Hemangiomes Larynges De L\'adulte A Propos De 9 Cas

L\'hémangiome laryngé de l\'adulte est extrêmement rare et présente des spécificités histologiques et évolutives. Il peut représenter un véritable défi thérapeutique. Les auteurs rapportent 9 cas d\'hémangiomes laryngés de l\'adulte colligés rétrospectivement sur une période de 20 ans (1984- 2004). Il s\'agissait de 6 hommes et 3 femmes, âgés en moyenne de 46 ans (17 à 75 ans). Les signes d\'appel étaient la dysphonie dans tous les cas, associée à des hémorragies de sang rouge extériorisées par voie buccale chez 3 patients. Le diagnostic reposait dans tous les cas sur la laryngoscopie directe qui retrouvait une tuméfaction glottique de couleur bleutée, à surface lisse. Une biopsie avec examen anatomo-pathologique a été systématique. Tous les patients ont bénéficié d\'une exérèse instrumentale de la masse par voie endoscopique, avec hémostase locale. Deux récidives ont été notées, pour lesquels une seconde exérèse instrumentale par voie endoscopique a été réalisée avec une évolution favorable. Le recul moyen était de 9 ans.The adult laryngeal hemangioma is extremely rare and presents histological and evolutionary particularities. It can represent a real therapeutic challenge. The authors report 9 cases of adult laryngeal hemangiomas over a period of 20 years (1984-2004). It was about 6 man and 3 women, old on average of 46 years ( 17 - 75 years). The signs of appeal were the dysphonia in every case, associated to bleedings of red blood exteriorized with oral way in 3 cases. Diagnosis based in every case on the direct laryngoscopy which found a glottic tumefaction of bluish colour, in smooth surface. A biopsy with anatomo-pathological exam was realized in every case. All the patients benefited from an instrumental excision of the mass by endoscopic way, with local haemostasis. Two recurrences were noted, which benefited from a second endoscopic instrumental excision, with a favorable evolution. Average follow up was of 9 years. Journal Tunisien d\'ORL et de chirurgie cervico-faciale Vol. 16 2006: pp. 5-

Controle des variations hemodynamiques secondaires a la microlaryngoscopie en suspension. [Control of hemodynamic variations secondary to suspension microlaryngoscopy]

The objective was to evaluate the clinic interest of the esmolol in the attenuation of the hemodynamic response to suspension microlaryngoscopy (mls). It was a prospective, randomized and double blind study, having included 29 patient ASA II and III, distributed in two groups, having received respectively before laryngoscopy: group A (n = 15), esmolol in intravenous (i.v.) at the dose of 150 micrograms.kg-1 and DS group (n = 14), 10 ml of normal saline at 0.9%. Has been achieved a general anaesthesia i.v. based on propofol, fentanyl and atracurium. After tracheal intubation, it has been assured an artificial ventilation. The two groups were comparable for the demographic and anesthetic characteristics. A significant decrease of the mean arterial pressure (-11%) and of the prp (product systolic arterial pressure heart rate) have been raised during the mls, in the group esmolol, whereas the variations of the cardiac frequency were comparable. In order to assure a better hemodynamic control during the mls, it seems important, in addition to the adjustment of the recommended dose of esmolol, to cover the whole duration of the endoscopic act by a continuous drip

Les Microcarcinomes papillaires de la thyroide a propos de 37 cas

No Abstract. Journal Tunisien d\'ORL et de chirurgie cervico-faciale Vol. 17 2006: pp. 16-1