[Caseous sinusitis. Clinical, x-ray computed, surgical, histopathological, biological, biochemical and myco-bacteriological aspects. Apropos of 33 cases].

We analyse the most important clinical, CT, surgical, histopathological, biological, biochemical, mycological and bacteriological features of caseous sinusitis, i.e. chronic, poorly symptomatic sinusitis which are resistant to usual treatment.

Intracanalicular and intratemporal facial nerve schwannomas.

Facial nerve schwannomas can mimic acoustic neuromas. We report herein two cases: a purely intracanalicular and an intratemporal facial nerve tumor extending into the internal auditory canal and the cerebellopontine angle. These tumors have to be suspected in patient with small-size tumors presenting with facial paralysis.

[Tonometric monitoring of the viability of free transplants of the jejunum and the stomach after total circulary pharyngolaryngectomy].

A prospective study concerning the tonometric viability supervision of 9 digestive free autografts after total pharyngolaryngectomy was conducted. This technic is based on the Henderson and Hasselbalch's equation which calculates the intramucosal pH (pHi) in the graft using a tonometric catheter. When the pHi is under 7.

[Cavernous hemangioma of the geniculate ganglion. Value of otoneurosurgical collaboration].

A patient with a progressive peripheral facial paralyses should be considered to have a tumor involved the facial nerve until proved otherwise. Haemangiomas of the temporal bone are uncommon and the present study discusses pathology, clinical presentation and therapeutic management of a tumor located at the geniculate ganglion. Complete surgical removal by the middle fossa approach is the treatment of choice with adequate margins and preservation of adjacent structures when it is oncologically possible.

[Hemangiopericytoma of the infratemporal fossa of nasopharyngeal manifestation. Value of the cervico-transoral approach].

Authors present one case of hemangiopericytoma of the infra-temporal fossa and the lateral wall of the nasopharynx. They describe the characteristics of this rare, recurrent and sometime malignant vascular tumor. The selected therapy is an aggressive and wide exeresis.

[Mucormycosis-actinomycosis and caseous dental sinusitis associated with sinusal foreign body].

The authors report an uncommon case of caseous dental sinusitis with infection or superinfection by mocorales and actinomycetes. The patient was healthy, without diabetes mellitus, but was treated for lymphoma 18 years before. This observation leads to a discussion of nosologic, diagnostic and therapeutic features of caseous sinusitis, dental or not, fungal or not, which are often or too often called aspergillosis sinusitis.

[Results of the use of parietal bone as bone graft donor site in facial reconstruction. Apropos of 71 cases].

The embryologic origin of the parietal bone is membranous bone. Experimentally, membranous bone grafts, maintain its original size, structure with good osteo-integration contrary to endochondral bone autografted (ilium, rib or tibia). The morbidity of skull bone grafts is much less than other donor site of bone.

[Congenital cholesteatoma and associated ossicular malformations].

15 cases of congenital cholesteatoma surgically treated from 1982 to 1992 are presented. Clinical diagnosis criteria, pathology, localisations and extensions to the middle ear are analyzed. Ossicular malformations were associated in one third of the patients of this series.

[Cholesteatoma in children. Apropos of 110 cases].

This retrospective study of 110 middle ear cholesteatomas, concerning children up to 15 years old which have been treated between 1982 and 1992 in the ENT department of the university hospital of Strasbourg, analyzes the particularities of this disease and the therapeutic strategy adopted. The evolution of middle ear cholesteatoma is more rapid in childhood than in adulthood, due to greater growth potential of tissue in childhood, persistence of Eustachian tube dysfunction and aggressive extension in middle ear. The surgical removal is said to be difficult with numerous postoperative recurrences.

[Ear prosthesis anchored on osseointegrated implants. Experience with 9 cases].

The use of osseointegrated titanium implants has improved the quality of auricle prosthesis fixation. Between december 1993 and july 1994, twenty two titanium fixtures have been surgically implanted in nine patients in the Ear Nose Throat department of the university hospital of Strasbourg. This method of auricle amputation repair achieves a good esthetic result with a low rate of postoperative complications.

[Thyroid metastases of Grawitz tumors: apropos of a case].

Secondary localisations of malignant tumors to the ENT areas are rare. One case of renal adenocarcinoma metastasis to the thyroid has been followed in our department. After a quick recall of the clinical story, we will try to point out the epidemiological and physiopathological specificities of this localisation and to emphasize its therapeutic difficulties.

[Vestibular neuritis].

Vestibular neuronitis is an acute disorder of the vestibular apparatus which manifests by sudden vertigo, without apparent cause, and without auditory or neurological symptoms. Clinically and by thermal stimulation tests, it is characterised by unilateral peripheral vestibular deficit. Evolution is favourable in several days to several weeks and prognosis is favourable, although disorders of moderate intensity may rather often persist, in the form of positional vertigo, sometimes paroxysmal, or disorders of equilibrium on abrupt movement.

