[Ventilatory examination before an aesthetic rhinoplasty]. / Le bilan ventilatoire pré-rhinoplastie esthétique.

Nose and nasal cavity provide ventilation, inspired air conditioning and olfaction. They may be the seat of inflammatory, infectious and malignant disease, or preoperative or postoperative architectural abnormalities, altering these functions, for which clinical examination will be a variable return. First of all, we'll see, after a brief physiological reminder, descrambling examination which allows non-ENT surgeon to select patients justifying a further preoperative functional exploration. In total, there will be three groups of patients: those who have no cons-indication to rhinoplasty, those with an indication of aesthetic and functional rhinoseptoplasty, those with cons-indication for rhinoplasty.

Late pneumolabyrinth after undiagnosed post-traumatic perilymphatic fistula. Case report illustrating the importance of systematic emergency management.

INTRODUCTION: Temporal bone fracture is a common complication of high-energy cranial trauma. Labyrinth involvement is rare, but there is a risk of perilymphatic rupture that is often underestimated on initial clinical examination due to the predominance of neurological and/or somatic symptoms. CASE REPORT: A patient presented with overlooked perilymphatic fistula, decompensated by hyperpressure effort due to poorly adapted management. DISCUSSION: Following a review of the literature on post-traumatic pneumolabyrinth, overall management (from diagnosis to treatment, via prevention advice) was analyzed. A constructive critique of the patient's treatment was thus made. CONCLUSION: We argue for a systematic management protocol in cranial trauma with temporal bone fracture, comprising ENT examination, millimetric-scale cross-sectional imaging of the fracture site, and standardized counseling to prevent late complications.

Management of vascular malformations of the parotid area.

OBJECTIVES: To describe our experience in the management of vascular malformations of the parotid area. MATERIALS AND METHODS: This was a retrospective study. Among 614 parotidectomy performed between 1998 and 2008 at our institution, 10 cases (1.6%) of vascular malformations have been identified. Clinical features and management of these patients were analyzed. RESULTS: Clinical presentation was usually related to that of a benign, slow-growing and asymptomatic tumor. There was a marked female predominance (90%). In any case, the diagnosis of vascular malformation could be obtained with certainty preoperatively. Surgical excision was performed most often referred to diagnosis. Sixty percent of vascular malformations were located in the superficial lobe of the parotid gland. On the histological we found a classic look with benign vascular proliferation of endothelial cells in the walls. The vessel lumen was either the head of a congestion or thrombosis or calcification (phleboliths). CONCLUSION: Vascular malformations of the parotid gland, rare disease, are mainly venous. The terminology is based on clinical data, scalable, histological and hemodynamic as classified by the International Society of Study of Vascular Anomaly (ISSVA). Despite advances in imaging including MRI they remain difficult to diagnose. The treatment of reference is surgical excision.

[Aesthetic profiloplasty: retrospective study of 101 cases]. / La profiloplastie esthétique : étude rétrospective à partir de 101 cas.

OBJECTIVES: Aesthetic profiloplasty focuses on patients with normal dental occlusion and summarizes the association of a rhinoplasty and genioplasty. The aim of our study is to analyze the dysmorphoses overall profile, as well as different surgical techniques. This also allows to validate a method of analysis and construction of an aesthetic project based on a profile photograph. MATERIALS AND METHODS: This is a retrospective study of 101 adult patients undergoing profiloplasty at our institution over a period of 35 years. RESULTS: 18 patients (17.8%) had an abnormality of the nasofrontal angle, 62 (61.3%) abnormal and the nasolabial angle 101 a chin dysmorphia. CONCLUSION: We studied profiloplasty focusing on its borders, first of all the nasal profile and then the facial profile with the chin. Our profilometric building is simple, didactic and to obtain a good cosmetic result. The Marseilles School Pech and Cannoni was intended, regarding rhinoplasty, trying to get a natural result for a consistent look. Through profiloplasty we continued this teaching of "natural reworked" to achieve the most harmonious profile.

Transoral surgical treatment of Eagle's syndrome: case report and review of literature.

Eagle's syndrome is a symptomatic abnormal length of the styloid process and/or a calcification of the stylohyoid ligament. Diagnosis is based on common pharyngeal symptoms and is confirmed by radiologic examination, more particularly CT-scan. Medical and surgical treatments are described. Medical treatment consists in repeated local anaesthetics, steroid infiltration or analgesics administration. It is purely symptomatic and has no long-term effectiveness. Surgical treatment remains the treatment of choice and consists of removal of the abnormal process. Both transoral and external approaches have been described. The advantages of the transoral approach is a shorter operative time, the absence of aesthetic prejudice and a lesser risk of neurovascular injury. Few post operative complications have been described (surgical cervical emphysema, cervical swelling, trismus and moderate breathing difficulty) but none of the studies reported neurovascular injury, deep cervical infection nor long-term complication. We present the technique, a case report and a review of the literature of the transoral approach.

[Parathyroïd adenoma induced by long term lithium therapy: case report and review]. / Adénome parathyroïdien induit par le traitement au long cours par lithium: cas clinique et revue.

UNLABELLED: We report a case of a parathyroid adenoma during a long term lithium treatment without therapeutic overdose. CASE REPORT: A 73-years-old woman presented a demonstrative biological syndrome with hypercalcemia, elevated parathormone, normal urinary cyclic AMP, normocalciuria. CONCLUSION: This lithium induced hyperparathyroidism differs from the classic primary hyperparathyroidism with parthyroid adenoma where urinary cyclic AMP excretion is elevated and where there is hypercalciuria. Lithium is blocking the negative feedback of calcium on parathormone secretion and stimulates the growth of parathyroid adenoma. Treatment is surgical and consists in adenoma ablation. Calcemia follow up is indicated in patients with long term lithium therapy

[Fractures of the nose: simplified diagnosis and management]. / Fractures du nez: diagnostic et prise en charge simplifiée.

Fracture of the nose is a frequent injury. Careful management is necessary to avoid not only cosmetic but also functional sequels. Therapeutic modalities are simple and can easily be carried out under local anesthesia.