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Bouatay R, Benelhaj C, Saad J, Zrig A, Ferjaoui M, Elkorbi A, Kolsi N, Harrathi K, Koubaa J. Interest of computer tomography in the study of prognostic factors of otosclerosis. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08585-1. [PMID: 38530462 DOI: 10.1007/s00405-024-08585-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 02/26/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Otosclerosis is a primary osteodystrophy of the otic capsule that causes stapedo-vestibular ankylosis. Its diagnosis is suspected on the basis of clinical and audiometric elements, basically in the presence of conductive hearing loss with a normal eardrum. The CT-scan is an essential examination for the preoperative evaluation of otosclerosis. The aim of our study was to evaluate the use of CT-scanning in predicting the functional outcome of otosclerosis surgery by correlating postoperative audiometric results and preoperative CT findings. METHODS We conducted a retrospective study at the ENT Department in association with the Medical Imaging Department of our hospital, over a period of 8 years, from January 2014 to December 2022 and involving 90 patients (104 ears). RESULTS The average age of our patients was 40 years with extremes ranging from 22 to 61 years. We noted a sex ratio of 0.38. The preoperative CT-scan showed signs of otosclerosis in 87% of the cases and infra-radiological forms in 13% of the cases. Veillon stage II was the most frequent radiological stage encountered with a percentage of 48%. A good audiometric evolution, defined by a closure of postoperative Air Bone Gap (ABG ≤ 20 dB) and by an improvement of Bone Conduction (BC gain ≥ 0), was recorded in 86 cases (82.7%) for ABG and in 84 cases (80.8%) for BC gain. Scanographic predictive factors of poor postoperative outcome for ABG and BC gain were: advanced stages (Veillon stage III and IV), endosteal effraction, and round window involvement. According to multivariate analysis, only the extent of otosclerotic foci was directly and independently associated with the postoperative audiometric outcome. CONCLUSION The CT-scan is an essential examination in the preoperative evaluation of otosclerosis. It allows a positive diagnosis to be made and evaluate the extension of otosclerosis. Moreover, thanks to the analysis of the extent of the otosclerosis foci, mainly by the Veillon classification, the CT-scan allows to predict the postoperative audiometric prognosis.
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Affiliation(s)
- Rachida Bouatay
- ENT Department, Fattouma Bourguiba Hospital of Monastir, Monastir, Tunisia.
- University of Monastir, Monastir, Tunisia.
| | - Chirine Benelhaj
- Medical Imaging Department, Fattouma Bourguiba Hospital of Monastir, Monastir, Tunisia
| | - Jamel Saad
- Medical Imaging Department, Fattouma Bourguiba Hospital of Monastir, Monastir, Tunisia
- University of Monastir, Monastir, Tunisia
| | - Ahmed Zrig
- Medical Imaging Department, Fattouma Bourguiba Hospital of Monastir, Monastir, Tunisia
- University of Monastir, Monastir, Tunisia
| | - Mehdi Ferjaoui
- ENT Department, Fattouma Bourguiba Hospital of Monastir, Monastir, Tunisia
- University of Monastir, Monastir, Tunisia
| | - Amel Elkorbi
- ENT Department, Fattouma Bourguiba Hospital of Monastir, Monastir, Tunisia
- University of Monastir, Monastir, Tunisia
| | - Naourez Kolsi
- ENT Department, Fattouma Bourguiba Hospital of Monastir, Monastir, Tunisia
- University of Monastir, Monastir, Tunisia
| | - Khaled Harrathi
- ENT Department, Fattouma Bourguiba Hospital of Monastir, Monastir, Tunisia
- University of Monastir, Monastir, Tunisia
| | - Jamel Koubaa
- ENT Department, Fattouma Bourguiba Hospital of Monastir, Monastir, Tunisia
- University of Monastir, Monastir, Tunisia
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Bouatay R, Bhar S, Bouaziz N, El Korbi A, Ferjaoui M, Kolsi N, Harrathi K, Koubaa J. [Thyroglossal duct cysts in adult : clinical and therapeutic features]. Rev Med Liege 2023; 78:649-653. [PMID: 37955295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
Thyroglossal duct cysts (TDCs) are rare congenital cervical malformations in adults, which expose to two major risks: infection and malignant degeneration which remains the most dreaded complication in adults. AIMS OF THE STUDY This study aims to establish the clinical, management of TDC during adulthood, as well as the evolutionary aspects of these malformations in this age group. PATIENTS ET METHODS This is a retrospective study on 61 adults over 18 years old, undergoing TDC surgery in our department. RESULTS The average age was 33.7 years with a sex ratio M/F of 1.10.The circumstances of discovery were dominated by a median cervical swelling in 53 patients (86,9%). The swelling was median in 28 cases and located in ad-hyoid in 32 cases. Cervical ultrasound confirmed the diagnosis of TDC in all patients. CT scans were performed on 15 patients. Surgical excision according to the Sistrunk method was performed on all patients. Three of our patients have experienced a degenerated TDC requiring total thyroidectomy with central neck dissection, followed by radioactive iodine therapy. CONCLUSION CT scan keeps indications in adults. The treatment is surgical in order to prevent the risks degeneration, which is specific complication in adulthood.
