[Unilateral frontal sinus aspergillosis: the combined endoscopic and mini-trephination approach]. / Aspergillose unilatérale du sinus frontal: voie d'abord combinée endoscopique et par clou de Lemoyne.

OBJECTIVE: Aspergillosis is a common fungal infection of the paranasal sinuses. Localization in the frontal sinus is usually secondary to involvement of one of the other sinuses. Isolated frontal sinus aspergillosis is rare and only 5 cases are described in literature. CLINICAL CASE: We report a case of a patient with a frontal sinus aspergilloma associated with ipsilateral chronic ethmoidal and maxillary sinusitis, successfully treated with a combined endoscopic and mini-trephination approach "Lemoyne technique". DISCUSSION AND CONCLUSION: The endoscopic approach to the frontal sinus is considered the best way to deal with frontal sinus aspergilloma, but it is sometimes not sufficient to guarantee the complete removal of the fungus ball. In such cases a mini-trephination of the frontal sinus with associated irrigation provides a more accurate visualization and toilette of the sinus.

[Plastic surgery indications for the repair of nasal tip and nasal alae defects]. / Les indications de la chirurgie plastique dans la réparation des pertes de substance de la pointe du nez et de l'aile narinaire.

Analyze methods of reconstruction of non-transfixing and transfixing loss of substance of the nasal tip and nasal ala. We would like to share the attitude guiding our selecting of the different methods to rehabilitate this mobile and functional portion of the nose. We retrospectively studied 32 cases of defects of the tip and ala treated between 2007 and 2009. There were 26 basal cell carcinomas, 5 squamous cell carcinomas and 1 melanoma. The minimum postoperative follow-up was one year. For reconstruction we used local flaps: medial dorsal flap, bilobed flap, transverse island flap and regional flaps: fronto-glabellar flap, forehead flap, nasolabial flap. In this study we analyzed the aesthetic and functional result achieved at the nasal orifice. We also studied the histopathological reports regarding safety tissue margins, both in depth and peripherally. Most of the defects of the tip and the alae of less than 1 cm were repaired by local flaps; bilobed or transverse island flaps. For the median region, the Rintala mid-dorsal flap appears to give better results. Tissue losses greater than 1 cm often required the use of a fronto-glabellar flap that allowed delivery of more tissue with less scarring at the donor site. The nasolabial flap may have the disadvantage of removing the crease and sometimes a certain thickness at the arc of rotation, which might require further thinning at a later stage. For transfixing loss of substance, we must repair all the layers: skin, cartilage and mucosa. The forehead flap with respect to the principles of the aesthetic subunits of the nose is the flap of choice. We stress on the importance of ample resection with adequate safety margins peripherally and in depth.

[The protocol of postop monitoring after endonasal endoscopic procedure: patient care]. / Protocole be surveillance post-operatoire apres chirurgie endo- nasale endoscopique--a l'attention du personnel soignant.

TITLE: A protocol for post-operative follow-up after endoscopic sinus surgery. A guide for nursing staff. SUMMARY: Endoscopic sinus surgery requires rigorous postoperative care by the nursing staff. There is a risk of complications in this surgery with a serious outcome if the postoperative care is defective. To be certain that this monitoring is done regularly the authors propose a card of evalation which is filled dice the arrival of the patient in recovery room and then with regular intervals. This card is the guarante of a recognition of the problem by the surgeon but also by the nursing staff. It facilitates the fast installation of the treatment in case of need.