Les corps étrangers en ORL: expérience de dix ans

Les corps étrangers (CE) représentent une pathologie fréquemment rencontrée en pratique ORL d'urgence. Ils peuvent constituer une urgence vitale par leur aspect ou leur siège. Nous présentons le bilan de dix ans sur la prise en charge des CE de la sphère ORL avec une revue de la  littérature. Il s'agit d'une étude rétrospective entre Janvier 2004 et Décembre 2013, incluant tous les cas de CE des voies aéro-digestives supérieures et auriculaires colligés dans le service d'ORL au CHU Mohammed VI de Marrakech au Maroc. Sur les 1317 cas de CE de la sphère ORL colligés durant cette période, 80,48% concernaient les enfants. Le sex-ratio était de 1,5. L'âge moyen était de 12,92 ans. Les CE oesophagiens étaient les plus fréquents (47,53%). Les complications ont été rencontrées dans 11,69% des cas. Les CE dans la sphère ORL restent fréquents en pratique quotidienne surtout chez les enfants. Leur prise en charge nécessite une intervention rapide avec un matériel adapté et des médecins entrainés. La prévention reste la meilleure solution

CORPS ETRANGER VEGETAL INTRA-ORBITAIRE : A PROPOS D’UN CAS

Foreign vegetative bodies of the orbit are rare. They are often missing read and they can lead to potentially serious orbital and intra skull complications. We report the case of a ten years old child suffering right orbital traumatism caused by a chip of wood. He has consulted the doctor a month later for orbital cellulitis associated with skin fistula. The scanner has shown a right orbital foreign body. The ablation orbitotomy earlier piece of wood with a suitable antibiotic treatment has allowed a clinical improvement with visual recovery. The notion of orbital traumatism as well as the inflammatory, secondary orbital syndrom should suspect the presence of a foreign intra-orbital body, urging complementary medical examinations.Les corps étrangers végétaux de l’orbite sont rares. Ils sont souvent méconnus, pouvant entrainer des complications orbitaires et intracrâniennes potentiellement graves. Nous rapportons l’observation d’un enfant de 10 ans victime d’un traumatisme orbitaire droit provoqué par un morceau de bois. Il consulte 1 mois plus tard pour une cellulite orbitaire associée à une fistule cutanée. Le scanner a montré la présence d’un corps étranger orbitaire droit. L’ablation par orbitotomie antérieure du fragment de bois associée à un traitement antibiotique adapté a permis une amélioration clinique avec récupération visuelle. La notion de traumatisme orbitaire et un syndrome inflammatoire orbitaire secondaire doivent faire suspecter la présence d’un corps étranger intra-orbitaire et encourager la réalisation d’examens complémentaires en urgence pour une meilleure prise en charge

Retropharyngeal Abscess in Adults: Five Case Reports and Review of the Literature

Retropharyngeal abscesses are rare in adults. They occur mostly in immunocompromised patients or as a foreign body complication. We report 5 cases of retropharyngeal abscess collected in the ENT Department of CHU Mohammed VI of Marrakech, during a two-year period (December 2008 to December 2009). Local trauma by foreign body ingestion was the aetiology in four patients. The presenting symptoms, for all patients, were fever, odynophagia, torticollis, and trismus, and the clinical examination showed bulging of the posterior wall of the oropharynx. The radiography of cervical spine showed prevertebral thickening in all cases, this thickening was associated with an aspect of vertebral lysis of the fourth cervical vertebra in one case. A CT scan was performed in all our cases and showed features of retropharyngeal abscess which was associated, in one case, with spondylodiscitis. The biological assessment found one case of diabetes. The intradermal reaction to the tuberculin was clearly positive in one case. Endobuccal abscess puncture was practiced in 4 cases; only one organism was identified by culture: Staphylococcus aureus treatment was based on triple intravenous antibiotics and anti-Koch's therapy (in one case), and the surgical drainage under general anesthesia was also performed in the case of the diabetes patient which required also the correction of hyperglycemia in intensive care unit. The outcome was good in all our patients. The diagnosis of retropharyngeal abscess can be difficult and one must seek a comorbidity; a tuberculosis aetiology must be considered in countries with a high prevalence. The management of these cases is based on antibiotics and surgical drainage

Capillary Hemangioma of the Middle Ear: One Case Report and Review of the Literature

Hemangiomas are rare benign vascular tumors; there are several types including the capillary hemangiomas, we present the case of an exceptional localization of capillary hemangioma in the middle ear. We report the case of a 60-year-old female which consults for episodes of pulsatile tinnitus, otorragies, and hearing loss of the left ear. The clinical examination revealed a reddish polypoid mass in the left external auditory canal, the radiological tests showed a vascular mass in the middle left ear. The tumor was surgically removed, the histological study revealed a capillary hemangioma. The incidence of hemangiomas in the temporal bone, especially in the middle ear, is exceptional. Medical imaging guides to the vascular nature of these tumors that make confusion with other vascular tumors such as tympanic paragangliomas. The management is often surgical and the final diagnosis is histological