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Affiliation(s)
- Rachida Bouatay
- Service d'ORL et de CCF, CHU Fattouma Bourguiba de Monastir, Tunisie
| | - Salma Bhar
- Service d'ORL et de CCF, CHU Fattouma Bourguiba de Monastir, Tunisie
| | - Nawress Bouaziz
- Service d'ORL et de CCF, CHU Fattouma Bourguiba de Monastir, Tunisie
| | - Amel El Korbi
- Service d'ORL et de CCF, CHU Fattouma Bourguiba de Monastir, Tunisie
| | - Mehdi Ferjaoui
- Service d'ORL et de CCF, CHU Fattouma Bourguiba de Monastir, Tunisie
| | - Naourez Kolsi
- Service d'ORL et de CCF, CHU Fattouma Bourguiba de Monastir, Tunisie
| | - Khaled Harrathi
- Service d'ORL et de CCF, CHU Fattouma Bourguiba de Monastir, Tunisie
| | - Jamel Koubaa
- Service d'ORL et de CCF, CHU Fattouma Bourguiba de Monastir, Tunisie
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Ferjaoui M, Kolsi N, Boughzala W, Kharrat O, Bouatay R, Harrathi K, Elkorbi A, Koubaa J. Management of jugular tympanic paraganglioma: a case report. Pan Afr Med J 2022; 43:166. [PMID: 36825128 PMCID: PMC9941617 DOI: 10.11604/pamj.2022.43.166.29457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 11/04/2022] [Indexed: 02/25/2023] Open
Abstract
Paragangliomas could be localized from the skull base to the pelvic floor. Tympanic localization represents the most common benign tumor of the middle ear. Diagnosis is based on clinical signs with a great contribution of radiology. A 40-year-old male presented with isolated tinnitus of the right ear evolving for 18 months. Examination revealed a red bulging right-sided tympanic membrane and a conductive hearing loss. Tomodensitometry and Magnetic resonance imagery showed findings in favor of a right jugular tympanic paraganglioma. The tumor was classified type B according to FISCH classification. The patient underwent surgery consisting in tympanotomy using a retro auricular access route. The postoperative course was uneventful. There was no recurrence during the one-year follow-up. Jugular tympanic paraganglioma diagnosis is guided by a combination of epidemiological, clinical and radiological features. Treatment is still not consensual, but surgery still have its indications in localized forms of head and neck paragangliomas (HNP´s).
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Affiliation(s)
- Mehdi Ferjaoui
- Ear, Nose, Throat Department of Fattouma Bourguiba, University Hospital of Monastir, Resaerch Laboratory LR18Sp08, Monastir, Tunisia,Corresponding author: Mehdi Ferjaoui, Ear, Nose, Throat Department of Fattouma Bourguiba, University Hospital of Monastir, Resaerch Laboratory LR18Sp08, Monastir, Tunisia.
| | - Naourez Kolsi
- Ear, Nose, Throat Department of Fattouma Bourguiba, University Hospital of Monastir, Resaerch Laboratory LR18Sp08, Monastir, Tunisia
| | - Wiem Boughzala
- Ear, Nose, Throat Department of Fattouma Bourguiba, University Hospital of Monastir, Resaerch Laboratory LR18Sp08, Monastir, Tunisia
| | - Ons Kharrat
- Ear, Nose, Throat Department of Fattouma Bourguiba, University Hospital of Monastir, Resaerch Laboratory LR18Sp08, Monastir, Tunisia
| | - Rachida Bouatay
- Ear, Nose, Throat Department of Fattouma Bourguiba, University Hospital of Monastir, Resaerch Laboratory LR18Sp08, Monastir, Tunisia
| | - Khaled Harrathi
- Ear, Nose, Throat Department of Fattouma Bourguiba, University Hospital of Monastir, Resaerch Laboratory LR18Sp08, Monastir, Tunisia
| | - Amel Elkorbi
- Ear, Nose, Throat Department of Fattouma Bourguiba, University Hospital of Monastir, Resaerch Laboratory LR18Sp08, Monastir, Tunisia
| | - Jamel Koubaa
- Ear, Nose, Throat Department of Fattouma Bourguiba, University Hospital of Monastir, Resaerch Laboratory LR18Sp08, Monastir, Tunisia
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Bouatay R, Farhati A, Abdelali M, N NK, Korbi AE, Ferjaoui M, Harrathi K, Koubaa J. Diagnostic strategy and therapeutic management of sinonasal inverted papilloma: our experience with review of literature. Egypt J Otolaryngol 2022. [DOI: 10.1186/s43163-022-00371-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Abstract
Background
The sinonasal inverted papilloma is a rare benign tumor, characterized by local aggressiveness, a high rate of recurrence after surgical resection, and the possibility of malignant transformation. The aims of this study are to analyze diagnostic strategy and therapeutic modalities and to evaluate results after surgery.
Methods
We report a retrospective study, including patients operated for inverted sinonasal papilloma in our department. Preoperatively, all patients were assessed by CT scan (computed tomography), 9 of them by MRI (magnetic resonance imaging).
Results
The average age of our patients was 52 years with a male predominance. The most common symptom was unilateral nasal obstruction. The endoscopic appearance was suggestive of inverted papilloma (IP) in 75% of cases. Thirty-two patients underwent an exclusive endonasal endoscopic surgery; one patient was operated with a combined approach. Two patients underwent external approaches. A recurrence was observed in 4 patients (11%).
Conclusion
Preoperative investigation for IP is essentially based on MRI, also required in case of recurrence. Histological examination of the entire tumor is crucial to rule out an associated carcinoma. The “all endoscopic” management is not always achievable for these tumors.
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Kolsi N, Bouaziz N, Ferjaoui M, Harrathi K, Bouatay R, Koubaa J. Cartilage Graft in Myringoplasty: What Are the Factors
Influencing Hearing Gain? J Audiol Otol 2022; 26:208-213. [PMID: 36111452 PMCID: PMC9597273 DOI: 10.7874/jao.2022.00108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/13/2022] [Indexed: 12/02/2022] Open
Abstract
Background and Objectives We present the anatomical and functional results on the use of cartilage in myringoplasty and use the data to analyze the factors influencing hearing gain. Subjects and Methods This retrospective study included 161 cases of cartilage myringoplasties collected over an 11-year period (2010-2020). Of the 161 cases, the etiology of the tympanic perforations was simple chronic otitis media in 154 (95.65%) ears and traumatic in 7 (4.35%) ears. The mean preoperative Rinne was 26.20±7.05 dB. The most commonly used approach was retroauricular, and the common graft material was tragal or conqual cartilage. Results After the follow-up period (mean:15 months), the anatomical success rate was 93.2%; there were nine cases of reperforation, of which three were reoperated with a good final result. The hearing success rate (residual Rinne ≤20 dB) was 91.9% with an average gain of 11.48±8.62 dB. The only factor significantly influencing the anatomical outcome was the history of chronic rhinosinusitis. In univariate studies, several factors influencing the functional result were revealed; the only one retained after elimination of bias was the anatomical result. Conclusions We recommend cartilage as the material of choice for myringoplasties as it has been shown to be resistant to predictive factors of failure after tympanic repair surgery. We recommend the adequate management of all chronic rhinosinusitis before performing myringoplasty.
