Mise au point d'une hypoacousie

Hypoacusis is a common complaint among young and older patients. This common symptom addressed in general medicine is often but not always due to a benign disease ;sometimes, lifethreatening emergencies occur and must be recognised. Moreover, hypoacusis is known to lead to social isolation and nervous breakdown among old people, and to slow down speech learning among children. Unfortunately, the general practitioner is not tooled to assess accurately the hard-of-hearing patient, but nevertheless, he can get easily a first differential diagnosis. First of all, comprehensive history and clinical exam can be quickly carried out. In particular cases, specialised investigations and ENT consultations are indicated. That is why this article is built to answer basic questions to frequent clinical problems involving a reduced audition, and to suggest first-line recommendations.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Oto-rhino-laryngologie & chirurgie cervico-faciale

MED5 - MEDC019info:eu-repo/semantics/published

Oto-rhino-larynogologie et chirurgie cervico-faciale

MED5, MEDC019info:eu-repo/semantics/published

Basal cell carcinoma of the external auditory canal

Carcinomas of the external auditory canal are rare, nevertheless they are associated with a relatively poor prognosis. Among these tumours, basal cell carcinomas are less frequent than squamous cell carcinomas. Anyway, it is difficult to determine if their prognosis is better, as in other localizations on the body. We reviewed six patients, presenting locally advanced basal cell carcinomas of the external auditory canal and considered the history of their disease, the treatment procedures and final oncological outcome. Four of the patients died of the disease within five years from surgery. They presented local recurrences even after radical surgical excision in free tissue margins. From these findings we have the impression that basal cell carcinoma of the external auditory canal behave, even after radical surgery, as an aggressive tumour associated with a really poor prognosis.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

New fitting rules for dead region patients

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Importance of clinical and radiological follow-up in head and neck cancers

Problems/objectives: To evaluate the relevance of routine head and neck ultrasonography (US), computed tomography (CT), chest X-ray, and standard clinical examination for the early detection of recurrences, second primary tumours, and distant metastases in the follow-up of patients treated for head and neck cancers. Methodology: Retrospective cohort study. Results: One hundred ninety-five patients were reviewed. Seventy-one recurrences appeared during the follow-up period. Five recurrences were diagnosed during head and neck US and CT. Sixty-four recurrences were diagnosed based on patients' complaints or standard clinical examination. Two lung malignancies were diagnosed during the annual chest X-ray. Conclusion: Systematic head and neck US and CT exams revealed recurrent cancers with poor efficiency and should be performed only after clinical suspicion of recurrence or second primary tumours. The value of an annual chest X-ray remains debatable. Routine clinical follow-up is clearly crucial for the detection of early recurrences and second primary tumours.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Superior vena cava syndrome caused by intrathoracic goitre with hyperthyroidism

info:eu-repo/semantics/publishe

Hearing aid and Koebner phenomenon

Koebner phenomenon may be related to frictions of a hearing aid on the external ear and retroauricular skin.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Mediastinal tracheostomy: Unilateralresection of the anterior chest wall

Since the first reliable mediastinal tracheostomy described by Grillo et al. in 1966, many new techniques have been described in order to reduce the number of complications. We here report the case of a 55-year-old man who was referred for surgery with post-radiochemotherapy recurrence of a double neoplasm of the pharyngolarynx extending to the proximal trachea and the medial part of the oesophagus. Through a median sternotomy, a pharyngolaryngoesophagectomy was performed with an extended tracheal resection. The reconstruction of the upper digestive tract was performed with a gastric pull-up. The mediastinal tracheostomy was performed with a pectoralis major muscular flap through a right unilateral resection of the manubrium, the right clavicular head and the right first and second costal cartilages. Historically, the mediastinal tracheostomy was performed through a large bilateral resection of the anterior chest wall, in order to prevent the tension on the tracheocutaneous sutures. Nowadays, with the possibility of various pedicled flaps, bilateral resection no longer seems to be necessary. This unilateral resection leads to a reduction in post-operative sequelae.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Overlay versus underlay tympanoplasty. Comparative study of 122 cases

Introduction: In tympanoplasty, the most common two techniques for positioning the graft relative to the remnant of both the tympanic membrane and of the annulus, are the "overlay" and the "underlay" techniques. Each technique has advantages and disadvantages. Methods: One hundred and twenty-two cases over the age of 8 years who had undergone a tympanoplasty for tympanic membrane perforation secondary to chronic otitis media were included. All patients had a minimum 3-month postoperative otoscopic and audiometric follow-up. Results: of 122 cases, 115 tympanoplasties (94 %) were anatomically successful. At frequencies of 0.5, 1, 2, and 4 kHz, the mean air-bone gap improved significantly from 21.7 dB preoperatively to 8.4 dB postoperatively giving a mean gain of 13.3 dB. Conclusion: In our series the underlay or overlay positioning of the graft does not significantly influence the rate of postoperative perforations or complications with the exception of epithelial pearls, which occur significantly more frequently following the overlay technique for perforations that require fibro-epidermal cleaving across a large area.SCOPUS: ar.jinfo:eu-repo/semantics/publishe