[Foreign body in the maxillary sinus. Considerations on maxillary sinus approaches wound closure]. / Corps étranger du sinus maxillaire. Considérations sur la fermeture des abords maxillaires.

INTRODUCTION: Paranasal intra-sinus foreign bodies are often related to wounding agents or to penetrating trauma, as caused by car crashes. The maxillary sinus is the most often affected region. We present an atypical clinical case of a foreign body in the maxillary sinus. CASE REPORT: A 27-year-old male patient, consulted for right facial pain associated to a yellow and fetid nasal discharge. Tooth no. 16 had been extracted five months before. Twenty days after extraction, there was an oro-antral fistula which was closed with surgical dental cement. At consultation, the fistula was patent in the tooth alveolus. A "cone beam" CT scan showed a 2-cm long hyper dense image with well-defined margins within the right maxillary sinus, associated with sinusal mucosa thickening. The diagnosis was an oro-antral fistula complicated by maxillary sinusitis due to a foreign body. The foreign body was removed under general anesthesia and antibiotic therapy, through an antero-lateral antrotomy, and sinus curettage was performed. The anterior cortical wall was fixed with a titanium miniplate. The fistula was closed with a buccal fat pad. There was no complication during the 24-month follow-up. DISCUSSION: Foreign bodies may be found in the sinuses, especially in the maxillary sinus. They are often of iatrogenic origin. CT scan may confirm the diagnosis. The treatment is surgical removal.

[Clinical experiences with a variable balanced diet in a neurological intensive care station]. / Klinische Erfahrungen mit einer variablen Sondendiät auf einer neurologischen Intensivstation.

The variable balanced diet (Berodiät V) consisting of only a few requirement-adapted components can be used for longterm tube feeding in many patients of a neurological intensive care unit. This extraordinarily high energy supply necessary in this group of patients can be accomplished without difficulties, which makes it possible to dispense with longterm parenteral feeding. Preparation and administration are unproblematic. Cases of intolerance were observed only, if the rate of administration was too high.