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Ferjaoui M, Kolsi N, Bergaoui E, Naouar M, Bouatay R, Harrathi K, Elkorbi A, Koubaa J. [Odontogenic cervical-facial cellulitis: report of 87 cases]. Rev Med Liege 2022; 77:181-186. [PMID: 35258867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Cervical-facial cellulitis are infections of the cellular fatty spaces of the face and neck with a tendency towards locoregional extension, septic and thromboembolic complications that can affect the patient's vital and/or functional prognosis. The management is multidisciplinary including a medical component, surgical drainage associated with the treatment of the causal tooth. This is a retrospective study including 87 cases of odontogenic head and neck cellulitis hospitalized in the ENT and head and neck surgery department at Fattouma Bourguiba Monastir hospital over a period of 4 years between January 2017 and December 2020. The study included 48 women and 39 men. The most affected age group was young adults (54 %). The main contributing factors were poor oral hygiene (76 %), tobacco (41 %) and alcohol (19 %). Anti-inflammatory medicines intake was found in 31 % of cases. The average consultation time was 5 days. The main reason for consultation was painful head and neck swelling associated with trismus (70 %) and fever (52 %). The cervical-facial scan was performed in 93 % of patients. It revealed suppurative cellulitis (64 %), extension to upper aerodigestive ways (20 %), compression of upper aero-digestive tract (11,5 %), Lemierre syndrome (4,6 %) and gangrenous cellulitis with mediastinal extension (1,1 %). All patients received large spectrum antibiotic, associated in 25 % of cases with surgical drainage. Treatment of the dental cause was performed in all patients. The evolution was favourable in 98,9 % of cases. There is only one death due to a septic shock (1,1 %), which is consistent with most of the results reported in the literature. Head and neck cellulitis can affect the functional and vital prognosis of the patient in the absence of rapid and adequate management. The treatment remains primarily preventive.
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Affiliation(s)
- M Ferjaoui
- Service d'Otorhinolaryngologie et de Chirurgie cervico-faciale, CHU Fattouma Bourguiba, Monastir, Tunisie
- Laboratoire de Recherche LR18Sp08 : Imagerie diagnostique et interventionnelle, CHU Fattouma Bourguiba, Monastir, Tunisie
| | - N Kolsi
- Service d'Otorhinolaryngologie et de Chirurgie cervico-faciale, CHU Fattouma Bourguiba, Monastir, Tunisie
| | - E Bergaoui
- Service d'Otorhinolaryngologie et de Chirurgie cervico-faciale, CHU Fattouma Bourguiba, Monastir, Tunisie
| | - M Naouar
- Service d'Otorhinolaryngologie et de Chirurgie cervico-faciale, CHU Fattouma Bourguiba, Monastir, Tunisie
| | - R Bouatay
- Service d'Otorhinolaryngologie et de Chirurgie cervico-faciale, CHU Fattouma Bourguiba, Monastir, Tunisie
| | - K Harrathi
- Service d'Otorhinolaryngologie et de Chirurgie cervico-faciale, CHU Fattouma Bourguiba, Monastir, Tunisie
- Laboratoire de Recherche LR18Sp08 : Imagerie diagnostique et interventionnelle, CHU Fattouma Bourguiba, Monastir, Tunisie
| | - A Elkorbi
- Service d'Otorhinolaryngologie et de Chirurgie cervico-faciale, CHU Fattouma Bourguiba, Monastir, Tunisie
| | - J Koubaa
- Service d'Otorhinolaryngologie et de Chirurgie cervico-faciale, CHU Fattouma Bourguiba, Monastir, Tunisie
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El Korbi A, Bhar S, Bergaoui E, Harrathi K, Koubaa J. Post COVID-19 rhino-cerebral mucormycosis: report of a case and literature review. Pan Afr Med J 2022; 42:202. [PMID: 36284570 PMCID: PMC9547023 DOI: 10.11604/pamj.2022.42.202.33690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 06/21/2022] [Indexed: 11/25/2022] Open
Abstract
The pandemic of coronavirus disease 2019 (COVID-19) still remains on an upsurge trend. The second and the waves of this disease have led to panic in many countries, and some parts of the world suffering from the fourth wave. In the midst of this pandemic, COVID-19 patients are acquiring secondary infections such as mucormycosis also known as “black fungus disease”. Mucormycosis is a serious, but rare opportunistic fungal infection that spreads rapidly, and hence prompt diagnosis and treatment are necessary to avoid mortality and morbidity rate. We report in this paper, a case of a diabetic patient who presented with bilateral nasal obstruction, anosmia, and frontal headache diagnosed with rhinocerebral mucormycosis developing after COVID-19 infection with a favorable outcome after a medico-surgical treatment. Through this case, we aim to aware patricians of this possible association and the importance of early diagnosis to optimize treatment outcomes.
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Affiliation(s)
- Amel El Korbi
- Department of Ear, Nose, and Throat (ENT), Fattouma Bourguiba Teaching Hospital, Monastir, Tunisia
- Research Unit, Quality and Security of Care, University of Monastir, Monastir, Tunisia
- Corresponding author: Amel El Korbi, Department of Ear, Nose, and Throat (ENT), Fattouma Bourguiba Teaching Hospital, Monastir, Tunisia.
