E Stramandinoli

Careful assessment of tumor extension is required before partial laryngectomy in order to ensure optimal carcinological safety. Laryngoscopy and CT-scan constitute the explorations of reference. We investigated the value of these two examinations and their association for the evaluation of glottic and supraglottic tumors. We compared laryngoscopy and CT findings with those of the pathologic examination of the surgical specimen in a retrospective study of 57 patients. The results were presented by T-staging, then as a function of the laryngeal floor of the tumor and the anatomic localization. The laryngoscopy findings were most contributive for small tumors. Large spaces are better examined with the scanner. This study showed that the performance of laryngoscopy and CT-scan for the assessment of glottic and supraglottic tumors can be improved by a better knowledge of the limitations of each type of explorations for this type of assessment. CT-scan currently provides a better topographic assessment of the tumor than endoscopy; even higher performance can be expected with the advent of technological advances.

Cervical spondylodiscitis is described more often in children than in adults. Many cases occur after cervical or facial surgery, usually as a complication after difficult intubation, endoscopy or foreign body extraction. We report the first case of cervical spondylodiscitis occurring subsequent to secondary tracheoesophageal puncture for implantation of a phonatory prosthesis. Signs were not specific leading to difficult diagnosis and treatment. We discuss the impact of bacterial contamination during tracheoesophageal puncture.

We report a case of Wegener's disease with an exceptional 10-year course before diagnosis subsequent to the development of severe ENT features. Mucosal ulcerations involving the mouth and the pharynx were highly extensive and resolved completely, but temporarily, with cyclophosphamide and corticosteroid therapy.

Between January 1997 and June 1999, we screened for hearing loss using evoked otoacoustic emissions in 320 newborns in the neonate intensive care unit at the Amiens University Hospital. The purpose of this study was to search for correlations between deafness and one of the hearing loss risk factors identified by the Joint Committee on Infant Screening. Three risk factors were found to be significant: craniofacial abnormalities, low birth weight (less than 1500 g) and a familial history of hearing loss. Unfortunately a large proportion of the infants were lost to follow-up. Evoked otoacoustic emission provide an excellent screening technique for hearing loss in newborns. Such screening implies however the creation of networks to assure patient follow-up.

We report our functional results about 81 ossiculoplastys during tympanoplasty with closed technique in chronic cholesteatomatous otitis. We discuss our functional results and the post-operative assessment of the audiometric gain. Patients presented either cholesteatomatous otitis sequelea or any preliminary status (retraction pockets) with attical impairment.