[Results of alginate and hypertonic solution in wound healing of head and neck cancers]. / Résultats de l'association de deux produits issus de la mer dans les troubles de la cicatrisation en cancérologie cervico-faciale.

INTRODUCTION: In head and neck cancers, complications such as pharyngostoma, orostoma, or fistula can present following surgery or surgery after irradiation. OBJECTIVE: To report the results of the association of two sea-derived products (Sinomarin and Algosteril) compared to normal saline for the management of healing. MATERIAL AND METHODS: This is retrospective study (1998-2000). Thirty patients were included in group 1 (Sinomarin-Algosteril) and 17 patients in group 2 (normal saline). The average age was respectively 60 and 56.2. Patients in both groups presented with advanced head and neck carcinoma (T3-T4) and healing complications. RESULTS: The delay of healing was respectively of 33.53 and 72.94 days. Results were statistically significant (Student T-test P < 0.05). CONCLUSION: Our results show the efficiency (p < 0.05) of the Sinomarin Algosteril association in head and neck cancer healing complications.

[Surgical methods of removal of T4 nasopharyngeal malignancies. A preliminary report on 18 cases]. / Place de la chirurgie dans le traitement des cancers du cavum classés T4.

OBJECTIVES: To describe the technique and evaluate postoperative sequelae and results of transfacial surgical removal of T4N0 nasopharyngeal malignant neoplasms. MATERIAL AND METHODS: Eighteen cases of surgically-treated nasopharyngeal cancers, managed between january 1993 and october 2000, were retrospectively studied. Three patients were non-responders to neoadjuvant chemotherapy, 6 suffered local recurrence following standard treatment and 7 were operated first either because of a huge and osteolytic tumor or because of an uncommon histolopathology. RESULTS: Preoperative Vth nerve neuralgia (8 cases) was alleviated (4 cases) or cured (3 cases). At the time of diagnosis, ophthalmoplegia was observed in 3 cases. It disappeared postoperatively in 2 cases and after following radiation therapy in one. Median follow-up of the series was of 31.8 mths. Four patients were died of disease; one of them from distant metastases 4 years post-surgery. One patient is alive with distant metastases. The 13 last (72.2%) are alive without disease with a 35.6 mths median follow-up (6-77 mths). DISCUSSION: This short and heterogeneous series cannot lead to any evidence-based conclusion. But mid-term free-of-disease survival of 4 of the 5 patients suffering local recurrence and of patients presenting with so-called non-radiation-sensitive tumors is to be considered. In comparison with the high risk of neurological sequels following reirradiation, absence of specific toxicity of surgery observed in this series is to be underlined. CONCLUSION: In selected cases surgical treatment does not demonstrate any toxicity and is able to offer mid-term local control of the disease. Its role is to be evaluated further before inclusion in the therapeutic algorithm of these very bad prognosis-associated tumors.

[Malignant melanoma of the nasosinal mucosa. Retrospective study apropos of 20 cases]. / Mélanomes malins des muqueuses naso-sinusiennes. Etude rétrospective à propos de 20 cas.

Twenty patients were treated for malignant melanoma (MM) of the mucosal surfaces of the nose and sinuses between 1987 and 1999 in our department. The mean age of these patients was 64 years, and there were 11 females and 9 males (sex ratio 1.2). Two patients had a past history of cutaneous or choroidal malignant melanoma, and were considered as having secondary melanoma. All patients presented with nasal obstruction and/or recurrent epistaxis. None of the patients with primary MM had either lymphadenopathy or distant metastases. 17 patients were treated surgically by the transfacial approach, aiming to obtain a cure. Radiotherapy and chemiotherapy were given only to the patients with secondary MM. Six patients have since presented with single or multiple local recurrence, and nine had distant metastases. The 3-year survival rate was 60%. This retrospective study has allowed us to compare the results of our series with these in the literature, and to review the treatment of this rare condition.

[Otolaryngological manifestations of sarcoidosis. Report of 10 cases and review of the literature]. / Manifestations ORL de la sarcoïdose. A propos de 10 cas. Revue de la littérature.

Sarcoidosis is a systemic chronic granulomatous condition of unknown aetiology. Although the mediastino-pulmonary type is the commonest, the condition may affect the head and neck in a significant number of cases, obliging the practising ENT surgeon to be familiar with the condition. The diagnosis is made by a combination of clinical, biochemical, radiological and histopathological features. We present 10 cases of sarcoidosis with exclusively cervico-facial features which have passed through the department between 1985 and 1996, including a typical nasal case with combined features, and a very rare pharyngeal case. The definitive diagnosis, always with histological confirmation, was sometimes made only after some delay, demonstrating the polymorphic nature of the clinical features, which are rarely pathognomonic. Special investigations, carried out virtually routinely once the diagnosis of ENT sarcoidosis was made, demonstrated only one case of associated pulmonary disease. Treatment was reserved for the symptomatic cases (4 out of 10), and consisted of systemic steroids whose dose and duration was determined by the clinical response.

[Syncopal neuralgia of the glossopharyngeal nerve caused by tumoral invasiveness. Therapeutic management. Apropos of 2 cases]. / Névralgie syncopale du glossopharyngien par envahissement tumoral. Conduite thérapeutique. A propos de deux cas.

Cases of glossopharyngeal neuralgia are relatively rare, and are occasionally secondary to an upper cervical carcinomatous invasion. The combination with syncopal episodes suggests the creation of a reflex pathway between the glossopharyngeal nerve and the vagus nerve by connections between the bulbar nuclei. The fact that the syncopal episode is systematically preceded by a neuralgic crisis enables its differentiation from other active vasomotor phenomena. Treatment is based essentially on pain-killers and occasionally, in the event of escape, by a neurosurgical resection of the root of the glossopharyngeal nerve and of the upper part of the vagus nerve. In the light of two recent cases, the authors recall the therapeutic management and the physiopathological mechanism of this particular form of neuralgia.