[Parathyroid cysts: reprot of 2 cases and review of the literature]

Although parathyroid cysts are rarely described in the literature, they should be considered in the differential diagnosis of cysts occurring in the anterior compartment of the neck. We report two cases. The presence of elevated parahormone in the clear fluid aspirate is the diagnostic criterion. Parathyroid cysts may be functional, probably resulting from cystic formation of a parathyroid adenoma, or non function with their own epithelial lining, probably arising from remnants of the pharyngeal pouch or Kursteiner's canal. Search for both hypercalcemia and hypophosphoremia are needed. Fine needle aspiration provides the diagnosis and is also the treatment of choice for non-functional parathyroid cysts. Aspiration of functional cysts can reduce the hormone level to normal prior to surgical removal.

[Maxillary ameloblastoma. Illustration apropos of a clinical case]

The authors report a case of maxillary ameloblastoma presenting as nasal obstruction. An histopathologic description is done. The difference of clinical course between intra-osseous and extra-osseous (peripheral) ameloblastoma are recalled. The desmoplatic histologic type, recently described in medical literature, is exceptional. Surgery remains the adapted treatment in most cases.

Infiltrating lipoma of the head and neck: a report of one pediatric case

Infiltrating lipomas are rare benign tumors. Several cases have previously been reported in the oral cavity but only three cases have been reported to date in children. We report a case of a 7-year-old child with an infiltrating lipoma of the neck and a posterior extension to the fourth and fifth cervical roots and the vertebral artery. The absence of any neurological signs, negative clinical and radiological examination results, as well as, the surgical risk of total removal and high rate of recurrence suggested a period of watchful waiting. After 5 years, the patient's clinical and radiological characteristics remain stable. A review of the literature regarding this pathology in the head and neck area, in both children and adults is also presented.

[Spheno-ethmoidal rhinoscleroma. Report of a case and review of the literature]

We report an unusual case of spheno-ethmoidal rhinoscleroma. This chronic granulomatous disease occurs sporadically in Western Europe. Culture is necessary for diagnosis showing the causative organism of rhinoscleroma, Klebsiella rhinoscleromatis. Immunocytochemistry is used in any suspicious case with a negative culture. Antibiotics are the mainstay of therapy for several weeks, using ciprofloxacine or rifampicin, until the nasal biopsies demonstrated no Klebsiella organism.

[Use of CO2 laser in endoscopic treatment of Zenker's pharyngo-esophageal diverticula. Experience apropos of 33 cases]

Microendoscopic treatment of hypopharyngeal (Zenker's) diverticulum was performed in 31 patients during the period 1990-1995. The CO2 laser combined with the operating microscope has been used. 33 endoscopic procedures were performed (2 procedures were needed for 2 patients). The average age of the patients was 70.3 years (46-86 years). The average length of the general anesthesia was 48 minutes; the average length of the endoscopic procedure was 20 minutes. No major complication occurred for 32/33 cases (97%). Mediastinitis occurred for 1 case (3%) and was successfully treated by surgical and IV antibiotherapy. The average duration of hospitalization was 5 days (3-5 days) (patient with mediastinitis excluded): the average follow-up was 19 months (1-62 months). 28/31 patients (90.3%) were highly or fairly satisfied. Considering the external approach microendoscopic CO2 laser diverticulotomy offers comparable functional results. Moreover, this procedure is quick, requires a shorter hospitalization stay and is followed by a very low percentage of complications. Additionally, no visible scar is noted. Optimal management of Zenker's diverticulum remains controversial. However, we advocate that microendoscopic CO2 laser diverticulotomy should be considered as a first-line treatment option for patients with hypopharyngeal diverticulum.