Juvenile recurrent parotitis (JRP) is a rare disease of childhood occurring between the ages of 3 and 5 years, characterized by recurrent non-suppurative parotitis, spontaneously evolving towards parotid gland dysfunction. Clinically, JRP presents in the form of unilateral or bilateral, usually asynchronous, swelling of the parotid gland. The diagnosis is based on ultrasound characteristics. Widespread use of sialendoscopy has opened up new prospects for the management of this disease. This review of the literature evaluates the role of sialendoscopy in the management of JRP. A Medline search retrieved 68 articles, 18 of which concerned JRP. Standard treatment consists of antibiotics for at least 10 days at the acute phase of the disease. All studies demonstrated the diagnostic value of sialendoscopy by visualizing strictures, hypovascularization and whitish intraductal debris. Sialendoscopy is also useful for treatment, by allowing intraductal lavage and, when possible, dilatation of strictures. Lavage is performed with saline solution, hydrocortisone, antibiotics or a combination of these solutions, with no significant differences in terms of efficacy. The mode of administration with or without sialendoscopy also appears to provide similar results. Sialendoscopy appears to be a diagnostic and therapeutic option, although it has not been shown to be more effective than simple lavage. All lavage solutions appear to be effective.

La parotidite récurrente juvénile (PRJ) est une maladie rare de l’enfant débutant entre 3 et 5 ans. Elle est caractérisée par la récidive de parotidite non suppurative évoluant spontanément vers le dysfonctionnement glandulaire. Cliniquement, elle se présente sous la forme d’une tuméfaction uni- ou bilatérale, le plus souvent asynchrone, de la glande parotide. Le diagnostic repose sur des critères échographiques caractéristiques. La démocratisation de la sialendoscopie a ouvert de nouvelles pistes pour sa prise en charge. Cette revue de la littérature a eu pour but d’évaluer cette technique dans la prise en charge des PRJ. Nous avons recensé dans Medline 68 articles dont 18 concernaient la PRJ. La plupart des équipes s’accordent pour prescrire un traitement par antibiotique d’une durée d’au moins 10jours en phase aiguë de la maladie. La sialendoscopie a dans toutes les études un intérêt diagnostique en visualisant des sténoses, une hypovascularisation et des débris intracanalaires blanchâtres. Elle a également un intérêt thérapeutique grâce aux lavages endocanalaires et quand cela est possible à la dilatation des sténoses. Les lavages se font par solution saline, d’hydrocortisone, d’antibiotique ou d’association de ces composés sans différences significatives d’efficacité. Le mode d’administration avec ou sans sialendoscopie semble également équivalent. La sialendoscopie semble être une option diagnostique et thérapeutique. Elle n’a cependant pas montré d’efficacité supérieure aux lavages simples. Les produits de lavages semblent tous efficaces.

Glottic cancers discovered at an early stage (T1-T2) can be treated with either radiotherapy or surgery. The aim of our study is to analyse survival and functional results of supra-cricoid partial laryngectomy (SCPL) with crico-hyoido-epiglottopexy (CHEP) as surgical treatment for glottic carcinoma with anterior commissure involvement. We performed a retrospective study (1996-2013) which included patients who underwent SCPL-CHEP for glottic squamous cell carcinoma with involvement of the anterior commissure. Before surgery, all patients underwent staging including head, neck and chest CT-scan with contrast injection as well as suspension laryngoscopy under general anaesthesia. A total of 53 patients were included. The median follow-up period was 124 months. Tumour resection was complete in 96.2% of cases. The overall, specific and recurrence-free survival rates at 5 years were, respectively, 93.7%, 95.6% and 87.7%. The average period of hospitalisation was 18 days. The average time elapsed before decannulation and before restoration of oral feeding were 15 and 18 days, respectively. SCPL-CHEP is an important option for laryngeal surgical preservation. It allows adequate disease control as well as good functional results as long as the indications are well respected and the surgical techniques are mastered.