| | - Salma Bhar
- Department of Ear, Nose, and Throat (ENT), Fattouma Bourguiba Teaching Hospital, Monastir, Tunisia
| | - Emna Bergaoui
- Department of Ear, Nose, and Throat (ENT), Fattouma Bourguiba Teaching Hospital, Monastir, Tunisia
| | - Khaled Harrathi
- Department of Ear, Nose, and Throat (ENT), Fattouma Bourguiba Teaching Hospital, Monastir, Tunisia
- Research Unit, Quality and Security of Care, University of Monastir, Monastir, Tunisia
| | - Jamel Koubaa
- Department of Ear, Nose, and Throat (ENT), Fattouma Bourguiba Teaching Hospital, Monastir, Tunisia
- Research Unit, Quality and Security of Care, University of Monastir, Monastir, Tunisia
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Korbi AE, Houas J, Kolsi N, Bouatay R, Ferjaoui M, Toumi A, Harrathi K, Koubaa J. Fungal necrotizing external otitis: diagnosis, management and outcomes of 15 cases. Pan Afr Med J 2022; 42:306. [PMID: 36425541 PMCID: PMC9653543 DOI: 10.11604/pamj.2022.42.306.27168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 08/06/2022] [Indexed: 11/30/2022] Open
Abstract
Fungal necrotizing external otitis (NEO) is a rare disease. It is an aggressive and potentially fatal infection. The most commonly reported pathogen is Candida. We aim through this study to share our experience in the management of fungal necrotizing external otitis and discuss its diagnosis tools, anti-fungal treatment choice, and outcomes. We included fifteen patients with diagnosis criteria of fungal NEO; clinical features of NEO with positive culture swabs and/or positive serologic test to a fungal pathogen. The mean age was of 70 years with a prevalence of males. The main symptoms were otalgia (n=15) and otorrhea (n=7). Facial palsy was observed in four cases. Fungal pathogens were Candida(n=10) and Aspergillus (n=5). Complications were observed in eight cases: extension to the temporo-mandibular (n=4), abscess in the retropharyngeal space (n=2), abscess in the parapharyngeal space (n=1) and thrombophlebitis of the internal jugular vein (n=1). Six patients were treated with fluconazole, eight with voriconazole, and one patient with itraconazole. After a mean duration of 52 days of antifungal therapy, fourteen patients have been cured with normalization of the ear symptoms, biological, and imaging features. One patient died of septic shock. No recurrence of the disease was observed after a follow-up of 12 months in all cases.
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Affiliation(s)
- Amel El Korbi
- Ear Nose and Throat Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- Research Unity Interventional Radiology (LR18SP08), University of Monastir, Monastir, Tunisia
- Corresponding author: Amel El Korbi, Ear Nose and Throat Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia.
| | - Jihene Houas
- Ear Nose and Throat Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Naourez Kolsi
- Ear Nose and Throat Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Rachida Bouatay
- Ear Nose and Throat Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Mehdi Ferjaoui
- Ear Nose and Throat Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Adnene Toumi
- Research Unity Interventional Radiology (LR18SP08), University of Monastir, Monastir, Tunisia
- Department of Infectious Diseases, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Khaled Harrathi
- Ear Nose and Throat Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Jamel Koubaa
- Ear Nose and Throat Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
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Korbi AE, Tkhayat SB, Bouatay R, Ferjaoui M, Kolsi N, Harrathi K, Koubaa J. [Therapeutic outcomes of nasopharyngeal carcinomas: a single-center study conducted at the Fattouma Bourguiba University Hospital in Monastir, Tunisia]. Pan Afr Med J 2021; 38:143. [PMID: 33912313 PMCID: PMC8052626 DOI: 10.11604/pamj.2021.38.143.15510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 01/19/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction les carcinomes nasopharyngés (CNP) sont relativement fréquents dans le pourtour méditerranéen. La survie a été largement améliorée avec les nouvelles techniques d´irradiation et les nouvelles molécules de chimiothérapie. L´objectif de notre étude est d´analyser les résultats thérapeutiques et décrire les facteurs pronostiques des CNP. Méthodes il s´agit d´une étude rétrospective menée entre janvier 1995 et décembre 2014, des observations de patients traités et suivis dans notre service pour un carcinome du nasopharynx. Le recueil des données a été réalisé à partir d´une fiche type. L´analyse statistique a été réalisée à l´aide du logiciel SPSS. La survie a été calculée selon la méthode de Kaplan-Meier. Résultats soixante-treize cas de CNP ont été colligés. L´âge moyen était de 48 ans. Une prédominance masculine a été notée. La majorité des tumeurs (56%) étaient localement avancées (T3-T4). Après un recul moyen de 45,5 mois, le taux de récidives locorégionales était de 19,4%. Trois patients (4%) ont présenté des métastases osseuses. La survie globale à 5 ans était de 65%. Les facteurs influençant positivement la survie globale à l´analyse étaient le stade TNM précoce et le fractionnement de 1,8 Grays/séance de la radiothérapie. Les taux de récidives locales et ganglionnaires étaient respectivement de 13,8% et 5,5%, essentiellement pour des tumeurs classées T4 N2. Les séquelles thérapeutiques étaient dominées par les otites séromuqueuses (42,7%), le trismus (38,7%) et la xérostomie (32%). Conclusion la survie globale des CNP s´est améliorée particulièrement avec l´avènement de la radio-chimiothérapie concomitante. Néanmoins, la toxicité tardive invalidante demeure non négligeable. Les facteurs de bon pronostic retrouvés dans cette étude étaient le stade tumoral précoce ainsi que la modalité de fractionnement de la radiothérapie.
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Affiliation(s)
- Amel El Korbi
- Service d´Otorhinolaryngologie et de Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire Fattouma Bourguiba, Monastir, Tunisie.,Unité de Recherche, Qualité et Sécurité des Soins (UR12SP41), Université de Monastir, Monastir, Tunisie
| | - Sarra Ben Tkhayat
- Service d´Otorhinolaryngologie et de Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire Fattouma Bourguiba, Monastir, Tunisie
| | - Rachida Bouatay
- Service d´Otorhinolaryngologie et de Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire Fattouma Bourguiba, Monastir, Tunisie
| | - Mehdi Ferjaoui
- Service d´Otorhinolaryngologie et de Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire Fattouma Bourguiba, Monastir, Tunisie
| | - Naourez Kolsi
- Service d´Otorhinolaryngologie et de Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire Fattouma Bourguiba, Monastir, Tunisie
| | - Khaled Harrathi
- Service d´Otorhinolaryngologie et de Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire Fattouma Bourguiba, Monastir, Tunisie
| | - Jamel Koubaa
- Service d´Otorhinolaryngologie et de Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire Fattouma Bourguiba, Monastir, Tunisie
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Korbi AE, Jellali S, Kolsi N, Bouatay R, Njim L, Berguaoui E, Ferjaoui M, Harrathi K, Koubaa J. Pediatric naso-sinusal inverted papilloma: report of a case and literature review. Pan Afr Med J 2020; 37:373. [PMID: 33796186 PMCID: PMC7992401 DOI: 10.11604/pamj.2020.37.373.27186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 12/03/2020] [Indexed: 11/22/2022] Open
Abstract
Inverted papilloma is a rare nasosinusal tumor that mainly occurs in adults during the 5th decade. The occurrence in children is exceptional and only few cases have been reported in the litterature. Clinical and radiological findings mimic other benign nasosinusal pathologies; therefore, diagnosis is based on histopathology either via biopsy or following surgical excision. Here we present a rare case of pediatric inverted papilloma in a 11-year-old child and we discuss clinical, radiological, therapeutic and evolutionary features through a literature review.
