[Roasai- Dorfman disease: a two cases report]

Rosai-Dorfman disease [RDD] is a benign lymphoproliferatif disorder characterized by cervical lymphadenopathies with a consistent risk of airways' compression and esthetical prejudice. Extra nodal localizations are also described. To report two pediatric cases of RDD. The first case concerned a patient with a prolonged nodal involvement of RDD. Remission seems to be natural although it coincided with a sulfam‚thoxazole- trim‚thoprime therapy. The second case illustrated an extranodal form of RDD localized in soft tissue and paranasal sinus with extension to nasal cavity which were corticodependant. RDD is usually a benign disorder. Particular localizations, lack of effective therapy and the high risk of recurrence are important issues in this rare affection

[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

[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

[Proximal gastro-esophageal reflux monitoring in patients with suspected laryngopharyngealreflux disease]

To assess the frequency and associated actors of proximal acid reflux in patients with ENT manifestations of gastroesopliageal reflux disease, and to compare the pHmetric parameters in the distal and the proximal esophagus in these patients. We conducted an open-prospective study, including consecutive patients with chronic pharyngitis or laryngitis. Twenty four hour esophageal pH-monitoring was performed, using a double sensor catheter. Proximal reflux was defined according to the recently published recommendations. We studied 43 patients [17 men and 26 women], mean age 39,5 years [15- 67 years]. Distal reflux was detected in 35 patients [81%]. Proximal reflux was detected in 26 patients [60%]. Ratio of numbers of proximal to distal reflux episodes was 0.34 [0- 0.90]. The proximal reflux episodes were characterized by a small number of episodes exceeding 5 minutes [2.6 + 4.4 vs 10.8 + 9.1: p <0.0001]. a less duration of longest reflux episode [15.6 + 23.5 vs 50.2 + 61 6 minutes p< 0.0001] and better esophageal clearance [1.6 + 1 vs 2.5 + 1 minutes/reflux p = 0.006], associated with a significant correlation between numbers of proximal reflux episodes and distal acid exposure time[r = 0.52 p <0.0001]. Proximal reflux is frequent in patients is with chronic pharyngitis or laryngitis. Proximal reflux episodes are correlated to distal acid exposure and associated with a better esophageal clearance

[Substernal goiter: diagnosis and therapeutic problems]

Sudsternal goiter has particular nosological, diagnostic and therapeutic problems. This study is to study the epidemiologic and clinical particularities of this disease and to emphasize on therapeutic problems essentially surgical management. We report a retrospective study about 25 cases of substernal goiter operated in the Rabta hospital between January 1996 and December 2005. The mean age at operation was 61 years and sex-ratio was 0, 5. Patients were almost symptomatic. Surgery was carried by cervicotomy in all but one ease in which sternotomy was necessary. Histological exam didn't find any mailgnity signs in 95.6%of cases. Substernal goiter surgery is more delicat than the cervical one. Accurate diagnosis leads to good surgical results

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%

[Nasosinusal sarcoidosis: 2 cases. a report of 2 cases]

Nasosinusal sarcoidosis is a rare non caseating granulomatous disease. It may be inaugural, isolated or associated with multisystemic sarcoidosis. We report two cases of nasosinusal sarcoidosis associated to multisystemic sarcoidosis. Both patients were females aged over 43 years. In one case, the primary symptom was a nasal obstruction. Tomodensitometric and guided biopsy findings provided the main diagnostic criteria. Anti-malaric treatment was prescribed in both cases. Stabilisation of the lesions was noted. We tried to reveal through this study the diagnostic and therapeutic difficulties of nasosinusal sarcoidosis

[Rhinoscleroma: a report of 2 cases]

Rhinoscleroma is a rare chronic granulomatous infection caused by Klebsiella rhinoscleromatis. Because of its mundane clinical presentation as chronic rhinits, it is frequently unrecognized. The authors report the cases of two female patients with pseudotumoral rhiniscleromas located in the septum and in the rhinopharynx respectively CT scan permitted a precise evaluation of the extent of the lesion Among the various para-clinical examinations required, bacteriological studies are very important and should be performed comcomitantly with biopsy