32 results on '"Ferjaoui M"'
Search Results
2. EPV169/#639 Anxiety and depression in breast cancer patients during COVID-19 pandemic in Tunisia
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Berrazaga, Y, primary, Rachdi, H, additional, Mejri, N, additional, Ferjaoui, M, additional, Daoud, N, additional, and Boussen, H, additional
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- 2021
- Full Text
- View/download PDF
3. EPV213/#503 Platinum -sensitive or resistant relapsed ovarian cancer: which predictive factors?
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Berrazaga, Y, primary, Mejri, N, additional, Rachdi, H, additional, Ferjaoui, M, additional, Arfaoui, R, additional, Daoud, N, additional, and Boussen, H, additional
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- 2021
- Full Text
- View/download PDF
4. EPV214/#506 Overall survival prognostic factors in recurrent epithelial ovarian cancer in Tunisia
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Berrazaga, Y, primary, Mejri, N, additional, Rachdi, H, additional, Ferjaoui, M, additional, Daoud, N, additional, and Boussen, H, additional
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- 2021
- Full Text
- View/download PDF
5. Fistules perilymphatiques post-traumatiques a propos de 13 cas
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Khamassi, K, Lahiani, R, Jlassi, N, Boulakbeche, R, Hassan, CH, Mannoubi, S, Ben Salah, M, Kaffel, N, and Ferjaoui, M
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fistule périlymphatique, traumatisme, vertige, surdité, tomodensitométrie, chirurgie - Abstract
Introduction : La fistule péri-lymphatique (fPL) post-traumatique réalise une communication anormale entre le compartiment liquidien périlymphatique et l’oreille moyenne. Son diagnostic est souvent difficile du fait du tableau clinique parfois incomplet. L’imagerie est indispensable afin d’étayer le diagnostic. Le traitement repose sur la chirurgie.Patients et méthode : : il s’agit d’une étude rétrospective à propos de 13 patients colligés sur une période de 13 ans (1996-2008). un examen ORL complet, une audiométrie et une imagerie (tomodensitométrie des rochers) ont été réalisés dans tous les cas. Tous les patients ont bénéficié d’un traitement médical et ont été opérés sous anesthésie générale. Le contrôle ultérieur était clinique, audiométrique et radiologique avec un recul moyen de 22 mois.Résultats :L’âge moyen était de 29 ans (20-47 ans) et le sex-ratio 3,33. Les signes fonctionnels étaient essentiellement représentés par l’hypoacousie dans 12 cas (92,3%), les vertiges dans 11 cas (84,6%) et les acouphènes dans 4 cas (30,8%). L’écoulement d’un liquide eau de roche par l’oreille a été rapporté par 2 patients (15,4%). L’examen clinique trouvait un nystagmus spontané battant du côté controlatéral au traumatisme chez un seul patient, et un signe de la fistule positif chez 2 patients (15,4%). A l’audiométrie, 9 patients (69,3%) avaient une surdité de perception ou mixte dont 6 cas de cophose. une surdité de transmission a été objectivée dans 3 cas. un patient avait une audition subnormale. La TdM des rochers a montré une fracture extra-labyrinthique dans 5 cas (38,5%) et une fracture trans-labyrinthique ou mixte dans 6 cas (46,2%). un pneumolabyrinthe a été constaté chez 5 patients (38,5%). une exploration chirurgicale a été indiquée chez tous les patients. En per-opératoire, une fPL a été mise en évidence dans tous les cas. Le siège de la fistule était au niveau du promontoire et/ou au niveau des fenêtres. un colmatage de la fistule a été réalisé dans tous les cas. Les matériaux utilisés étaient essentiellement de l’aponévrose temporale superficielle, du périchondre tragal et de la graisse. En post-opératoire, les vertiges se sont améliorés chez patients parmi les 11 vertigineux (81,8%). L’audition était améliorée chez 2 patients parmi les 9 ayant une surdité de perception ou mixte (18,2%).Conclusion : La fistule périlymphatique post-traumatique est de diagnostic difficile. Celui-ci est étayé par un faisceau d’arguments cliniques et paracliniques et n’est confirmé qu’en per-opératoire. L’indication d’une exploration chirurgicale et son délai dépendent essentiellement de la symptomatologie clinique et de son évolution dans le temps.Mots clés : fistule périlymphatique, traumatisme, vertige, surdité, tomodensitométrie, chirurgieObjective : Post-traumatic perilymphatic fistula (PLf) realises an abnormal communication between the perilymphatic fluid compartment and the middle ear. its diagnosis is often difficult because the clinical presentation is sometimes incomplete. imaging is essential in order to support the diagnosis. Treatment is based on surgery.Patients and methods : We carry a retrospective study about 13 patients collected over a period of 13 years (1996- 2008). A complete ENT examination, audiometry and imaging (petrous CT scan) were performed in all cases. All patients received medical treatment and were operated under general anaesthesia. Subsequent control was clinical, radiological and audiometric with a mean period of 22 months.Mean age was 29 years (20-47 years) and sex ratio 3.33. Symptoms were mainly hearing loss in 12 cases (92.3%), vertigo in 11 cases (84.6%) and tinnitus in 4 cases (30.8%). flow of liquid from the ear was reported by 2 patients (15.4%). Clinical examination showed spontaneous nystagmus beating to the contralateral side of the trauma in one patient, and a positive sign of the fistula in 2 patients (15.4%). At