INTRODUCTION:Chondrosarcomas are cartilaginous tumors that range from low-grade tumors with low metastatic potential to high-grade aggressive tumors with premature and high metastatic rate. Low-grade types have few karyotype abnormalities and are near-diploid, while high-grade chondrosarcomas originate from complex karyotypes and are aneuploid. The most common karyotype aberrations found include 12q13-15 and 9p21 rearrangements. Here, it is presented a case of chondrosarcoma of the hyoid bone with its image, surgical procedure and pathological correlation as well as a review of the literature.CASE PRESENTATION:A sixty-three year old man presented with a large cervical mass located at submental level. The CT scan revealed a voluminous and well-limited mass of 5 x 4 x 3 cm located in the suprahyoid region. The operative finding revealed a grade 2 chondrosarcoma originating from the hyoid bone.DISCUSSION:Chondrosarcoma of the. hyoid bone is a rare pathology, thus making it difficult to diagnose. Fine needle biopsies have high diagnostic accuracy, although correct grading is only obtained 46% of the time. CT scan is the golden standard to characterize tumor extension and origin. Surgical excision is the treatment of choice for chondrosarcoma.
INTRODUCTION:Contrary to osteomas and exostosis of the external ear canal, middle ear osteomas are rare benign tumors that are usually revealed by progressive hearing loss.CASE REPORT:We here report the case of 56-year-old woman who had a left ear conductive hearing loss. A CT-scan showed a bone-density tumor in the left posterior epitympanum, hanging up to the tegmen tympani. A surgical middle ear exploration showed an epitympanic osteoma, confirmed by a histological exploration. The tumor was left in place and an ossicular prosthesis was inserted, which permitted a significant gain in the audiogram air-bone gap.DISCUSSION:Middle ear osteomas are rare benign tumors (31 cases described from 1964), with male preponderance (sex ratio: 1.75). They always present with a hearing loss, and the diagnosis is made by CT-scan. The treatment is surgical in cases of significant discomfort and generally produces a good improvement in symptoms.
A male patient with post lingual hearing loss was implanted at 16 years of age with a Nucleus cochlear implant (Cochlear) in his left ear. Twenty two years later, he developed a cholesteatoma in relation to the mastoid portion of the facial nerve and in contact with the electrodes array. The cholesteatoma was removed and the ear canal reconstructed. There was no post-operative facial palsy and the cochlear implant was preserved. Although cholesteatoma is a rare complication of the cochlear implant surgery, it still can occur and can be a source of potential damage to the implant. The origin of this late-presenting complication could be excessive bone drilling associated with the pressure caused by the loop of the electrodes array on the posterior canal wall. Implanted patients must have a close and particular long-term follow-up, especially when a surgical breach of the canal wall or a tear of the tympanic membrane have occurred during surgery, as well as in those patients in whom excessive thinning-out of the posterior meatal wall was done.
INTRODUCTION:The schwannoma of the glossopharyngeal nerve is a rare etiology among the tumor masses developed in the parapharyngeal space.CASE REPORT:We report the case of a 33 years old woman in whom a large schwannoma of the left glossopharyngeal nerve was discovered incidentally on a brain MRI. Respiratory evolutionary prognosis imposed trans-oral surgical treatment.DISCUSSION:We discuss the diagnostic and therapeutic strategy for the benign tumors of the parapharyngeal space.CONCLUSION:The schwannoma of the glossopharyngeal nerve is a benign rare lesion. The difficulty lies on the surgical strategy and the choice of the approach. The functional suites are marked by difficulty swallowing and require intensive speech therapy.
OBJECTIVE:To present a case of thyroid sarcoidosis revealed by a multinodular goiter and cervical and mediastinal adenopathies.METHODS:We summarize the clinical presentation of a thyroid sarcoidosis. A review of literature regarding this topic is also presented.RESULTS:A 48-year-old woman presented dysphagia without dyspnea. Clinical and radiological explorations find a multinodular goiter with cervical and mediastinal adenopathies. The symptomatic side of the goiter and the association with adenopathies justify the surgery. Total thyroidectomy and mediastinal lymphadenectomy are processed. Histopathological examination of the thyroid reveal a goiter without malignity, a vesicular nodule, and non necrotizing granulomas consistent with sarcoidosis, as in the adenopathy.CONCLUSION:The interest here, is the difficulty to make the diagnostic without histopathology, between a thyroid cancer with lymphadenopathies and extrapulmonary sarcoidosis (involving thyroid and adenopathies).
