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Int J Surg Case Rep ; 87: 106399, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34583263


INTRODUCTION: Mandibular localization of tuberculosis is rare and represents less than 2% of skeletal locations. Its clinical and radiological features are not specific. In this paper, we report a case of fortuitous discovery of mandibular tuberculosis after a histopathological analysis of the surgical resected specimen during surgical management of an ameloblastoma. PRESENTATION OF CASE: A 50-year-old female patient was admitted to our department with a 2 years history of left cheek swelling, the clinical examination revealed a left cheek swelling, extending from the mandibular angle to below of temporomandibular joint, measuring approximately 5 cm in diameter. The swelling was firm to hard in consistency, and cervical lymphadenopathy of submandibular region was noticed. Computed tomography (CT) scan revealed a large multiloculated osteolytic expansive lesion measuring 56 ∗ 48 ∗ 53 mm. An interrupting hemimandibulectomy, was performed from the left parasymphys opposite to 33 tooth, extending to the left temporomandibular joint. The histopathological findings confirmed the diagnosis of ameloblastoma, with negative free margin. A mandibular and lymph node tuberculosis were associated with giant cells and caseating necrosis. The patient was successfully treated with a standard anti-tuberculosis therapy. DISCUSSION: Ameloblastoma is a benign odontogenic tumor, 80% of these tumors are found in the mandible. Primary mandibular tuberculosis is an extremely rare entity. Its clinical presentation is not specific. Radiologically, tuberculosis has no characteristic appearance. However, it is possible to evoke it in case of a lytic image of the mandible. The positive diagnosis is based on histology. The treatment is medical, but surgery is necessary for some cases. CONCLUSION: The association between ameloblastoma and mandibular tuberculosis represents an extremely rare entity. Mandibular tuberculosis is rare and should be considered as a possible diagnosis in pandemic areas.

Ann Med Surg (Lond) ; 69: 102695, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34457252


Introduction: Woakes' syndrome is a rare condition commonly defined as recurrent sinonasal polyposis with consecutive destruction of the nasal pyramid. Till now, only a few cases have been reported in the literature. The purpose of this paper is to present the features of woakes' syndrome through two new clinical cases, adding some valuable insight to the recently reported cases. Case report: We report a series of two consecutive adults male and female patients, aged 55 and 58 years, with Samter's triad, who presented recurrent nasal polyposis and progressive broadening of the nasal dorsum. Facial CT showed in both patients the same radiologic pattern of nasal and paranasal cavities obliteration with nasal bone deformation. Both patients underwent functional endoscopic sinus surgery and correction of the bony nasal vault deformity without osteotomies. At 3 months follow-up, the nasal air passage remained free and aesthetic outcomes were observed. Discussion: having been described over 130 years ago, the etiology of woakes' syndrome remains unclear. Treatment includes topical treatment and sinonasal surgery. Surgical treatment of the nasal dorsum deformity is rarely addressed. Conclusion: These observations suggest that the external nose deformity may be successfully corrected by digital compression, in combination with endoscopic sinus surgery.

Int J Surg Case Rep ; 83: 105988, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34052713


INTRODUCTION: The internal jugular vein thrombosis is usually due to intravenous drug abuse, prolonged central venous catheterization or deep head-neck infections or trauma. Related malignancies, or inflammatory etiologies are described. Our case is interesting by the ingestion of a sewing needle that passes from the pharynx to the internal jugular vein via migration, leading to life-threatening complications: deep neck space infection and internal jugular vein thrombosis. CASE REPORT: We report a case of a 40 years old patient, for acute cervical cellulitis in a context of odynophagia and fever, a CT scan revealed a jugular vein thrombosis, penetrated by a metal density foreign body. The diagnosis of ingested foreign body complicated by cervical cellulitis and thrombosis of the internal jugular vein was made. The patient underwent neck surgery with intravenous antibiotics. The postoperative course was uneventful, after one year of follow-up, no complications have been observed. DISCUSSION: no consensus has been reached concerning the management of postoperative and post traumatic vein thrombosis. Taking into account the risk of extension of the thrombus and the hemorrhagic risk each case should involve discussions among a multidisciplinary team. CONCLUSION: The internal jugular vein thrombosis is a rare complication of ingested foreign bodies which may lead to life threat. The early diagnosis and adequate treatment of its life-threatening complications may result in excellent prognosis.

