[Ear nose sarcoma. Reprt of 3 cases]

Head and neck sarcoma are very rare malignant tumors which can occur on any different ENT localization. The authors report tree different variety of ENT sarcoma diagnosed and treated at the oto-rhino-laryngological department of military hospital of Tunis. We intend to remind of clinical and histological particularities, therapeutic modalities and finally to evaluate the follow-up. From 2001 to 2007, three cases of head and neck sarcomas were diagnosted in ENT department of military hospital of Tunis. the study concerned a women [22 years old] and two men 36 and 76 years old. It deals with an orbital rhabdomyosarcoma, a carcinosarcoma of submandibular gland and a maxillary chondrosarcoma. In each case, diagnosis was validated by the immunohistochemistry. All patients had surgical removal of their tumor. External irradiation or/and chemotherapy was also indicated for all cases. ENT sarcomas are aggressive neoplasm. Long-term survival is bad with high potentialities of local recurrence and distant metastases

[Mycosic malignant external otitis due to aspergillus, about 2 cases]

Malignant external otitis is a severe uncommon infectious disease of the external auditory canal. Diabetes and immunodepression constitute the principal risk factors. The Pseudomonas aeruginosa is the most common germ. Since it is often a primary bacterial disease, initial mycosic infection is exceptional. However, Aspergillus can cause severe and dangerous forms. The authors reported two cases of mycosic malignant external otitis due to aspergillus. The pretherapeutic check-up included a computed tomography and technetium bone scintigraphy practiced in order to assess the extension. The diagnosis was confirmed by a mycological analysis of auricular sample. Hyperbaric oxygenation and medical treatment associating systemic antimycosic drugs, parenteral antibiotherapy were instituted for both patients. Death occured in one case, due to skull basis osteomyelitis. After 16 months of follow up, the second patient is still alive with no obvious complications

[Hyperbaric oxygen [HBO] on sudden hearing loss about 69 cases]

Sudden hearing loss is a typical otologic urgency. The pathophysiological mechanisms and the definition of sudden deafness are controversed. Several therapeutic diagrams were proposed for the management of this sensorineural urgency. But therapeutic results were not estimated to be efficient with conventional medical treatments. The purpose of the study: The authors report this study to evaluate the efficiency of hyperbaric oxygen [HBO] on sudden hearing loss, to revise factor prognosis and finally to seek for clinical forms of sudden deafness in which HBO must be primary indicated. A retrospective study was performed on 69 patients with sudden deafness, treated by HBO after unfavourable evolution under conventional treatments: In spite of the late time [20 days], fifty six percent of the patients had a satisfactory recovery. Efficiency of HBO was improved when it is practiced before the tenth day of the affection [92%]. Finally, this study shows an excellent systemic tolerance of HBO; since no severe incidents were recorded

[Naso-sinusal tuberculosis: in 3 cases]

Tuberculosis remains a real public health problem in Tunisia. Extra-pulmonary localizations account for 20 to 30% of tuberculosis disease, dominated by the node, osseous and urogenital localization. The authors present three cases of extra-pulmonary tuberculosis concerning the maxillary sinuses which represents an unusual localization of the disease. They were a man and 2 women old respectively of 30, 65 and 36 years. The main symptoms were dominated by nasal obstruction, posterior throwing and dental pains. All the patients profited from a complete clinical exam. A tomodensitometry exam was performed for the 3 patients. A maxillary sinus biopsy with anatomopathologic exam was made and had confirmed tuberculosis in all the cases. The three patients were treated with anti-tuberculosis quadruples for 2 months then double for 8-9 months and the evolution was good in all the cases after a 22 month retreat

[Factors influencing the results of the myringoplasty a retrospective a retrospective study about 633 cases]

The myringoplasty is the surgical reparation of a tympanic perforation without ossicular lesions. We achieved a retrospective study over a period of 17 years, concerning 633 myringoplasties operated in the Military Hospital of Tunis. The purpose of this work is to determine the factors influencing the results of the myringoplasty. A good result was obtained in 80 to 91, 6%of cases. These results were obtained using the Temporalis Fascia and the Underlay technique

[Labyrinthine fistula - about 14 cases]

Labyrinthine fistulae constitute a potentially severe complication of cholesteatoma, because of its consequences on cochleovestibular function and of the association with other possible complications. A retrospective analysis has been conducted on 14 fistulae due to cholesteatoma. Fistula was often limited and involved semi circular external canal in all cases. Open technique with removal of the cholesteatoma matrix was performed for all patients. After 2 years of follow up, the outcome was favourable for 12 patients except 2 cases of cholesteatoma recidive. Audition still unchanged in 64% of cases. Surgical management of labyrinthine fistulae is controversial. General and local conditions as well as fistula aspects make every case particular, and the choice of the best surgical technic is necessary for the therapeutic results