[Dermatofibrosarcoma protuberans of the face: Long term patient of a follow up].

We report the case of a patient 40 years old affected by a facial tumour diagnosed as a dermatofibrosarcoma protu­berans. He has been followed in our clinic for the last 22 years. He got a recurrency after 11 years and after an other surgery he his actually free of disease. The purpose of this article is to evaluate the tumoral recurrency and the long term follow up.

[The silent sinus syndrome: A reconstruction of the orbital floor with Medpor implant]. / Le silent sinus syndrome: reconstruction orbitaire par implant Medpor.

INTRODUCTION: The silent sinus syndrome (SSS) is a rare clinical entity in both ENT and ophthalmology. It is characterized by enophthalmos and ptosis associated with a reduction in pressure in the maxillary sinus caused by chronic hypoventilation. The objective of this study was to demonstrate the importance of maxillary hypoplasia whether congenital or acquired in this disease, and the use of Medpor implant for reconstruction of the orbital floor. MATERIAL AND METHODS: We report 3 cases of silent sinus syndrome proved clinically and radiologically. The first is a 45 year old male patient complaining of enophthalmos which occurred gradually, without any medical history; the second case is that of a woman of 39 years with a gradual onset enophthalmos, with a history of sinusitis; the third case, a man of 25 years who had a history of nasal trauma and consults for enophthalmos and diplopia. RESULTS: Endoscopic surgery is performed quickly allowing a disappearance of enophthalmos and diplopia. All patients underwent a reconstruction of the orbital floor with a Medpor implant fixed by miniplates without complications.

[Post operative Caldwell-Luc procedure maxillary cyst: Report of a case]. / Syndrome post Caldwell Luc: à propos d'un cas.

Rare complication of radical surgery (Caldwell Luc procedure) of the maxillary sinus, maxillary cyst can occurred several years after. We describe the case of a patient 56 years old, who came to our consultationfor repeated pain in the right maxillary region with moderate facial asymmetry. In her history we noted a previous sinus surgery (Caldwell Luc) more than 10 years before. The imaging showed an expansive process filled with proteinic tissue of the posterior wall of the maxillary. With the history of the former surgery, we suspected the existence of a mucocele. She underwent an endonasal surgery and the pathological examination of the specimen revealed an intra osseous cyst lined with ciliated respiratory type mucosa post surgery of the maxillary sinus. The diagnosis of a maxillary cyst complicating a Caldwell Luc was established based on the results obtained with the clinico-radiological and pathological results.

[Oncocytoma of the parotid gland: a case report]. / Oncocytome de la glande parotide: a propos d'un cas.

Oncocytoma is a rare benign salivary gland tumour with an incidence rate about 1-2%. It is located in the parotid gland in 82% of cases. The aging mitochondrial hypothesis could explain the predilection between 70 and 90 years. Clinical and radiological features of the parotid oncocytoma are not different from those of the others parotid benign tumors. We report a case of oncocytoma of the left parotid gland in a 69 years woman in whom fine needle aspiration cytology (FNAC) was for a pleomorphic adenoma. Through this case we highlight the importance of histopathology in the positive diagnosis of parotid oncocytoma as well as in it's differential diagnosis and also the place of FNAC.

[Setting up a "Bonebridge"]. / Mise en place d'un "Bonebridge".

Hearing rehabilitation after bilateral radical mastoidectomy has different options. The Bonebridge is a new type of middle ear implant bone conduction. It leaves the external ear canal opened and offers acoustic and aesthetic advantages that make it a new alternative of choice. We report our first case of Bonebridge implanted on a 17 years old patient. He had bilateral conductive hearing loss secondary to a bilateral radical mastoidectomy with open technique and meatoplasty for a bilateral cholesteatoma. The surgical technique is described. After 8 months of use the hearing gain is stable without cutaneous adverse effect.

Arytenoid asymmetry in opera singers.

