Germinal Center- Like Diffuse Large B cell Lymphoma of the Frontal Sinus Misdiagnosed as a Pott’s Puffy Tumor

Non-Hodgkin’s Lymphoma (NHL) of the frontal sinus is very rare and early diagnosis is usually made with some delay because of the non-specificity of the clinical presentation and overlapping with other diseases. We report herein the story of a 40-year-old man who presented to the outpatient clinic with pain and swelling of the forehead. The first diagnosis was a subacute rhinosinusitis mimicking a Pott’s puffy tumor. On the CT scan, there was a partial opacity of the left frontal sinus with osteomyelitis of the anterior and posterior tables of the frontal sinuses. He received broad-spectrum antibiotics and systemic glucocorticosteroids. He responded well to the treatment but the symptoms and signs relapsed at the completion of the treatment. A second CT scan was performed but no significant improvement was found compared with the first CT scan. As there was no pus coming from the middle meatus we decided to take specimen for bacteriological and histopathological examination during a therapeutic window. This was done via a supraciliary incision and frontal trephine. The final diagnosis was a diffuse large B cell lymphoma, germinal center B cell like subtype. He underwent 6 cycles of chemoimmunotherapy with R-CHOP and central nervous system prophyllaxis via intrathecal methotrexate. 2 years after the initiation of the treatment the patient is still free of symptom and disease confirmed by serial PET scans

Effect of CO 2 Laser Stapedotomy on Tinnitus in Patients with Otosclerosis and Predictive Role of Audiological Features

Objective: To evaluate the effect of CO 2 laser stapedotomy and analyze the influence of audiometric factors on the evolution of tinnitus. Study design: Retrospective case series. Setting: Tertiary referral center. Patients: 151 ears (139 patients, 17 years to 74 years) underwent Laser-Intervention: CO 2 laser stapedotomy procedure for otosclerosis. Results: The incidence of preoperative tinnitus in patients with otosclerosis in our cohort is 51.7%, with a complete disappearance in 61% of the cases. We haven't found any statistically significant results between the resolution of tinnitus after surgery and the hearing result pre and postoperatively (BC, AC, ABG, SRT, and WRS). On the other hand, we haven't found any audiometric predictive factors of the effects of surgery on tinnitus. We have seen a tendency to have more tinnitus regarding the number of laser shots, but the results aren't statistically significant. Conclusion: Stapedotomy may also improve tinnitus in most of the patients with a diagnostic of otosclerosis. The tinnitus status does not appear to be related to the preoperative or postoperative audiometric results

Effect of CO² laser stapedotomy on tinnitus in patients with otosclerosis and predictive role of audiological features

Objective: To evaluate the effect of CO 2 laser stapedotomy and analyze the influence of audiometric factors on the evolution of tinnitus. Study design: Retrospective case series. Setting: Tertiary referral center. Patients: 151 ears (139 patients, 17 years to 74 years) underwent Laser-Intervention: CO 2 laser stapedotomy procedure for otosclerosis. Results: The incidence of preoperative tinnitus in patients with otosclerosis in our cohort is 51.7%, with a complete disappearance in 61% of the cases. We haven't found any statistically significant results between the resolution of tinnitus after surgery and the hearing result pre and postoperatively (BC, AC, ABG, SRT, and WRS). On the other hand, we haven't found any audiometric predictive factors of the effects of surgery on tinnitus. We have seen a tendency to have more tinnitus regarding the number of laser shots, but the results aren't statistically significant. Conclusion: Stapedotomy may also improve tinnitus in most of the patients with a diagnostic of otosclerosis. The tinnitus status does not appear to be related to the preoperative or postoperative audiometric results

Evaluation of the transmastoid plugging approach for superior semicircular canal dehiscences: a retrospective series of 30 ears.

The classical surgical approach for superior semicircular canal dehiscences (SSCD) is via the extradural middle cranial fossa. This pathway is used to resurface or to plug the SSC. In this paper, we present long-term data on an alternative route: the transmastoid pathway. The predictive factors for a successful surgery are equally presented in this paper. Thirty reports of patients operated between September 2007 to January 2020 were analysed. SSCD was confirmed by the association of concordant complaints, audiometric data, cervical vestibular evoked myogenic potentials (cVEMP) responses and computerized tomography findings. Before and after surgery, the following factors were analysed: auditory and vestibular subjective symptoms, Tullio phenomenon, pure-tone audiometry thresholds for air and bone conduction, air-bone gap, cVEMP threshold, and computerized tomography data, for instance the size of the dehiscence. The follow-up is 21 months on average. The transmastoid approach significantly improves all symptoms (although there were less probing results for the vestibular symptoms). Objectively, we can observe, a closure of the audiometric air-bone gap on the low frequencies and an improvement in the cVEMP. The only correlation that was identified was between the preoperative cVEMP results and the postoperative air conduction. The originality of this study is the long postoperative follow-up. It allowed us to evaluate the symptoms in the long term and to determine a predictive factor of postoperative complication, which has not yet been described until today.The transmastoid plugging technique is safe and effective. Additional long-term data with a larger cohort are needed to confirm our results and correlation studies

Auditory Neuropathy Spectrum Disorders: From Diagnosis to Treatment: Literature Review and Case Reports.

Auditory neuropathy spectrum disorder (ANSD) refers to a range of hearing impairments characterized by deteriorated speech perception, despite relatively preserved pure-tone detection thresholds. Affected individuals usually present with abnormal auditory brainstem responses (ABRs), but normal otoacoustic emissions (OAEs). These electrophysiological characteristics have led to the hypothesis that ANSD may be caused by various dysfunctions at the cochlear inner hair cell (IHC) and spiral ganglion neuron (SGN) levels, while the activity of outer hair cells (OHCs) is preserved, resulting in discrepancies between pure-tone and speech comprehension thresholds. The exact prevalence of ANSD remains unknown; clinical findings show a large variability among subjects with hearing impairment ranging from mild to profound hearing loss. A wide range of prenatal and postnatal etiologies have been proposed. The study of genetics and of the implicated sites of lesion correlated with clinical findings have also led to a better understanding of the molecular mechanisms underlying the various forms of ANSD, and may guide clinicians in better screening, assessment and treatment of ANSD patients. Besides OAEs and ABRs, audiological assessment includes stapedial reflex measurements, supraliminal psychoacoustic tests, electrocochleography (ECochG), auditory steady-state responses (ASSRs) and cortical auditory evoked potentials (CAEPs). Hearing aids are indicated in the treatment of ANSD with mild to moderate hearing loss, whereas cochlear implantation is the first choice of treatment in case of profound hearing loss, especially in case of IHC presynaptic disorders, or in case of poor auditory outcomes with conventional hearing aids