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El Omri M, Naouar M, Bellakhddher M, Bergaoui E, Kermani W, Abdelkefi M. Huge second branchial cleft cyst: A case report. Int J Surg Case Rep 2024; 115:109251. [PMID: 38219521 PMCID: PMC10826803 DOI: 10.1016/j.ijscr.2024.109251] [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: 11/10/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/16/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Second branchial cysts are benign dysembryological cystic tumors that develop in the antero-lateral part of the neck. They represent 2 % of laterocervical tumors of the neck and are usually diagnosed before adulthood. The cysts can increase in size and cause multiple complications. Ultrasound and MRI (Magnetic Resonance Imaging) confirm their cystic nature. Treatment consists of surgical excision. CASE PRESENTATION We report the case of a 31-year-old woman who presented with a left laterocervical swelling measuring 8 cm, which had been present for 18 months without any other associated symptoms. An exploratory cervicotomy was performed, and the histological diagnosis was a second branchial cleft cyst without signs of malignancy. CLINICAL DISCUSSION The definitive diagnosis of a second branchial cleft cyst is confirmed by anatomopathological examination. Therapeutic management is always surgical and should be performed as early as possible to limit the risk of complications. CONCLUSION Second branchial cleft cysts are relatively uncommon malformations. Diagnosis is suspected based on physical examination, guided by imaging data, and confirmed by anatomopathological examination. Treatment is surgical, with complete removal of the cyst being necessary to prevent recurrence.
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Affiliation(s)
- Malika El Omri
- Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Sousse, Tunisia
| | - Maroua Naouar
- Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Sousse, Tunisia.
| | - Mouna Bellakhddher
- Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Sousse, Tunisia
| | - Emna Bergaoui
- Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Sousse, Tunisia
| | - Wassim Kermani
- Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Sousse, Tunisia
| | - Mohamed Abdelkefi
- Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Sousse, Tunisia
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Nouri A, Ksia A, Bouzaffara B, Munsterer O, Hidouri S, Chahed J, Sahnoun L, Mekki M. A New Operative Approach for Long-Gap Esophageal Atresia. J Indian Assoc Pediatr Surg 2019; 24:132-134. [PMID: 31105401 PMCID: PMC6417061 DOI: 10.4103/jiaps.jiaps_172_17] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Surgical management of long-gap esophageal atresia (LGEA) remains challenging. Yet, there is a consensus among pediatric surgeons to preserve native esophagus. We used a new surgical technique to successfully manage three children diagnosed with LGEA. This technique consists of a combined thoracic and cervical approach to the EA repair using the patient's native esophagus. All patients initially had had gastrostomy and continuous upper pouch suction while awaiting surgery. This new technique has the potential to become the choice method in LGEA management.
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Affiliation(s)
- Abdellatif Nouri
- Department of Pediatric Surgery, Monastir Medical School, Fattouma Bourguiba Teaching Hospital, Research Laboratory, Monastir, Tunisia
| | - Amine Ksia
- Department of Pediatric Surgery, Monastir Medical School, Fattouma Bourguiba Teaching Hospital, Research Laboratory, Monastir, Tunisia
| | - Bochra Bouzaffara
- Department of Pediatric Surgery, Monastir Medical School, Fattouma Bourguiba Teaching Hospital, Research Laboratory, Monastir, Tunisia
| | - Oliver Munsterer
- Department of Pediatric Surgery, Mainz Medical School, Mainz, Germany
| | - Saida Hidouri
- Department of Pediatric Surgery, Monastir Medical School, Fattouma Bourguiba Teaching Hospital, Research Laboratory, Monastir, Tunisia
| | - Jamila Chahed
- Department of Pediatric Surgery, Monastir Medical School, Fattouma Bourguiba Teaching Hospital, Research Laboratory, Monastir, Tunisia
| | - Lassaad Sahnoun
- Department of Pediatric Surgery, Monastir Medical School, Fattouma Bourguiba Teaching Hospital, Research Laboratory, Monastir, Tunisia
| | - Mongi Mekki
- Department of Pediatric Surgery, Monastir Medical School, Fattouma Bourguiba Teaching Hospital, Research Laboratory, Monastir, Tunisia
