The contribution of molecular biology in the treatment of laryngopharyngeal reflux : a state of art

Le reflux pharyngo-laryngé (RPL) est actuellement largement mis en cause dans les pathologies laryngées. Le diagnostic et le traitement, calqués sur les méthodes appliquées au reflux gastro-oesophagien, rencontrent de nombreux échecs. Depuis peu, plusieurs auteurs tentent de mettre en évidence les mécanismes d'action propres du RPL au niveau moléculaire. Des pompes H+/K+ ATPase ont été mises en évidence au niveau des glandes sous-muqueuses du larynx humain. D'autre part, l'absence d'anhydrase carbonique au niveau de l'épithélium des cordes vocales chez les patients présentant un RPL pourrait rendre compte de la localisation préférentiellement glottique des atteintes laryngées. Enfin, la présence de pepsine active et d'acides biliaires dans l'épithélium laryngé semble jouer un rôle prépondérant dans la physiopathologie du RPL

Autologous costochondral cartilage implant in two cases of velopharyngeal insufficiency

The velopharyngeal sphincter is critical in enabling the functions of speaking and swallowing. Velopharyngeal insufficiency (VPI) results in hypernasal speech and nasal regurgitation. A frequent cause of VPI is congenital cleft palate, but otolaryngologists sometimes encounter iatrogenic VPI after surgery. Treatment of VPI with prostheses is often successful but not always well tolerated. Many surgical procedures have been proposed to correct palatal length or to enlarge the posterior pharyngeal wall. We report two cases in which autologous costochondral cartilage was used as implant augmentation. This approach is indicated and efficient when the velopharyngeal deficit is less than 5 rum. An autologous costochondral cartilage implant procedure is safe and reversible and can be expected to incite minimal host reaction

Management of thyroid nodules

SCOPUS: re.jinfo:eu-repo/semantics/publishe

Sudden hearing loss

Sudden hearing loss. This update on the latest studies and management policies for patients suffering from sudden sensorineural hearing loss (SSHL) represents a cooperative effort of Belgian ENT surgeons from various corners of the country. SSHL has an incidence ranging from 5 to 20 cases per 100,000 persons per year, and is a relative medical emergency, as only 30% to 65% of the patients recover spontaneously. Nowadays, treatment varies a great deal between countries and hospitals. The various etiologies and therapeutic modalities are reviewed, and evidence levels are indicated. Finally, diagnostic and therapeutic organigrams are proposed along with a Belgian therapeutic cocktail in view of conducting a large Belgian study on the management of SSHL