Impact of asthma on endoscopic sinus surgery outcomes for chronic rhinosinusitis with polyposis - A cohort study.

INTRODUCTION: Chronic rhinosinusitis with polyposis (CRSwNP) is a multifactorial naso-sinusal inflammatory disease that affects 2-4% of the adult population. It highly affects the patient quality of life (QoL) in many levels making it a public health issue. The management of CRSwNP is based on a detailed clinical history, a complete endoscopic examination and a precise computed tomographic (CT) analysis. The aim of this study is to evaluate the prevalence and severity of the various CRS clinical manifestations as well as to highlight the potential relationship between symptom scores, asthma and ESS outcomes. PATIENTS AND METHODS: A retrospective cohort study was performed in the 20 August hospital, between January 2017 and December 2018, on patients diagnosed with CRS according to guidelines recommendations, and were beforehand refractory to initial medical therapy and elected to FESS. The patients were divided into two groups, the first group (G1) of patients with asthma and the second (G2) without asthma in order to expose an eventual significant difference in the improvement of symptoms after surgery. The Sino Nasal Outcome Test-22 (SNOT-22) was used to evaluate QOL. RESULTS: A total of 100 patients participated in the study with an average age of 44.53 years. The sex ratio was 1.04 (51% men). Asthma was present in 48% of patients while 20% of patients were intolerant to aspirin with a significant difference between the asthmatic and non-asthmatic group (p < 0.05). It appears that asthma was not objectively correlated with a higher Lund Mackay radiological score (p > 0.05). A higher significant improvement was observed between preoperative and postoperative SNOT-22 scores in group with asthma [42.7 ± 16.3 versus 11.8 ± 9.1] and in group without asthma [38.3 ± 15.1 versus 10.5 ± 14.2]. CONCLUSION: Asthma in CRS is an additional symptom in these patients, mainly reflected in the subset of nasal symptoms in SNOT-22. However, it did not significantly affect the quality of life of the CRSwNP population.

Advanced adenoid cystic carcinoma of maxillary sinus: Rare case report and review of literature.

INTRODUCTION: Maxillary sinus adenoid cystic carcinoma (MSACC) is a rare malignancy with a propensity for distant metastasis CASE PRESENTATION: We report a case of a 55 years-old male who was admitted to our department with a complaint of right nasal obstruction and anosmia. Clinical examination, radiological investigations and histopathological examination found a mass compatible with advanced adenoid cystic carcinoma of the right maxillary sinus. Treatment consisted of radio chemotherapy. CONCLUSION: Adenoid cystic carcinoma of the maxillary sinus may represent a serious diagnostic challenge. It should be considered in the differential diagnosis of Sino nasal tumors even if it's rare.

Cervical lymphoepithelial cyst: Case report and literature review.

INTRODUCTION: The cervical lymphoepithelial or branchial cleft cyst are benign dysembryologic cystic tumors developing in the anterolateral region of the neck. They are relatively uncommon anomalies.The aims of this study are to analyze the anatomoclinical features and to discuss the modalities of care for the management of this disease. PRESENTATION OF CASE: We report a case of a 70 years-old woman who was admitted to our department with a complaint of painless mass in the right supraclavicular region. Clinical examination and radiological investigations found a mass compatible with cervical cyst. Treatment consisted of the complete resection of the cyst. histopathological examination found a Cervical lymphoepithelial cyst. CONCLUSION: The cervical lymphoepithelial can be easily misdiagnosed. It is imperative that clinicians make an accurate diagnosis for appropriate treatment (that is, surgical excision).

Schwannoma of the extracranial portion of the accessory nerve presenting as spinal adenopathy.

Schwannomas are benign tumours arising from Schwann cells in the peripheral nerve. The schwannoma of the accessory nerve is a very rare entity. We report a case of Schwannoma of the extracranial accessory nerve. A 22-year-old man presented with a slow-growing mass, located on the right upper neck. The patient did not have any neurological deficit. CT scan showed a hypodense mass behind sternocleidomastoid muscle. The suspected diagnosis was an adenopathy of the accessory spinal chain. Surgery was done via transcervical approach. The histopathological analysis concluded with a diagnosis of schwannoma. No recurrence was noted at the follow-up examination 29 months after surgery.

Nasopharyngeal adenoid cystic carcinoma, suggestion of therapeutic innovations: A case report and review of literature.

INTRODUCTION: Nasopharyngeal adenoid cystic carcinoma is a rare tumor. Compared with others nasopharyngeal tumors, it is characterised by slow evolution but it is locally aggressive and has a high tendency to recurrences. Due to the rarity of cases, no consensus exists about treatment approaches. PRESENTATION OF THE CASE: We report the case of a 55-year-old-woman, with a locally advanced adenoid cystic carcinoma. The patient was operated by endoscopic surgery, received radiation and had a good objective response. The follow-up showed no local recurrence after one year. CONCLUSION: The aim of this work is to review the literature concerning this rare malignancy, and discusses treatment approaches in initial situations and during recurrences.We supported the interest of the intraoperative neuronavigation system for surgical safety.