An encephalocele is a congenital malformation characterized by the herniation of brain content beyond the normal confines of the skull. Transethmoidal encephaloceles represent a rare subtype of ...anterior encephaloceles and consists in a protrusion of the brain content in the nasal cavity through a defect in the horizontal plate of the ethmoid bone. Clinically it usually manifests by upper airway obstruction. We report the case of an 8-month-old infant with a transethmoidal encephalocele revealed by a chronic nasal obstruction and snoring. The patient underwent left frontal craniotomy allowing repositioning of the herniation. Ethmoidal defect was repaired by a fascia lata graft. Post operative recovery was uneventful apart from a CSF rhinorrhea which spontaneously dried up in 3 days.
Introduction: Laryngocele is an air-filled dilatation of the laryngeal saccule that extends upward within the false vocal folds. Different etiologies lead to laryngocele congenital malformation, ...weakness of the laryngeal tissues and increased intralaryngeal pressure. Laryngocele may be a secondary iatrogenic complication following subtotal laryngectomy. Case Report: We report the case of a 61-year-old patient who presented an external laryngomucocele 8 years after a supracricoid partial laryngectomy with cricohyoidoepiglottopexy (SCPL-CHEP). We focus on the clinical aspects and therapeutic attitude, then discuss the physiopathological conditions that could generate this late complication. Conclusion: Laryngocele after subtotal laryngectomy should be considered a late iatrogenic complication. Histological examination is necessary after surgical management of laryngocele, as the association with cancer is frequent.
Schwannomas commonly occur in the head and neck but infrequently involve the oral cavity and rarely afect the tongue. In this observation, the clinical and pathologic characteristics of a rare case ...of schwannoma of the tongue was evaluated.
A rare case of schwannoma of the tongue was evaluated.
A 29-year-old man, without any significant medical history was referred to our Department of Otolaryngology and Cervicofacial Surgery at the Salah Azaiez Institute for evaluation of a mass in the tongue. .
Clinically, the patient presented with a lingual mass noted to be slowly increasing in size. He reported associated tongue pain localized to the lesion. The duration of symptoms was 12 months. Examination revealed a 1,5 cm mass on the right lateral part of the tongue.
It had semielastic consistency, is movable, causes pain when touched, and is covered by a nonulcerated mucosa. No radiologic investigations were needed because the mass was easily seen and palpable.
An excisional biopsy was done under general anesthesia by transoral approach. The entire lesion was removed completely from the tongue using blunt dissection.
There were no perioperative and postoperative complications, and there was no need for nasogastric tube insertion postoperatively. Tissue was sent for histopathologic examination.
On gross examination, the histopathologic examination reveals a well-defined neoformation surrounded by fibrous connective tissue in a capsule-like form where remains of nerve endings. There is no mitotic activity. The final diagnosis was a benign schwannoma.
The postoperative outcome was uneventful, with no signs of recurrence even after two years.
Although schwannomas are often asymptomatic, given enough time, they can cause significant health issues such as significant dysphagia, dysarthria, and obstructive sleep apnea. The rarity of lingual schwannoma may explain the limited knowledge concerning these tumours. The treatment is exclusively surgical. The prognosis is excellent after resection, as malignant transformation is exceptional.
To Study the oncological and functional results of Anterior frontal vertical partial laryngectomy (Tucker).
Retrospective study conducted over a period of 10 years 2013-2022 collecting 19 patients ...treated with Tucker partial laryngectomy for laryngeal cancer.
All patients were male. Mean age was 58 years. Three patients were diabetic and four were hypertensive. Seventeen patients had glottic limited tumor. Two patients had a subglottique extension. No lymph-nodes and no distant metastatic extension were noted. Fifteen patients had the two arytenoids preserved. The histological type was in all cases squamous cell carcinoma. Resection limits were healthy in 17 cases and cramped in 2 cases. Postoperative complications were surgical site infection (2 cases) and lung infection (2 cases). The mean postoperative decannulation time was 11 days 4-22 days. The mean time to remove the nasogastric tube was 15 days 7-24 days. The mean duration of hospitalization was 17 days 13-28 days. Eight patients benefited from speech therapy rehabilitation. The average time to resume an audible voice was 10 days. For a mean follow-up of 3 years, one patient presented recurrenceand was treated with total laryngectomy.
Anterior frontal vertical partial laryngectomy allows to have good oncological and fuctional results for selected early stage of laryngeal cancers.
Darier Ferrand Dermatofibrosarcoma (DFSP) is a rare skin tumor, characterized by its local aggressivity and high potential of recurrence. It affects mainly young and middle-aged adults. Its location ...in the head and neck region represents nearly 12.5 % of all DFSP.
