Intracranial abscess and empyema from ENT origin

Intracranial abscess and empyemas from ENT infection are rare. The aim of our study was to recall the treatment and therapeutic results. It was a retrospective study from 1995 to 2006 concerning. 23 patients who had brain abscesses secondary to an ENT infection. The infections origin was otological in 56% of cases, sinusal in 44%. Bacterias were identified in 40% of cases. All patients benefited a medical treatment to basis of at least 2 antibiotics a long length going from 20 days to 3 less by intravenous way. Nine patients benefited neurosurgery with an ENT treatment surgical. Nine patients had alone neurosurgery and 5 cases had an ENT surgery alone. The treatment consists in excision or single punction of the abscess. 72% are alive and well. We have no dead. The classical intracranial hypertension associated to high fever is usually truncated. The diagnosis is more precocious thanks to the progress of the medical imagery. Multibacterial infections are frequent. Treatment is medical and surgical. Recovery requires a specific surgical treatment of the ENT infection in more than 60% of cases. An adapted treatment permits a recovery without after effects in at least the half of cases

[Hypopharyngeal Zenker's diverticulum about four cases]

The hypopharyngeal Zenker's diverticulum is a rare pathology [1%of oesophagien pathology]. It is up to a hernia of the oesophagus posterior wall throught the fibres of the pharynx inferior constrictor muscle. Many pathogenic hypotheses are put forword; it is generally benign but can cause serious complications. The treatment can be difficult. The best treatment seems to be diverticulectomy with cricopharyngeal myotomy. Endoscopic treatment can be a good therapeutic alternative. We report four cases of patients with DPO three women and one man; the mean age of patients was 67 years. All our patients suffered from dysphagia and loss of weight. The diagnostic, clinically suspected was cofirmed by radiological examinations. All our patients were operated. Surgery was satisfactory for three patients. One patient died