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Affiliation(s)
- Amel El Korbi
- Ear-Nose-Throat (ENT) Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia.,Research Unity (UR12SP41), Quality and Security Care, University of Monastir, Monastir, Tunisia
| | - Sondes Jellali
- Ear-Nose-Throat (ENT) Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Naourez Kolsi
- Ear-Nose-Throat (ENT) Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia.,Research Unity (UR12SP41), Quality and Security Care, University of Monastir, Monastir, Tunisia
| | - Rachida Bouatay
- Ear-Nose-Throat (ENT) Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Leila Njim
- Anatomical and Cytological Pathology Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Emna Berguaoui
- Ear-Nose-Throat (ENT) Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Mehdi Ferjaoui
- Ear-Nose-Throat (ENT) Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Khaled Harrathi
- Ear-Nose-Throat (ENT) Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Jamel Koubaa
- Ear-Nose-Throat (ENT) Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
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11
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Korbi AE, Jellali S, Jguiri M, Bellalah A, Ferjaoui M, Bouatay R, Kolsi N, Harrathi K, Koubaa J. Castelman's disease of the neck: a case report and literature review. Pan Afr Med J 2020; 37:369. [PMID: 33796182 PMCID: PMC7992414 DOI: 10.11604/pamj.2020.37.369.26909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 11/14/2020] [Indexed: 11/26/2022] Open
Abstract
Castleman’s disease is a rare pathology, poorly understood. It is considered as a lymphoproliferative disorder, described for the first time in 1954, which may be confused with other causes of lymphadenopathy. We report in this paper the case of a young women presenting with left latero-cervical lymphadenopathy. All the investigations were negative except a large high-vascularized level II cervical lymphadenopathy. We performed a cervicotomy. The extemporaneous histological exam was non-contributive. We decided to perform a complete level II and III left cervical lymphadenectomy. The diagnosis of unicentric Castleman's disease was confirmed based on the final histological study of the specimen, and the absence of other cervical and extra-cervical lymphadenopathy. The patient is free of recurrence at the time of reporting this article.
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Affiliation(s)
- Amel El Korbi
- ENT Department of Fattouma Bourguiba, University Hospital of Monastir, Monastir, Tunisia.,Research Unit "Quality and Security of care" (UR12SP41), University of Monastir, Monastir, Tunisia
| | - Sondes Jellali
- ENT Department of Fattouma Bourguiba, University Hospital of Monastir, Monastir, Tunisia
| | - Mahbouba Jguiri
- Department of Rheumatology, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | - Ahlem Bellalah
- Anatomical and Cytological Pathology Department, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | - Mehdi Ferjaoui
- ENT Department of Fattouma Bourguiba, University Hospital of Monastir, Monastir, Tunisia
| | - Rachida Bouatay
- ENT Department of Fattouma Bourguiba, University Hospital of Monastir, Monastir, Tunisia
| | - Naourez Kolsi
- ENT Department of Fattouma Bourguiba, University Hospital of Monastir, Monastir, Tunisia.,Research Unit "Quality and Security of care" (UR12SP41), University of Monastir, Monastir, Tunisia
| | - Khaled Harrathi
- ENT Department of Fattouma Bourguiba, University Hospital of Monastir, Monastir, Tunisia
| | - Jamel Koubaa
- ENT Department of Fattouma Bourguiba, University Hospital of Monastir, Monastir, Tunisia
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12
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Harrathi K, Omri ME, Fradi R, Korbi AE, Kolsi N, Bouatay R, Koubaa J. Parapharyngeal metastasis from papillary thyroid microcarcinoma. Pan Afr Med J 2020; 37:18. [PMID: 33062120 PMCID: PMC7532843 DOI: 10.11604/pamj.2020.37.18.22933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 07/11/2020] [Indexed: 11/13/2022] Open
Abstract
Carcinoma of the thyroid gland is one of the most commonly encountered endocrine malignancies. Papillary carcinoma is the most common histological type and its pattern of metastasis are usually lymphatic. Lymphatic metastasis to parapharyngeal space is rare and have been reported, so we report the case of a 50-year-old male patient who had an occult papillary carcinoma of the thyroid presented as right lateral node of the neck and a nodal involvement of the right parapharyngeal space.
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Affiliation(s)
- Khaled Harrathi
- Ear, Nose and Throat Department and Cervical Surgery Fattouma Bourguiba Hospital, Medicine University, Monastir, Tunisia
| | - Malika El Omri
- Ear, Nose and Throat Department and Cervical Surgery Fattouma Bourguiba Hospital, Medicine University, Monastir, Tunisia
| | - Rim Fradi
- Ear, Nose and Throat Department and Cervical Surgery Fattouma Bourguiba Hospital, Medicine University, Monastir, Tunisia
| | - Amel El Korbi
- Ear, Nose and Throat Department and Cervical Surgery Fattouma Bourguiba Hospital, Medicine University, Monastir, Tunisia
| | - Naourez Kolsi
- Ear, Nose and Throat Department and Cervical Surgery Fattouma Bourguiba Hospital, Medicine University, Monastir, Tunisia
| | - Rachida Bouatay
- Ear, Nose and Throat Department and Cervical Surgery Fattouma Bourguiba Hospital, Medicine University, Monastir, Tunisia
| | - Jamel Koubaa
- Ear, Nose and Throat Department and Cervical Surgery Fattouma Bourguiba Hospital, Medicine University, Monastir, Tunisia
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13
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Bouatay R, Harrathi K, Chefai J, Abdejlil N, Koubaa J. [Salivary ductal carcinoma of the parotid: A rare and agressive entity]. Cancer Radiother 2020; 24:135-137. [PMID: 31992517 DOI: 10.1016/j.canrad.2019.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 06/18/2019] [Accepted: 06/19/2019] [Indexed: 02/07/2023]
Abstract
We report a rare case of salivary duct carcinoma and we study its clinical and evolutionary features. A 64-year-old patient was referred for right peripheral facial paralysis. MRI showed suspected formation of the right parotid gland. Treatment included total parotidectomy and ipsilateral neck lymph node dissection. The histology concluded to a ductal carcinoma of the parotid with lymph node metastasis. Radiation therapy has been indicated. Salivary duct carcinoma of the parotid gland is a highly aggressive and uncommon tumor. Treatment of localized forms is based on surgery and radiotherapy.
