Les ostéomes sinusiens

Introduction: Osteoma of the paranasal sinus is a rare and benign tumor that develops slowly when therapy becomes mandotory, it is necessarily surgical. Results: We report 38 cases of osteoma, operated by external approach in 36 cases and endonasal approach in 2 cases. The osteoma involved the frontal sinus in 27 cases, ethmoid in 5 cases and the junctional zone in 6 patients. The follow up patients was correctly done in 36 cases. The functional results were satisfying without recurrence in 34 of them (follow-up: 18 months). In the other 2 patients a recurrence was diagnosed. Conclusion: sinus osteoma is a benign tumor. Symptomatic form does been treated by a surgery. The approach depends on the location of osteoma and CT-Scan may guide the choice   Key words: Osteoma, sinus, external approach, endonasal approach.

Implantation cochléaire et malformation de l’oreille interne

Les indications de l'implant cochléaire se sont élargies depuis 1995. La plupart des candidats à l'implant sont des enfants sourds profonds congénitaux. L'implant peut actuellement se discuter dans certains cas particuliers notamment chez des enfants présentant une malformation de l'oreille interne (vésicule unique, malformation de type Mondini, Mondini-like, dilatation de l'aqueduc du vestibule). Les risques sont chirurgicaux et infectieux : geyser à la cochléostomie, paralysie faciale, otoliquorrhée secondaire et méningite. Nous rapportons le cas d’une fille âgée de 4 ans et 8 mois qui a présenté suite à un traumatisme minime une surdité brutale totale bilatérale qui n’a pas récupéré sous traitement médical. L’audiométrie avait confirmé la surdité bilatérale et l’examen orthophonique a retrouvé un langage oral bien conservé. Une imagerie a été pratiquée mettant en évidence une dilatation bilatérale des aqueducs du vestibule et des sacs endolymphatiques avec un aspect normal de la cochlée et des canaux semi-circulaires. La patiente a bénéficiée d’une implantation cochléaire gauche avec des suites simples et un excellent résultat à 2 ans.Mots-clés : Implant cochléaire, malformation de l’oreille interne

Fibromatose desmoïde à localisation nasale

Introduction : Les fibromatoses desmoïdes sont des lésions histologiquement bénignes infiltrant les muscles et les aponévroses. Ces tumeurs siègent le plus souvent au niveau de la paroi abdominale et thoracique. La localisation cervicofaciale est rare. Observation : Nous rapportons le cas d’un nourrisson âgé de 1 an 9 mois qui a présenté une fibromatose desmoïde à localisation nasale. Le patient a été opéré par voie endonasale sous guidage endoscopique avec exérèse tumorale en monobloc. L’évolution a été favorable sans récidive pour un recul de 24 mois. Conclusion : Les fibromatoses desmoïdes correspondent à des proliférations fibreuses infiltrantes mais non métastasiantes. La chirurgie est le traitement de choix, toutefois ces tumeurs sont caractérisées par un risque de récidive imposant un suivi à long terme. Mots clés : Fibromatose desmoïde, cavité nasale, chirurgie

Mucocèle sphénoïdale bilatérale : a propos d’un cas

Les mucocèles sphénoïdales sont des formations pseudokystiques expansives, d’évolution lente, qui se développent au sein de la cavité sinusienne sphénoïdale. Elles possèdent la capacité d’éroder les parois osseuses et présentent une évolution pseudotumorale. Les rapports neuroméningés et orbitaires font la gravité de cette localisation sinusienne  la présentation clinique qui est souvent d’apparition retardée par rapport à la constitution de la mucocèle. L’imagerie (TDM et IRM) permet le diagnostic positif et le diagnostic différentiel avec certains processus développés au niveau de l’étage moyen de la base du crâne. La marsupialisation chirurgicale par voie endoscopique endonasale permet l’effondrement de la mucocèle.Mots-clés : mucocèle, sinus sphénoïda

La déhiscence du canal semi circulaire supérieur

Introduction : Superior semicircular canal dehiscence is a rare entity witch is recently described. The common symptom is pressure-induced vertigo.Patients and methods: we report 2 cases of superior semicircular canal dehiscence identified by computed tomography (CT) of the petrous bone in patients with mixed hearing loss and a normal tympanic membrane.Results: Superior semicircular canal dehiscence was bilateral in 1 patient.Mixed hearing loss with a normal tympanic membrane without vertigo was the presenting manifestation in all cases. Ultrahigh-resolution CT of the petrous bones with coronal and sagittal sections provided the diagnosis of superior semicircular canal dehiscence.Conclusion: Mixed hearing loss with a normal tympanic membrane should suggest superior semi circular canal dehiscence. Coronal and sagittal CT sections less than 1 mm in thickness establish the diagnosis.Key words : Superior semicircular canal, dehiscence, hearing loss

Unusual cause of severe toxic methemoglobinemia in an infant: a case report

Toxic methemoglobinemia is an uncommon blood disorder induced by exposure to certain oxidizing agents and drugs. In severe cases, this condition may rapidly lead to major cardiopulmonary compromise and constitutes an emergency requiring prompt recognition and early management. We report an unusual case of severe toxic methemoglobinemia following wide cutaneous application of a pomade containing benzocaine, resorcin, and oxyquinoline (Nestosyl®) in an infant