We report a rare case of a 68-year-old patient who was treated for a DFSP of the cheek's lower part with reconstruction using a pectoralis major musculocutaneous flap. The postoperative course was uneventful and the aesthetic result was good.
DFSP is a tumor of intermediate malignancy. Its optimal management is based on complete surgical excision requiring various reconstruction procedures for large defects. The treatment of unresectable lesions remains difficult despite the targeted therapies proposed and the improvement of radiotherapy techniques.
The ideal management of a DFSP is based on surgical excision passing largely in healthy tissues. This situation requires early diagnosis and is the guarantee of disease-free survival without major sequelae in head and neck locations.
•Darier Ferrand Dermatofibrosarcoma (DFSP) is a rare skin tumor, characterized by its local aggressivity and high potential of recurrence.•A histological proof is mandatory and a distant extension assessment is necessary in search of rare metastasis.•Its optimal management is based on complete surgical excision requiring various reconstruction procedures for large defects.•The treatment of unresectable lesions remains difficult despite the targeted therapies proposed and radiation therapy.
Objectives: port catheter fracture and migration could be an iatrogenic life-threatening complication. We aimed to sensitize head and neck surgeons to this complication. Observation: a 61-years old ...man was referred to our surgery department for management of T3N0M0 laryngeal cancer after failure of preservative treatment. The patient had received 2 cycles of chemotherapy and was judged a bad responder. A total laryngectomy with bilateral neck dissection was indicated. The port catheter was kept in place for possible further chemotherapy treatment. During neck dissection the catheter fractured and migrated. Post operative CT scan showed the distal part of the catheter bulging in the right cardiac chambers. The patient was transferred to an interventional cardiology unit where the foreign body was successfully retrieved using femoral venous access. Conclusion: port catheters are a real potential danger because of the risk of fracture and migration of the distal part. Removal of these devices should be performed in collaboration with medical care oncologists before every neck intervention.
Post intubation tracheal stenosis is a severe clinical condition with an increasing prevalence due to the advances of critical care medicine. This is a retrospective study including 12 cases of ...post-intubation tracheal stenosis managed by TRA in our head and neck surgery department between the years 2013 and 2019. All patients underwent preoperative clinical evaluation based on neck CT scan and endoscopy under general anaesthesia. Traffic road accidents and trauma were the main causes of prolonged intubation. Ten (10) patients required tracheostomy. According to the Cotton Meyer grading, 4 patients had grade II, 2 had grade III and 4 had grade IV. The mean length of stenosis was 16.2±5.6 millimeters. T-tube was inserted intraoperatively in 5 patients. 4 were successfully decannulated in a mean delay of 9.2 months. Early postoperative complications were subcutaneous emphysema, laryngeal edema, aspiration pneumonia, intra-tracheal migration of the T-tube, and vocal cord paralysis each complication occurred in 1 case. Late postoperative complications were granulation tissue formation observed in 5 cases and restenosis in 3 cases. The initial success rate of the TRA was 91.7%. Management of Post intubation tracheal stenosis requires a skillful multidisciplinary team. TRA guided by a meticulous preoperative evaluation is the gold standard. Keywords: tracheal resection, anastomosis, tracheal resection with end-to-end anastomosis, cervical computed tomography
Malignant tumors of the temporal bone are rare. They include a wide histological variety. They are mostly primary tumors with an estimated incidence of 0.8-1.0 per 1,000,000 inhabitants per year 1. ...Metastases form an uncommon subgroup. The clinical features of these temporal bone metastases are nonspecific and predominantly consist of hearing loss, vertigo, facial palsy, tinnitus, headache, otalgia or otorrhoea 2. The aim of our publication is to report a rare case of metastasis in the temporal bone as initial manifestation of lung cancer. Our patient was a 44-year-old man who presented for a right mastoid swelling with a grade VI right facial nerve palsy. Imaging and biopsy confirmed the diagnosis of small cell lung carcinoma petrous metastasis. The treatment was palliative. An osteolytic lesion of the temporal bone in an elderly patient may fit with a primary tumor of the temporal bone. It must, also, suggest the diagnosis of metastasis. The malignant tumor most frequently responsible is breast cancer, but lung cancer must also be considered in smoking patients.
Laryngocele is a rare benign lesion of the larynx caused by an abnormal dilatation of the laryngeal saccule. We report the case of a 78-year-old man presenting bilateral cervical painless soft mass. ...Bilateral external laryngocele diagnosis was confirmed by CT scan and the patient underwent a surgical resection.