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Affiliation(s)
- R Bouatay
- Service d'ORL et de CCF, CHU de Fatouma-Bourguiba de Monastir, Monastir, Tunisie; Université de Monastir, Monastir, Tunisie.
| | - K Harrathi
- Service d'ORL et de CCF, CHU de Fatouma-Bourguiba de Monastir, Monastir, Tunisie; Université de Monastir, Monastir, Tunisie
| | - J Chefai
- Service d'ORL et de CCF, CHU de Fatouma-Bourguiba de Monastir, Monastir, Tunisie; Université de Monastir, Monastir, Tunisie
| | - N Abdejlil
- Service d'anatomie pathologique, CHU de Fattouma-Bourguiba de Monastir, Monastir, Tunisie; Université de Monastir, Monastir, Tunisie
| | - J Koubaa
- Service d'ORL et de CCF, CHU de Fatouma-Bourguiba de Monastir, Monastir, Tunisie; Université de Monastir, Monastir, Tunisie
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Bouatay R, Aouf L, Hmida B, El Korbi A, Kolsi N, Harrathi K, Koubaa J. The role of imaging in the management of sinonasal mucoceles. Pan Afr Med J 2019; 34:3. [PMID: 31762872 PMCID: PMC6850736 DOI: 10.11604/pamj.2019.34.3.18677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 07/15/2019] [Indexed: 11/17/2022] Open
Abstract
Mucoceles are slow-growing paranasal sinus cystic masses whose clinical presentation varies according to the affected sinus. Diagnosis is often radiological, based essentially on CT scan. The aim of this work was to study the radiologic characteristics of mucoceles on CT scan and MRI. We conducted a retrospective study of patients with mucoceles explored by imaging and operated on in our department. In our series, fronto-ethmoidal sinuses were the most frequently affected (81%). Facial scan confirmed the diagnosis in the majority of cases. Magnetic resonance imaging (MRI) was performed in 4 cases. Eleven patients were operated on by endonasal approach, three by external approach and one by combined surgical approach. Recurrence was observed in two patients after an average delay of 24 months. CT scan is considered the method of choice in the investigation of mucoceles. MRI is indicated in some cases to assess any orbital or intracranial extension.
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Affiliation(s)
- Rachida Bouatay
- ENT Department at Fattouma Bourguiba Hospital, Monastir, Tunisie
| | - Lamia Aouf
- ENT Department at Fattouma Bourguiba Hospital, Monastir, Tunisie
| | - Badii Hmida
- Radiology Department at Fattouma Bourguiba Hospital, Monastir, Tunisie
| | - Amel El Korbi
- ENT Department at Fattouma Bourguiba Hospital, Monastir, Tunisie
| | - Naourez Kolsi
- ENT Department at Fattouma Bourguiba Hospital, Monastir, Tunisie
| | - Khaled Harrathi
- ENT Department at Fattouma Bourguiba Hospital, Monastir, Tunisie
| | - Jamel Koubaa
- ENT Department at Fattouma Bourguiba Hospital, Monastir, Tunisie
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15
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Bouatay R, Nasr RB, Moussa A, El Korbi A, Harrathi K, Koubaa J. [The importance of fine needle aspiration biopsy in the diagnosis of parotid tumors]. Pan Afr Med J 2019; 33:65. [PMID: 31448027 PMCID: PMC6689855 DOI: 10.11604/pamj.2019.33.65.18259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 05/16/2019] [Indexed: 11/18/2022] Open
Abstract
L'objectif de ce travail était de déterminer la valeur diagnostique de la cytoponction à l'aiguille fine (CPAF) et son apport dans la prise en charge des tumeurs parotidiennes, à travers une étude rétrospective portant sur 47 patients opérés d'une tumeur parotidienne et ayant eu une cytoponction préopératoire. Quatre-vingt-un pourcent des malades présentaient une tumeur bénigne et 19% une tumeur maligne. La sensibilité et la spécificité de la CPAF étaient respectivement de 78% et de 92%. Les tumeurs parotidiennes ont été correctement classées comme malignes ou bénignes dans 89% des cas, le taux d'exactitude globale était de 64,4%. La CPAF est un examen fiable permettant une information préopératoire sur le planning thérapeutique et les suites postopératoires.
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Affiliation(s)
- Rachida Bouatay
- Service d'Oto-rhino-laryngologie et de Chirurgie Cervico-faciale de l'Hôpital Universitaire Fattouma Bourguiba de Monastir, Tunisie
| | - Rim Ben Nasr
- Service d'Oto-rhino-laryngologie et de Chirurgie Cervico-faciale de l'Hôpital Universitaire Fattouma Bourguiba de Monastir, Tunisie
| | - Adnène Moussa
- Service d'Anatomie Pathologique de l'Hôpital Universitaire Fattouma Bourguiba de Monastir, Tunisie
| | - Amel El Korbi
- Service d'Oto-rhino-laryngologie et de Chirurgie Cervico-faciale de l'Hôpital Universitaire Fattouma Bourguiba de Monastir, Tunisie
| | - Khaled Harrathi
- Service d'Oto-rhino-laryngologie et de Chirurgie Cervico-faciale de l'Hôpital Universitaire Fattouma Bourguiba de Monastir, Tunisie
| | - Jamel Koubaa
- Service d'Oto-rhino-laryngologie et de Chirurgie Cervico-faciale de l'Hôpital Universitaire Fattouma Bourguiba de Monastir, Tunisie
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16
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Korbi AE, Houas J, Bouatay R, Harrathi K, Koubaa J. Primary papillary carcinoma of the thyroglossal duct in a 14-year-old female: case report and review of the literature. Pan Afr Med J 2019; 32:121. [PMID: 31223411 PMCID: PMC6560953 DOI: 10.11604/pamj.2019.32.121.15246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 02/02/2019] [Indexed: 11/11/2022] Open
Abstract
Thyroglossal duct carcinoma is a rare pathologic entity. The surgeon's main concern is whether to perform thyroidectomy or not. In this paper, we report another case of thyroglossal papillary duct carcinoma in a 14-old girl suspected preoperatively and confirmed postoperatively on the histological analysis of resected specimen by a Sistrunk procedure. Therapeutic strategy was completed by a total thyroidectomy with radioactive iodine therapy and suppressive levothyroxine therapy. In the absence of clear guidelines, the management of thyroglossal duct carcinoma is depending on the clinical situation and the experience of the team of surgeons.
