Post-injury smell disorders

Post-injury smell disorders.

PROBLEMS/OBJECTIVES

Head trauma is the third most common aetioiogy of post-traumatic olfactory loss (PTOL). This literature review aims to report the existing knowledge surrounding this issue, exploring the current understanding of the inducing pathogenesis and the assessment and management standards from the early phases to longer-term considerations.

METHODOLOGY

Literature search and appraisal in PubMed on the following themes directly associated with PTOL: olfactory disorders, trauma, pathogenesis, examination, recovery and treatment.

RESULTS

Scientific evidence was mainly available for epidemiology and exploration tools in cases suffering from PTOL. The current research into obj6ctive batteries of olfactory tests is promising.

CONCLUSIONS

This paper highlights the importance of an adequate assessment of PTOL for an early start in olfactory training.

Functional consequences of chronic ENT inflammation on the development of hearing and communicative abilities

Hearing processing and communication abilities development may be influenced by chronic inflammation of the airways in children, especially in case of otitis media and/or adenotonsillar hypertrophy. The present review summarizes the influence of adenotonsillar hypertrophy on speech abilities as well as the consequences of otitis media, with a particular focus on peripheral and central hearing, on the development of language, attention, and memory skills.

Consequences of chronic inflammation in children on facial growth, growth, behavioural disorders and smell

Adenotonsillar hypertrophy is a common paediatric/otolaryngological disorder that may be associated with secondary growth or facial growth impairment, sleep disturbances, neurocognitive deficits, or smell loss. Surgical removal of the hypertrophic tissue eliminates the mechanical obstacle of the airways and is therefore curative in most cases. The purpose of the present review is to outline the impact of adenotonsillar hypertrophy and adenotonsillectomy on growth, facial growth, sleep, behaviour and smell.

The use of grafting material in rhinoseptoplasty

Grafting is one of the current range of instruments that rhinoplasticians deploy to achieve durable and desired aesthetic and functional outcomes. Grafts can be classified according to anatomical site and, in the vast majority of cases, they involve augmentation rhinoseptoplasty. Visible grafting material is used for aesthetic purposes and functional grafting may involve invisible grafts. This article reviews the more widely described and more common indications for grafts in rhinoseptoplasty. The authors' rhinoseptoplasty philosophy involves a preference for autogenous grafts rather than alloplastic implants to achieve both aesthetically and functionally favourable results, particularly in long-term follow-up. They also prefer grafts in an open approach, reserving graft insertion with an endonasal approach for selected cases. The rate of complications associated with grafting is very low. The aim of this paper is to discuss the relevant anatomy, functional purpose and terminology, and to describe the authors' philosophy for grafting in rhinoseptoplasty.

Gastric choristoma of the midline neck in a newborn: a case report and review of the literature

The current report describes a 3-week-old boy presenting with a gastric choristoma of the anterior compartment of the neck. Initial examination at birth found 3 masses in the anterior region of the neck. The only remarkable symptom consisted of episodes of cyanosis induced by neck flexion. The neck mass was removed after computed tomography scan assessment. Pathology finding showed the diagnosis of gastric choristoma. Cervical location of a gastric choristoma in children is rare. Its presentation as a clinically palpable anterior compartment cervical mass at birth even more rare.

Transnasal repair of unilateral choanal atresia

OBJECTIVES

To evaluate the outcomes of the surgical correction of unilateral choanal atresia using a transnasal approach.

PATIENTS AND METHOD

Over a 36-months period (from 1999 to 2001), seven children underwent endoscopic endonasal repair of an unilateral choanal atresia using the microdebrider (powered instrumentation). At the end of the procedure, topical application of Mitomycin-C was performed. No postoperative nasal stenting was inserted. Clinical characteristics of these patients, CT scan examination, complications of the procedure and outcomes were analysed and compared to historical cases treated in the same institution from 1990 to 1998.

RESULTS

Seven patients (2 M/5F) (age 6 to 46 months) presented with primary unilateral choanal atresia and were operated during the period from 1999 to 2001. All the patients were symptomatic before surgical correction. No patients showed other facial anomaly. Of the 7 patients procedures, 6 (85.7%) remained patent (follow-up range 12 to 36 months). Mean surgical repair per patient before obtaining patent choana was 1.14. One patient required surgical transnasal revision nine months after the initial procedure with a patent choanal after this second procedure (follow-up 9 months). Minor turbinoseptal synechiae diagnosed 6 months after the surgical correction occurred in one patient and was the only postoperative complication. When compared to historical cases of unilateral choanal atresia (19 patients from 1990 to 1998) repaired without endoscopic control and without Mitomycin-C, it was shown that this current method provided better results; mean surgical repair per patient; 1.14 vs 1.89 and 85.7% of patent choanae at twelve months vs 47.3%.

CONCLUSION

An endoscopic endonasal approach without postoperative stenting, using the microdebrider seems to us the treatment of choice for unilateral choanal atresia. The exact role of the topical application of Mitomycin-C needs to be further investigated.

Parapharyngeal causes of sleep apnea syndrome: two case reports and review of the literature

Most patients with obstructive sleep apnea experience increased pharyngeal collapsibility which predisposes them to upper airway occlusion during sleep. Some patients with or without a higher-than-normal collapsibility may present other causes of sleep apnea syndrome. This article will focus on the parapharyngeal tumors leading to obstructive sleep apnea (OSAS). Two clinical cases will illustrate our review of the literature. The results of surgery will also be discussed.