Juvenile aggressive cemento-ossifying fibroma: case report and review of the literature.
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Biomedical subjects
Publications and source records attributed to P Eloy.
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Three hundred sixty-seven successive patients suffering from chronic maxillary sinusitis (CMS) were thoroughly examined by means of maxillary sinusoscopy, a CT scan of the facial sinuses, and sinusomanometry (SMM). Ninety-eight cases of unilateral CMS, 269 cases of bilateral CMS, and 444 chronic ethmoidal sinusitis (CES) cases were evaluated. According to SMM, the maxillary ostia were divided into two groups: 1. maxillary ostium patency (MOP) group and 2. the maxillary ostium nonpatency (MONP) group. The unilateral and bilateral pathologies were separately analyzed so as to minimize the effects of general or systemic causes on the results. MONP is, in both bilateral and unilateral groups, significantly linked with the presence of ethmoidal sinusitis (P < 10(-6); P = .026), while the correlation between MOP and the ethmoid status does not appear to be significant in either group. Thus, there seems to be a close relationship between CES and maxillary ostial dyspermeability in cases of CMS.
The dacryocystorhinostomy is an operation that connects directly the lacrymal sac to the nasal cavity. In 1904, Toti described the external approach but one had to wait until the development of the sinus surgery to have a new interest in the endonasal approach. It appears to be a safe, efficacious and a less traumatizing procedure preserving the lacrymal function without skin incision. It allows a procedure in a non-scarred field. A good relationship between the ENT and the ophthalmologist is required.
The use of Gax collagen is proposed for correcting velopharyngeal insufficiency with posterior pharyngeal wall augmentation. The indications for this procedure are velopharyngeal insufficiency that remains after surgery and treatment by a speech pathologist. The procedure is also valuable after velum paralysis. Collagen (2.5-5cc) is injected through a device designed for vocal-fold and laryngeal rehabilitation. Several injection points are necessary to raise a good Passavant's ridge. The muscular activity of the posterior pharyngeal wall models the collagen pad for the first 3 weeks; afterwards, the collagen shape remains unchanged due to its integration in the host tissues. At this time, five patients have been injected with Gax collagen and have improved. The oldest case dates from 28 months ago; the most recent dates from 8 months ago. There were no adverse reactions, and the results remain stable at the present time.
Three cases of malignant lymphoma involving the nose and/or the sinusal cavities are reported and discussed. An overview of the literature is made and some facts of theoretical and practical interest are pointed out, about diagnostic classification, staging, prognosis and treatment.
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