Clinical characteristics and prognostic factors of sinonasal undifferentiated carcinoma: a multicenter study.

BACKGROUND: Sinonasal undifferentiated carcinoma (SNUC) is a very rare entity with a poor prognosis. Due to the lack of studies on the subject, evidence is lacking concerning its management. METHODS: A multicenter collaborative study was conducted to assess treatment strategy, oncological outcome, and prognostic factors. RESULTS: Definitive analyses focused on 54 patients with a majority of advanced stage; the 3-year overall survival (OS) and 3-year recurrence-free survival (RFS) rates were, respectively, 62.4% and 47.8%. During the follow-up, 18 patients (33.3%) died, 10 (18.5%) developed metastases, 7 had lymph-node involvement (13%), and 12 (22.2%) showed recurrence or local progression. In univariate analyses, treatment modalities associated with improved RFS were induction chemotherapy (p = 0.02) and intensity-modulated radiotherapy (p = 0.007). In the multivariate analyses, only induction chemotherapy (p = 0.047, hazard ratio [HR] = 0.39) was significantly associated with improved RFS. CONCLUSION: Multimodal therapies including induction chemotherapy and intensity-modulated radiotherapy may improve the prognosis of SNUC; surgery might improve local control. Further multicenter studies are required.

Transtympanic pseudoaneurysm of the internal carotid artery complicating a myringotomy in a four-year old child: Case report and literature review.

We report the first case of a transtympanic iatrogenic internal carotid artery (ICA) pseudoaneurysm diagnosed in a 4-year-old child following a myringotomy. An endovascular treatment with a covered-stent was decided; spontaneous thrombosis was found during the therapeutic arteriography, and the procedure was aborted. Otoscopy and computed tomography (CT) scan monitoring showed a prolonged thrombosis and the disappearance of the pseudoaneurysm 18months after the diagnostic arteriography. Based on literature review, endovascular techniques seem to be preferred to the surgical approach for treatment of intrapetrous ICA pseudoaneurysm, however clinical and CT scan monitoring may also be a valid option.

ß-Tricalcium Phosphate Implants in the Surgical Treatment of Empty Nose Syndrome.

The objective of this study was to assess the efficacy and morbidity of a ß-tricalcium phosphate implant in the treatment of empty nose syndrome after turbinectomy. Only patients with a history of inferior turbinectomy and a complaint of permanent paradoxical nasal obstruction were included. ß-Tricalcium phosphate ceramic implants were implanted under the mucoperiosteal plane of the lateral nasal wall to replace the head of the inferior turbinate. Symptoms and quality of life were assessed by 2 questionnaires: the Nasal Obstruction Symptom Evaluation and Rhinosinusitis Quality of Life. Fourteen patients were included. The mean follow-up was 19.4 ± 13.4 months. Scores for the Nasal Obstruction Symptom Evaluation and Rhinosinusitis Quality of Life (frequency, bothersomeness, and impact) significantly improved after surgery (respectively, 73.9 ± 21.8 to 34.6 ± 28.6, 44.6 ± 17.1 to 34.8 ± 20.3, 43.6 ± 22.4 to 70.7 ± 21.5, and 59.9 ± 21.1 to 27.2 ± 25.3; P < .05). The use of ß-tricalcium phosphate seems efficient to repair empty nose syndrome by endonasal microplasty and shows a low complication rate.