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INTRODUCTION AND IMPORTANCE: Extracranial meningiomas of the sinonasal tract are rare tumors. The diagnosis is not generally evident. We report, through an observation, the clinical particularities, the diagnostic difficulties and the therapeutic approach of primary sinonasal meningiomas. CASE PRESENTATION: We report the case of a 54-year-old woman who presented with complaints of right nasal obstruction with the notion of recurrent epistaxis evolving for one year. At the examination, nasal endoscopy found a voluminous purplish-gray mass filling both the middle meatus and the olfactory cleft. The CT examination showed an ethmoïdonasal tumoral process extending to orbital cavity and infratemporal fossa without endocranial extension. A transnasal approach was performed, histopathological examination demonstrates a méningothélial meningioma rank1. The clinical, endoscopic and CT controls did not show tumor residue or a local recurrence. CLINICAL DISCUSSION: Meningioma is a common non-glial intracranial neoplasm. Primary or secondary extracranial meningioma (depending on whether they are isolated or associated with an intracranial tumor) location is uncommon, clinical presentation is nonspecific. Diagnostic confirmation is anatomopathological with immunohistochemically study. Imaging confirms the primary nature of these tumors. The prognosis is favorable after complete surgical excision without further adjuvant treatment. CONCLUSION: Primary nasosinus meningiomas are rare, with non-specific symtomatology and common with other local pathologies. Imaging confirms the primary character of these tumors, anatomopathological examination completed by immunohistochemical study confirms the diagnosis. Surgery with complete exeresis remains the best option with a good prognosis.

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Amygdaloid cysts are benign dysembryological cystic tumors that develop in the antero-lateral part of the neck; they represent 2% of laterocervical tumors of the neck; they are among the most frequent gill anomalies; they represent 6.1% to 85.2% of second cleft anomalies. They are due to the persistence of the cervical sinus during the differentiation of the branchial apparatus. They are manifested by a laterocervical swelling located at the anterior edge of the sterno-cleido-mastoid muscle. Their cystic nature is confirmed by ultrasound and CT. Treatment consists of surgical excision. We report the case of a 33-year-old man who consulted for a huge right laterocervical swelling that had been evolving for 16 months without any other associated symptoms. An exploratory cervicotomy with an anatomo-pathological study was performed, and the histological diagnosis retained was an amygdaloid cyst without signs of malignancy. The objective of this work is to analyze the anatomo-clinical characteristics and discuss the methods of management and the therapeutic indications of this affection.

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Neuroendocrine tumors are extremely rare in the middle ear. These tumors represent a spectrum of tumors with a diverse range of molecular abnormalities, functionality and anatomical locations. We present a rare case of middle ear neuroendocrine tumor, review the pathology and differential diagnosis of the tumors, and discuss the management and follow-up of patients with these tumors. We suspect that the middle ear neuroendocrine tumor is underdiagnosed and more cases can be detected through education and personal experience. Treatment is surgical resection, and long follow-up is recommended.

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Chondrosarcoma is a highly aggressive malignant tumor originating from cartilaginous and mesenchymal tissues. The aim of this report is to describe a rare case of nasosinusal chondrosarcoma with orbito-cerebral extension. Our patient was a 55-year-old with a right cheek swelling evolving over a year, with unilateral right nasal obstruction gradually becoming bilateral associated with hyposmia, bilateral exophthalmos, reduced bilateral deep visual acuity and permanent headaches. The clinical examination found a tumor obstructing the two nasal cavities. Imaging showed a lobulated heterogeneous tissue process occupying the paranasal sinuses, with calcifications and enhancement at its periphery, extending to the orbito-cerebral area. The histopathological analysis was in favor of chondrosarcoma. The patient was first treated with an incomplete surgical resection by an endonasal route due to the extension to the orbit and the brain and received adjuvant radiotherapy. Surgical excision is a prognostic factor in this type of sarcomas and reduces recurrence rates.

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Schwannoma arising from the cervical sympathetic chain are rare slow-growing tumors which represent a diagnostic challenge. We report a 80-year-old female patient presented with anterior neck triangle swelling. The radiological assessment was based on computed tomography and magnetic resonance imaging, which led to a preoperative diagnosis of vagus nerve schwannoma. However, surgical treatment revealed a cervical sympathetic chain mass rather than a vagus nerve mass. A complete removal was performed, and the anatomopathological examination was in favor of a schwannoma. In post-operative state, the patient presented a well-tolerated Horner's syndrome.

