Residual Fistula of Fourth Branchial Arch Anomalies and Recurrent Left-Side Cervical Abscess: Clinical Case and Review of the Literature

Congenital fourth branchial arch anomalies are uncommon entities. Most of these anomalies are diagnosed in childhood. The majority of cases occur on the left side. The clinical presentation of these anomalies varies with age. A respiratory distress is the usual clinical presentation in neonates, cervical cutaneous fistulas in late childhood or acute suppurative thyroiditis. Multiples diagnostic options have been described with different modalities of treatment. The majority of cases of fourth branchial arch anomalies are described only in case reports. We report a clinical case of recurrent cervical abscess in a young woman due to a residual fistula of fourth branchial arch

Variations de la production nasal de monoxyde d'azote (NO) dans la rhinosinusite chronique

Nous avons mesuré les variations de production nasale de monoxyde d'azote (NO) avant et après traitement chirurgical de 53 patients souffrant de rhinosinusite chronique (RSC) avec polypose ethmoïdale. Des corrélations avec les signes cliniques et para-cliniques ont été recherchées. La production nasale de NO diminue significativement en fonction de l'aggravation du stade de la polypose et chez les asthmatiques. La production nasale de NO a été significativement augmentée après l'opération. Ces valeurs restent cependant inférieures à celle du groupe témoin. Il n'y a pas de corrélation entre la production de NO nasal et l'obstruction nasale, la sévérité de l'inflammation, l'éosinophilie, l'olfactométrie, la rhinomanométrie, la présence d'une allergie ou du tabagisme. L'augmentation de la production nasale de NO après chirurgie endoscopique n'est pas le reflet de la gravité de l'inflammation rhinosinusienne préopératoire

Residual Fistula of Fourth Branchial Arch Anomalies and Recurrent Left-Side Cervical Abscess: Clinical Case and Review of the Literature

Congenital fourth branchial arch anomalies are uncommon entities. Most of these anomalies are diagnosed in childhood. The majority of cases occur on the left side. The clinical presentation of these anomalies varies with age. A respiratory distress is the usual clinical presentation in neonates, cervical cutaneous fistulas in late childhood or acute suppurative thyroiditis. Multiples diagnostic options have been described with different modalities of treatment. The majority of cases of fourth branchial arch anomalies are described only in case reports. We report a clinical case of recurrent cervical abscess in a young woman due to a residual fistula of fourth branchial arch

Recurrent Complete Pharyngo-Oesophageal Stricture Treated by Multidisciplinary Anterograde-Retrograde Endoscopic Dilation

Complete pharyngo-oesophageal stricture (PES) after radiotherapy for head and neck cancer is a relatively rare and difficult complication to manage. Historically this condition has been treated surgically, but endoscopic approaches are now available. We present a 61-year-old man with an epidermoid carcinoma of the supraglottic stage and a micro-invasive epidermoid carcinoma of the oropharynx treated surgically and subsequently by adjuvant radiotherapy. Eight months after the end of the radiotherapy, a complete PES was diagnosed and treated with a combined anterograde-retrograde endoscopic dilation (CARD). The procedure was performed using a transoral anterograde progression with a rigid pharyngoscope and a retrograde progression with an extra-slim nasal endoscope using the percutaneous gastrostomy already in place. Using both transillumination and direct visualisation from both sides of the complete stenosis patency was restored between the neopharynx and the oesophagus. Despite the use of an endoprosthesis, the complete PES recurred and the technique had to be performed a second time. Illustrating the complexity of the case different types of endoprosthesis and several dilations had to be performed for our patient to achieve and maintain a normal oral intake. This case report illustrates that even in complicated recurrent radiation-induced complete PES a CARD can be performed safely and successfully using different types of endoprosthesis

Sarcoidosis of the submandibular gland: A systematic review

INTRODUCTION: Submandibular gland sarcoidosis is rare and little is known about its clinical presentation besides the usual neck swelling. The aim of the study was to extract clinical knowledge on submandibular sarcoidosis from the literature. METHODS: A systematic review was performed using a search in Medline with the key-words "sarcoidosis," "submandibular," "submaxillary." RESULTS: Forty-six articles fitting the search criteria were found, whereas 31 had to be excluded because they did not report submandibular gland sarcoidosis. Twenty cases of submandibular gland sarcoidosis were considered suitable for analysis. Almost all reported cases concerned female patients. In some cases submandibular gland's swelling is the first and only manifestation of the disease. CONCLUSION: Sarcoidosis should be considered in the differential diagnosis of all progressive and painless swellings of the submandibular gland, especially in women. Rarely, it may be the first manifestation of the disease

Greffes trachéales : options actuelles

A critical review of publications on tracheal reconstruction is presented. The extent of the resection defect in terms of horizontal circumference or longitudinal extension determines the difficulty of the reconstruction. To allow a valid comparison, a classification of tracheal defects is proposed. The reconstruction materials can be subdivided into synthetic grafts, autografts, allografts, and bioengineering constructs. Reconstruction of tracheal defects greater than half of the tracheal length was not possible until recently. Numerous publications on animal experimental techniques, and rare human case reports show few successful outcomes. During the last five years, new reconstructive options have emerged: autograft of composite flaps mimicking tracheal architecture and bioengineered tracheal constructs