Since ultrasound has been established for diagnosis in ENT several new techniques have been introduced. But also ultrasonography has technically developed and thus has earned even more importance and indications. This was to be shown by this paper as well as the advantages and pitfalls. Ultrasound is quite useful in inflammatory, infectious and tumor pathology in order to make a better diagnosis or staging and to help the surgeon for punture or incision of a pathologic lesion (cytology, bacteriology, drainage). Especially in ENT oncology and post-treatment follow up ultrasound is a very precious technique. Ultrasound can be realized by the ENT specialist himself anywhere and at any time. It is a non aggressive, non invasive technique and its cost is relatively low. Unfortunately by itself it is not very performant to distinguish benign and malignant lesions. But its specificity can be considerably enhanced by combinating it with cytology (UGFNAB, ultrasound guided fine needle aspiration biopsy). Another important field of ultrasound is the examination of salivary glands.
BACKGROUND:Reconstruction of the mandible with microvascularized fibula transplants is actually a well-established procedure, yet the major component is the limited diameter of the diaphysis that can induce oral rehabilitation's failure, especially in dentate patients. In this paper, we report our surgical procedure allowing preservation of the mandibular height. The primary objective was to assess aesthetic and functional improvements of preservation of an osseous mandibular rim with a fibula free flap reconstruction.PATIENTS AND METHODS:Five patients (all males, mean age of 60 years) were treated with this method. Aetiologies were tumour in 3 cases, and osteoradionecrosis in the two others cases. We described all step of our surgical procedure and the functional, aesthetic and carcinologic results were evaluated. The follow up varies from 6 to 30 months.RESULTS:One patient died at 12 days from unrelated affection. For the other patients, both the aesthetics and functional outcomes were better than in case of mandibular interruption surgery. In fact, the mandibular contour of the mandibule was preserved and the height of mandible was restored. One patient is in progress of dental rehabilitation with osseous implants. Carcinologically, no local recurrence was observed.CONCLUSION:This technique is reliable and enables to optimize oral rehabilitation with endosteal implants. Nevertheless, we consider that the 3D scanner is essential before the intervention to evaluate the osseous reach. Moreover, if necessarily the procedure can be modified intraoperatively.
Introduction:Endoscopic sinus surgery has become the treatment of choice in the surgical management of patients with nasal polyposis. The aim of our study is to identify the role of some epidemiological, clinical and therapeutic factors in recurrence after surgery of nasal polyposis.Materials and methods:We conducted a retrospective study over a period of 11 years (between 2000 and 2010) including 184 patients operated for nasal polyposis after failure of prolonged medical treatment. We evaluated the impact of epidemiological and clinical factors (age, sex, asthma, Widal disease, allergy and stage of nasal polyposis at the time of surgery) and treatment (surgical technique, observance of postoperative topical steroids ) on postoperative recurrence.Results:Nasal polyposis recurred in 26.6% of patients after an average period of 23 months. Widal disease, asthma and bad observance of the intranasal steroid therapy were significantly associated with postoperative recurrence in the univariate analysis. In multivariate analysis the bad observance of the intranasal steroid therapy was the only factor significantly associated with recurrence.Conclusion:Postoperative steroids prescribed routinely in our practice can effectively prevent recurrence after endonasal surgery and this result was found in both univariate and multivariate analysis.
Exchanges, travel, intercountry adoption which has become an increasingly common practice, uprooting, etc. have disrupted the compositions of increasingly multilingual societies and families. The development of research in cognitive sciences and the birth of bilingualism as a field of study since the 1970s, together with recent advances in linguistics, psychology, neuroimaging and speech therapy have made it possible to better describe the neuropsychological function and development of the bilingual person, particularly in the development of the normo and hearing-impaired child, in both language and behavior. It also involves other pathological situations such as stuttering and autism seen in Alzheimer's disease. Bilingualism is now a recognized cultural, social, educational and professional substantial asset. Children who are able to express themselves in more than one language see their metalinguistic skills increase and show a stronger attachment to their parent's culture of origin.
