[A case of a naso-sinus meningoencephalocele]. / A propos d'un cas de méningo-encéphalocèle naso-sinusal

Beginning with a very vulgar symptomatology evoking with an adult, free from traumatic antecedents, a left ethmoido-maxillo-choanal polyp, the anatomo-pathologic survey of the lump, cutted out without incident, by the maxillary sinus (Caldwell-Luc), revealed the presence of zone of cerebral texture. The complaints of aqueous rhinorrhea increased and aggraved with diverse neuro-radiologic investigations enabled to state diagnostic of meningoencephalocele through ethmoidal left forepart osseous breach that was found and stopped up after by intracranial way. After this observation, the authors, looking at some generalities about meningoencephaloceles, insist on the frequency of the first manifestations generally from the first childhood, on the precious interest of the radiology in order to detect the osseous dehiscence and on the importance of neurosurgical exploration by intracranial mean before any endeavor of biopsy or of extraction of the lump by natural way. The originality of the reported case consist in the lack of symptomatology and in the late apparition of it, in the absence of septic meningitis complications after the extraction of the growth by low way (post-operative antibiotherapy), in the extention, unusual for the pharyngo-nasal kind of the cerebral hernia, into the maxillary sinus.

[Clinical aspects of hypertrophic lesions of the sinusal mucosa]. / Aspects cliniques des lésions hypertrophiques de la muqueuse sinusale

Ninety-five cases mucous hypertrophy of the maxillary sinus spreading over several years are examined in this study. They are made conspicuous by radiotomografies. If an hypertrophy of a sinous mucous is often silent or is accompanied with a minor symptomatology (pharynx or ear troubles), in the other cases, it is accompanied with strong headaches. A simple exaeresis of the polype without instrumental operation in the ostium region leads to their disappearance. This rather surprising result allows us to wonder if an ostial dyspermeability is sufficient to explain the sinous headache mechanism.