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Affiliation(s)
- Amel El Korbi
- ENT Department, Fattouma Bourguiba Hospital of Monastir, University of Monastir, Monastir, Tunisia.,Healthcare Research Unit UR12SP41, Tunisia
| | - Jihène Houas
- ENT Department, Fattouma Bourguiba Hospital of Monastir, University of Monastir, Monastir, Tunisia
| | - Rachida Bouatay
- ENT Department, Fattouma Bourguiba Hospital of Monastir, University of Monastir, Monastir, Tunisia
| | - Khaled Harrathi
- ENT Department, Fattouma Bourguiba Hospital of Monastir, University of Monastir, Monastir, Tunisia
| | - Jamel Koubaa
- ENT Department, Fattouma Bourguiba Hospital of Monastir, University of Monastir, Monastir, Tunisia
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Korbi AE, Bouatay R, Houas J, Ameur KB, Harrathi K, Koubaa J. A rare location of thyroglossal duct cyst in a newborn. Pan Afr Med J 2019; 31:104. [PMID: 31037165 PMCID: PMC6462388 DOI: 10.11604/pamj.2018.31.104.14777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 05/28/2018] [Indexed: 11/17/2022] Open
Abstract
Thyroglossal duct cyst of the tongue is a rare entity. Occurrence in the anterior part of the tongue is exceptional. We report in this paper a rare case of thyroglossal cyst of the anterior part of the tongue, discovered in a five-days-old newborn at delivery. Images have shown a cystic mass with homogenous liquid content. A transoral complete resection of the lesion was performed, with no postoperative complication. The histological analysis confirm the diagnosis of lingual thyroglossal duct cyst. There were no recurrence with a follow-up of eight months.
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Affiliation(s)
- Amel El Korbi
- ENT Department, Fattouma Bourguiba Hospital of Monastir, University of Monastir, Tunisia.,Healthcare Research Unit UR12SP41, Tunisia
| | - Rachida Bouatay
- ENT Department, Fattouma Bourguiba Hospital of Monastir, University of Monastir, Tunisia
| | - Jihène Houas
- ENT Department, Fattouma Bourguiba Hospital of Monastir, University of Monastir, Tunisia
| | - Karim Ben Ameur
- Neonatal Department, Maternity and Neonatal University Center, Unversity of Monastir, Tunisia
| | - Khaled Harrathi
- ENT Department, Fattouma Bourguiba Hospital of Monastir, University of Monastir, Tunisia
| | - Jamel Koubaa
- ENT Department, Fattouma Bourguiba Hospital of Monastir, University of Monastir, Tunisia
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18
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Korbi AE, Jellali S, Njima M, Harrathi K, Bouatay R, Ferjaoui M, Kolsi N, Koubaa J. Parotid Gland Oncocytoma: A Rare Case and Literature Review. J Med Cases 2019. [DOI: 10.14740/jmc3288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Abstract
Complications occur in 3% of the cases of frontal sinusitis. These are mainly oculo-orbital, intracranial and osteomyelitis. Our aim is to describe the contribution of different imaging modalities in the diagnosis of these complications and their post-treatment monitoring. within a 15 years period (2000-2014), 10 patients with complicated frontal sinusitis were included into this retrospective study. 10 patients (9 males) aged 9 to 70 year old (mean 28). Two of these patients (20%) had a history of craniofacial trauma. Frontal headache was present in all cases (100%), frontal swelling in 8 cases (80%) and unilateral palpebral edema in 3 cases (30%). A CT scan of the face and brain was performed in all cases and revealed frontal osteomyelitis in 6 cases (60%), extradural empyema in 3 cases (33%), intracranial frontal abscess in 2 cases (20%) and occulo-orbital complications in 3 cases (30%). Magnetic resonance imaging was performed in one patient and demonstrated thrombosis of the upper longitudinal sinus. 40% of our patients associated 2 complications. Cross-sectional imaging is important in early and accurate diagnosis of complicated frontal sinusitis.
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Affiliation(s)
- Naourez Kolsi
- Department of Otorhinolaryngology, Head and Neck Surgery at "Fattouma Bourguiba" Hospital, Monastir, Tunisia
| | - Ahmed Zrig
- Department of Radiology at "Fattouma Bourguiba" Hospital, Monastir, Tunisia
| | - Hamdi Chouchène
- Department of Otorhinolaryngology, Head and Neck Surgery at "Fattouma Bourguiba" Hospital, Monastir, Tunisia
| | - Rachida Bouatay
- Department of Otorhinolaryngology, Head and Neck Surgery at "Fattouma Bourguiba" Hospital, Monastir, Tunisia
| | - Khaled Harrathi
- Department of Otorhinolaryngology, Head and Neck Surgery at "Fattouma Bourguiba" Hospital, Monastir, Tunisia
| | - Jamel Koubaa
- Department of Otorhinolaryngology, Head and Neck Surgery at "Fattouma Bourguiba" Hospital, Monastir, Tunisia
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Mnari W, Kilani M, Harrathi K, Maatouk M, Koubaa J, Golli M. An unusual etiology of posttraumatic Collet-Sicard Syndrome: a case report. Pan Afr Med J 2016; 23:143. [PMID: 27279968 PMCID: PMC4885715 DOI: 10.11604/pamj.2016.23.143.9143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 03/16/2016] [Indexed: 11/16/2022] Open
Abstract
Posttraumatic Unilateral paralysis of the last four cranial nerves (IX-XI), known as collet-Sicard syndrome, is rare following closed head injury. A 21-year-old man presented with slurred speech, hoarseness voice and difficulty swallowing his saliva following closed head trauma. The cranial nerve examination revealed left sided severe dysfunction of cranial nerves VII, IX, X, XI, and XII. A CT-Scan of the neck was performed demonstrating a fracture of the left styloid process at the base of the skull. The Magnetic Resonance Imaging showed unusually well seen lower cranial nerves due to nerve edema. The patient was managed conservatively with steroids and regular sessions of neuromuscular and orthophonic rehabilitation. The nutrition had to be administered by gastrostomy since he was unable to swallow. Six months after the injury a total neurological recovery was noted. We present the exceptional case of Collet-Sicard Syndrome caused by styloid process fracture.
