Left parapharyngeal ectopic goitre associated with eutopic thyroid and postoperative Horner's syndrome.

INTRODUCTION: The authors report a case of left parapharyngeal ectopic goitre, in which resection was followed by postoperative Horner's syndrome, and describe the difficult management of this entity. CASE REPORT: A 25-year-old woman presented with upper oesophageal dysphagia and a well-demarcated left parapharyngeal mass displacing the great vessels laterally and posteriorly. The mass was resected via an exploratory neck incision. Histological examination of the operative specimen revealed hyperplastic thyroid parenchyma. The postoperative work-up revealed a eutopic and euthyroid thyroid gland. The postoperative course was marked by Horner's syndrome that persisted at 1-year follow-up. DISCUSSION: Parapharyngeal ectopic thyroid coexisting with a functional thyroid is extremely rare. Parapharyngeal masses are usually derived from the parotid gland and nerves. Surgery of the parapharyngeal space can cause injury to the sympathetic trunk, responsible for Horner's syndrome, as in our patient. CONCLUSION: Ectopic thyroid should be considered as a possible diagnosis of a parapharyngeal mass. Although rare, Horner's syndrome is a dreaded complication of surgery of the parapharyngeal space.

[Malignant parotid tumors: epidemiology in Togo]. / Tumeurs malignes de la parotide: épidémiologie au Togo.

INTRODUCTION: We had for aim to determine the epidemiological profile of malignant parotid tumors in sub-Saharan country: Togo. PATIENTS AND METHODS: We retrospectively studied the files of patients seen and treated for malignant parotid tumors, from January 1989 to December 31, 2008, at the Tokoin teaching hospital. Patients treated for another malignant tumor at the same time were excluded from the study. RESULT AND DISCUSSION: Ninety-six patients were included. Thirty-one tumors (32.29%) were malignant, in 18 male and 13 female patients with a sex ratio of 1.38. The average age was 39years (range 24-70years of age). Two patients could not undergo surgery. Histologically, there were 10 cases of squamous cell carcinoma (32.26%), 6 cases of adenoid cystic carcinoma (19.4%), 6 cases of adenocarcinoma (19.4%), 4 cases of carcinoma in pleomorphic adenoma (12.90%), 3 cases of mucoepidermoid carcinoma (9.7%), 1 case of acinar carcinoma (3.2%), and 1 case of cystadenocarcinoma (3.2%). DISCUSSION: Squamous cell carcinoma was the most frequent histological type observed in Togo, contrary to literature data for which mucoepidermoid carcinoma is the most frequent malignant parotid tumor.

[Primitive neuroectodermal tumor of the vagus nerve]. / Tumeur neuroectodermique primitive du nerf vague.

Primitive neuroectodermal tumors are a rare type of malignant neuroectodermal tumor that is very aggressive. Cervicofacial location is rare, even exceptional. We report a case of a 4-month-old male infant, referred from the pediatric clinic for severe supralaryngeal dyspnea, a firm mass under the left mandibular angle, mobile and extended to the parotid area, painful, with a curve of the left side wall of the oropharynx. Cervical computed tomodensitometry showed a well-limited mass in the carotid area, enhanced by the contrast product. A vascularized mass, which had developed at the expense of the vagus nerve, was removed surgically. Histology found a primitive neuroectodermal tumor.

Management of acquired cholesteatoma in children: a 15 year review in ENT service of CHNU de FANN Dakar.

OBJECTIVES: To analyze the epidemiology, diagnosis, management and the prognosis of cholesteatoma of the middle ear in children. METHODS: This was a retrospective study of 15 years (from 01 January 1995 to 31 December 2009) for patients aged 0-15 years admitted in ENT ward of FANN hospital for chronic otitis media complicated with cholesteatoma The parameters studied were epidemiology, clinical presentation, disease progression and management. RESULTS: Sixty-six participants were included. We noted a slight male predominance with a sex ratio of 1.44. The average mean age was 10 years. Most patients presented with signs of complications (69.7%) and mastoiditis was the most common complication (63.6%). The otorrhea was noted in almost all patients: n = 64 (97%) and deafness in 49 patients (74, 2%). There was a slight predominance of cholesteatoma on the right side (51.5%). Schuller's view of the mastoid cells was done in 21.2% of patients (n = 14) and showed sclerotic mastoid air cells for all them. Eighty-two percent (82%) of patients presented with conductive hearing loss. A radical mastoidectomy was performed in 66.7% and modified radical mastoidectomy in 33.3% of cases. Mean follow-up was 6 months. Recurrence of cholesteatoma was noted in 13% of cases. CONCLUSIONS: ENT ward of Hospital Fann is one of the two centers in Senegal where cholesteatoma of the middle ear are treated. This low number of cholesteatoma in children in a developing country is in relation to the fact that patients only present when complications develop: 70% of cases. The reason for this in our setting include insufficient human and manpower resources necessary for prompt management of the disease and also lack of awareness among the populace. In these settings we advocate canal wall down mastoidectomy (radical or modified radical) as the treatment of choice.