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INTRODUCTION: Stabbing is relatively frequent in Morocco and constitutes a major public health concern. Our observation is interesting by the particularity and the aggressiveness of the trauma leading to an irreversible bilateral blindness. CASE PRESENTATION: The present observation relates to a patient who was victim of a stabbing assault. The examination objectified a facial wound in front of the right lateral canthus with a broken weapon in place. An urgent craniofacial CT scan was performed showing a hyperdense penetrating path of the stabbing from the lateral wall of the right orbit, associated with a bursting of the globe, obliquely crossing the anterior ethmoid cells and severing the optic nerve on the left side. Surgical exploration was made with an extraction of the remaining part of the knife. Bilateral blindness was irreversible and the patient had a psychiatric follow up. CONCLUSION: Aggressions are a sad reality, expressing anger and violence on the part of a young adult, present in any society with often dreaded consequences.

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Angiofibromas represent <1% of all head and neck tumors and occur primarily in the nasopharynx. Extra-nasopharyngeal angiofibromas are rarer. Remarkably, only a case of external auditory canal location has been reported. We present a case of an angiofibroma in this unique location in a female who presented with fullness of right ear and hypoacusis for 6 months. The clinical examination found a mass in the right external auditory canal attached to the posterosuperior wall. Preoperative audiometry revealed average right conductive hearing loss of 37.5 dB. A computed tomography scan revealed a mass on the right external auditory canal. Surgical resection of the mass was performed and the histopathological assessment confirmed the diagnosis. Post-operative audiometry showed an improvement in hearing function. There was no recurrence after 5 years. The prognosis of these tumors is good after total bloc resection.

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INTRODUCTION: Woakes' syndrome is a rare condition commonly defined as recurrent sinonasal polyposis with consecutive destruction of the nasal pyramid. Till now, only a few cases have been reported in the literature. The purpose of this paper is to present the features of woakes' syndrome through two new clinical cases, adding some valuable insight to the recently reported cases. CASE REPORT: We report a series of two consecutive adults male and female patients, aged 55 and 58 years, with Samter's triad, who presented recurrent nasal polyposis and progressive broadening of the nasal dorsum. Facial CT showed in both patients the same radiologic pattern of nasal and paranasal cavities obliteration with nasal bone deformation. Both patients underwent functional endoscopic sinus surgery and correction of the bony nasal vault deformity without osteotomies. At 3 months follow-up, the nasal air passage remained free and aesthetic outcomes were observed. DISCUSSION: having been described over 130 years ago, the etiology of woakes' syndrome remains unclear. Treatment includes topical treatment and sinonasal surgery. Surgical treatment of the nasal dorsum deformity is rarely addressed. CONCLUSION: These observations suggest that the external nose deformity may be successfully corrected by digital compression, in combination with endoscopic sinus surgery.

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INTRODUCTION: and importance: Mucoceles are expansive pseudocystic formations, developed from the sinuses of the face, affecting mainly adults. Evolving at low noise, they are most often revealed by neurological or ophthalmological complications. We report a rare case of a bilateral frontal mucocele with orbito-cerebral extension following nasal sinus polyposis. CASE PRESENTATION: This was a 35-year-old patient with a history of Widal syndrome, who presented frontal headaches and left proptosis evolving for 4 months, in whom clinical examination revealed a left superomedial eyelid swelling, left proptosis and stage 2 nasosinus polyposis. Computed tomography and craniofacial magnetic resonance imaging were in favor of a bilateral frontal mucocele with left orbital and bilateral cerebral extensions. The patient was bilaterally operated by a combined approach including external Jacques eyebrow and endonasal Draf IIa procedure in addition to a radical total ethmoidectomy. The outcomes were favorable with regression of headaches and resolution of exophthalmos. CLINICAL DISCUSSION: The frontal mucocele, although benign, has an aggressive potential in the absence of treatment either towards the endocranium or the orbit behind the orbital septum causing intra-orbital extension, or in front of it; causing the dominant upper palpebral form as in the case of our patient. The treatment is still based on surgical excision of the cyst with drainage of the causal sinus, which was carried out for our patient. CONCLUSION: Despite its benign behavior, frontal mucocele may become serious by compression of neighboring organs which require an early and appropriate surgical management.

