is no difference in control rate between this group and older patients. It is difficult to draw conclusions from most of published reports because studies often include patients up to fourty years of age and tumors of various anatomic sites. Young age and alcohol and tobacco exposure do not appear significant factors of prognosis.

[Mandibular reconstruction in oncology: discussion of indications]. / Les reconstructions mandibulaires en cancérologie: discussion des indications.

The aim of the study was to assess the results of segmental mandibular resections and the validity of mandibular reconstructions. The medical records of 95 patients treated between January 1, 1987 and December 31, 1992 were reviewed. There were 82 (86%) carcinomas, 9 ameloblastomas and 4 sarcomas. Among the 82 patients treated for carcinoma, the overall 2- and 5-year survival rates were 70% and 33% respectively. The functional results evaluated one year after surgery showed no significant difference according to the reconstruction procedure: myocutaneous flap, osteomyocutaneous flap, titanium mandibular reconstruction plate or microsurgical transfer. The most important factor in functional rehabilitation is the amount of soft tissue resected. In head and neck oncology, aggressive surgical reconstruction of the mandible must only be used in patients with good general status and fair survival probability.

[Cleft palate and inflammatory diseases of the middle ear]. / Division palatine et pathologie inflammatoire de l'oreille moyenne.

Based on a series of 57 children who were operated for velar clefts, the authors studied the different associated aspects of middle ear inflammatory pathology: physiopathology, occurrence, evolution, complications. Seromucous otitis was initially found in 87% of the cases. Three years after surgery, it persisted in 70% of the cases. These children should be monitored on a long-term basis for timely detection of any and all evolution towards chronic otitis or even cholesteatomas.

[Accessory thymus in cervical ectopy: apropos of a case]. / Thymus accessoire en ectopie cervicale: à propos d'un cas.

Cervical tumors of thymic origin are considered to be uncommon lesions in the differential diagnosis of neck masses. They can be either cystic or solid. The authors present one case of solid cervical thymic tumor in a 2 month-old baby. The embryogenesis of the thymus explains the cervical location of these tumors. Theories of physiopathology are presented. The clinical presentation is variable and their nature is often recognized only upon surgery and preoperative pathologic examination. Some cases of thymoma and respiratory complications resulting from ectopic thymus have been described in the literature, so that total excision of the mass must be performed. This lesion may be more common than suggested in the literature.

[Subglosso-epiglottectomy: carcinologic and functional results]. / Subglosso-épiglottectomie: résultats carcinologiques et fonctionnels.

The authors report on 26 cases of patients treated by subglosso-epiglottectomy from 1978 to 1989. Whilst as far as survival and local oncological control are concerned the results are encouraging, the functional results are disappointing.

[A case history of lateral cervical tumor]. / Histoire d'une tumeur cervicale latérale.

The authors report on the observation of a voluminous aneurysm of the common carotid that had developed over 20 years in an 88-years old female patient. This was treated surgically by a Gore-Tex carotid graft with perfectly straightforward operative sequellae. With respect to this case, the author briefly review the semiology and diagnosis of aneurysms of the neck.