OBJECTIVES/HYPOTHESIS To identify barriers in access to care for head and neck cancer (H&NC) ... more OBJECTIVES/HYPOTHESIS To identify barriers in access to care for head and neck cancer (H&NC) patients in low- and middle-income countries (LMICs), specifically within Dakar, Senegal, using both quantitative and qualitative data. STUDY DESIGN Descriptive observational study. METHODS Patients with H&NC were selected from two independent university hospitals in Dakar, Senegal. A mixed-methods descriptive study was performed using a specifically tailored questionnaire and a focused ethnographic qualitative approach to identify factors that delay patient presentation, referral, and treatment. Quantitative data were analyzed using descriptive statistics and qualitative using a deductive approach based on a systematic review of the literature. RESULTS Thirty-three patients with a mean age of 57.8 years were included. Presentation delay was 5.7 months, mainly attributed to cost of consultation (39%), waiting time at doctor's office (15%), and distance to healthcare facility (12%). Referral delay greater than 3 months was observed in 60% of participants, secondary to misdiagnosis and lack of appropriate referral. Treatment delay was associated with limited local treatment capacity and securing cost of treatment. Cost of transportation impacted all delays. CONCLUSIONS This work used an evidence-based approach to identify barriers in access to care for H&NC patients in sub-Saharan Africa. It suggests the feasibility and transferability of this methodology which combined a quantitative approach based on the literature with a qualitative analysis. Insight provided by this study will be used to guide development of implementation strategies for early detection of H&NC in LMICs. LEVEL OF EVIDENCE 4 Laryngoscope, 2021.
Benché la patologia otorinolaringoiatrica quotidiana delle regioni intertropicali si confonda spe... more Benché la patologia otorinolaringoiatrica quotidiana delle regioni intertropicali si confonda spesso con quella delle regioni temperate, l’esercizio della specialità vi riscontra specificità proprie: da una parte la presenza di patologie infettive specifiche o di patologie ubiquitarie che rivestono sotto i tropici un aspetto particolare e che sono l’oggetto della prima parte di questo articolo; dall’altra, una patologia oncologica propria di queste regioni e che è analizzata dettagliatamente in questa sede; infine, condizioni d’esercizio particolari che sono legate alle frequenti carenze di apparecchiature. Esse conferiscono alle patologie ubiquitarie riscontrate alcune caratteristiche specifiche tanto nella loro evoluzione che nella loro gestione. Queste condizioni d’esercizio impongono un adattamento delle procedure abituali dei paesi temperati; questo articolo fornisce alcune linee generali sulle scelte terapeutiche adatte ai contesti locali.
The aim of our study has been to describe the cricopharyngeal muscle and its nerve supply from th... more The aim of our study has been to describe the cricopharyngeal muscle and its nerve supply from the recurrent laryngeal nerve and from the superior laryngeal nerve. Six normal adult human pharynges (12 sides) obtained from cadavers were studied. Micro-dissections were carried out thanks to a Leica microscope. Measures were obtained with a micro-digital caliber. The morphological feature of the cricopharyngeal muscle (CPM) showed three different muscular bundles: superior oblique muscle fibers are joining the inferior pharyngeal constrictor muscle, horizontal circular muscle fibers are 11 to 12mm high, and 3mm thick, inferior oblique muscle fibers are joining external layer of the superior oesophagus. The recurrent laryngeal nerve through its dorsal branch supplies the posterior part of the muscular bundles of the CPM. The superior laryngeal nerve by its lateral branch supplies the anterior part of the CPM. So this double vagal innervation of the CPM from superior and inferior laryngeal nerves participates in the laryngo-pharyngeal coordination specially for swallowing.
