Decompression sickness of the inner ear and relationship with a patent oval foramen: a study of 61 cases.

OBJECTIVE: To discuss the link between inner ear decompression sickness and patent foramen ovale. MATERIALS AND METHODS: Monocentric and retrospective study on decompression sickness of the inner ear requiring hyperbaric chamber treatment, from 2014 to 2021. RESULTS: Sixty-one patients of inner ear decompression sickness were included in this study. Twenty-four patients had vestibular injuries, 28 cochlear injuries and 9 cochleo-vestibular injuries. Compression chamber treatment was given, using an oxygen-helium mixture with oxygen partial pressure (PIO2) limited to 2.8 atmosphere absolute (ATA). All vestibular accidents completely recovered without clinical sequelae. For cochlear accident only 10 out of 37 patients (27%) recovered completely. A right-left shunt (patent foramen oval or intra-pulmonary shunt) was found in 31.1% of patients with inner ear decompression sickness (p > 0.05). CONCLUSION: The presence of patent foramen oval in patients with inner ear decompression was not statistically significant in our study. Understanding of the pathophysiology of decompression illness and the physiology and anatomy of the labyrinth would suggest a mechanism of supersaturation with degassing in intra-labyrinthine liquids.

[Risk factors for cancers of the oral cavity, pharynx (cavity excluded) and larynx]. / Facteurs de risque des cancers de la cavité buccale, du pharynx (cavum exclu) et du larynx.

OBJECTIVE: To review the risk factors for squamous cell carcinoma of the oral cavity, pharynx, and larynx. METHODS: Review of the literature using the Medline digital database (1980-2007). Previously published studies or studies not found in the database were included if relevant. Four types of studies were selected: (1) epidemiological, (2) toxicologic, (3) clinical, and (4) fundamental research. Publications concerning cancer of the nasopharynx were excluded. This work is based upon the ANAES guide for analysis of the literature and rating of guidelines, published in January 2000. RESULTS: The principal risk factors are tobacco and alcohol. Other risk factors, particularly infectious (viral) or environmental (nutritional and occupational), are also involved. From this analysis we conclude that: (1) most clinical and fundamental publications concern smoking and alcohol use; (2) studies of other risk factors are relatively old, especially those concerning nutritional and occupational factors; (3) most publications have a low level of scientific proof (grade C, levels 3 and 4). These 3 points explain the delay in the analysis of risk factors for upper aerodigestive tract (UADT) cancers. CONCLUSIONS: We must make up for this delay by prospective studies that include very large samples and use thorough and multivariate statistical analyses to estimate the impact of various toxic substances on the incidence of UADT cancer. This demands: (1) awareness on the part of all physicians who manage this type of cancer of the need to ask questions about exposure to risk factors besides than tobacco and alcohol; (2) collaboration between these physicians as well as with general practitioners, epidemiologists, nutritionists, and occupational physicians.

Course and prognosis of basaloid squamous cell carcinoma of the head and neck: a case-control study of 62 patients.

OBJECTIVE: To describe the natural history and evaluate the prognosis of basaloid squamous cell carcinoma (BSCC) of the upper aero-digestive tract as compared to the usual squamous cell carcinoma (SCC). MATERIALS AND METHODS: Sixty-two patients with BSCC and 62 patients with SCC were matched with regards to TNM classification, localisation and therapeutic modalities. Histological criteria, follow-up and 5-year survival were compared among the two groups. RESULTS: Survival rates were significantly higher in patients with SCC as compared to patients with BSCC. The rate of distant metastasis was six times higher in cases of BSCC, which was the major cause of mortality. CONCLUSION: This study reveals that BSCC has distinct histo-pathologic features and an aggressive clinical course, justifying its consideration as a separate entity with poor prognosis. The authors propose to systematically perform a chest CT-scan and FDG-PET to rule out early distant metastasis and to include adjuvant chemotherapy in treatment protocols.