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Garrel R, Bartolomeo M, Makeieff M, Crampette L, Guerrier B, Cartier C. Interest of video-assisted minimally invasive surgery in primary hyperparathyroidism. Eur Ann Otorhinolaryngol Head Neck Dis 2016; 133:247-51. [PMID: 27133292 DOI: 10.1016/j.anorl.2016.03.007] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Surgery is the only radical and definitive treatment for primary hyperparathyroidism. Exploration of the four parathyroid sites is giving way to minimally invasive techniques. The present study sought to compare two minimally invasive parathyroidectomy techniques, by classical cervicotomy (MIP-C) and by video-assistance (MIP-VA), in terms of success rate, complications rate, operating time, and patient and community physician satisfaction. MATERIALS AND METHOD A non-randomized retrospective comparative study included 112 patients presenting with primary hyperparathyroidism with identified parathyroid adenoma, operated on between January 2005 and October 2010. The two groups were constituted according to the surgeons' habitual practice: 54 cases of MIP-VA and 58 of MIP-C. RESULTS Results for MIP-VA and MIP-C were respectively: success, 96.3% vs. 100% (P=0.09); mean scar size, 1.47 vs. 3.43cm (P<0.01); hypocalcemia, 2 vs. 3 cases (P=0.1); theater time, 94.25 vs. 76min (P=0.02); and postoperative stay, 1.08 vs. 1.37 days (P=0.07). Patient satisfaction was comparable between groups, while 93.3% of community physicians found MIP-VA preferable to MIP-C, although only 39.3% had known the MIP-VA technique. CONCLUSION With efficacy, morbidity and patient satisfaction comparable to classical surgery, MIP-VA significantly reduced cervicotomy size and hospital stay. Community physicians considered it to be preferable to MIP-C.
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Affiliation(s)
- R Garrel
- Département d'ORL et CCF, Hôpital Guide-Chauliac, Pôle Neuroscience Tête et Cou, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France.
| | - M Bartolomeo
- Département d'ORL et CCF, Hôpital Guide-Chauliac, Pôle Neuroscience Tête et Cou, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France
| | - M Makeieff
- Département d'ORL et CCF, Hôpital Guide-Chauliac, Pôle Neuroscience Tête et Cou, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France
| | - L Crampette
- Département d'ORL et CCF, Hôpital Guide-Chauliac, Pôle Neuroscience Tête et Cou, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France
| | - B Guerrier
- Département d'ORL et CCF, Hôpital Guide-Chauliac, Pôle Neuroscience Tête et Cou, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France
| | - C Cartier
- Département d'ORL et CCF, Hôpital Guide-Chauliac, Pôle Neuroscience Tête et Cou, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France
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Togo S, Ouattara MA, Saye J, Sangaré I, Touré M, Maiga I, Dakouo DJ, Xing L, Guo L, Zhou AJ, Koumaré S, Koita AK, Sanogo ZZ, Yéna S. [Necrotizing cervico-facial cellulitis of dental origin in a developing country]. Rev Mal Respir 2016; 34:742-748. [PMID: 27132213 DOI: 10.1016/j.rmr.2016.03.006] [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: 07/22/2015] [Accepted: 03/19/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Necrotizing cellulitis of dental origin is a serious disease and requires prompt and effective management to avoid adverse outcomes. The purpose of this work is to describe the diagnostic and therapeutic difficulties encountered in this condition. METHODS This was a prospective study in the thoracic surgery department of Mali Hospital from January 2011 to February 2015. We collected consecutively 19 cases of complicating cervico-facial cellulitis of dental origin. The anatomical and clinical aspects, therapeutic modalities and difficulties are described. RESULTS Dental pain and fever were the predominant symptoms followed by cervical edema. Chest CT-scan was the basis for the diagnosis in all cases. Cervicotomy with debridement was the most performed surgical procedure. Pleural drainage was performed in 6 cases. Three patients (15.8%) died. CONCLUSION Necrotizing cellulitis of dental origin is a serious disease with high morbidity and mortality. The key radiological examination is the thoracic CT-scan. Early medico-surgical management by emergency care, tailored antibiotic therapy, removal of necrotizing tissues and drainage of collections are required to deliver a good outcome.