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2012
ABSTRACT Objectifs Rapporter un second cas de granulome à cholestérine de l’oreille moyenne, enva... more ABSTRACT Objectifs Rapporter un second cas de granulome à cholestérine de l’oreille moyenne, envahissant la cochlée. Patient et méthodes Une patiente de 54 ans, opérée autrefois d’une tympanoplastie avec stapédectomie a consulté pour une otorrhée droite sur une oreille cophosée. L’otomicroscopie montrait une perforation tympanique antérieure avec écoulement mucopurulent. La tomodensitométrie (TDM) objectivait une lésion comblant la caisse du tympan, dénudant le nerf facial tympanique, détruisant les osselets ; la cochlée et le vestibule étaient ossifiés à l’exception du tour basal de la cochlée. L’apex pétreux était normal. L’imagerie par résonnance magnétique (IRM) montrait une image envahissant la caisse et le tour basal de la cochlée donnant un hypersignal hétérogène en T1 non rehaussé par l’injection de gadolinium, et hyperintense en T2. Le diagnostic de granulome à cholestérine de l’oreille moyenne était suspecté et un geste chirurgical décidé en raison de la dénudation du nerf facial et de l’envahissement de la cochlée. Résultat L’intervention a permis l’exérèse d’une masse compressive, jaune-brunâtre, envahissant le tour basal de la cochlée, évocatrice d’un granulome à cholestérine, diagnostic confirmé histologiquement. Conclusion L’invasion directe de la capsule otique par un granulome à cholestérine est extrêmement rare. La chirurgie dans un tel cas doit être proposée afin d’éviter la survenue de complications neurologiques.
ABSTRACT Introduction – But de l’étude le but de ce travail est l’analyse morphologique du muscle... more ABSTRACT Introduction – But de l’étude le but de ce travail est l’analyse morphologique du muscle crico-aryténoïdien postérieur (MCAP) et de son innervation par le nerf laryngé inférieur (NLI). Ce muscle est considéré comme le seul abducteur du larynx. Sa physiologie reste encore mal connue et objet de controverse. Matériels et méthodes douze larynx adultes ont été prélevés au Laboratoire d’Anatomie. Après fixation, les 24 hémi-larynx ont été disséqués sous microscope opératoire. Résultats trois arguments morphologiques permettent de suggérer que le MCAP n’est pas uniquement abducteur du larynx : Le MCAP présente deux groupes de fibres musculaires d’orientation différente : des fibres supérieures et médiales d’orientation horizontale et mécaniquement adductrices ; des fibres inférieures et latérales d’orientation verticale et abductrices. L’innervation des 2 groupes de fibres musculaires provient de deux collatérales non anastomosées, à partir du NLI dans son segment vertical pour le groupe latéral et son segment géniculé pour le groupe médial. La terminaison de la branche nerveuse destinée à la partie horizontale du MCAP, se termine dans le muscle inter-aryténoïdien, adducteur puissant du larynx. Conclusion ainsi, le MCAP semble bien posséder une fonction mixte, abductrice pour sa partie verticale latérale, adductrice pour sa partie horizontale médiale.
Revue de laryngologie - otologie - rhinologie, 2000
Two children cases report of an ingested fish bone perforating upper digestive tract lumen and co... more Two children cases report of an ingested fish bone perforating upper digestive tract lumen and completely migrating to the retropharyngeal space in the neck are presented. It is an unusual presentation and we describe our management. In one case it was necessary to performed a cervicotomy to remove the foreign body. In other case the rigid endoscopy could remove the fish bone with forceps under direct vision. The literature is reviewed to improve the early recognition and treatment for these migrating foreign bodies.
Revue de stomatologie et de chirurgie maxillo-faciale, 2003
We report an exceptional case of giant cell tumor of the submaxillary gland in a 76-year-old woma... more We report an exceptional case of giant cell tumor of the submaxillary gland in a 76-year-old woman. The tumor progressed slowly over a period of 40 years. Submaxillectomy removed a 3-kg mass before fixation. The postoperative period was uneventful and the patient was discharged fifteen days later. Pathology examination revealed a pleomorphous adenoma developed within the salivary gland.
