1,721,064 research outputs found
Tumorrezidiv-Chirurgie von Plattenepithelkarzinomen im Kopf-Hals- Bereich – Teil 2: Organspezifische Rezidivchirurgie
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Fonction olfactive après chirurgie hypophysaire transsphénoïdale
No full textPituitary surgery remains mainly performed trough a transnasal, transseptal and transsphenoidal way. This surgical approach can damage intranasal structures and, in particular, may impede olfactory function. Our study investigates olfactory function in 67 patients undergoing this type of surgery before and 3 months after surgery. Mean olfactory scores were identical pre- and postoperatively. However, on an individual bases seven percent of the patients showed a clear decrease in olfactory function. In conclusion, transnasal, transseptal and transsphenoidal surgery is relativelv safe with regards to olfactory functionLes voies transnasale, transseptale et transsphénoïdale restent encore aujourd’hui l’abord standard de la chirurgie hypophysaire. Le passage transnasal-transseptal peut engendrer des dommages au niveau de l’épithélium olfactif et des structures nasales. Notre étude visait à investiguer les fonctions olfactives chez 67 patients soumis à ce type de chirurgie. Les tests psychophysiques olfactifs pour les fonctions ortho et rétronasale ont été effectués avant et trois mois après la chirurgie. Les résultats ont montré que la moyenne de la fonction olfactive, autant ortho que rétronasale, n’a pas changé avant et après l’opération. En revanche, l’analyse individuelle montre que toutefois 7% des patients ont eu une péjoration de leur fonction olfactive.En conclusion, la chirurgie hypophysaire transnasale, transseptale et transsphénoïdale comporte relativement peu de risques pour la fonction olfactive
L’IRM peut-elle prédire la perte de l’odorat et sa récupération spontanée après traumatisme crânien ?
No full textPour comprendre l’utilité de l’IRM dans la prise en charge des troubles olfactifs post-traumatiques, nous avons analysé les lésions post-traumatiques des aires cérébrales pertinentes pour la perception des sens chimiques, effectué une analyse de cluster et identifié quatre groupes qui diffèrent par la taille et la localisation des lésions. Nous avons appelé ces groupes : I) légère ; II) modéré ; III) large - hémisphère droit et IV) large - bulbes olfactifs et l'hémisphère gauche. Ces clusters corrélaient avec la sévérité de la dysfonction olfactive et prédisent avec précision la présence d'anosmie lorsque les patients appartiennent au cluster III ou IV. Concernant le pronostic, les chances d’amélioration de la fonction olfactive étaient beaucoup plus élevées pour le cluster I. En utilisant cette nouvelle classification, nous espérons mieux prendre en charge les patients souffrant d’anosmie post-traumatique tant sur le plan diagnostic que pronostic
Pharyngolaryngeal involvement by varicella-zoster virus
No full textINTRODUCTION
Involvement of cranial nerves V, VII, and VIII by varicella-zoster virus (VZV) is widely reported in the literature, whereas involvement of cranial nerves IX and X is rarer and therefore poorly characterized.
MATERIAL AND METHODS
We performed a systematic review of the literature through MEDLINE (up to January 2012). We selected cases reporting pharyngolaryngeal involvement by VZV and extracted clinical features, complementary studies, treatments, and outcome. We added three cases to the existing literature.
RESULTS
Of the 65 screened articles, 38 were included reporting 54 cases. The main clinical features were odynodysphagia and dysphonia reflecting underlying hemipharyngolaryngeal palsy. Vesicles were seen in 66% of the patients. Besides the involvement of cranial nerves IX and X, concomitant involvement of other cranial nerves was seen in 48% of the cases. The most concerned nerves were cranial nerves VII and VIII. Virological tests (63%) and imaging (28%) were performed, with the latter being systematically normal. Seventy-two percent of patients were treated with antiviral agents and/or corticosteroids. Twenty-six percent of patients made a full recovery while the remaining had some persistent deficits. We did not find statistically significant differences in outcomes according to age or treatments received.
CONCLUSIONS
Pharyngolaryngeal involvement by VZV is rare and seldom restricted to the ninth and tenth cranial nerves. It occurs mostly within the context of cranial polyneuropathy. Regardless of the treatment, full recovery is rare and long-term sequelae persist in many cases, especially with speech and swallowing impairment. Close monitoring and follow-up are therefore essential
Rapidly fluctuating anosmia: A clinical sign for unilateral smell impairment.
No full textReports about fluctuating olfactory deficits are rare, as are reports of unilateral olfactory loss. We present a case of unilateral anosmia with contralateral normosmia, presenting as rapidly fluctuating anosmia. The olfactory fluctuation occurred in sync with the average nasal cycle duration. Examination after nasal decongestion, formal smell testing, and imaging revealed unilateral, left-sided anosmia of sinonasal cause, with right-sided normosmia. We hypothesize that the nasal cycle induced transient anosmia when blocking the normosmic side. Fluctuating olfactory deficits might hide a unilateral olfactory loss and require additional unilateral testing and thorough workup. Laryngoscope, 126:E57-E59, 2016
Sleep apnea: Do not forget to inspect the throat!
Get PDFObstructive sleep apnea syndrome (OSAS) is a widespread and underdiagnosed disease. Causes are mostly related to obesity and anatomy with oro-pharyngeal narrowing. Parapharyngeal tumors are rare but can easily be treated. Careful oro-pharyngeal examination in OSAS patient is cheap, easy to perform by non-ENT specialists, quick, and avoids inadequate treatment
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