[Allergies in ENT]. / Les allergies en ORL.

Allergy is quite frequent and ENT syptoms are usually the visible part of a general disease. Questioning remains the most important part of the enquiry for clinical examination is usually poor if notdesapointing. Biological testings detailed in this paper may be of some help; In Africa, test-treatements using cheap and unharmfull drugs give often the best evidence of allergy. Seldom, ENT allergy may be or become life-threatening. Its detection and appropiate actions are briefly mentioned.

[Endonasal dacryorhinocystostomy]. / La dacryorhinocystostomie par voie endo-nasale.

Endonasal dacryorhinocystostomy is a surgical procedure performed to re-establish continuity of the lacrimal duct by partial diversion followed by dilatation. A simultaneous rhinologic and ophthalmologic approach is used. This simple and elegant procedure that results in no residual scarring is indicated for any blockage of the lacrimal duct due to congenital or acquired causes. Except for children under 6 years of age and in patients in poor general condition, contra-indications are uncommon. Operative and postoperative complications are rare. After a review of the relevant anatomy the authors of this report describe the equipment and basic techniques used to perform dacryorhinocystostomy. Endonasal dacryorhinocystostomy was performed in 15 patients presenting chronic (n = 14) or acute (n = 1) dacryocystitis in Madagascar. At six months follow-up the procedure was successful in 14 cases and unsuccessful in one case due a cutaneous fistula. Because it is simple and well-tolerated and results in no residual scarring, endonasal dacryorhinocystostomy is the method of choice for treatment of lacrimal duct obstruction in tropical areas in general and in Black Africa in particular.

[660 cases of histologic extra-pulmonary tuberculosis at the Pasteur Institute in Madagascar]. / A propos de 660 cas de tuberculoses histologiques extra-pulmonaires étudiés a l'Institute Pasteur de Madagascar.

A 33 months retrospective study (from September 1992 to May 1995) of 8525 patients indicated that the incidence of histologic extrapulmonary tuberculosis (EPT) was 7,7%. The 8341 malagasy native patients presented an incidence of 7.8%. Male are more frequently infected than female. Most samples came from Antananarivo, with a prevalence reaching 12,5% while it was only 2,9% in the provinces. Most pathologic EPT were pleural tuberculosis (55,6%) and ganglial tuberculosis (34%). Peritoneal tuberculosis were much less frequent. According to literature data in Madagascar, the incidence of histologic EPT is obviously increasing.

[Entomophthoromycoses in Madagascar (three cases)]. / Les entomophthoromycoses à Madagascar (à propos de trois cas malgaches).

The authors present three new cases of Entomophthoromycosis observed in Madagascar: Two cases of subcutaneous entomophthoromycosis without isolation of germ. An immunofluorescence technique showed the Basidiobolus ranarum to be the real cause. One case of rhinoentomophthoromycosis with isolation of Conidiobolus coronatus (first isolation in Madagascar).

[Atypical cylindroma of the ethmoid]. / A propos d'un cylindrome de l'ethmoïde à expression atypique.

The authors relate an ethmoidal cylindroma, whose extension includes the orbital apex, without any ocular symptomatology. They wonder about the possibility of an early diagnosis of such tumors.

[A severe form of external otitis: necrosing diabetic otitis]. / Une forme grave d'otite externe: l'otite nécrosante des diabétiques.

Otitis externa are of usual observation in inter-tropical regions. Pseudomonas aeruginosa is responsible generally. But, when immunodeficiency is associated or on diabetic diathesis, such an otitis externa can be extremely dangerous: extensive osteitis of the base of the skull, paralysis of the last pairs of cervical nerves rapidly creeping, built a clinical identity called malignant external otitis, leading to death in 50% of the cases.

[Lightning injury of the ear]. / Fulguration d'oreille.

Three cases of auricular fulguration are described and used as a basis for a review of physical characteristics and histopathologic consequences of lightning strikes. Cases are presented and discussed in relation to these fundamental and experimental data.

[Evaluation of the analgesic effect of UP 341-01 in patients presenting with acute pain in ORL]. / Evaluation de 'activité antalgique de l'UP 341.01 chez des patients présentant une douleur aiguë en O.R.L.

The authors report the results obtained with a new analgesic, UP 341.01, which is a bioprecursor of paracetamol. Two groups of patients with acute pain, due to suppurative acute otitis media before myringotomy, were given an intravenous injection of 1 or 2 g of UP 341.01 respectively. Changes in the severity of pain were assessed over five hours by means of a verbal five point scoring system. During this study, UP 341.01 proved efficient and well tolerated.