Annales d'oto-laryngologie et de chirurgie cervico faciale : bulletin de la Société d'oto-laryngologie des hôpitaux de Paris, 2004
To describe different sequences on magnetic resonance imaging (MRI) in otosclerosis with peri-coc... more To describe different sequences on magnetic resonance imaging (MRI) in otosclerosis with peri-cochlear involvement. MRI T1 and T2 sequences with T1 gadolinium injection and computed tomography (CT) scans with millimetric slices on axial and coronal views were obtained. The diagnosis of bilateral otosclerosis was confirmed by surgical exploration. On the CT scan, there was a fourth turn of the cochlea which appeared on the MRI T1 sequence with an intermediate signal and on the T2 sequences with a high intensity signal. After gadolinium injection, there was signal enhancement, suggestive of active otospongiosis. On the CT scan, there was another lesion in front of the cochlea with endosteal involvement. This was no however visible on the MRI, even after gadolinium infusion, in accordance with inactive otospongiosis. We reviewed the literature concerning MRI and results in otosclerosis. MRI of the labyrinth with T1 sequences and gadolinium injection can be contributive to the diagnosis...
The authors are reporting of an exceptional case of giant cell tumor of the submaxillar gland in ... more The authors are reporting of an exceptional case of giant cell tumor of the submaxillar gland in a lady of 76 years old. She presents a progressively slow evolution within a period of 40 years. After a standard check up, a submaxillectomy was carded out. The weight of the operated mass was 3 kg before the pathological fixation. The post-operative period was without any problems and the patient was discharged after fifteen days. The anatomo-pathological examination concluded a pleomophic adenoma developed by the salivery gland.
Allergy is quite frequent and ENT syptoms are usually the visible part of a general disease. Ques... more Allergy is quite frequent and ENT syptoms are usually the visible part of a general disease. Questioning remains the most important part of the enquiry for clinical examination is usually poor if notdesapointing. Biological testings detailed in this paper may be of some help; In Africa, test-treatements using cheap and unharmfull drugs give often the best evidence of allergy. Seldom, ENT allergy may be or become life-threatening. Its detection and appropiate actions are briefly mentioned.
Morphologie : bulletin de l'Association des anatomistes, 2007
The purpose of our study has been to describe the pre-operatively MR Imaging appearance of masses... more The purpose of our study has been to describe the pre-operatively MR Imaging appearance of masses in the parotid gland which may be sources of clinical and radiological confusion. Sixty-eight adults patients with a parotid mass (39 female, 29 male) has been prospectively investigated. T1-weighted, T2-weighted, diffusion-weighted and contrast-enhanced dynamic MR images were performed by using a 1.5 or 1 T MR Imaging unit (Philips Gyroscan Intera 1.5 T. Siemens Expert 1 T). All patients underwent a parotidectomy with histopathologic analysis. In case of pleomorphic adenoma (N=30) MR imaging sensibility, specificity and accuracy were respectively 87.5, 80.5 and 83%. In case of Warthin tumors (N=13) the same values were respectively 45.5, 93 and 85%. In case of malignant tumors (N=13) theses values were respectively 71, 89 and 87%. Our routine MR Imaging study appears excellent not only for assessing the type and extent of benign salivary gland tumors and the relationship to adjacent st...
Morphologie : bulletin de l'Association des anatomistes
The aim of our study has been to describe the cricopharyngeal muscle and its nerve supply from th... more The aim of our study has been to describe the cricopharyngeal muscle and its nerve supply from the recurrent laryngeal nerve and from the superior laryngeal nerve. Six normal adult human pharynges (12 sides) obtained from cadavers were studied. Micro-dissections were carried out thanks to a Leica microscope. Measures were obtained with a micro-digital caliber. The morphological feature of the cricopharyngeal muscle (CPM) showed three different muscular bundles: superior oblique muscle fibers are joining the inferior pharyngeal constrictor muscle, horizontal circular muscle fibers are 11 to 12mm high, and 3mm thick, inferior oblique muscle fibers are joining external layer of the superior oesophagus. The recurrent laryngeal nerve through its dorsal branch supplies the posterior part of the muscular bundles of the CPM. The superior laryngeal nerve by its lateral branch supplies the anterior part of the CPM. So this double vagal innervation of the CPM from superior and inferior larynge...
ABSTRACT Background and purposeThe purpose of our study has been to describe the pre-operatively ... more ABSTRACT Background and purposeThe purpose of our study has been to describe the pre-operatively MR Imaging appearance of masses in the parotid gland which may be sources of clinical and radiological confusion.