We studied whether there is a relationship between nausea and vestibular disorders in patients treated with intensity modulated radiation therapy (IMRT) for head and neck cancer.We performed a prospective single-centre study that enrolled 31 patients. A videonystagmography was carried out before and within 15 days after radiation therapy for each patient. Nausea was assessed at baseline, every week, and at the post-radiotherapy videonystagmography visit.Twenty-six patients had benefited from a complete interpretable videonystagmography. For 14 of these patients vestibular damage was diagnosed post-radiotherapy. During irradiation, six patients felt nauseous, but without dizziness. In univariate analysis, we found a relationship statistically significant between the average dose received by the vestibules and vestibular disorder videonystagmography (P=0.001, odds ratio [OR]: 1.08 [1.025-.138]), but there was no relationship between vestibular disorder videonystagmography and nausea (P=0.701).Irradiation of the vestibular system during IMRT does not seem to explain the nausea.

Purpose. - We studied whether there is a relationship between nausea and vestibular disorders in patients treated with intensity modulated radiation therapy (IMRT) for head and neck cancer.Patients and methods. - We performed a prospective single-centre study that enrolled 31 patients. A videonystagmography was carried out before and within 15 days after radiation therapy for each patient. Nausea was assessed at baseline, every week, and at the post-radiotherapy videonystagmography visit.Results. - Twenty-six patients had benefited from a complete interpretable videonystagmography. For 14 of these patients vestibular damage was diagnosed post-radiotherapy. During irradiation, six patients felt nauseous, but without dizziness. In univariate analysis, we found a relationship statistically significant between the average dose received by the vestibules and vestibular disorder videonystagmography (P=0.001, odds ratio [OR]: 1.08 [1.025-.138]), but there was no relationship between vestibular disorder videonystagmography and nausea (P=0.701).Conclusions. - Irradiation of the vestibular system during IMRT does not seem to explain the nausea. (C) 2016 Societe francaise de radiotherapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.

L’analyse cytologique d’un nodule thyroïdien retrouve fréquemment la présence de cellules oncocytaires (ou cellules de Hürthle) dans les néoplasmes folliculaires, dont seule l’analyse histologique définitive permet de caractériser son potentiel bénin ou malin. Cependant, les cellules oncocytaires sont aussi une population des glandes parathyroïdes.La découverte d’un nodule thyroïdien en échographie thyroïdienne sur un antécédent de lobo-isthmectomie partielle gauche a conduit à une analyse cytologique retrouvant un néoplasme folliculaire à cellules oncocytaires. La patiente présentait aussi une hyperparathyroïdie avec hypercalcémie. Les scintigraphies aux 123I/99mTc-sestamibi et au 18F-fluorocholine (TEP-CT) retrouvent une fixation unique en regard du lobe thyroïdien gauche restant. Une totalisation de lobo-isthmectomie gauche avec exploration de la loge est réalisée. L’histologie définitive retrouve un adénome parathyroïdien, intrathyroïdien, au sein du tissu thyroïdien résiduel. La parathormone se normalise.Des ressemblances cytomorphologiques sont retrouvées entre une lésion parathyroïdienne et une lésion thyroïdienne à cellules oxyphiles. La nature parathyroïdienne, et non thyroïdienne, doit être fortement suspectée en préopératoire, en cas présence d’une hyperparathyroïdie.

OBJECTIVE:The aim of the present study was to determine the value of tonsillectomy in the initial diagnostic work-up of head and neck squamous cell carcinoma of unknown primary (HNSCCUP).MATERIAL AND METHODS:A single-center retrospective study (1999–2012) included 45 patients. All cases underwent physical examination, panendoscopy and contrast-enhanced neck and chest CT scan; 27 (60%)also underwent 18-FDG PET scan. Imaging was systematically performed before panendoscopy. In 34 cases (75%), histologic tonsil samples ipsilateral to the HNSCCUP were collected (28 tonsillectomies and 6 biopsies) during panendoscopy. Categoric variables were compared on Chi-square test.RESULTS:Clinical examination and CT did not identify any primary tumor. In 13 cases (38%), invasive squamous cell carcinoma (SCC) was diagnosed on histological samples (12 tonsillectomies, 1 biopsy). For these 13 cases, lymph nodes were located in the upper or middle jugular group, and in 3 cases lymph nodes were cystic on CT scan. In 7 cases (26%), there was an abnormal tonsillar 18-FDG uptake ipsilateral to the cervical lymphadenopathy; tonsillectomy was performed, and SCC was found in 5 of these cases:i.e., 18-FDG PET showed sensitivity and specificity of respectively 55.5 and 88.8%.CONCLUSION:Tonsillectomy has a role in the initial diagnostic work-up of HNSCCUP. It is especially useful when lymph nodes are located in the upper and/or middle jugular group with a cystic aspect on CT.

