[Abnormal trajectory of the internal carotid artery in the middle ear. Report of a case]. / Trajet aberrant de l'artère carotide interne dans l'oreille moyenne. A propos d'une observation.

The authors report a case with an aberrant course of the internal carotid artery within the middle ear--a rare abnormality with only about fifty cases so far reported in the literature. The combination of pulsatile tinnitus and a retro-tympanic mass calls for a precise anatomical investigation of the temporal bone before any surgery is undertaken. The role of the various complementary investigations is discussed. A high resolution CT scan is the key investigation, and is sufficient to give the diagnosis in the majority of cases. Angio-MRI currently affords the possibility of confirming this vascular malpositioning in a non-invasive way. Arteriography should be used only when there is remaining doubt about the possibility of a glomus tumour, or before treatment by clamping. The most logical course to adopt would seem to us to be to abstain from treatment once this diagnosis has been made, given the risk of major haemorrhage and the potential neurological complications.

[Apropos of 2 cases of Scedosporium apiospermum nasosinusal infection]. / A propos de deux cas d'infection nasosinusienne à Scedosporium apiospermum.

We report two cases of nasosinusal infection caused by Scedosporium apiospermum and involving the nasal fossa in one case and the maxillary sinus in the other. The course of the disease varied according to the patient's immune status. The otherwise healthy patient (case n. 1) was completely cured by surgery, whereas the immunosuppressed patient (case n. 2) had local extension with pseudotumoral symptoms and lysis of the inter-sinusonasal septum; an early surgical treatment combined with local administration of a specific antifungal agent resulted in an apparent cure, but the patient died a few months later. A review of the literature confirms the invasive potential of this fungus which in immunosuppressed patients (by therapeutic immunosuppressants or by a debilitating disease) becomes a dangerous opportunistic organism. Cultures on Sabouraud's medium provide an accurate diagnosis and enable antifungal drugs to be tested, miconazole being the most regularly effective of them. In healthy subjects surgery is the sole treatment of nasal or sinusal lesions, while in all immunocompromised patients it must be combined with an antifungal treatment.

[Carbocysteine in catarrhal ORL diseases]. / La carbocistéine dans les affections O.R.L catarrhales.

By stimulating an enzyme, the sialyltransferase, Carbocisteine has a privileged place in mucomodifying therapeutics. It allows the substitution of pathologic secretions, congesting and aggressive, by physiologic restructured mucus. Tested with success in the E.N.T. catarrhal diseases, Rhinathiol interest is passed in review in each concerned pathologies. About interest of repairing mucociliary transport on the clinical symptomatology improvement.

[Treatment of subglottic stenoses using the Pearson's operation: apropos of 3 cases]. / Traitement des sténoses sous-glottiques par l'opération de Pearson: à propos de trois cas.

Surgery of stenoses of the laryngo-tracheal junction is governed by the necessity of maintaining the support of the cricoid-arytenoid articulations and of preserving the recurrent nerves. Sub-total cricoid resection with conservation of the recurrent nerves, known as Pearson's operation, enables the treatment of fixed sub-glottic stenoses with mobile larynx. On the basis of three recent observations, the authors define the indications and the performance of this surgery. The respiratory and vocal results are considered satisfactory in these three cases.

[Florid oral papillomatosis: evaluation apropos of 2 cases]. / Papillomatoses orales florides: mise au point à propos de deux cas.

Oral florid papillomatosis is a rare, so-called pre-neoplastic non-obligatory complaint. The authors, on the basis of two cases, attempt to define the concept of malignity associated with this complaint and the resulting surgical principles.