European annals of otorhinolaryngology, head and neck diseases, 2012
To report a second case of cholesterol granuloma of the middle ear invading the cochlea. A 54-yea... more To report a second case of cholesterol granuloma of the middle ear invading the cochlea. A 54-year-old woman, who had undergone right-side tympanoplasty with stapedectomy, complained of intermittent right-side otorrhea associated with cophosis. Otomicroscopy found anterior eardrum perforation with mucopurulent effusion. Computed tomography (CT) showed a lesion filling the tympanic cavity, exposing the tympanic facial nerve, with destruction of the ossicles; the vestibule and cochlea were ossified except for the basal turn. The petrous apex was normal. Magnetic resonance imaging (MRI) showed invasion of the cavity and basal turn of the cochlea by a mass in heterogeneous hypersignal on T-1 weighted images, non-enhanced by gadolinium injection, and hyperintensity on T2-weighted images. Cholesterol granuloma of the middle ear was suspected, with surgery indicated due to the facial nerve exposure and cochlear invasion. A brownish-yellow compressive mass invading the basal turn of the coc...
The Annals of otology, rhinology, and laryngology, 2006
The purpose of this study was to investigate the various diagnoses of patients who present with p... more The purpose of this study was to investigate the various diagnoses of patients who present with positional nystagmus. Positional maneuvers were systematically performed in the plane of the posterior canal (PC; Dix-Hallpike maneuver) and the horizontal canal (HC; patients were rolled to either side in a supine position) on 490 consecutive patients essentially referred for vertigo and/or gait unsteadiness. One hundred patients (20%) presented positional nystagmus. This nystagmus had a peripheral origin in 83 patients, including 80 patients with benign paroxysmal positional vertigo (BPPV). In BPPV, the PC was involved in 61 patients, the HC in 18 patients (geotropic horizontal nystagmus in 11 and ageotropic in 7; changing from geotropic to ageotropic or the reverse in 4 patients), and both the PC and HC in 1 patient. There was evidence of central positional nystagmus in 12 patients, including positional downbeat nystagmus during the Dix-Hallpike maneuver in 7 patients with various neur...
OBJECTIVES/HYPOTHESIS To identify barriers in access to care for head and neck cancer (H&NC) ... more OBJECTIVES/HYPOTHESIS To identify barriers in access to care for head and neck cancer (H&NC) patients in low- and middle-income countries (LMICs), specifically within Dakar, Senegal, using both quantitative and qualitative data. STUDY DESIGN Descriptive observational study. METHODS Patients with H&NC were selected from two independent university hospitals in Dakar, Senegal. A mixed-methods descriptive study was performed using a specifically tailored questionnaire and a focused ethnographic qualitative approach to identify factors that delay patient presentation, referral, and treatment. Quantitative data were analyzed using descriptive statistics and qualitative using a deductive approach based on a systematic review of the literature. RESULTS Thirty-three patients with a mean age of 57.8 years were included. Presentation delay was 5.7 months, mainly attributed to cost of consultation (39%), waiting time at doctor's office (15%), and distance to healthcare facility (12%). Referral delay greater than 3 months was observed in 60% of participants, secondary to misdiagnosis and lack of appropriate referral. Treatment delay was associated with limited local treatment capacity and securing cost of treatment. Cost of transportation impacted all delays. CONCLUSIONS This work used an evidence-based approach to identify barriers in access to care for H&NC patients in sub-Saharan Africa. It suggests the feasibility and transferability of this methodology which combined a quantitative approach based on the literature with a qualitative analysis. Insight provided by this study will be used to guide development of implementation strategies for early detection of H&NC in LMICs. LEVEL OF EVIDENCE 4 Laryngoscope, 2021.