L’objectif de notre étude était de déterminer l’intérêt de l’amygdalectomie dans le bilan initial des adénopathies cervicales malignes d’apparence primitive. Il s’agissait d’une étude rétrospective monocentrique (1999–2012). Quarante-cinq patients ont été inclus. Tous ont eu un examen clinique, une panendoscopie, un scanner cervico-thoracique injecté. Vingt-sept patients (60 %) ont eu un TEP-scanner au 18-FDG. Dans tous les cas, les examens radiologiques ont été faits avant la panendoscopie. Dans 34 cas (75 %), un prélèvement amygdalien homolatéral à l’atteinte ganglionnaire (28 amygdalectomies, 6 biopsies) a été fait lors de l’endoscopie. La comparaison des variables catégorielles a été faite grâce au test du Chi2. L’examen clinique et le scanner n’ont pas identifié de tumeur primitive. Dans 13 cas (38 %), un carcinome malpighien invasif a été diagnostiqué sur les prélèvements histologiques (12 amygdalectomies, 1 biopsie). Pour ces 13 cas, la ou les adénopathies étaient situées dans les territoires sous-digastriques et/ou sus-omo-hyoïdiens et dans 3 cas, l’adénopathie était kystique au scanner. Une fixation amygdalienne homolatérale à l’atteinte ganglionnaire a été retrouvée au TEP-scanner 18-FDG dans 7 cas (26 %). Pour ces 7 patients, une amygdalectomie a été pratiquée avec la présence d’un carcinome épidermoïde dans 5 cas, soit une sensibilité et une spécificité du TEP-scanner 18-FDG respectivement de 55,5 et 88,8 %. L’amygdalectomie a sa place dans le bilan initial d’une AMAP. Son intérêt est d’autant plus grand que l’adénopathie est située dans les territoires sous-digastrique et/ou sus-omo-hyoïdien avec un aspect kystique au scanner.

Seulement 10 % des hémangiomes intramusculaires (HAIM) sont localisées au niveau de la face et du cou. Très peu de cas de localisation massétérine sont recensés. Le but de notre travail était, à partir d’un cas d’hémangiome caverneux intramassétérin, de faire le point sur la clinique, les examens paracliniques utiles au diagnostic et de préciser les traitements possibles de cette tumeur. Un patient de 70 ans a consulté pour une tuméfaction située en avant de la glande parotide gauche, évoluant depuis deux ans. La tuméfaction était ferme, indolore, bien limitée, oblongue, mesurait 3 cm de grand axe, située dans le muscle masséter. Elle ne variait pas de volume en fonction de la position de la tête. L’IRM était en faveur d’une tumeur vasculaire. Elle a été opérée par voie de parotidectomie. Les suites ont été simples. L’anatomopathologie a confirmé le diagnostic d’hémangiome caverneux. Les HAIM de la face et du cou sont le plus souvent localisés dans le muscle masséter. Leur évolution est lente. Ils sont de taille variable, bien limité, avec une surface lisse. L’IRM est indispensable avant le traitement qui est chirurgical soit par voie externe, soit par voie buccale.