Background:Peptide receptor radionuclide therapy (PRRT) is a very promising treatment option in neuroendocrine tumours, with good results, but there are only few reports regarding its use in paragangliomas.Methods:The authors conducted a retrospective study during the period of May 2011 to February 2014 in an Oncological Centre. Ten patients with jugular-tympanic paragangliomas and four with carotid body paragangliomas were treated with three cycles of Lutetium labelled peptide (177 Lu-DOTATATE). Treatment response was assessed with a PET-CT with 68 Ga-DOTANOC and clinical criteria.Results:Ten of the fourteen patients showed a decrease in the tumor standard uptake value (SUV) after treatment. 90% of patients with Jugulotympanic paragangliomas had symptomatic improvement or stabilization. Patients with carotid body paragangliomas and patients with a low uptake of 68 Ga-DOTANOC had a worse response to the treatment. The tumor SUV value was a predictor of treatment response [R= 0,64; F= 8,212; p= 0,014].Conclusion:Peptide receptor radionuclide therapy can be a therapeutic option in selected cases of head and neck paragangliomas.
Objective:Detect the hearing deficiencies of the candidates of the gendarmerie’s competition.Material and method:Prospective study realized over 3 years (2008-2010), in the ENT service of the Gendarmerie to Agban (Abidjan). Examination included an otoscopy and a pure tone audiometry.Results:On 23121 candidates, 1245 had a plug of earwax (5.4%). They were aged from 18 to 25 years old (average age: 22.85 years). Eardrum was pathological in 0.5 % of the cases. Prevalence of hearing loss was 1.5%. Hearing loss included sensorineural hearing loss (56.7%), deafness of transmission (29.4%) and mixed deafness (13.9%). Deafness was unilateral in 79.8% and bilateral in 20.2%.Conclusion:Result of audiogram will be useful for tracking or assessing cases of noise-induced hearing loss attributable to military service.
Introduction:Eagle syndrome, also termed stylohyoid syndrome is a radioclinical entity characterized by an elongated styloid process. Although frequent, it remains largely underdiagnosed by clinicians [1]. We report one case of Eagle syndrome studied at the ENT and radiology departments of the Heinrich Lübke hospital in Dioubrel. Radiologic, therapeutic and clinical data have been documented. The aim of our work is to report a case of Eagle syndrome in a 32 year old patient and to present the diversity of the presenting symptoms, the diagnostic challenges and the therapeutic options.Conclusion:Eagle syndrome represents an unusual and underappreciated entity and must be sought after in every underlying pharyngeal symptomatology with a normal clinical examination.
While in «art» and «traditional» music, the nimbleness of the voice and the mastering of the vocal tone are put into perspective, in «popular» music, sound engineering takes the lead, and relegates the vocal virtuosity of the interpreter to second place. We propose to study here three technologies with contributions to music. All are developed and patented by the Bell Labs: The artificial larynx (and its derivatives, Sonovox and TalkBox), the vocoder and the speech synthesis. After a presentation of the source-filter theory, vital to these innovations, the principle of these three technologies is explained. A brief historical is outlined and is complemented by examples of films and musical selections depicting these processes. In light of these elements, we conclude: Sound engineering, and in particular the modification of voice sonority, has become an indispensable component in the process of «pop» artistic musical creation.
Subject:To evaluate patients wearing hearing aid at the International Center of Auditory Correction in Abidjan.Method and material:It is a descriptif and transversal study from 07/01/99 to 06/30/10. We have included the files of patients completely filled. We have studied the indications, prosthetics gains and the satisfaction after hearing aid.Results:We have achieved 536 files. The average was 36 years. The indications have been in 76.1% cases of sensorineural hearing loss. The hearing loss has been associated in 13.2% cases to language disorder. For all patient we have noticed bilateral hearing loss in 496 cases (92.5%). The behind the ear aids have been chosen in 69% cases. The type was analogical or digital respectively in 65% and 35% des cas. The prosthetic pure tonal gain was more than 30 dB in 66.8% cases and the prosthetic speech reception threshold gain more than 30 dB in 55.3% cases. The patients have been respectively satisfied less satisfacted, no satisfacted in 68.47%, 22.76% and 8.7% cases.Conclusion:The hearing aids have improved the audition in most of the indications. The proportion of patients satisfied was proportionally equivalent to the audiometric results.
