Endoscopic endonasal management of congenital intranasal meningocele in a 2-month-old infant.

INTRODUCTION: Nasal meningocele, which is usually congenital, is a rare anomaly resulting from meningeal herniation into the nasal cavities through a bone defect in the skull base. CASE REPORT: An 8-day-old boy was referred with respiratory disturbance and nasal obstruction. Examination showed a cyst-like grayish swelling filling the right nasal cavity. CT scan showed opacity, of fluid-like density, filling the right nasal fossa, in contact with a small bony defect in the right cribriform plate. MRI ruled out herniated brain parenchyma and enabled diagnosis of meningocele. The patient was operated on at the age of 2 months through a transnasal endoscopic approach. Immediate postoperative course was favorable. MRI control at 8 months was normal. DISCUSSION: Modern imaging (CT scan and MRI) is of paramount importance in the preoperative evaluation of nasal meningocele. Endoscopic endonasal (EE) surgery is currently the treatment of choice. CONCLUSION: Steady progress in instrumentation, technique and skills will increase the feasibility of skull-base surgery using an endonasal approach in the pediatric population.

Tuberculose extra ganglionnaire de la tete et du cou

Les localisations ORL extra ganglionnaires de la tuberculose sont peu communes. La symptomatologie clinique est trompeuse; posant ainsi le probleme de diagnostic differentiel avec la pathologie tumorale. Nous rapportons 12 cas de localisations extra ganglionnaires de tuberculose; colliges au service ORL de l'EPS Fattouma Bourguiba de Monastir entre 1995 et 2009. L'age moyen de nos patients est de 38 ans. L'etude topographique a montre 3 localisations laryngees; 3 au niveau des glandes salivaires; 2 amygdaliennes; 2 rhinopharyngees; 2 rhino sinusiennes. Le diagnostic etait anatomopathologique dans tous les cas. Tous nos patients ont recu un traitement antituberculeux avec une bonne evolution

[Contribution of endoscopic laser coagulation in the treatment of multicentric sinonasal inverted papilloma. A case report]. / Place du traitement endoscopique au laser du papillome inversé naso-sinusien multifocal. A propos d'une observation.

OBJECTIVE: To describe a new method of treatment of multicentric sinonasal inverted papilloma by laser endoscopic coagulation. MATERIAL AND METHODS: We report a case of multicentric sinonasal inverted papilloma involving the nasopharynx in a 62-year-old man. The treatment was a laser diod cauterisation. RESULTS: The evolution was favourable without complications or recurrence after a 16 months follow-up period. CONCLUSION: Laser endoscopic coagulation seems to be an effective treatment for multicentric sinonasal inverted papilloma especially for lesions with a difficult surgical access.

[Laser coagulation in the endoscopic management of fourth branchial pouch sinus]. / Traitement endoscopique au laser des fistules de la 4e poche endobranchiale.

OBJECTIVES: To describe a new method of treatment of the fourth branchial pouch sinuses by laser endoscopic coagulation of the fistula. MATERIAL AND METHODS: Retrospective study of two children aged 3 and 12 years with fourth branchial pouch sinuses. Both children presented recurrent cervical abscesses. The diagnosis was established on results of ultrasound, barium study, CT scan and pharyngoscopy. After recovering from infection, the definitive treatment was a laser diode cauterization of the fistulous route and its pharyngeal opening. RESULTS: Outcome was rapidly favorable in both children without complications or recurrence. DISCUSSION: These two cases and other reports in the literature confirm the role of endoscopic management for the treatment of the fourth branchial pouch sinus. Laser treatment is especially useful because of its convenience, its harmlessness and its reliability. CONCLUSION: Fourth branchial pouch sinuses are rare. Surgery, which can be difficult and not without risks, is the generally accepted treatment. This new laser method combines ease of treatment and efficacy.

[Early auditory evoked potentials in spinocerebellar heredodegenerative involvement]. / Apport du potentiel évoqué auditif précoce dans les atteintes hérédo-dégénératives spino-cérébelleuses.

Results of early auditory evoked potentials, recorded during exploration of spinocerebellar heredodegenerative lesions (21 cases of Friedreich's disease, 8 cases of Pierre-Marie's disease and 3 cases of Strumpell-Lorraine disease), are analyzed. Tracings showed alteration of auditory BER whereas tonal audiometry was normal. Analysis of BER demonstrated lengthening of the latency periods, a rise in thresholds without latency period increases and a tracing that was sometimes flat or with waves that were difficult to recognize.