Vertigo and psychological disorders

Vertigo and psychological disorders. Vertigo may be a symptom of psychiatric illness. Alternatively, vestibular dysfunction or other organic causes of dizziness may trigger psychiatric disorders such as anxiety, depression or panic attacks. Different mechanisms might account for the link between anxiety and vestibular disorders. The ENT specialist must be aware of this reality to take into account the psychological dimension of vertigo in his diagnosis approach. This may lead to different types of treatment depending of the nature of the disorder. Some questionnaires can be useful in this respect

Tinnitus

This article is based on a review of the literature and the experience of some experts. Its goal is to present an overview of the physiopathology of tinnitus and perspectives of treatment based on recent publications. Tinnitus is a problem of society, affecting about 10% of the population. The causes of tinnitus are extremely diverse. Objective tinnitus is generally pulsatile and from arterial or venous origin; subjective tinnitus can be generated at any level of the auditory pathways. Approach to tinnitus includes qualification through anamnesis and specialized questionnaires, and thorough audiological characterization. Sometimes, imaging is indicated as it can reveal the cause of the tinnitus in case of a vascular abnormality or a retro-cochlear tumour. Among the various medications prescribed for tinnitus, only anti-depressants proved to be efficient when secondary depression is present. Hearing aids are useful for hearing impaired patients but the efficiency of tinnitus maskers is not proved. Tinnitus Retraining Therapy is very promising but results must be confirmed by future studies. Studies about neurostimulation are in progress. In the future, better understanding of the physiopathology of tinnitus will lead to new treatments.SCOPUS: re.jinfo:eu-repo/semantics/publishe

Craniofacial fibrous dysplasia: A 10-case series

International audienceObjective: Fibrous dysplasia of bone is a rare sporadic benign congenital condition in which normal cancellous bone is replaced by fibro-osseous tissue with immature osteogenesis. Sarcomatous transformation is exceptional. Lesions may involve one bone (monostotic) or several (polyostotic). Fibrous dysplasia may be associated with cafe-au-lait skin macules and endocrinopathy in McCune-Albright syndrome, or with myxoma in Mazabraud's syndrome. Methods: We report ten cases of patients followed up for craniofacial fibrous dysplasia in our center between 2010 and 2015. Results: Mean age was 43 years (range, 10-72 years). Clinical symptoms comprised headache (n = 3) and sensorineural disorder: recurrent anterior uveitis (n = 1), visual acuity loss, epiphora and vestibular syndrome (n = 1), and hearing loss (n = 1). All cases were monostotic. The sphenoid bone was most commonly involved (n = 5), followed by the ethmoid (n = 1), frontal (n = 1), fronto-ethmoid (n = 1), temporal (n = 1) and fronto-ethmoido-sphenoid (n = 1) bones. Five patients were treated with intravenous pamidronate, a bisphosphonate: evolution was favorable for 3 of them at 1-6 months after treatment initiation, with resolution of headache or vestibular syndrome; the other 2 patients were stable. Two patients were operated on. Conclusion: Diagnosis of craniofacial fibrous dysplasia should be considered in case of headache, neuralgia, sensory disorder, functional disorder or infectious ENT complications. A medico-surgical approach is useful for these patients

Tinnitus

This article is based on a review of the literature and the experience of some experts. Its goal is to present an overview of the physiopathology of tinnitus and perspectives of treatment based on recent publications. Tinnitus is a problem of society, affecting about 10% of the population. The causes of tinnitus are extremely diverse. Objective tinnitus is generally pulsatile and from arterial or venous origin; subjective tinnitus can be generated at any level of the auditory pathways. Approach to tinnitus includes qualification through anamnesis and specialized questionnaires, and thorough audiological characterization. Sometimes, imaging is indicated as it can reveal the cause of the tinnitus in case of a vascular abnormality or a retro-cochlear tumour. Among the various medications prescribed for tinnitus, only anti-depressants proved to be efficient when secondary depression is present. Hearing aids are useful for hearing impaired patients but the efficiency of tinnitus maskers is not proved. Tinnitus Retraining Therapy is very promising but results must be confirmed by future studies. Studies about neurostimulation are in progress. In the future, better understanding of the physiopathology of tinnitus will lead to new treatments.SCOPUS: re.jinfo:eu-repo/semantics/publishe

Sinonasal mucosal melanomas

SummaryObjectivesSinonasal mucosal melanomas account for approximately 1% of all melanomas. These tumors are particularly aggressive, with a recurrence rate between 37 and 54% and a 5-year survival rate between 20 and 46%. Metastases are frequent. The main objective of this study was to analyze all of our cases of sinonasal mucosal melanomas and determine any prognostic factors.Patients and methodsAll our cases of sinonasal mucosal melanoma over a period of 10 years were included. Ten cases were analyzed. The mean age was 71 years (range: 61–85 years) for seven women and three men. The clinical, radiological, anatomopathological, and surgical data as well as the characteristics of disease progression were analyzed. These data were compared to those reported in the literature.ResultsThe mean follow-up was 36.3 months (range: 2–96 months). The 5-year overall survival was 40%. Seven patients developed local recurrences after a mean follow-up of 16 months (range: 2–27 months) with associated metastases in three cases. Analysis of the prognostic factors showed that tumors classified as T1 and limited to the nasal fossae had a better prognosis.ConclusionSinonasal mucosal melanomas are rare tumors with a high mortality rate. Treatment of these tumors requires extensive surgical treatment associated with external radiotherapy

Phase I study of ribociclib plus cetuximab in patients with recurrent or metastatic squamous cell carcinoma of the head and neck

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