Introduction:The treatment for head and neck cancer with radiotherapy can cause different alterations of the auditory system. We report two cases of chronic otitis of the external and middle ear secondary to osteoradionecrosis of the temporal bone. This article aims to report the experience of the surgical approach in such condition.Cases report:The first patient was treated with radiotherapy in his childhood for a cerebellar tumor. He developed years later a cholesteatoma which invaded the mastoid cavities through a destruction of the external auditory canal. The second was treated for a malignant parotid tumour 15 years before by surgery and radiotherapy. She developed a chronic otorrhea with a partial destruction of the bony external auditory canal. Both patients were treated by surgery with reconstruction including bone, cartilage, fascia and skin grafts. The outcome was good in both cases. Osteoradionecrosis of the temporal bone is a rare but serious complication of radiotherapy for head and neck cancer. This complication can occur even many years after the treatment. Our two cases demonstrate a way to solve this pathology. A long term supervision with regular cares is essential in order to get a good healing. Due to the improvement of the radiation therapy we could expect less complications of this type in the future.
Stuttering is a communication disorder affecting speech which is then considered disfluent. What happens when a person who stutters speaks several languages? There will be constant interactions between multilinguism and stuttering. The disorder will generally appear differently according to the spoken language. Linguistic factors have an impact on stuttering, with disfluencies appearing differently according to the speaker’s proficiency in using each language. Emotional factors related to the choice of the spoken language can exaggerate the disorder, hence influencing the speaker’s choice of a language, even choices in life. These factors are to be taken into consideration when assessing stuttering, with a particular attention to cultural aspects. Finally, stuttering variability according to the spoken language will also have an impact on therapeutic decisions.
Background:Amyloidosis is a rare pathology, due to a toxic accumulation of amyloid proteins infiltrating tissues. Published studies have low statistical power. However it seems that ENT localization have favorable prognosis. Management and check up are not well codified.Methods:Bicentric retrospective study conducted between 1987 and 2015, from patient diagnosed with ENT amyloidosis. The study was performed to the database of the pathology department. People concerned, history, symptoms and diagnostic features were analysed. The immunologic and clinical status, locations, extension check, treatment and prognosis have been evaluated.Results:Twenty patients were evaluated, ten men and ten women, average age was 55.5 year of age. Three patients were afflicted with familial amyloidosis. Main localisation was larynx (80%), main type was immunoglobulinic (AL) (80%). Amyloidosis was mostly localised (90%) and primary form (80%). Dysphonia was the most frequently encountered symptom. Most performed examination were local biopsy and creatinine clearance (100%), serum protein electrophoresis (SEP) (89%), myelogram and/or bone marrow aspiration (75%), and trans thoracic echography (TTE) (75%). Surgical removal was performed for 75% of the patients. Global rate of recurrence was 70%, about 4.6 years after diagnosis. In familial forms, overall survival was 66% at ten years. In non-familial forms, overall survival was 100%.Conclusion:ENT amyloidosis are mostly AL, laryngeal, primary and localised. Distant extension check should be managed by internal medicine specialist and associate creatinine clearance, local biopsy, TTE, SEP and myelogram. Head and neck forms treatment is based on surgical removal, familial forms are of poor prognosis.
There has been some emphasis on the practice of multilingualism. It is seen as encouraging children creativity, linguistic sensitivity and openness. In this article, we seek to find out if the different qualities demonstrated in multilingualism can also be developed in a monolingualism context. Despite the fact that it is a single language system - where grammar, accents, the rhythm of the sentence remain unchanged - it will be interesting to draw some parallels with multilingualism. This will lead us to study the processes of oral and written language acquisition in children. The associations with stuttering will also be mentioned.
A wide variety of pistons are available for stapes surgery in otosclerosis. The objective of this work was to analyze the short-term and medium-term results of Soft-CliP® piston in primary stapes surgery and to compare it with a conventional prosthesis. The study was prospective, monocentric, randomized, based on efficiency of Soft-CliP® prosthesis (11 patients) versus Causse® Teflon prosthesis (9 patients) in otosclerosis surgery. Epidemiological data, treatment modalities, pure-tone audiometric results and outcome of patients were studied. Mean follow-up was 10 months. Soft-CliP® placement was statistically longer. The mean postoperative air-bone gap was within 10 dB in 73% and 67% of cases at 2 months and in 82% and 89% of cases at medium-term in Soft-CliP® and Teflon groups respectively. A statistically significant decrease in mean air-bone gap and for all frequencies was observed at 2 months and at medium term, with no difference between the 2 groups. The main result was the demonstration of the reliability and safety of Soft-CliP® prosthesis. With a new design, Soft-CliP® placement was easy. The biomechanics of ossicular chain should be better preserved, and the risk of incus erosion and necrosis decreased. A study on a larger population in the long-term would validate these results.