INTRODUCTION: Otolaryngologists commonly observe asymmetrical movements of the arytenoid cartilages, but few authors have described the clinical implications of this asymmetry, especially in singers. OBJECTIVES: The aim of this study was to determine the epidemiological and clinical characteristics of arytenoid asymmetry in adduction in a group of healthy opera singers and to evaluate the impact of this asymmetry on the voice. PATIENTS AND METHODS: The medical charts and laryngeal video recordings of 245 healthy opera singers were retrospectively reviewed. Arytenoid asymmetry was defined in relation to the position of the corniculate cartilages, cuneiform cartilages and aryepiglottic angle. RESULTS: The subjects had a mean age of 38.54years (range: 18 to 85 years) and presented a male-to-female sex ratio of 1.02. About 5% of subjects had a history of smoking. The most common vocal symptoms were occasional dysphonia (4%), followed by vocal fatigue (2%) and pharyngeal dryness (2%). Arytenoid asymmetry was slightly more common in males (50.6%) and predominantly affected the right side (64.5%). The most common form of asymmetry was cuneiform asymmetry (37.5%), followed by aryepiglottic angle asymmetry in 33.1% of cases and corniculate asymmetry in 29.4% of cases. Mild asymmetry was observed in the majority of cases. No correlation was observed between arytenoid asymmetry and vocal symptoms. CONCLUSION: Almost one out of two singers was likely to present arytenoid asymmetry in adduction. The presence of this asymmetry does not appear to be correlated with any vocal symptoms.

Rhinophyma: Our experience based on a series of 12 cases.

INTRODUCTION: Rhinophyma is a rare, benign and unsightly disease of the skin of the nose that was first described a very long time ago, as illustrated by portrait of an old man with a bulbous nose holding his grandson, by Ghirlandaio in 1490. It was described for the first time by Ferdinando Hebra Von (1816-1880), as the third stage of rosacea. The objective of this study is to report the author's experience and propose a new treatment option in the management of rhinophyma. MATERIAL AND METHODS: We describe our experience of rhinophyma based on a retrospective case study. RESULTS: We identified 12 cases over a 12-year period, with a marked male predominance. The therapeutic approach was the same in all patients, consisting of a combination of dermabrasion, decortication and application of fibrin glue, with a favourable outcome in every case with complete epithelialisation. CONCLUSION: Rhinophyma is a rare condition of uncertain pathophysiology. Management is surgical and, in view of the many techniques and procedures proposed, we advocate the slogan "to each his own technique", until a consensus has been reached. Our technique combining dermabrasion, decortication and application of fibrin glue has given very good results.

Intraorbital foreign body: A rifle bullet removed 20 years after the accident.

INTRODUCTION: Trauma of the orbit and eyeball is common, but intraorbital bullet is a relatively rare event. CLINICAL CASES: The authors report the management of a patient with chorioretinitis sclopetaria secondary to a gunshot wound twenty years previously. DISCUSSION: The clinical, diagnostic and therapeutic aspects of this unusual case of intraorbital foreign body are discussed.

Post-traumatic Pott's puffy tumour: A case report.

INTRODUCTION: Osteomyelitis of the frontal sinus is a rare clinical entity and generally occurs as a complication of trauma to the forehead or frontal sinusitis. It can be responsible for life-threatening complications, as the first symptoms may appear to be minor. Early diagnosis and appropriate management to prevent central nervous system complications significantly reduce the morbidity and mortality. CASE REPORT: The authors report the case of a 34-year-old man with Pott's puffy tumour following trauma to the frontal sinus. DISCUSSION: The diagnosis was suggested clinically and confirmed radiologically. Treatment was surgical with craniotomy and external drainage.

[Cochlear implant in a patient with dilatation of the endolymphatic sac and vestibular aqueduct]. / Implante coclear en paciente con dilatación del saco endolinfático y del acueducto del vestíbulo.

We present an 8 years patient old with a giant dilatation of the vestibular aqueduct associated with profound and progressive bilateral sensorineural hearing loss. The patient received a cochlear implant and during the surgery a pulsatile clear fluid via the cochleostomy was observed, without gusher. We present all the problems, and offer some advices for this kind of surgery.

Melanotic neuroectodermal tumor of infancy: a case report.

A male patients, two months of age, was affected by a rapidly growing tumor on the left side of the mandible. There were no other clinical or pathological signs. A thorough examination, as well as radiographic, tomographic and tomodensitometric tests showed the presence of a tumor on the maxilla. It was of low density, encapsulated and shifting the germinal teeth. Surgical removal revealed a melanotic neuroectodermal tumor typical of that in children. The tumor recurred in the same location and was actually larger, less than a month after the operation. A new screening was done for vanilmandelic acid and radiographies of the skull base and skeletal series were negative. The patient was operated on again, with the same histological diagnosis. The diagnosis and treatment are discussed.

Lymphangioma of the larynx as a cause of progressive dyspnea.

