Carcinome epidermoïde du larynx chez la femme

Le cancer du larynx est assez rare chez la femme. Cependant, il risque d’être en recrudescence à cause de l’augmentation du tabagisme féminin. Peu de travaux se sont consacrés à rechercher les spécificités du cancer du larynx chez la femme.But: Analyser le profil épidémiologique et clinique des femmes porteuses d’un carcinome épidermoïde du larynx et dégager les caractéristiques thérapeutiques, évolutives et les facteurs pronostiques chez cette population.Méthodes: étude rétrospective portant sur 50 femmes prises en charge pour un carcinome épidermoïde du larynx sur une période de treize ans (1994-2006).Résultats : L’âge moyen de nos patientes était de 63,5 ans. L’intoxication tabagique était retrouvée chez 32,6% des patientes. Chez 30% de nos patientes aucun facteur de risque n’a été retrouvé. Les signes cliniques étaient dominés par la dysphonie suivie de la dyspnée et la dysphagie. Les tumeurs prenaient naissanceau dépend de l’étage glottique dans 55,8% des cas. Nous avons relevé que 60,4% des tumeurs étaient vus à un stade évolué T3-T4 et que 95,3% des tumeurs étaient initialement classées N0. La chirurgie a été pratiquée chez 47,5% des patientes tandis que 16,2% ont reçu une radio-chimiothérapie. La survie globale cumulée était de 78,8% à 3 ans et de 73,5% à 5 ans.Conclusion : L’absence des facteurs de risque classiques chez un grand nombre de nos patientes laisse supposer le rôle d’autres facteurs étiopathogéniques dans la genèse du cancer du larynx chez la femme. Toute dysphonie chez la femme doit être explorée même en l’absence de facteurs de risque. La prise en charge et le pronostic semblent superposables à celui de l’homme.Mots clés : Tumeur – Larynx – Femme – Epidémiologie – TabagismeLaryngeal cancer is quite uncommun in women. However, it may be on the rise due to the increase in smoking among women. Few studies have been devoted to find the specifics of laryngeal cancer in women.Purpose: to analyze the epidemiological and clinical profile of squamous cell carcinoma of the larynx in women, and to identify therapeutic characteristics and prognostic factors in this population.Methods: retrospective study of 50 womens treated for squamous cell carcinoma of the larynx over a period of thirteen years (1994- 2006).Results: The mean age of our patients was 63.5 years. The tobacco abuse was found in 32.6% of patients. In 30% of our patients no risk factors were found. Clinical signs were dominated by dysphonia followed by dyspnea and dysphagia. Primary tumor was localized in glottis in 55.8% of cases. We found that 60.4% of tumors were seen at an advanced stage T3-T4 and 95.3% of the tumors were initially classified N0. The surgery was performed in 47.5% of patients, while 16.2% received chemoradiotherapy. The cumulative overall survival was 78.8% at 3 years and 73.5% at 5 years.Conclusion: The absence of conventional risk factors in a large number of our patients suggests the role of other etiologic factors in the genesis of laryngeal cancer in women. Every dysphonia in women should be explored even in the absence of risk factors. The  management and prognosis seem congruent with that of man.Key words: Tumor-larynx-women-epidemiology-smokin

Anatomie du nerf laryngé externe et ses applications chirurgicales

Objectif : La lésion de la branche externe du nerf laryngé supérieur (BeNLS) , non rare lors de la chirurgie thyroïdienne, est responsable de modifications de la voix et de troubles de la déglutition. Mais ses différentes variantes anatomiques ainsi que les faibles taux de son identification ont découragé les chirurgiens de son repérage systématique.Le but de notre travail est de faire une description anatomique des variantes de la BeNLS , d’estimer la fréquence des nerfs à risque et de décrire les techniques chirurgicales de son identification pour proposer une approche systématique de sa préservation.Matériel et méthodes: Il s’agit d’une étude prospective portant sur 10 patients ayant eu une chirurgie thyroïdienne et chez qui on a procédé à un repérage systématique de la BeNLS dans l’espace avasculaire de Reeve. On a utilisé la classification de Cernea pour regrouper les variations anatomiques rencontrées.Résultats : On a procédé à la dissection de 13 nerfs. Le taux  d’identification de la BeNLS était de 84% , 38% sont de Type 2a , 46% sont de Type 2b. Des complications ont été notées chez 3 patients dont 2 qui présentent une BeNLS de Type Ni.Conclusion : On pense que la variante anatomique de la BeNLS de type 2 présente un risque de blessure car le chirurgien manipule le pédicule supérieur au niveau du centimètre critique situé au-dessus du pôle supérieur de la thyroïde. Le sous-type 2b , le plus fréquent dans notre série , est une variante à haut risque. L’identification du nerf lors de la chirurgie thyroïdienne est la solution de choix.Mots-clés : Branche externe du nerf laryngé supérieur, anatomie, muscle crico-thyroïdien, chirurgie thyroïdienne, voix

