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.

Erythema nodosum revealing parathyroid carcinoma.

INTRODUCTION: Parathyroid carcinoma (PTC) is a rare parathyroid tumor. We report a case of PTC revealed by erythema nodosum (EN). CASE STUDY: A 53-year-old woman was admitted for EN exploration. Biology found hypercalcemia (3 mmol/L) and 184.89 ng/L parathormonemia. Histology following cervicotomy diagnosed PTC. Postoperative course was free of complications. At eight months' follow-up, there was no recurrence of EN. DISCUSSION/CONCLUSION: PCT is rare and life threatening. Paraneoplastic EN is rare, and has not previously been reported in association with PCT. Solid neoplasia and hemopathy should be systematically explored for in case of recurrent EN or resistance to conventional treatment.

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.

[Endobronchial lipomas and their treatment: one case report]. / Lipomes endobronchiques et leur traitement: a propos d'un cas.

PURPOSE: Starting from a clinical observation of an endobronchial lipoma and in the light of worldwide literature, the aim of this case report is to specify the epidemiology, the key points of the diagnosis and the advantage of endoscopy both in the diagnosis and the treatment of these rare benign bronchopulmonary tumours. CLINICAL CASE: Recent pneumopathy in the right superior lobe bronchial area in a 73 year old female, symptomatic with cought. Biopsy exeresis gave the histological diagnosis. DISCUSSION AND CONCLUSION: The clinical symptoms due to bronchial obstruction associated with the conventional radiological and computed tomography signs orientate the diagnosis definitively obtained through the anatomopathological study. This histological study is carried out from biopsies performed either during a bronchial fibroscopy or during a tracheobronchoscopy. By confronting the benign macroscopic aspect and the data from the extemporaneous anatomopathological study of the lesion, endoscopy provides an early-stage diagnosis and makes it possible to perform a concomitant and conservative treatment before the stage of irreversible broncho-pulmonary complications. It also avoids the risks and sequelae of classical surgery by thoracotomy.