Benché la patologia otorinolaringoiatrica quotidiana delle regioni intertropicali si confonda spe... more Benché la patologia otorinolaringoiatrica quotidiana delle regioni intertropicali si confonda spesso con quella delle regioni temperate, l’esercizio della specialità vi riscontra specificità proprie: da una parte la presenza di patologie infettive specifiche o di patologie ubiquitarie che rivestono sotto i tropici un aspetto particolare e che sono l’oggetto della prima parte di questo articolo; dall’altra, una patologia oncologica propria di queste regioni e che è analizzata dettagliatamente in questa sede; infine, condizioni d’esercizio particolari che sono legate alle frequenti carenze di apparecchiature. Esse conferiscono alle patologie ubiquitarie riscontrate alcune caratteristiche specifiche tanto nella loro evoluzione che nella loro gestione. Queste condizioni d’esercizio impongono un adattamento delle procedure abituali dei paesi temperati; questo articolo fornisce alcune linee generali sulle scelte terapeutiche adatte ai contesti locali.
The aim of our study has been to describe the cricopharyngeal muscle and its nerve supply from th... more The aim of our study has been to describe the cricopharyngeal muscle and its nerve supply from the recurrent laryngeal nerve and from the superior laryngeal nerve. Six normal adult human pharynges (12 sides) obtained from cadavers were studied. Micro-dissections were carried out thanks to a Leica microscope. Measures were obtained with a micro-digital caliber. The morphological feature of the cricopharyngeal muscle (CPM) showed three different muscular bundles: superior oblique muscle fibers are joining the inferior pharyngeal constrictor muscle, horizontal circular muscle fibers are 11 to 12mm high, and 3mm thick, inferior oblique muscle fibers are joining external layer of the superior oesophagus. The recurrent laryngeal nerve through its dorsal branch supplies the posterior part of the muscular bundles of the CPM. The superior laryngeal nerve by its lateral branch supplies the anterior part of the CPM. So this double vagal innervation of the CPM from superior and inferior laryngeal nerves participates in the laryngo-pharyngeal coordination specially for swallowing.
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2012
ABSTRACT Objectifs Rapporter un second cas de granulome à cholestérine de l’oreille moyenne, enva... more ABSTRACT Objectifs Rapporter un second cas de granulome à cholestérine de l’oreille moyenne, envahissant la cochlée. Patient et méthodes Une patiente de 54 ans, opérée autrefois d’une tympanoplastie avec stapédectomie a consulté pour une otorrhée droite sur une oreille cophosée. L’otomicroscopie montrait une perforation tympanique antérieure avec écoulement mucopurulent. La tomodensitométrie (TDM) objectivait une lésion comblant la caisse du tympan, dénudant le nerf facial tympanique, détruisant les osselets ; la cochlée et le vestibule étaient ossifiés à l’exception du tour basal de la cochlée. L’apex pétreux était normal. L’imagerie par résonnance magnétique (IRM) montrait une image envahissant la caisse et le tour basal de la cochlée donnant un hypersignal hétérogène en T1 non rehaussé par l’injection de gadolinium, et hyperintense en T2. Le diagnostic de granulome à cholestérine de l’oreille moyenne était suspecté et un geste chirurgical décidé en raison de la dénudation du nerf facial et de l’envahissement de la cochlée. Résultat L’intervention a permis l’exérèse d’une masse compressive, jaune-brunâtre, envahissant le tour basal de la cochlée, évocatrice d’un granulome à cholestérine, diagnostic confirmé histologiquement. Conclusion L’invasion directe de la capsule otique par un granulome à cholestérine est extrêmement rare. La chirurgie dans un tel cas doit être proposée afin d’éviter la survenue de complications neurologiques.
ABSTRACT Introduction – But de l’étude le but de ce travail est l’analyse morphologique du muscle... more ABSTRACT Introduction – But de l’étude le but de ce travail est l’analyse morphologique du muscle crico-aryténoïdien postérieur (MCAP) et de son innervation par le nerf laryngé inférieur (NLI). Ce muscle est considéré comme le seul abducteur du larynx. Sa physiologie reste encore mal connue et objet de controverse. Matériels et méthodes douze larynx adultes ont été prélevés au Laboratoire d’Anatomie. Après fixation, les 24 hémi-larynx ont été disséqués sous microscope opératoire. Résultats trois arguments morphologiques permettent de suggérer que le MCAP n’est pas uniquement abducteur du larynx : Le MCAP présente deux groupes de fibres musculaires d’orientation différente : des fibres supérieures et médiales d’orientation horizontale et mécaniquement adductrices ; des fibres inférieures et latérales d’orientation verticale et abductrices. L’innervation des 2 groupes de fibres musculaires provient de deux collatérales non anastomosées, à partir du NLI dans son segment vertical pour le groupe latéral et son segment géniculé pour le groupe médial. La terminaison de la branche nerveuse destinée à la partie horizontale du MCAP, se termine dans le muscle inter-aryténoïdien, adducteur puissant du larynx. Conclusion ainsi, le MCAP semble bien posséder une fonction mixte, abductrice pour sa partie verticale latérale, adductrice pour sa partie horizontale médiale.