Pan Afr Med J ; 24: 322, 2016.
Artigo em Francês | MEDLINE | ID: mdl-28154677


Malignant otitis externa is also referred to as skull base osteomyelitis. Pseudomonas aeruginosa is the most common offending pathogen. However, fungal origin is not uncommon. 80-year-old patient having persistent left earache since two months despite adequate treatment. Otologic examination showed signs of inflammation in the auricular pavilion, ear canal stenosis with granulomas and purulent otorrhea. CT scan showed a filled otomastoid, extensive inflammatory process affecting the pre-auricular and retro-auricular tissues and lysis of the tympanic bulla. Given the lack of improvement, mycological examination was performed which revealed the presence of Candida Albicans. Cases of malignant otitis externa caused by Candida albicans are rarely reported. Fungal origin should be suspected in patients who have negative bacteriological samples and no improvement despite adequate antibiotic treatment. It should be confirmed by sometimes multiple mycological samples. Malignant otitis externa caused by Candida albicans is a rare potentially mortal infection.

Candida albicans/isolamento & purificação , Candidíase/diagnóstico , Otite Externa/diagnóstico , Idoso de 80 Anos ou mais , Candidíase/microbiologia , Feminino , Humanos , Otite Externa/microbiologia , Otomicose/diagnóstico , Otomicose/microbiologia
Pan Afr Med J ; 24: 269, 2016.
Artigo em Francês | MEDLINE | ID: mdl-28154624


External auditory canal cholesteatoma is defined as an accumulation of keratin leading to osteolytic bony erosion. It is a rare or underdiagnosed otologic entity. Our study aims to illustrate one case of external auditory canal cholesteatoma. Hypertensive diabetic patient, 65 years of age, under therapy suffering from severe right earache, insomnia, hearing loss, small purulent otorrhea and right facial paralysis grade V since 3 months. Initially the diagnosis was malignant external otitis. The patient underwent antibiotic therapy without improvement. Otologic examination showed burgeoning ulcerative lesion of the posterior wall of the right external auditory meatus. Systematic lesion biopsy was performed and confirmed the diagnosis of cholesteatoma. The patient underwent open technique tympanoplasty. External auditory canal cholesteatoma is rare, clinical symptoms are not specific, coronal CT scan makes a major contribution to a positive diagnosis showing bony crater of external auditory meatus. Treatment depends on the extent of the lesions. It can be based on simple local cares or on open technique tympanoplasty. External auditory canal cholesteatoma may have multiple clinical aspects and lend to confusion with other pathologies of the external auditory meatus.

Colesteatoma/diagnóstico , Meato Acústico Externo/patologia , Otopatias/diagnóstico , Timpanoplastia/métodos , Idoso , Biópsia/métodos , Colesteatoma/patologia , Colesteatoma/cirurgia , Otopatias/patologia , Otopatias/cirurgia , Humanos , Masculino , Otite Externa/diagnóstico
Pan Afr Med J ; 24: 272, 2016.
Artigo em Francês | MEDLINE | ID: mdl-28154627


Sinus barotrauma is the second most frequently reported injury after middle ear barotrauma. The front sinus is the most common site affected. This is a rare and specific pathology. We here report the case of a 26-year-old patient having severe left frontal pain with ipsilateral epistaxis after a dive. CT scan showed left frontal hemosinus. Patient evolution was good after therapy. Frontal sinus barotraumas are accidents related to the variations in environmental pressure. Epistaxis is a sign of serious health condition, CT scanner plays a role in evaluating potential predisposing factors and establishing monitoring procedures. Patient treatment aims to relieve symptoms and to remove predisposing factors. Frontal sinus barotraumas are a rare injury ; orbital and encephalic complications are exceptional. Their treatment coincides with that of their causal pathology.

Barotrauma/etiologia , Mergulho/lesões , Seio Frontal/lesões , Doenças dos Seios Paranasais/etiologia , Adulto , Barotrauma/diagnóstico por imagem , Barotrauma/terapia , Seio Frontal/diagnóstico por imagem , Humanos , Masculino , Doenças dos Seios Paranasais/diagnóstico por imagem , Doenças dos Seios Paranasais/terapia , Tomografia Computadorizada por Raios X/métodos