[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

[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

[ odontogenic maxillary sinusitis: about 31 cases]

The odontogenic maxillary sinusitis is the consequence of the distribution of an inflammatory or infectious process of a tooth in sinus mucous membranes. The purpose of our work is to study epidemiological profile, clinical and radiological characteristics allowing the diagnosis of this pathology as well as the various therapeutic strategies adopted. We report a retrospective study of 31 observations of odontogenic maxillary sinusitis brought together in the service of ORL and of CMF of Rabta hospital over a period of 12 years. In our series, the frequency of this pathology was considered at 42,5% among the group of all maxillary sinusitis brought together during the same period, the average age was of 38 years with a sex ratio of 1,04. The dental antecedents are obvious in 80% of cases, the iatrogenie was found in 64% of cases. Dental causes were dominated buy para-apical cysts [29%], and the movement of the dough canalaire [23%] especially in fongic forms of sinusitis