[Mycobacterial cervical lymphadenitis: role of surgery]. / Adénopathies cervicales tuberculeuses: place de la chirurgie.

OBJECTIVE: To discuss the place of surgery in the management of mycobacterial cervical lymphadenitis. PATIENTS AND METHODS: It's a retrospective study (1982-2002) about 246 patients treated in the ENT department of Farhat Hached Sousse for cervical lymph node tuberculosis. Resolution was considered when neither symptoms nor lymphadenopathy in examination were noted. RESULTS: The mean age of our patients was 28 years. A light female prevalence was noted. In 5 patients diagnosis was established by lymph node punction. A medical treatment of first intention was then managed with a failure in 3 cases, after deadlines from 3 to 4 months. All other patients were operated: cellulolymphadenectomy (47%), adenectomy (47%) or drainage of a cervical abscess (4%). Recurrence and antituberculosis treatment resistance were noted respectively in 6% and 3% of cases. DISCUSSION: Two questions are still discussed in the management of mycobacterial cervical lymphadenitis: 1- Is surgery necessary for the diagnosis? 2- When is surgery indicated directly? Histological specimen established the diagnosis in all cases and excluded a mestastatic lymph node. In some situations surgery must be indicated at first: cold abscess, lymph node fistulation. CONCLUSION: Surgery still has an important place in the treatment of tuberculosis lymphadenopathy.

[Submandibular lithiasis. Report of 48 cases]. / Les sous-mandibulites lithiasiques. A propos de 48 cas.

This retrospective study concerned 48 patients treated surgically for sub mandibular lithiasis. Results of medical imaging (plain films, sialography, ultrasonography) are confronted with operative findings. The surgical indications are analysed according to lithiasis localisation.

[An unusual cause of neonatal respiratory distress: nasopharyngeal hamartoma. 2 case reports]. / Une cause rare de détresse respiratoire néonatale: l'hamartome nasopharyngé, à propos de 2 cas.

We report two cases of nasopharyngeal hamartomas revealed by neonatal respiratory distress. Hamartomas are congenital and benign pseudotumors. Treatment was carried out by excision of the tumor and pedicle under general anesthesia.

[Gougerot-Sjögren syndrome disclosed by MALT lymphoma of the salivary glands. Report of 3 cases]. / Syndrome de Gougerot-Sjögren révélé par un lymphome MALT des glandes salivaires. A propos de trois cas.

Sjögren's syndrome is characterized by an increased risk of developing non-Hodgkin's lymphoma. The lymphoma is most frequently extra-nodal, preferentially affecting the salivary gland: low-grade MALT lymphoma. Conversely, underlying Sjögren's syndrome has been recently identified by some authors in patients with non-Hodgkin's lymphoma. In the present report, we present three cases of Sjögren's syndrome disclosed by low-grade salivary gland MALT lymphoma. The patients were all women aged 33, 38 and 52 years. Extension work-up revealed nodal and bone marrow involvement in one case and no evidence of disseminated disease in the two others. Using the European criteria, all of our patients had certain Sjögren's syndrome. Labial salivary gland biopsy and immunopathological studies in newly diagnosed low-grade MALT lymphoma would be helpful in identifying the real frequency of this association.

[Ear myiasis. Two case reports]. / Les myiases auriculaires. A propos de deux observations.

The authors report two cases of aural myiasis. This pathology rarity induced us to search after epidemiologic, clinic and therapeutic peculiarity of this parasitical disease.

[Intratympanic meningioma. Apropos of a case]. / Méningiome intra-trympanique. A propos d'un cas.

A 40 year old woman presented with a meningioma of the intratympanic region, a very rare localization which raises problems of differential diagnosis from jugular glomus tumors. A brief historical survey and complete etiopathogenic study are presented, and clinical features and results of complementary examinations, particularly angiography and computed tomography, are described. Treatment is exclusively surgical and diagnosis is confirmed with certitude by histopathology only.

[Therapeutic trial of tiapride in ENT]. / Essai thérapeutizue du tiapride en ORL.

Tiapride was studied in 60 patients with ENT affections. The dosage was 1 to 2 ampoules IM a day for 7 to 10 days, followed by a half a tablet 3 to 4 times a day for 2 weeks to 2 months. Results were excellent or good for 16 out of 20 cases of essential headache, 6 out of 6 cases of Barré Liéou's syndrome, 7 out 8 cases of sinus pain, 6 out of 8 cases of Méniè's disease, and 6 out of 6 cases of facial paralysis "a frigore". In 7 cases of post-concussion syndrome, excellent results were observed in all the patients, on headache. Vertigo was reduced in intensity. The effects was moderate or nil on tinnitus and deafness due to Ménières syndrome, as well as in 2 casls of facial neuralgia. Tolorance was excellent as, in these 60 patients, only 2 cases of dry mouth and 1 case of vomiting in a diabetic were reported.

[Multiple sclerosis in Tunisia: cochleo-vestibular study (author's transl)]. / Sclérose en plaques en Tunisie: étude cochléo-vestibulaire.

The authors undertook in Tunisia a cochleo-vestibular study of multiple sclerosis. 94 cases were included, with the following results:--67 patients had spontaneous nystagmus in the dark.--With provocation studies: - 52 cases showed signs of an irritative-type central vestibular syndrome, - 25 cases had a deficiency-type central vestibular syndrome. All of the patients underwent audition studies but the results showed that only 5 patients had a bilateral and symetrical retro-labyrinthine type perception deafness.