Coblation turbinate reduction in childhood allergic rhinitis.

INTRODUCTION: Nasal obstruction is the allergic rhinitis symptom least amenable to medical treatment, and inferior turbinectomy may be required. Coblation is a minimally invasive technique that is effective in obstruction secondary to inferior turbinate hypertrophy. The present study assessed efficacy in children presenting with obstructive allergic rhinitis after failure of medical management. PATIENT AND METHODS: This prospective study included nine children with allergic rhinitis. Coblation was performed after assessment of rhinitis. Obstruction was assessed on rhinomanometry and a visual analog scale; other rhinologic functional signs were assessed on interview, and functional impact was assessed on the PRQLQ quality of life questionnaire. RESULTS: After the procedure, all nine children showed reduced nasal obstruction and improved rhinologic function signs, confirmed by the favorable evolution of PRQLQ scores. CONCLUSIONS: The study demonstrated the interest of coblation in controlling nasal obstruction in children with allergic rhinitis refractory to medical treatment, with conserved nasal function. Larger-scale studies with longer follow-up will be needed to confirm these results.

[Cephalic cancer pain controlled by intraventricular administration of morphine and clonidine]. / Douleurs céphaliques néoplasiques contrôlées par administration intraventriculaire de morphine et de clonidine.

A 47-year-old woman suffered from a pharyngeal cancer causing pain only poorly relieved by high doses of oral morphine. Oral administration was switched to the intracerebroventricular (ICV) route but pain relief was only transient despite a daily dosage up to 1.5 mg of morphine. Finally an effective pain relief was achieved with increasing doses of clonidine (5 to 30 micrograms) in combination with morphine (1.5 mg) by ICV route. Neither arterial hypotension nor sedation occurred and the patient recovered transiently a better quality of life.

[Mucocutaneous leishmaniasis. Report of 2 cases]. / La Leishmaniose cutanéo muqueuse. A propos de deux cas.

Two new cases of midfacial granuloma caused by leishmaniasis are reported. This disease is very rare in France but very frequent in South America, where it occurs in two forms called UTA and Espundia. These are described here as well as the means of diagnosis and treatment for this disease. A brief review of the cases published in France seems to indicate that the disease is underestimated in this country. The study of the cases published in other African or European countries shows that all species of Leishmania can produce a midfacial granuloma.

[Serous otitis in children. A manifestation of atopy?]. / Otite séro-muqueuse de l'enfant. Une manifestation de l'atopie?

A study in a consecutive series of children aged 10 months and 2 and 4 years, attending for general health examinations, allowed comparison of a group of 94 children with serous otitis with a control group of 85 children. About 100 parameters, including past history, and results of clinical and paraclinical examinations, were compared, and findings used for statistical analysis. Results confirmed the usual clinical picture of serous otitis in children. In addition, four criteria were demonstrated that were all related to an allergic diathesis: a previous history of familial allergy, spasmodic nocturnal cough, blood hypereosinophilia and maxillary rhinosinusitis. Allergy appears, therefore, to play a role in the physiopathology of serous otitis and should be the object of screening with the aim of prevention and therapy.