Revue de laryngologie - otologie - rhinologie, 2000
Two children cases report of an ingested fish bone perforating upper digestive tract lumen and co... more Two children cases report of an ingested fish bone perforating upper digestive tract lumen and completely migrating to the retropharyngeal space in the neck are presented. It is an unusual presentation and we describe our management. In one case it was necessary to performed a cervicotomy to remove the foreign body. In other case the rigid endoscopy could remove the fish bone with forceps under direct vision. The literature is reviewed to improve the early recognition and treatment for these migrating foreign bodies.
Revue de stomatologie et de chirurgie maxillo-faciale, 2003
We report an exceptional case of giant cell tumor of the submaxillary gland in a 76-year-old woma... more We report an exceptional case of giant cell tumor of the submaxillary gland in a 76-year-old woman. The tumor progressed slowly over a period of 40 years. Submaxillectomy removed a 3-kg mass before fixation. The postoperative period was uneventful and the patient was discharged fifteen days later. Pathology examination revealed a pleomorphous adenoma developed within the salivary gland.
Annales d'oto-laryngologie et de chirurgie cervico faciale : bulletin de la Société d'oto-laryngologie des hôpitaux de Paris, 2004
To describe different sequences on magnetic resonance imaging (MRI) in otosclerosis with peri-coc... more To describe different sequences on magnetic resonance imaging (MRI) in otosclerosis with peri-cochlear involvement. MRI T1 and T2 sequences with T1 gadolinium injection and computed tomography (CT) scans with millimetric slices on axial and coronal views were obtained. The diagnosis of bilateral otosclerosis was confirmed by surgical exploration. On the CT scan, there was a fourth turn of the cochlea which appeared on the MRI T1 sequence with an intermediate signal and on the T2 sequences with a high intensity signal. After gadolinium injection, there was signal enhancement, suggestive of active otospongiosis. On the CT scan, there was another lesion in front of the cochlea with endosteal involvement. This was no however visible on the MRI, even after gadolinium infusion, in accordance with inactive otospongiosis. We reviewed the literature concerning MRI and results in otosclerosis. MRI of the labyrinth with T1 sequences and gadolinium injection can be contributive to the diagnosis...
The authors are reporting of an exceptional case of giant cell tumor of the submaxillar gland in ... more The authors are reporting of an exceptional case of giant cell tumor of the submaxillar gland in a lady of 76 years old. She presents a progressively slow evolution within a period of 40 years. After a standard check up, a submaxillectomy was carded out. The weight of the operated mass was 3 kg before the pathological fixation. The post-operative period was without any problems and the patient was discharged after fifteen days. The anatomo-pathological examination concluded a pleomophic adenoma developed by the salivery gland.
Allergy is quite frequent and ENT syptoms are usually the visible part of a general disease. Ques... more Allergy is quite frequent and ENT syptoms are usually the visible part of a general disease. Questioning remains the most important part of the enquiry for clinical examination is usually poor if notdesapointing. Biological testings detailed in this paper may be of some help; In Africa, test-treatements using cheap and unharmfull drugs give often the best evidence of allergy. Seldom, ENT allergy may be or become life-threatening. Its detection and appropiate actions are briefly mentioned.
