Facial paralyses in children may be grouped under headings displaying a certain amount of individuality. Chronologically, first to be described are neonatal facial paralyses. These are common and are nearly always cured within a few days. Some of these cases are due to the mastoid being crushed at birth with or without the use of forceps. The intra-osseous pathway of the facial nerve is then affected throughout its length. However, a cure is often spontaneous. When this desirable development does not take place within three months, the nerve should be freed by decompressive surgery. The special anatomy of the facial nerve in the new-born baby makes this a delicate operation. Later, in all stages of acute otitis, acute mastoiditis or chronic otitis, facial paralysis can be seen. Treatment depends on the stage reached by the otitis: paracentesis, mastoidectomy, various scraping procedures, and, of course, antibiotherapy. The other causes of facial paralysis in children are very much less common: a frigore or viral, traumatic, occur ring in the course of acute poliomyelitis, shingles or tumours of the middle ear. To these must be added exceptional causes such as vitamin D intoxication, idiopathic hypercalcaemia and certain haemopathies.

Adolescent↗

PubMedDate not supplied

[Does mastoiditis still exist? (author's transl)].

The authors report 382 cases of mastoidectomy verified by histological examination and draw certain conclusions: There were 5 errors in diagnosis, i.e. 1.3 per cent. Most cases were aged between 4 and 12 months. Below the age of two years it was usually bilateral, exceptionally so after the age of two years. Diagnosis was mainly clinical and based on the following axiom: "All infants with acute otitis who, in spite of proper medical treatment, have at the end of one month of a weight curve either stationary or falling, and eardrums not strictly normal, have mastoiditis". This therefore implies close and prolonged supervision by the same observer throughout the period antibiotic treatment and at least one week after stopping the latter. The treatment is still mastoidectomy and not antrotomy but one may hope with more accurate diagnosis that new methods of treatment may be developed to the extent where immediate and long term supervision of the child may be ensured.

Anti-Bacterial Agents↗

PubMedDate not supplied

[Eosinophilic granuloma of the ear. General review apropos of 2 case reports].

The eosinophilic granuloma is part of the histiocytosis X classification, having a common histological substratum, the granuloma, which is characterized by a proliferation of histiocytes (reticulo-endothelial cells) and a cytoplasmic inclusion body (the X body) whose étiopathogenic significance is not yet established. These histiocytes are accompanied by other cells and in particular granulocytes, the majority of which are eosinophils. Histiocyte proliferation leads to a destruction of bone which is the organ preferentially affected. At first there is osteolysis (this explains the lacunar aspects seen radiologically) followed by sclerosis. The clinical classification established by Lichtenstein in 1953 outlines the tissue form (eosinophil granuloma), the acute disseminated form (Letterersive) and the chronic disseminated form (Hand-Schüller-Christian). This classification is still accepted today but it needs to be refined to include the transitionary forms, and solitary bone granulomas whose long terme evolutive nature it is impossible to measure clinically, biologically, or histologically. From our observation we note that therapy (surgery, radiotherapy, chemotherapy) is effective in controlling the acute growth spurts in a majority of the cases but does not seem to effect the potential long terme evolution.

Bone Diseases↗

PubMedDate not supplied