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Affiliation(s)
- S Togo
- Service de chirurgie thoracique, centre hospitalo-universitaire du Point G, Bamako, Mali.
| | - M A Ouattara
- Service de chirurgie thoracique, centre hospitalo-universitaire du Point G, Bamako, Mali
| | - J Saye
- Service de chirurgie thoracique, centre hospitalo-universitaire du Point G, Bamako, Mali
| | - I Sangaré
- Service de chirurgie thoracique, centre hospitalo-universitaire du Point G, Bamako, Mali
| | - M Touré
- Service de chirurgie thoracique, centre hospitalo-universitaire du Point G, Bamako, Mali
| | - I Maiga
- Service de chirurgie thoracique, centre hospitalo-universitaire du Point G, Bamako, Mali
| | - D J Dakouo
- Service de chirurgie thoracique, centre hospitalo-universitaire du Point G, Bamako, Mali
| | - L Xing
- Service de chirurgie thoracique, centre hospitalo-universitaire du Point G, Bamako, Mali
| | - L Guo
- Service de chirurgie thoracique, centre hospitalo-universitaire du Point G, Bamako, Mali
| | - A J Zhou
- Service de chirurgie thoracique, centre hospitalo-universitaire du Point G, Bamako, Mali
| | - S Koumaré
- Service de chirurgie A, centre hospitalo-universitaire du Point G, Bamako, Mali
| | - A K Koita
- Service de chirurgie A, centre hospitalo-universitaire du Point G, Bamako, Mali
| | - Z Z Sanogo
- Service de chirurgie A, centre hospitalo-universitaire du Point G, Bamako, Mali
| | - S Yéna
- Service de chirurgie thoracique, centre hospitalo-universitaire du Point G, Bamako, Mali
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Di Crescenzo V, Vitale M, Valvano L, Napolitano F, Vatrella A, Zeppa P, De Rosa G, Amato B, Laperuta P. Surgical management of cervico-mediastinal goiters: Our experience and review of the literature. Int J Surg 2015; 28 Suppl 1:S47-53. [PMID: 26721191 DOI: 10.1016/j.ijsu.2015.12.048] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [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: 04/18/2015] [Revised: 05/15/2015] [Accepted: 05/25/2015] [Indexed: 11/17/2022]
Abstract
AIM We analyze and discuss the clinical presentation, the diagnostic procedures and the surgical technique in relation to post-operative complications and results in cervico-mediastinal thyroid masses admitted in Thoracic Surgery Unit of AOU Second University of Naples from 1991 to 2006 and in Thoracic Surgery Unit of AOU "S. Giovanni di Dio & Ruggi D'Aragona" of Salerno over a period of 3 years (2011-2014). METHODS We reviewed 97 patients who underwent surgical treatment for cervico-mediastinal goiters. 47 patients (49.2%) had cervico-mediastinal goiter, 40 patients (40%) had mediastino-cervical goiter and 10 patients (10.8%) had mediastinal goiter. 73 cases were prevascular goiters and 24 were retrovascular goiters. We performed total thyroidectomy in 40 patients, subtotal thyroidectomy in 46 patients and in 11 cases the resection of residual goiter. In 75 patients we used only a cervical approach, in 21 patients the cervical incision was combined with median sternotomy and in 1 patient with transverse sternotomy. RESULTS Three patients (3.1%) died in the postoperative period (2 cardio-respiratory failure and 1 pulmonary embolism). The histologic study revelead 8 (7.7%) carcinomas. Postoperative complications were: dyspnea in 9 cases (10.7%), transient vocal cord paralysis in 6 patients (9.2%), temporary hypoparathyroidism in 9 patients (9.2%) and kidney failure in 1 case (0.9%). CONCLUSIONS The presence of a cervico-mediastinal thyroid mass with or without respiratory distress requires a surgical excision as the only treatment option. Thyroid masses extending to the mediastinum can be excised successfully by cervical incision. Bipolar approach (cervical incision and sternotomy) has an excellent outcome, achieving a safe resection, especially in large thyroid masses extending to the mediastinum with close relations to mediastinal structures and in some limited cases (carcinoma, thyroiditis, retrovascular goiter, ectopic goiter). Postoperative mortality and morbidity is very low, independent of surgical techniques. Other surgical approaches for excision of a Posterior Mediastinal Thyroid Goiter reported in literature are: VATS techniques to remove an ectopic intrathoracic goiter, robot-assisted technique for the removal of a substernal thyroid goiter, with extension into the posterior mediastinum.