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Affiliation(s)
- Walid Mnari
- Imaging Department, Fattouma Bourguiba University Hospital, Medical university, Monastir, Tunisia
| | - Mohamed Kilani
- Neurosurgery Department, Fattouma Bourguiba University Hospital, Medical university, Monastir, Tunisia
| | - Khaled Harrathi
- Otorhinolaryngology Department, Fattouma Bourguiba University Hospital, Medical University, Monastir, Tunisia
| | - Mezri Maatouk
- Imaging Department, Fattouma Bourguiba University Hospital, Medical university, Monastir, Tunisia
| | - Jamel Koubaa
- Otorhinolaryngology Department, Fattouma Bourguiba University Hospital, Medical University, Monastir, Tunisia
| | - Mondher Golli
- Imaging Department, Fattouma Bourguiba University Hospital, Medical university, Monastir, Tunisia
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Gassab E, Krifa N, Kedous S, Zrig A, Hattab N, Harrathi K, Koubaa J, Gassab A. Endoscopic endonasal management of congenital intranasal meningocele in a 2-month-old infant. Eur Ann Otorhinolaryngol Head Neck Dis 2013; 130:345-7. [PMID: 23688657 DOI: 10.1016/j.anorl.2011.10.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Revised: 04/19/2011] [Accepted: 10/11/2011] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Nasal meningocele, which is usually congenital, is a rare anomaly resulting from meningeal herniation into the nasal cavities through a bone defect in the skull base. CASE REPORT An 8-day-old boy was referred with respiratory disturbance and nasal obstruction. Examination showed a cyst-like grayish swelling filling the right nasal cavity. CT scan showed opacity, of fluid-like density, filling the right nasal fossa, in contact with a small bony defect in the right cribriform plate. MRI ruled out herniated brain parenchyma and enabled diagnosis of meningocele. The patient was operated on at the age of 2 months through a transnasal endoscopic approach. Immediate postoperative course was favorable. MRI control at 8 months was normal. DISCUSSION Modern imaging (CT scan and MRI) is of paramount importance in the preoperative evaluation of nasal meningocele. Endoscopic endonasal (EE) surgery is currently the treatment of choice. CONCLUSION Steady progress in instrumentation, technique and skills will increase the feasibility of skull-base surgery using an endonasal approach in the pediatric population.
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Affiliation(s)
- E Gassab
- Service d'ORL et de chirurgie cervico-faciale, CHU Fattouma-Bourguiba, rue 1(er)-Juin-1995, 5000 Monastir, Tunisia.
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22
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Hammami S, Ben Meriem C, Hadded S, Harrathi K, Ghédira Besbès L, Chouchane S, Guédiche M. P335 - Stridor congénital intermittent révélateur d’un kyste valliculaire chez un nourrisson. Arch Pediatr 2010. [DOI: 10.1016/s0929-693x(10)70731-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Chaabane A, Aouam K, Harrathi K, Yahia NB, Gassab E, Njim L, Boughattas NA. Acute generalised exanthematous pustulosis (AGEP) after cefotaxime use. Case Reports 2009; 2009:bcr06.2008.0343. [DOI: 10.1136/bcr.06.2008.0343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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24
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Gassab E, Harrathi K, Ben Mahmoud F, Krifa N, Hasnaoui M, Kadi S, Hafsa C, Koubaa J, Gassab A. [Benign cervico-facial schwannomas]. Tunis Med 2009; 87:295-296. [PMID: 19835291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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25
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Gassab E, Harrathi K, Hamroun H, Hizem A, Ben Mahmoud F, Kadi S, Taieb T, Elkadhi F, Hafsa C, Ben Yahya S, Kheirallah M, Koubaa J, Gassab A. [Paranasal sinus mucoceles]. Tunis Med 2008; 86:855-857. [PMID: 19472799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Mani R, Belcadhi M, Harrathi K, Rejeb AB, Benali M, Abdelkefi M, Bouzouita K, Bouzouita H. [Mycobacterial cervical lymphadenitis: role of surgery]. Rev Laryngol Otol Rhinol (Bord) 2005; 126:99-103. [PMID: 16180349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
OBJECTIVE To discuss the place of surgery in the management of mycobacterial cervical lymphadenitis. PATIENTS AND METHODS It's a retrospective study (1982-2002) about 246 patients treated in the ENT department of Farhat Hached Sousse for cervical lymph node tuberculosis. Resolution was considered when neither symptoms nor lymphadenopathy in examination were noted. RESULTS The mean age of our patients was 28 years. A light female prevalence was noted. In 5 patients diagnosis was established by lymph node punction. A medical treatment of first intention was then managed with a failure in 3 cases, after deadlines from 3 to 4 months. All other patients were operated: cellulolymphadenectomy (47%), adenectomy (47%) or drainage of a cervical abscess (4%). Recurrence and antituberculosis treatment resistance were noted respectively in 6% and 3% of cases. DISCUSSION Two questions are still discussed in the management of mycobacterial cervical lymphadenitis: 1- Is surgery necessary for the diagnosis? 2- When is surgery indicated directly? Histological specimen established the diagnosis in all cases and excluded a mestastatic lymph node. In some situations surgery must be indicated at first: cold abscess, lymph node fistulation. CONCLUSION Surgery still has an important place in the treatment of tuberculosis lymphadenopathy.
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Affiliation(s)
- R Mani
- CHU Farhat Hached, Service ORL, 4000 Sousse, Tunisie.
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