[Extemporaneous anatomo-pathological test in surgery of thyroid cancers. Values and limitations]. / L'examen anatomo-pathologique extemporané dans la chirurgie des cancers thyroïdiens. Intérêts et limites.

We report our experience in surgical treatment of thyroid cancer; 2470 total or partial thyroidectomies were performed for a thyroid nodule, 205 were primitive thyroid carcinoma (8.3%). Intraoperative frozen sections diagnoses were performed in 100% of the patients. In this study, a 100% specificity and 74% sensitivity were found. Data for each histological type were compared with the previous studies. Each false negative macroscopic aspect carcinoma's size, differenciation, plurificality were studied in order to understand the limits of frozen sections diagnoses. The higher rate of false negative was found with small, well differenciated vesicular carcinoma. This study shows that high accuracy of frozen sections diagnoses allows to improve the intraoperative management of thyroid cancer. The high specificity of frozen sections diagnoses strengthens our reliance upon this examination.

[Value of ultrasonography in the detection of metastatic cervical lymph nodes]. / Intérêt de l'échographie dans la recherche des adénopathies cervicales métastatiques.

A prospective study of 18 consecutive patients with carcinoma of upper respiratory and digestive tracts is presented. The authors describe the lymph node involvement in these cases. Preoperative ultrasound exploration of the cervical node regions was performed and US findings were compared with obtain by physical examination. Despite the limitations of ultrasonography, the diagnostic and prognostic interest were emphasized. Associated with color doppler, higher specificity and sensibility were noted.

[Hyo-sub-glosso-epiglottectomy in the surgical treatment of tumors of the vallecula and anterior laryngeal margin]. / La hyo-sub-glosso-épiglottectomie dans le traitement chirurgical des tumeurs de la vallécule et de la margelle antérieure.

Hyo-sub-glosso-epiglottectomy was performed in 56 patients with a tumour of the vallecula or the anterior laryngeal margin. Tumour classification in most of the patients was T2 and N0-N1. Survival rate at 3 years was 54% and 40% at 5 years. Major impairment of deglutition occurred in 5.4% of the cases. This operation is indicated for limited tumours of the vallecula and the anterior laryngeal margin.

[Fistula of the 4th endo-branchial pouch. Apropos of 4 cases]. / Fistules de la 4e poche endobranchiale. A propos de 4 cas.

The congenital fistula of the piriform sinus is a rare, often overlooked, malformation originating in the branchial pouch. More than 70 observations have been reported in the literature. The authors describe four new cases of documented fistula of the fourth endobrachial pouch. The terminology of these malformations and the different hypotheses concerning the fistular routes is given. The authors discuss their own observations and those reported in the literature in order to better define the clinical diagnosis and the request for complementary examinations for fistulae of the piriform sinus. Surgical exploration is the ultimate diagnostic and therapeutic step.

[Post-traumatic infections of the frontal sinus]. / Infections post-traumatiques du sinus frontal.

Post-traumatic infectious complications of the frontal sinus occur more frequently after multiple fractures than after isolated fractures. The greatest frequency is found with open traumas of the sinus, due to the presence of foreign bodies and to bone and mucosal destruction. Such infectious complications are curatively treated both medically and surgically, to eliminate the bony and mucosal infection and to restore the normal physiology of the frontal sinus. Stress is laid on the preventive treatment, especially on the quality of the initial surgical treatment, either by restoring the sinus with gauging of the nasal-frontal canals, or by eliminating the sinusal function by a canalization which appears preferable to exclusion by obliteration.