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INTRODUCTION: The internal jugular vein thrombosis is usually due to intravenous drug abuse, prolonged central venous catheterization or deep head-neck infections or trauma. Related malignancies, or inflammatory etiologies are described. Our case is interesting by the ingestion of a sewing needle that passes from the pharynx to the internal jugular vein via migration, leading to life-threatening complications: deep neck space infection and internal jugular vein thrombosis. CASE REPORT: We report a case of a 40 years old patient, for acute cervical cellulitis in a context of odynophagia and fever, a CT scan revealed a jugular vein thrombosis, penetrated by a metal density foreign body. The diagnosis of ingested foreign body complicated by cervical cellulitis and thrombosis of the internal jugular vein was made. The patient underwent neck surgery with intravenous antibiotics. The postoperative course was uneventful, after one year of follow-up, no complications have been observed. DISCUSSION: no consensus has been reached concerning the management of postoperative and post traumatic vein thrombosis. Taking into account the risk of extension of the thrombus and the hemorrhagic risk each case should involve discussions among a multidisciplinary team. CONCLUSION: The internal jugular vein thrombosis is a rare complication of ingested foreign bodies which may lead to life threat. The early diagnosis and adequate treatment of its life-threatening complications may result in excellent prognosis.

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The purpose of this study was to evaluate the functional outcomes of ossiculoplasties. We conducted a retrospective study, in the department of ear, nose and throat (ENT) and congestive cardiac failure (CCF) at the University Hospital Mohammed VI, in Oujda, from October 2018 to March 2020. Out of 45 patients with secondary otitis, 30 had gone ossiculoplasty using endoscopic transmeatal approach. These patients were enrolled in the study. The average age of patients was 31.8 years, with a F/M sex ratio of 1.5. The examination of the eardrum showed type A otitis (18 cases) type B otitis (5 cases), type C otitis (3 cases) and type D otitis (4 cases), according to Austin classification; 70% of patients who had undergone surgery had hearing loss between 30 and 40 dB and 30% of patients had hearing loss of ≥40 dB. Type II ossiculoplasty was performed in 26 cases, using tragal cartilage in 18 cases. Autologous incus interposition graft and placement of titanium PORP were performed in 4 cases each, whereas ossiculoplasty type III was performed in 4 cases, with placement of titanium TORP. Type II ossiculoplasty group had a hearing gain of ≥20 dB (all cases), whereas type III ossiculoplasty group had a hearing gain of ≥1 dB (1 case). Success rate was 90%. The analysis of these results shows that the overall outcome is slightly worse in patients undergoing type III ossiculoplasty than in those undergoing type II ossiculoplasty. However, comparative studies between the placement of prostheses and autografts or between different types of materials have only shown minor differences reported by the same author or the same team. Many authors highlighted that the preservation of the handle of malleus could provide better functional results.

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Sinus barotrauma is the second most frequently reported injury after middle ear barotrauma. The front sinus is the most common site affected. This is a rare and specific pathology. We here report the case of a 26-year-old patient having severe left frontal pain with ipsilateral epistaxis after a dive. CT scan showed left frontal hemosinus. Patient evolution was good after therapy. Frontal sinus barotraumas are accidents related to the variations in environmental pressure. Epistaxis is a sign of serious health condition, CT scanner plays a role in evaluating potential predisposing factors and establishing monitoring procedures. Patient treatment aims to relieve symptoms and to remove predisposing factors. Frontal sinus barotraumas are a rare injury ; orbital and encephalic complications are exceptional. Their treatment coincides with that of their causal pathology.

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Malignant otitis externa is also referred to as skull base osteomyelitis. Pseudomonas aeruginosa is the most common offending pathogen. However, fungal origin is not uncommon. 80-year-old patient having persistent left earache since two months despite adequate treatment. Otologic examination showed signs of inflammation in the auricular pavilion, ear canal stenosis with granulomas and purulent otorrhea. CT scan showed a filled otomastoid, extensive inflammatory process affecting the pre-auricular and retro-auricular tissues and lysis of the tympanic bulla. Given the lack of improvement, mycological examination was performed which revealed the presence of Candida Albicans. Cases of malignant otitis externa caused by Candida albicans are rarely reported. Fungal origin should be suspected in patients who have negative bacteriological samples and no improvement despite adequate antibiotic treatment. It should be confirmed by sometimes multiple mycological samples. Malignant otitis externa caused by Candida albicans is a rare potentially mortal infection.

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