[Extracranial head and neck neurogenic tumors: report of 47 cases]

Extracranial head and neck neurogenic tumors are rare and usually revealed by histological examination. The aim of this study was to review the clinical, radiological and therapeutic particularities of these tumors

Methods: This retrospective study concerns 47 patients with neurogenic tumors of the head and neck, operated on between 1989 and 2011 [22 years period]. All patients had complete physical examination and ultrasonography was performed when a cervical extension was found. CT scan and MRI were performed in 16 cases. Minimum follow up was 4 years

Results: A sinusonasal tumor was found in 9 cases and a cervical mass was seen in 28 cases. Parapharyngeal extension was observed in two cases

Two patients had tympano-jugular glomic tumors and 8 of them had a cervical soft tissue tumor

Complete surgical resection was performed in 46 patients

Histological examination revealed a benign tumor in 91% of cases [n=43], 24 of them were schwannomas. Malignant tumors were seen in 4 cases: esthesioneuroblastoma [3 cases] and malignant schwannoma [1 case]. These patients received post operative radiotherapy

After surgery, two patients had Claude Bernard Horner syndrome and one had a definitive facial nerve palsy

Conclusion: Extracranial head and neck neurogenic tumors may have several aspects depending on their localisation and their histological type. Surgery, when performed, should be complete with minimum complications

Causes and management of failure in endoscopic middle meatus antrostomies

The aim of this study is to analyse the causes and the management of failed endoscopic middle meatus antrostomies [EMMA] in chronic sinusitis and benign sinonasal lesions or tumors. We carried a retrospective study about 257 EMMA cases performed in our department for 201 patients between 1996 and 2006. All patients had complete ORL examination and preoperative sinonasal CT. After surgery, preoperative and postoperative symptoms were compared and nasal endoscopy was performed in all cases. Persistent rhinologic and radiological symptoms were considered as a failure of surgery. In these cases, revision surgery was performed, either by endoscopic approach or by Caldwell-Luc procedure. Mean follow-up period was 2 years. The indication of surgery was the presence of chronic sinusitis, benign lesions or benign tumors in 53.2%, 41.8% and 5% of cases respectively. Seventy-one EMMA procedures failed [27.6%]. Causes of failure were mainly represented by the presence of synechia [38%], ostium stenosis [24%], medical causes and comorbidity [15.5%], persistent or recurrent lesions [15.5%] and missed natural ostium [7%]. Nineteen patients [9.4%] required revision surgery because of persistent symptoms after medical therapy. Either endoscopic or vestibular approaches were performed. Seventy-three percent of the revision cases respond to surgical treatment with complete resolution of symptoms. Failure of EMMA can be due to numerous and variable causes. The management of failed EMMA includes medical therapy, revision endoscopic surgery or vestibular approaches

[Recurrent upper respiratory tract infections in children and allergy: a cross-sectional study of 100 cases]

Upper respiratory tract [URT] infections are common in children. The knowledge of their risk factors allows in some cases better management. The aim of our study is to evaluate the role of allergy in this pathology. Through a cross-sectional study about 100 children having recurrent URT infections, we evaluated the prevalence of allergy in order to find a relation between the two pathologies in general, and between allergy and each recurrent pathology. The results were compared with those of a reference group involving 164 children. Our study confirms a statistically significant association between allergy and, recurrent URT infections [p=0,01], also between allergy and rhinopharyngitis [p=0,02], rhinosinusitis [p=0,001] and acute otitis media [p=0,01]. Allergy represents a risk factor for recurrent URT infections, particularly for rhinopharyngitis, rhinosinusitis and acute otitis media. Adequate management of allergy may consequently be beneficial for the treatment and the prevention of these infections