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Complicated sinusitis in children:18 cases report

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World Journal of Otorhinolaryngology 2015年第1期5卷 30-36页

作者： Ali Mardassi Nabil Mathlouthi Hajer Mbarek Chiraz Halouani Sameh Mezri Cyrine Zgolli ghassen chebbi Rania Ben Mhamed Khemaies Akkari Sonia Benzarti ENT Department Military Hospital

AIM: To precise the clinical characteristics of rhinosinusitis in pediatric population, their complications and therapeutic ***: All infants younger than 15 years adm-itted to the Ear, Nose and Throat Department of the Military Hospital of Tunis, Tunisia for a complicated rhinosinusitis between 2006 and 2013 were evaluated. Data related to patients and the disease were collected and analyzed: past medical history, complaints, clinical examination, radiologic findings, therapeutic management and evolution. RESULTS: Eighteen cases were identified with a mean age of 5.1 years(5 mo to 13 years)(SD ± 3.1). A male preponderance was noted in 72% of the cases. Rhinorrhea and fever were the most common presenting symptoms. Radiological explorations(computed tomography-scan ± magnetic resonance imaging) have been practiced for all of our patients. Orbital involvement was found in 77% of the cases associated with meningitis in 2 cases. Antibiotherapy was prescribed to all our patients. Surgical procedures were performed in 8 cases: endoscopic sinus surgery and/or external drainage of orbital abscess. After an average follow-up period of 2.5 years, 3 of our patients were lost. The ophthalmic sequelae noted in 3 cases(16%) were permanent and caused important functional and social problems. A favourable outcome has been noted in the rest of our patients. CONCLUSION: Rhinosinusitis can be extremely severe in children requiring urgent radiological imaging and aggressive treatment to avoid orbital and intracranial complications.

关键词： Rhinosinusitis Children Imaging Orbit Meningitis Antibiotherapy Surgery

Synchronous carcinoma of head and neck: 2 cases report

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World Journal of Otorhinolaryngology 2015年第2期5卷 74-77页

作者： Ali Mardassi Nabil Mathlouthi Nawel Hlila Chiraz Halouani Sameh Mezri Cyrine Zgolli ghassen chebbi Rania Ben Mhamed Khemaies Akkari Sonia Benzarti Ear Nose and Throat Department the Military Hospital Tunis

Multiple primary cancers are becoming an increasingly frequent situation and are often the source of many diagnostic and therapeutic difficulties. We report the case of two patients diagnosed with head and neck synchronous carcinomas. The first case is a 33-yearold man with a history of a keratinizing squamous cell carcinoma of the eye lid and who was operated 4 mo later from a mucoepidermoid carcinoma of thesubmandibular salivary gland. The second case is a 71-year-old woman who underwent a total parotidectomy for a mucoepidermod carcinoma of the left parotid gland and who consulted 2 mo later for epistaxis. The explorations concluded to a squamous cell carcinoma of the nasopharynx. The patient had a complementary radiotherapy. No local neither distant recurrence of the two tumors has been detected after a follow-up of 36 mo in the first case and 24 mo in the second one.

关键词： Carcinoma Submandibular gland Parotid gland Nasopharynx Radiotherapy

Infrathyroidian hydatid cyst: Diagnostic difficulties and therapeutic management, a case report

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World Journal of Otorhinolaryngology 2015年第2期5卷 78-81页

作者： Ali Mardassi Nabil Mathlouthi Hajer Mbarek Chiraz Halouani Sameh Mezri Cyrine Zgolli ghassen chebbi Rania Ben Mhamed Khemaies Akkari Sonia Benzarti Ear Nose and Throat Department of the Military Hospital

Hydatidosis is a cosmopolitan anthropozoonose common to humans and many mammals. The cervical localization is rare even in endemic countries. We report a case of cervical hydatidosis located in the infra-thyroidian region. The diagnosis was suspected on clinical and radiological examinations(Ultrasonography, computed tomography-scan). The surgical removal of the cyst was difficult because of the inflammatory tissue around the mass. The confirmation of the diagnosis was obtained by the histopathological examination. During the followup, a local recurrence of the disease was diagnosed after 9 mo treated successfully by surgery.

关键词： Hydatidosis Anthropozoonose Cervical localization Ultrasonography Surgery Histopathology

Nasopharyngeal carcinoma: Long term follow-up of 83 patients

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World Journal of Otorhinolaryngology 2015年第2期5卷 65-70页

作者： Ali Mardassi Nabil Mathlouthi Nawel Hlila Chiraz Halouani Sameh Mezri Cyrine Zgolli ghassen chebbi Rania Ben Mhamed Khemaies Akkari Sonia Benzarti ENT Department Military Hospital of Tunis

AIM: To analyzes the clinical, paraclinical, therapeutical and evolutive features of nasopharyngeal carcinoma(NPC).METHODS: All the patients treated for a nasopharyngeal carcinoma between 2000 and 2013 in the Ear-NoseThroat Department of the Military Hospital of Tunis, Tunisia were collected in this study. Eighty-three patients signed a written consent prior to study enrollment. The gender ratio(M/W) was 6.5 with a median age of 49 years(range 16-85). The median follow up time was 37 mo(18 to 108 mo). The evolution, during and after the end of therapy, was assessed on clinical biological and radiological exams. Different parameters were analyzed and compared to other series: complications of chemo and radiotherapy, recurrence of the disease, metastasis and overall survival ***: Of the 83 patients of our study, 15% had T1 tumors, 20% had T2, 23% had T3 and 41% had T4 disease. At the time of diagnosis, 14% of the patients had a cranial nerve deficit. Only 12 patients had exclusive radiotherapy and the remaining of our patients had concomitant radio chemotherapy. Iatrogenic complications were diagnosed in 53% of the cases: radioepithelitis(28%), radiodermatitis(9%), xerostomia(17%), osteoradionecrosis(3%), cerebral radionecrosis(1%) and a pancytopenia(17%). The follow-up period varied from 18 to 108 mo(average: 37 mo). During the first six months after treatment, a persistence of the disease was found in 11% of patients, while a recurrence of the cancer was diagnosed in 6% and distant metastasis developed in 14% of the patients. Fifteen patients needed remedial chemotherapy for a relapse or metastasis and five had palliative chemotherapy for very advanced cases. We report 3 cases of death during the follow-up. CONCLUSION: Despite its excellent radio-chemotherapy response, and general good prognosis, a careful follow-up of patients with NPC is necessary to detect and manage any iatrogenic complication, locoregional recurrence or metastasis of the disease.

关键词： Nasopharyngeal carcinoma Cranial nerve Radiotherapy Chemotherapy Metastasis