[Long-term esophageal and oropharyngeal pH-metry in ORL manifestations of gastroesophageal reflux in children]. / La pH-métrie couplée, oesophagienne et oro/hypopharyngée, de longue durée dans les formes ORL de reflux gastro-oesophagien de l'enfant.

Several studies published over the last few years have pointed out the importance of gastroesophageal reflux (GER) in the pathogenesis of certain cases of chronic or recurrent pharyngo-laryngitis. While the presence of an acid reflux at the level of the pharyngo-larynx has recently been demonstrated in certain cases, the real incidence and pathogenic impact of this reflux is not precisely known. A new technique of continuous 24 hour bi-level monitoring of endoluminal pH in the esophagus and the oro/hypopharynx has made it possible to observe the variations in acid-base balance in contact with the pathological mucosa. 21 patients, 2 months to 7.5 years old, presenting recurrent episodes of pharyngitis or laryngitis, underwent continuous pH monitoring during a 24 hour hospitalization. 6 control subjects, 1 month to 13 years old, presenting no chronic or recurrent ear, head or neck pathology and no sign or symptom of GER were subjected to the same monitoring regimen. A statistically significant difference between the 2 groups is evident for most of the parameters analysed. The most discriminative parameter is the fraction of the total recording time where the pharyngeal readings remain under ph6 (p < 0.0005). These results demonstrate that, in this clinical condition, acid of gastroesophageal origin is in contact with the pharyngeal mucosa. This suggests that the acid has a causal role in the pathological changes observed in the pharyngolaryngeal mucosa.

[Mycoses in otorhinolaryngology. Apropos of 167 cases]. / Les mycoses en O.R.L. A propos de 167 cas.

The authors observed 167 cases of E.N.T. mycoses over a 14-year period (1974-1988) in the E.N.T. Departments of the Abidjan University Hospitals in the Ivory Coast, and in two private health institutions in the city. The majority of cases involve candidiasis (91 cases, or 54.5%), followed by aspergillosis (72 cases, 43.1%) and rhinoentomophtorosis (4 cases, 2.4%). Men are more affected than women (125 as against 42). Men suffering from rhinoentomophtorosis are, for the most part, farmers. Among the contributory factors, we found respectively the abuse of antibiotics, either alone or in association with corticoids for general or local use (ear drops), bathing in lagoons, and diabetes. Bacterial infection is often associated with these mycoses--mainly streptococci and staphylococci aurei. Clinical signs are dominated by pruritus, dull pains, a feeling of fullness in the ear, or of burning in the pharynx. An association of systemic Miconazole and Amphotericin B (local use) has given the best results for candidiasis and aspergillosis. For rhinoentomophtorosis, treatment was long, and even disappointing, until the use of Ketoconazole which may without doubt be considered as the medicament of choice.