[Intracranial complications of sinusitis]

Intracranial complications of sinusitis are always a subject of actuality. They present diagnostic and therapeutic problems. To study the clinical characteristics and treatment modalities for intracranial complications of sinusitis while insisting on their severity. Retrospective study concerning 7 patients who had intracranial complications secondary to sinusitis. Our study was about 3 men and 4 women. The mean age of patients was 24 years. Neurologic signs were the most common symptoms. The diagnosis was confirmed by CT scan and lumbar puncture. The different complications were empyema in 5 cases and meningitis in 2 cases. Treatment included parenteral antibiotic therapy and surgery. The neurosurgical management has been achieved in 3 cases. Control was obtained in 4 cases, the mean receding was 18 months. Intracranial complications of sinusitis must be evoked, especially in cases of febrile headache or facial oedema. CT scan must be realized in slightest doubt. The treatment must be started precociously allowing a cure without after-effects

[ plunging goiter: about 43 cases]

The plunging goiter consists in a goiter whose lower limit is not palpable in surgical position. To study the epidemiologic characteristics, the circumstances of discovery, the clinical signs, and the management of this disease. A retrospective study about 43 cases of plunging goiters operated during a period of 14 years in the ENT department of the hospital The Rabta Tunis. The average age of our patients was 59.3 years. On physical examination, goiter was palpable in 41 patients [95.3%]. The plunging character of the goiter was noted, at echography, in 26 patients. A cervico-thoracic scanner was performed in 41 patients [95.3%]. It helped to confirm the plunging goiter in all patients. These goiters were most frequently pre vascular [73.2%] compared to the innomined venous trunk. The lower limits of the intrathoracic extensions were on the level of the superior vena cava in 4 cases [9.7%], on the level of the left brachio-cephalic venous trunk in 16 cases [39%] and on the level of the aortic arch in 15 cases [36,5%]. The cervical incision was sufficient in 39 cases [97.5%] and we used a combined sternotomy in one patient [2.5%]. The plunging goiter is a thyroid tumour cervical originally descended, then developed, in the mediastinum. A good clinical examination and paraclinical can reach a definite diagnosis and to achieve better surgical

[Allergic rhinitis]

Allergic rhinitis is a daily problem to which are confronted principally general practitioner, paediatrician, ear, nose and throat specialist and allergologist. Also, this subject is still always alife because allergy seems in a constant progression in our society. To clarify diagnostic and therapeutic criteria of this affection. We have realized a literature review concerning physiopathology, clinical symptoms, the position of preclinical investigations and finally therapeutic modality of allergic rhinitis. Appropriated treatment of allergic rhinitis should be general it requires a knowledge and better comprehension of the disease and optimum prevention, if it is possible, of allergic symptoms

Chontirosarcoma of sinonasal cavity: a case report and brief literature review

Chondrosarcomas are slow-growing malignant tumors that usually arise from cartilaginous structures. it may occur in the head and neck region with a predilection for the maxillofacial skeleton, where it has been reported to occur particularly in the mandible anti maxilla. Ghondrosarcomas of the sinonasal tract is very rare. Report a new case. We present the case of a 43-year-old man presenting with an incidental finding of a chondrosarcoma of the maxillary and ethmoid sinus with nasal extension. The tumor was completely resected using a transnasal endoscopic approach. Treatment has followed by a radiation therapy and the patient was considered free of disease at her 5 years follow-up. Surgery is the mainstay treatment of chondrosarcomas. In selected patients, complete resection can be achieved using transnasal endoscopic approach

Acute otomastoiditis in children, About 44 cases

Acute mastoiditis with osteitis is secondary to bacteria involving mastoid cavities. Describe the epidemiologic aspects. Between 1990 and 2003, we listed 44 files of children hospitalized for acute mastoiditis. The treatment was in any case medical associated to a surgical treatment in 30 cases. The age of our patients was consisted between 2 months and 14 years with an average is 2 years. The sex ratio of patient was 1.1. 29 patients didn't have any antecedents particular O.R.L, 8 patients were followed for otitis middle chronic and 7 had an cholesteatomateuse. The auricular old-fashioned swelling was the most frequent functional sign. A scanner has been achieved in 13 cases. The treatment was medico-surgical in 30 cases is 68.8% and an only antibiotherapie in 14 cases is 31.8%