Evidence for an abundant old population of Galactic ultra long period magnetars and implications for fast radio bursts

Two recent discoveries, namely PSR J0901-4046 and GLEAM-X J162759.5-523504.3 (hereafter GLEAM-X J1627), have corroborated an extant population of radio-loud periodic sources with long periods (76 s and 1091 s respectively) whose emission can hardly be explained by rotation losses. We argue that GLEAM-X J1627 is a highly-magnetized object consistent with a magnetar (an ultra long period magnetar - ULPM), and demonstrate it is unlikely to be either a magnetically or a rotationally-powered white dwarf. By studying these sources together with previously detected objects, we find there are at least a handful of promising candidates for Galactic ULPMs. The detections of these objects imply a substantial number, $N \gtrsim 13000$ and $N \gtrsim 500$ for PSR J0901--4046 like and GLEAM-X J1627 like objects, respectively, within our Galaxy. These source densities, as well as cooling age limits from non-detection of thermal X-rays, Galactic offsets, timing stability and dipole spindown limits, all imply the ULPM candidates are substantially older than confirmed Galactic magnetars and that their formation channel is a common one. Their existence implies widespread survival of magnetar-like fields for several Myr, distinct from the inferred behaviour in confirmed Galactic magnetars. ULPMs may also constitute a second class of FRB progenitors which could naturally exhibit very long periodic activity windows. Finally, we show that existing radio campaigns are biased against detecting objects like these and discuss strategies for future radio and X-ray surveys to identify more such objects. We estimate that ${\cal O}(100)$ more such objects should be detected with SKA-MID and DSA-2000.Comment: 22 pages, 10 figures. Published in MNRA

Application of the Fisher-Rao metric to ellipse detection

The parameter space for the ellipses in a two dimensional image is a five dimensional manifold, where each point of the manifold corresponds to an ellipse in the image. The parameter space becomes a Riemannian manifold under a Fisher-Rao metric, which is derived from a Gaussian model for the blurring of ellipses in the image. Two points in the parameter space are close together under the Fisher-Rao metric if the corresponding ellipses are close together in the image. The Fisher-Rao metric is accurately approximated by a simpler metric under the assumption that the blurring is small compared with the sizes of the ellipses under consideration. It is shown that the parameter space for the ellipses in the image has a finite volume under the approximation to the Fisher-Rao metric. As a consequence the parameter space can be replaced, for the purpose of ellipse detection, by a finite set of points sampled from it. An efficient algorithm for sampling the parameter space is described. The algorithm uses the fact that the approximating metric is flat, and therefore locally Euclidean, on each three dimensional family of ellipses with a fixed orientation and a fixed eccentricity. Once the sample points have been obtained, ellipses are detected in a given image by checking each sample point in turn to see if the corresponding ellipse is supported by the nearby image pixel values. The resulting algorithm for ellipse detection is implemented. A multiresolution version of the algorithm is also implemented. The experimental results suggest that ellipses can be reliably detected in a given low resolution image and that the number of false detections can be reduced using the multiresolution algorithm

Locally recurrent subcutaneous and muscular hydatid cysts of the leg: an unusual case report

We report a rare case of 50-year-old Moroccan woman with local recurrence of a subcutaneous hydatid cyst in proximity to the medial surface of the tibia and another cyst at the tibialis posterior muscle in the absence of liver, lung und spleen involvement. The first surgery was done in another hospital three years ago; no adjuvant treatment was performed after surgery. Recurrence was diagnosed according to the MRI appearance, serological and pathological findings. The patient underwent complete excision of the subcutaneous cyst with two centimeters of the medial gastrocnemius muscle; the tibialis posterior muscle cyst was intraoperatively drained and irrigated with scolicidal agent as it was next to the posterior tibial pedicle. A periopertive anthelmintic chemotherapy was administered. Two years after the patient showed no recurrence. This case report and literature review describe an approach to the diagnosis and management of this pathological entity