Ventricular Dysrhythmias Associated with Poisoning and Drug Overdose: A 10-Year Review of Statewide Poison Control Center Data from California

Background: Ventricular dysrhythmias are a serious consequence associated with drug overdose and chemical poisoning. The risk factors for the type of ventricular dysrhythmia and the outcomes by drug class are not well documented. Objective: The aim of this study was to determine the most common drugs and chemicals associated with ventricular dysrhythmias and their outcomes. Methods: We reviewed all human exposures reported to a statewide poison control system between 2002 and 2011 that had a documented ventricular dysrhythmia. Cases were differentiated into two groups by type of arrhythmia: (1) ventricular fibrillation and/or tachycardia (VT/VF); and (2) torsade de pointes (TdP). Results: Among the 300 potential cases identified, 148 cases met the inclusion criteria. Of these, 132 cases (89 %) experienced an episode of VT or VF, while the remaining 16 cases (11 %) had an episode of TdP. The most commonly involved therapeutic classes of drugs associated with VT/VF were antidepressants (33/132, 25 %), stimulants (33/132, 25 %), and diphenhydramine (16/132, 12.1 %). Those associated with TdP were antidepressants (4/16, 25 %), methadone (4/16, 25 %), and antiarrhythmics (3/16, 18.75 %). Drug exposures with the greatest risk of death in association with VT/VF were antidepressant exposure [odds ratio (OR) 1.71; 95 % confidence interval (CI) 0.705–4.181] and antiarrhythmic exposure (OR 1.75; 95 % CI 0.304–10.05), but neither association was statistically significant. Drug exposures with a statistically significant risk for TdP included methadone and antiarrhythmic drugs. Conclusions: Antidepressants and stimulants were the most common drugs associated with ventricular dysrhythmias. Patients with suspected poisonings by medications with a high risk of ventricular dysrhythmia warrant prompt ECG monitoring

Demonstration of 16QAM-OFDM UDWDM Transmission Using a Tunable Optical Flat Comb Source

International audience<p>A new approach for designing broad and flattened spectrum multicarriers optical sources is presented leading to a32 spectral lines source using a dual-arm Mach-Zehnder modulator (MZM) and a 41 spectral lines source from two-stage MZM.A modified simulated annealing-based optimization method isapplied to derive the necessary settings allowing the optical flat comb source (OFCS) to be ultraflat. The OFCS is mooted as a technology to enhance the overall capacity of an access optical network by increasing the number of WDM channels.Here, we demonstrate an ultra-dense WDM (UDWDM) trans-mission for application to passive optical networks (PON) with (11x12.5Gbps) Quadrature Amplitude Modulation (QAM) based on a 4b/s/Hz spectral efficiency orthogonal frequency division multiplex (16QAM-OFDM) transmitter and direct detection. We use an OFCS to generate the 11 subcarriers spaced by 6.25GHz, made of a two-stage MZM. We study the performance of 3 filtered channels in terms of error vector magnitude (EVM) in back-to-back (B-to-B) conditions and after propagation through 25km and 100km standard single mode fiber (SSMF).</p

Monitoring of dioxin-like, estrogenic and anti-androgenic activities in sediments of the Bizerta lagoon (Tunisia) by means of in vitro cell-based bioassays: contribution of low concentrations of polynuclear aromatic hydrocarbons (PAHs).

International audienceWe used an array of in vitro cell-based bioassays to assess dioxin-like, estrogenic and (anti-)androgenic activities in organic extracts of sediments from the Bizerta lagoon, one of the largest Tunisian lagoons subjected to various anthropogenic and industrial pressures. The sediments were sampled both in winter and summer 2006 in 6 stations differently impacted and in one reference station located in the seawards entrance of Ghar el Melh lagoon. Chemical analyses of the 16 priority PAHs showed that the sediments were low to moderately contaminated (2-537 ng/g dry weight). By using the estrogen- (MELN) and androgen-responsive (MDA-kb2) reporter cell lines, significant estrogenic and anti-androgenic activities were detected only in the Menzel Bourguiba (MB) site, the most contaminated site, both in winter and summer. By using 7-ethoxyresorufin-O-deethylase (EROD) induction in the fish PLHC-1 cell line after both 4 and 24 h of cell exposure, dioxin-like activities were detected in all analysed samples. Dioxin-like activities were higher after 4 h exposure, and varied according to the sites and the sampling season. While highly significant correlation was observed between bioassay- and chemical analyses-derived toxic equivalents (TEQs), PAHs accounted for only a small part (up to 4%) of the detected biological activities, suggesting that other readily metabolised EROD-inducing compounds were present. This study argues for the use of short time exposure to assess biological TEQs in low contaminated samples and provides new induction equivalent factors (IEF(4h)) for 16 PAHs in the PLHC-1 cell line. Finally, our results stress the need to further characterise the nature of organic chemical contamination as well as its long-term impacts on aquatic wildlife in the Bizerta lagoon