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Affiliation(s)
- V Di Crescenzo
- Department of Medicine and Surgery, Thoracic Surgery Unit, University of Salerno, Italy.
| | - M Vitale
- Department of Medicine and Surgery, University of Salerno, Italy.
| | - L Valvano
- General Surgery Unit, AOU "S. Giovanni di Dio & Ruggi D'Aragona", Salerno, Italy.
| | - F Napolitano
- Department of Medicine and Surgery, Thoracic Surgery Unit, University of Salerno, Italy.
| | - A Vatrella
- Department of Medicine and Surgery, Section of Respiratory Disease, University of Salerno, Italy.
| | - P Zeppa
- Department of Medicine and Surgery, Pathology Unit, University of Salerno, Italy.
| | - G De Rosa
- Biomorphological and Functional Sciences Department, Italy.
| | - B Amato
- Department of Public Health, "Federico II" University of Naples, Italy.
| | - P Laperuta
- Department of Medicine and Surgery, Thoracic Surgery Unit, University of Salerno, Italy.
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Parolini F, Morandi A, Macchini F, Gentilino V, Zanini A, Leva E. Cervical/thoracotomic/thoracoscopic approaches for H-type congenital tracheo-esophageal fistula: a systematic review. Int J Pediatr Otorhinolaryngol 2014; 78:985-9. [PMID: 24856837 DOI: 10.1016/j.ijporl.2014.04.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Revised: 04/02/2014] [Accepted: 04/04/2014] [Indexed: 01/05/2023]
Abstract
PURPOSE Aim of this systematic review is to investigate the thoracic and cervical surgical approaches of H-type tracheo-esophageal fistula (TEF) according to the position of the fistula. METHODS The PubMed database was searched for original studies on H-type TEF treatment published between 1977 and 2012. Manuscripts finally included were divided into open and thoracoscopic surgery groups. RESULTS Seventeen studies were selected for open surgery group, and most of them agree on the importance of pre-operative diagnosis of the fistula by preliminary tracheoscopy. Right cervicotomy was used in 70 cases (76.9%), left cervicotomy in 12 (13.2%), and thoracotomy only in 9 (9.9%). Five studies were included in thoracoscopic group (6 patients). Indications for the surgical approach (cervical vs thoracic) according to the position of the TEF were clearly described in 10 manuscripts, and all stated differences in surgical technique details. Complications and mortality rates were not statistically correlated to the different surgical approaches. CONCLUSIONS The evidence base in regard to the treatment of H-type fistula in children is poor and the skills and preferences of the surgeons guide the choice of the procedure. Surgical division of the fistula is curative, and the key to a successful repair is the pre-operatively identification of the level of the fistula with tracheoscopy. Right cervicotomy seems to be the approach of choice in the majority of case, with the thoracic approach appropriate only for fistulae opening below T2. Further well-designed prospective studies which take into account of selection and performance bias are strongly required.
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Affiliation(s)
- Filippo Parolini
- Department of Paediatric Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy; Department of Paediatric Surgery, Azienda Ospedaliera Spedali Civili Brescia, Italy.
| | - Anna Morandi
- Department of Paediatric Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Francesco Macchini
- Department of Paediatric Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Valerio Gentilino
- Department of Paediatric Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Andrea Zanini
- Department of Paediatric Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Ernesto Leva
- Department of Paediatric Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
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