The following is a case report of a lymphangioma of the larynx in a 16-year-old girl with Down's Syndrome. The clinical record of the girl, the diagnosis of the tumour and its surgical treatment as well as the postoperative course and the follow-up results are described.

Primary localized nasopharyngeal amyloidosis. A case report.

Primary localized amyloidosis of the nasopharynx is a rare disease. We present the case of a 13-year-old girl, to our knowledge only the second pediatric case reported in the literature. Symptoms were nasal obstruction and bleeding from the oral cavity. Physical examination revealed a mass in the nasopharynx and left side of the soft palate. The diagnosis was made by biopsy and histopathologic study of the surgical specimen. Immunohistochemical study revealed amyloid light chains (AL). The main treatment was surgical. At follow-up 9 months later, no recurrence had developed. While rare, localized amyloidosis should be considered in the differential diagnosis of nasal obstruction, epistaxis and glue ear, and must be recognized and understood by the otolaryngologist to allow appropriate diagnostic and therapeutic planning.

Association of spontaneous anterior fossa CSF rhinorrhea and congenital perilymphatic fistula in a patient with recurrent meningitis.

A case of recurrent meningitis associated with spontaneous cerebrospinal fluid (CSF) rhinorrhea and left sensorineural hearing loss in a 4-year-old boy was found to be due to simultaneous congenital defects. High resolution CT examination clearly showed an anterior fossa defect and an inner ear malformation, including demineralization in the region of the footplate of the stapes, and thus provided clear guidance for the surgeon.

Major congenital anomalies of the internal carotid artery: agenesis, aplasia and hypoplasia.

Agenesis, aplasia and hypoplasia of the internal carotid arteries (ICA) are rare congenital disorders with few descriptions in the otorhinolaryngological literature. We present two cases of major abnormalities of the ICA, one with isolated hypoplasia and another with agenesis associated with ear malformation and facial palsy. We briefly review the normal anatomy and discuss the main aspects of these malformations.

Nasal gliomas: main features, management and report of five cases.

Nasal gliomas are neurologic malformations that should be considered in the presence of a congenital nasal mass. Appropriate pre-operative examination must be performed to identify a possible connection with CNS, which is present in 15-20% of the cases. This examination should determine whether initial craniotomy is necessary. Here, we report five cases and review the main characteristics and management of this pathology.

[Intranasal encephalocele]. / Encefalocele intranasal.

We present a case of an intranasal encephalocele in a 6-year old girl, that appears as an intranasal mass with CSF rhinorrhea. The surgical treatment is described, specially the extracranial step through a paralateronasal via. The embryogenesis, classification, diagnosis and management of these rare congenital lesions are discussed.

[The use of extraoral osteointegrated implants in otolaryngology and maxillofacial surgery in children]. / El uso de los implantes osteointegrados extraorales en otorrinolaringología y cirugía maxilofacial en los niños.

We present our clinical experience with extraoral osteointegrated implants in children. We treated a total of a twenty cases. Seventeen were cases of auricular ephitesis, and in six of them we also inserted a bone conduction auditory prosthesis. In three cases we inserted an orbital ephitesis. Two operations are necessary to place the osteointegrated implants in the temporal and orbital regions respectively. We made a follow-up study of these patients for approximately two years, and we present the resulting statistics, and complications that we encountered. We conclude that osteointegrated implants in carefully pre-selected children, offer excellent ephitesis setting and a reliable method of installing bone conduction hearing aids.

[Use of expanded polytetrafluoroethylene in nasal augmentation]. / El uso del politetrafluoroetileno expandido en rinoplastia de aumento.

PTFE-e patches were used in nasal augmentation in 14 patients with a four-year follow-up. This material was chosen because it is inert and biologically compatible with human tissue. None of the patients in which this material was used had intolerance reaction, skin changes, material extrusion, or signs of infection. A review of the world literature showed no cases of poor results with PTFE-e. It is concluded that the best material for nasal augmentation is autologous material, but if not available or difficult to obtain, PTFE-e is the most acceptable synthetic material and produces good results.

[Cochlear assessment before cochlear implantation by computer tomography with a modified Stenvers projection]. / Valoración de la cóclea preimplante coclear mediante tomografía computarizada en incidencia de Stenvers modificada.

In the study protocol of candidates for cochlear implantation, the patency of the cochlea should be assessed. Therefore we systematically add the Stenvers modified projection to the routine coronal and axial sections which permits the visualization in a single sation of practically all the coils of the cochlea. This projection also is useful in postoperative controls, to confirm the correct intracochlear position of the electrode.