OBJECTIVE:The aim of our study was to perform an oncologic analysis of patients treated for head and neck squamous cell carcinoma of an unknown primary (HNCCUP).PATIENTS AND METHODS:35 cases were included in our monocentric restrospective study (1999-2010). All patients had a complete clinical exam as well as head, neck and chest CT scans. The primary tumour remained undetected after panendoscopy 25 patients underwent a routine tonsillar biopsy ipsilateral to the lymphadenopathy. In 9 cases (36%), an invasive squamous cell carcinoma was detected on pathological examination. These patients were excluded from further study. Kaplan-Meier method was used for survival analysis. Univariate and multivariate analysis were also performed using Cox's regression model.RESULTS:The therapeutic management of patients' majority (73%) consisted of lymphadenectomy with frozen section examination which confirmed the presence of an invasive squamous carcinoma in the resected lymph node(s). This was followed by ipsilateral neck dissection and radiotherapy or radiochemotherapy. Patients with unresectable lymph node(s) underwent exclusive radiochemotherapy. Specific survival rates at 1, 3 and 5 years were respectively 77%, 52% and 47%. The median survival time was 3 years. The comparison of univariate and multivariate survival curves confirmed that the lymph node status is an important factor for survival (HR 8.3 [2.03-33.96]).CONCLUSION:Our results are consistent with those found in the medical literature. HNCCUP has a poor prognosis which correlates with the lymph node status.

INTRODUCTION:Only 10% of intramuscular hemangiomas (IMH) are located in the head and neck region. There are very few reports of masseteric location. The present study of a case of intra-masseteric cavernous hemangioma discusses clinical presentation, paraclinical diagnostic workup and treatment options. CASE REPORT:A 70-year-old male patient consulted for a swelling of 2 years' evolution, anterior to the left parotid gland. The swelling was firm, painless, well-contoured, oblong, 3 cm on its long axis, and located in the masseter muscle. There was no effect of head position on tumor volume. MRI showed a vascular tumor. Surgical resection was performed via parotidectomy. There were no postoperative complications. Pathological examination confirmed the diagnosis of cavernous hemangioma. DISCUSSION:Head and neck IMH is commonly located in the masseter muscle. Evolution is slow. Size is variable, contours are well defined and the surface is smooth. MRI is essential ahead of treatment, which is surgical on an external or intra-oral approach.

Olfactory disorders are fairly common in the general population. Exploration, on the other hand, is seldom performed by ENT specialists, even in reference centers. There may be three reasons for this: this particular sensory modality may seem unimportant to patients and/or physicians; available treatments may be underestimated, although admittedly much yet remains to be done; and olfactory exploration is not covered by the national health insurance scheme in France. Advances in research in recent decades have shed light on olfactory system functioning. At the same time, several techniques have been developed to allow maximally objective olfactory assessment, as olfactory disorder is sometimes the first sign of neurodegenerative pathology. Moreover, objective olfactory assessment may be needed in a medico-legal context. The present paper updates the techniques currently available for olfactory exploration.

A 4 year-old female patient was treated for persistent right-sided dacryocystitis and xerostomia. MRI was performed to screen for a dry syndrome; which resulted in the diagnosis of agenesis of the parotid and submandibular glands as well as lacrimal duct malformation. An MRI of each parent was normal. The mother's history revealed 4 days of pyrexia during the 8th week of amenorrhea. This was an isolated case, with no family history, characterized by a febrile episode during pregnancy at the period of main salivary gland genesis. Epigenetic mechanisms could be implicated.

Non-Hodgkin lymphomas are lymphoid malignant neoplasms with diverse biological and clinical behavior. Patients typically present with persistent painless lymphadenopathy, but some patients may present with constitutional symptoms or with involvement of organs other than the lymphoid and hematopoietic system. An accurate diagnosis, careful staging of the disease, and identification of adverse prognostic factors form the basis of treatment selection. Patients commonly receive chemoimmunotherapy as initial treatment, and radiation therapy may be added if patients have early-stage disease. Most patients respond well to treatment, but relapses are frequent and additional therapies including stem cell transplant are often needed. Because many subtypes of lymphoma remain incurable with current management strategies, clinical trials are in progress to identify novel therapies with promising activity in this disease.