ABSTRACT
Parmi les tumeurs de la tête et du cou, le carcinome adénoïde kystique ne représenteque 1%. C'est la tumeur maligne la plus fréquente des glandes salivaires accessoires.Sa localisation dans la fosse nasale est exceptionnelle. Nous rapportons un cas de carcinome adénoïde kystique de la fosse nasale chez une patiente de 42 ans qui se présente pour une symptomatologie nasale. La tomodensitométrie objective un processus tissulaire de la fosse nasale droite, l'endoscopie montre une tumeur s'étendant au vestibule avec à la biopsie un carcinome adénoïde kystique. La prise en charge chirurgicale a consisté en une exérèse de la tumeur avec maxillectomie totale suivie d'une radiothérapie
Subject(s)
Carcinoma, Adenoid Cystic/diagnosis , Carcinoma, Adenoid Cystic/radiotherapy , Morocco , Nasal Cavity , Salivary GlandsABSTRACT
AIMS: Insertion of a foreign body in the nasal cavity is a very common incident in children. It is easily diagnosed, but the type of foreign body varies and extraction can sometimes be difficult, with risk of complications. The present study reports nasal foreign bodies seen in emergency in our ENT department, with an update on the state of knowledge. MATERIALS AND METHODS: A prospective study between May and August 2011 included all patients admitted to the ENT emergency unit for nasal foreign body. Data comprised age, gender, circumstances of discovery, symptoms, type of foreign body, extraction method and complications. RESULTS: Two hundred and sixty cases of nasal foreign body were included, representing 4.3% of all consultations in the unit. Mean age was 3 years (range: 1-16 years); the sex ratio was 1.4 (male predominance). The incident was reported by a family member or the actual child in 76.9% of cases (n=199), or discovered following nasal symptoms in 23.1% (n=61). The main types of foreign body were non-organic synthetic beads in 18.8% of cases and vegetable forms in 17.7%. Extraction was easy, using forceps, micro-hooks or suction, in 91.53% of cases. Complications comprised infection (n=48), epistaxis (n=18) and nasal septum perforation (n=1). CONCLUSION: Nasal foreign bodies are a frequent accident in medical practice, especially in young children. They are generally harmless, but may incur complications if overlooked or when a button cell is involved, whence the importance of timely extraction. The best treatment, however, remains prevention.
Subject(s)
Foreign Bodies , Nose , Adolescent , Child , Child, Preschool , Emergency Treatment , Female , Foreign Bodies/diagnosis , Foreign Bodies/epidemiology , Foreign Bodies/therapy , Humans , Infant , Male , Prospective StudiesABSTRACT
INTRODUCTION: Early-onset preeclampsia is associated with a greater risk of cardiovascular disease than late-onset preeclampsia. OBJECTIVES: We tested the hypothesis that young women, with previous early-onset preeclampsia, have unique differences in long term cardiovascular phenotype compared to late-onset preeclampsia or normal pregnancy. METHODS: 140 women (mean age 40 yrs) were followed up 6-13years following pregnancy. 90 had had preeclampsia (45 early onset (before 34 weeks of gestation), 45 late onset) and 50 had normotensive uncomplicated pregnancies. Women with cardiovascular risk factors present before pregnancy were excluded. Fasting lipids, glucose, insulin and circulating cytokines were measured. Central blood pressure (BP) and arterial stiffness (pulse wave velocity (PWV)/augmentation index (AI)) were assessed by applanation tonometry, common carotid intima media thickness (cIMT) by ultrasound and cutaneous capillary density by intravital microscopy. 46 women returned for assessment of cardiac structure and function by magnetic resonance and echocardiography as well as ambulatory blood pressure monitoring. RESULTS: All women with a previous history of preeclampsia had 5-10mmHg higher peripheral and central BP (P<0.001) as well as elevated total: HDL cholesterol (P<0.003), insulin resistance (P<0.04) and circulating TNFα (P<0.007). They also had increased arterial stiffness (P<0.04) and cIMT (P<0.005). Cardiac size and systolic function were preserved but there was evidence of abnormal diastolic relaxation (E/E' -P<0.04). In contrast early-onset preeclampsia was associated with characteristic differences in peri-pregnancy blood pressure, long term ambulatory measures and microvascular function. CONCLUSION: Early onset preeclampsia is associated with unique features in long term cardiovascular phenotype. Pregnancy disease characteristics may identify women at greatest potential benefit from monitoring and primary prevention.