[Vascularized parietal bone island flap. A technical note apropos of a case of reconstruction of the palate after hemi-maxillectomy].

Closure of wide palate defects is still a very complex problem and a real challenge for cervico-facial surgeons. The authors present an original technics drifted of the one D.W.

[A new approach to the mechanism of vestibular response to caloric stimulation].

Barany's classical hydrodynamic theory has been called into question by the zero-gravity Spacelab experiments, and several new hypotheses are put forth to explain the vestibular response to caloric stimulation. We have developed a mathematic model based on the analysis of an experimental model of the semicircular canal, incorporating observations done with zero-gravity and with gravity. Two purely mechanical phenomena are involved: one one hand, the modification of the hydrostatic pressure on both sides of the cupula due to a temperature variation if the semicircular canal is not in the horizontal plane in normal gravity conditions; on the other hand, local changes in endolymph pressure and volume due to the mechanical and osmotic properties of the canal, which are independent from gravity and from the position of the canal.

[Pulsatile tinnitus and arteriovenous fistula. Apropos of a case].

Objective pulsatile tinnitus is an unusual disease. Diagnosis, suspected by the interrogation, can be confirmed by vascular radiography. Treatments are discussed and can use surgical solution or interventional radiology.

[Correlations between anatomy and x-ray computed tomography in cancers of the pharyngo-larynx. Apropos of a prospective study of 35 patients].

A prospective study has been conducted in 35 cases of pharyngolaryngeal's carcinoma, between december 1990 and june 1992 in the department of Head and Neck Surgery of Strasbourg. The authors compared, in a statistic analysis, Computed Tomography and histopathologic's correlations. The operative specimen were sectioned in the horizontal plane to correspond with the CT sections.

[Lingual necrosis after neck irradiation].

Lingual necrosis is a rarely observed pathology. The authors report a case of a lingual necrosis in the follow up of an irradiation. Horton's disease is the first diagnosis to evoke facing a lingual necrosis.

[Uncommon caseous maxillary sinusitis of dental origin caused by Microsporum canis].

The authors report an uncommon case of maxillary sinusitis due to Microsporum canis. To their knowledge this is the first observation in which a zoophilic dermatophytic fungus which grows usually on keratin has been isolated in a dental maxillary sinusitis in human. This observation makes it possible to discuss nosologic and diagnostic features of dental caseous sinusitis and fungal sinusitis which are often or too often called aspergillosis sinusitis.

[Spontaneous hemorrhage of the parathyroid disclosed by an extensive cervical hematoma].

Extra capsular bleeding occupies a particular place within the evolutional complications of parathyroid tumors. Its rarity, the difficulty of the pre-operative diagnosis and its potential evolution towards airway obstruction by compression underline its singular character. A case is presented where an evolutive cervico-thoracic hematoma, evolving without functional symptoms, has led to the diagnosis of parathyroid hyperplasia.

[Thrombophlebitis of the lateral sinus. Apropos of a case].

About one case of septic sigmoid sinus thrombosis, the authors present various clinical and paraclinical elements of this rare pathology, whose entity are generally subtle for benign but also for serious forms. Although uncomplicated dural venous thrombosis carries an excellent prognosis with proper treatment, delay in diagnosis and institution of appropriate therapy may lead to serious, or even fatal, consequences. The modern literature is reviewed and the pathology, presentation and management of lateral sinus pathology is discussed.

[Post-traumatic aneurysm of the internal carotid artery].

The authors present a typical case of a traumatic internal carotid aneurysm rupture appearing 40 years after a blunt head trauma and surgically treated with success. The etiopathogenic and clinical aspects are reviewed and the important place of the angiography in diagnostic and therapeutical strategy is discussed.

[Extensive cervical hematoma complicating multinodular goiter. Apropos of a case].

The massive hemorrhagic accidents of multinodular goiter are very rare, implicating the vital prognosis through an airway obstruction by tracheal compression. To illustrate this situation, the authors present an original case with a large cervico-thoracic hematoma without any respiratory's difficulties. The serious evolutive potential of that situation in spite the unworrying aspect of the patient, bring them to operate in delayed emergency.

[Polyposis of the nasal sinuses. Epidemiology and clinical aspects of 350 cases. Treatment and results with a follow-up over 5 years on 93 cases].

The authors report a series of 350 patients referred for clinical investigation of nasal polyps between 1980 and 1990. 93 patients were followed for more than 5 years. Allergy to inhalants was rarely found (2.

[Laryngeal sarcoidosis: apropos of a case].

The authors report an unusual case of laryngeal sarcoidosis. After having explained it, they describe the elements of diagnosis about this rarely isolated pathology, its complications and treatment as well.

[Tumors of the parotid area. Apropos of 203 surgical explorations].

The authors present their clinical, radiological and histological conclusions, according to a retrospective personal study about 203 chirurgical explorations from the parotid gland. The pleomorphic adenoma and the cystadenoma are presented more precisely and basically their chirurgical indications; the other histological types met are only presented through several tables.