Morphologie : bulletin de l'Association des anatomistes, 2007
The purpose of our study has been to describe the pre-operatively MR Imaging appearance of masses... more The purpose of our study has been to describe the pre-operatively MR Imaging appearance of masses in the parotid gland which may be sources of clinical and radiological confusion. Sixty-eight adults patients with a parotid mass (39 female, 29 male) has been prospectively investigated. T1-weighted, T2-weighted, diffusion-weighted and contrast-enhanced dynamic MR images were performed by using a 1.5 or 1 T MR Imaging unit (Philips Gyroscan Intera 1.5 T. Siemens Expert 1 T). All patients underwent a parotidectomy with histopathologic analysis. In case of pleomorphic adenoma (N=30) MR imaging sensibility, specificity and accuracy were respectively 87.5, 80.5 and 83%. In case of Warthin tumors (N=13) the same values were respectively 45.5, 93 and 85%. In case of malignant tumors (N=13) theses values were respectively 71, 89 and 87%. Our routine MR Imaging study appears excellent not only for assessing the type and extent of benign salivary gland tumors and the relationship to adjacent st...
Morphologie : bulletin de l'Association des anatomistes
The aim of our study has been to describe the cricopharyngeal muscle and its nerve supply from th... more The aim of our study has been to describe the cricopharyngeal muscle and its nerve supply from the recurrent laryngeal nerve and from the superior laryngeal nerve. Six normal adult human pharynges (12 sides) obtained from cadavers were studied. Micro-dissections were carried out thanks to a Leica microscope. Measures were obtained with a micro-digital caliber. The morphological feature of the cricopharyngeal muscle (CPM) showed three different muscular bundles: superior oblique muscle fibers are joining the inferior pharyngeal constrictor muscle, horizontal circular muscle fibers are 11 to 12mm high, and 3mm thick, inferior oblique muscle fibers are joining external layer of the superior oesophagus. The recurrent laryngeal nerve through its dorsal branch supplies the posterior part of the muscular bundles of the CPM. The superior laryngeal nerve by its lateral branch supplies the anterior part of the CPM. So this double vagal innervation of the CPM from superior and inferior larynge...
ABSTRACT Background and purposeThe purpose of our study has been to describe the pre-operatively ... more ABSTRACT Background and purposeThe purpose of our study has been to describe the pre-operatively MR Imaging appearance of masses in the parotid gland which may be sources of clinical and radiological confusion.
European annals of otorhinolaryngology, head and neck diseases, 2012
To report a second case of cholesterol granuloma of the middle ear invading the cochlea. A 54-yea... more To report a second case of cholesterol granuloma of the middle ear invading the cochlea. A 54-year-old woman, who had undergone right-side tympanoplasty with stapedectomy, complained of intermittent right-side otorrhea associated with cophosis. Otomicroscopy found anterior eardrum perforation with mucopurulent effusion. Computed tomography (CT) showed a lesion filling the tympanic cavity, exposing the tympanic facial nerve, with destruction of the ossicles; the vestibule and cochlea were ossified except for the basal turn. The petrous apex was normal. Magnetic resonance imaging (MRI) showed invasion of the cavity and basal turn of the cochlea by a mass in heterogeneous hypersignal on T-1 weighted images, non-enhanced by gadolinium injection, and hyperintensity on T2-weighted images. Cholesterol granuloma of the middle ear was suspected, with surgery indicated due to the facial nerve exposure and cochlear invasion. A brownish-yellow compressive mass invading the basal turn of the coc...
The Annals of otology, rhinology, and laryngology, 2006
The purpose of this study was to investigate the various diagnoses of patients who present with p... more The purpose of this study was to investigate the various diagnoses of patients who present with positional nystagmus. Positional maneuvers were systematically performed in the plane of the posterior canal (PC; Dix-Hallpike maneuver) and the horizontal canal (HC; patients were rolled to either side in a supine position) on 490 consecutive patients essentially referred for vertigo and/or gait unsteadiness. One hundred patients (20%) presented positional nystagmus. This nystagmus had a peripheral origin in 83 patients, including 80 patients with benign paroxysmal positional vertigo (BPPV). In BPPV, the PC was involved in 61 patients, the HC in 18 patients (geotropic horizontal nystagmus in 11 and ageotropic in 7; changing from geotropic to ageotropic or the reverse in 4 patients), and both the PC and HC in 1 patient. There was evidence of central positional nystagmus in 12 patients, including positional downbeat nystagmus during the Dix-Hallpike maneuver in 7 patients with various neur...
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