audiometry, 9 patients (69.3%) had sensorineural or mixed deafness, of which 6 cases of cophosis. Transmission deafness was found in 3 cases. One patient had a subnormal hearing. Petrous CT scan showed extra-labyrinthic fracture in 5 cases (38.5%) and trans-labyrinthic or mixed fracture in 6 cases (46.2%). A pneumolabyrinth was found in 5 patients (38.5%). Surgical exploration was indicated in all patients. PLf was found in all cases. The localization of the fistula was at the promontory and / or at the windows. Blockage of the fistula was achieved in all cases. Materials used were essentially superficial temporal fascia, tragal perichondrium and fat. Postoperatively, vertigo improved in 9 patients among 11 (81.8%). Hearing was improved in 2 patients among the 9 having sensorineural or mixed deafness (18.2%).Conclusion: TPost-traumatic perilymphatic fistula trauma is difficult to diagnose. This is supported by a beam of clinical and paraclinical arguments, and is confirmed intraoperatively. The indication for surgical exploration and its delay depend mainly on clinical symptomatology and its evolution over time.Keywords : perilymphatic fistula, trauma, vertigo, deafness, CT scan, surgery
- Published
- 2015
6. L’acupuncture : comme alternative dans la prise en charge de la paralysie faciale peripherique idiopathique : experience tunisienne
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Marrakchi, J, Souli, I, Kaffel, N, Zakraoui, L, Jouini, L, Lahiani, R, Khammassi, K, Ben Salah, M, and Ferjaoui, M
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paralysie faciale périphérique, acupuncture, traitement - Abstract
La paralysie faciale périphérique idiopathique ou à frigoré (PfPi) est la plus fréquente des paralysies faciales. Elle pose un problème thérapeutique malgré la diversité des traitements proposés. L’acupuncture est une des alternatives proposées parmi cet arsenal thérapeutique. Le but de ce travail est d’évaluer l’apport de l’acupuncture dans le traitement de la PfPi et de dégager les différents facteurs pronostiques pouvant influencer la récupération de la fonction faciale. Notre étude a regroupé 40 patients porteurs de PfPi recrutés aux services d’ORL de l’hôpital régional de Jendouba et de l’hôpital de Charles Nicolle sur une période de 14 mois et pris en charge aux centres d’acupuncture à l’hôpital Mongi Slim et à l’hôpital régional de Jendouba. Tous les patients ont été traités, auparavant, selon le concept de la médecine occidentale, et n’ont été adressés qu’après échec du traitement médical conventionnel. L’évaluation de notre travail est basée sur deux tests : le testing musculaire de freyss et le grading de House et Brackman. L’étude statistique s’est basée sur le logiciel « SPSS ». Les résultats de cette étude montrent que le traitement par acupuncture trouve son indication lorsque le traitement médical conventionnel a échoué, même après un long délai de consultation.Mots-clés : paralysie faciale périphérique, acupuncture, traitement.The Bell’s palsy is the most common peripheral facial paralysis. it poses a therapeutic problem despite the diversity of treatments. Acupuncture is an alternative among the proposed therapeutic arsenal. The purpose of this study was to evaluate the contribution of acupuncture in the treatment of facial paralysis and to identify different prognostic factors that may influence the recovery of facial function. Our study included 40 patients with Bell’s palsy recruited in the services of ENT in Jendouba hospital and Charles Nicolle hospital over a period of 14 months and supported in centers of acupuncture in Mongi Slim hospital and Jendouba hospital. All patients were previously under the concept of medical treatment, and were sent after failure of this treatment. The evaluation of our work is based on two tests: muscle testing of freyss and grading of House and Brackman. The study is based on statistical software "SPSS". The results of this study show that treatment with acupuncture is indicated in Bell’s palsy when conventional medical treatment has failed and even after a long period of consultation.Keywords: facial palsy, acupuncture, treatment.
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- 2015
7. Prise en charge des paralysies faciales compliquant un traumatisme de l’os temporal
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Khamassi, K, Smaili, A, Kesraoui, I, Lahiani, R, Bougacha, L, Kaffel, N, Ben Salah, M, and Ferjaoui, M
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paralysie faciale, traumatisme, fracture, os temporal, tomodensitométrie, corticoïdes, décompression - Abstract
Introduction : Les paralysies faciales périphériques (PFP) compliquant les traumatismes de l’os temporal sont devenues de plus en plus fréquentes, du fait de développement de ’activité humaine. Le but de ce travail est de rapporter nos résultats en matière de prise en charge de ces PFP, et à travers une revue de la littérature, de préciser les caractéristiques cliniques, paracliniques et de proposer une conduite à tenir adéquate devant cette pathologie.Matériel et méthodes : Il s’agit d’une étude rétrospective à propos de 16 patients, pris en charge dans notre service sur une période de 12 ans (2001-2012). Tous les patients ont bénéficié d’un interrogatoire, d’un examen ORL complet. Une tomodensitométrie des rochers a été réalisée dans tous les cas. Les explorations du nerf facial ont été basées surtout sur l’EMG de détection. Le traitement a été médical ou médico-chirurgical. Le suivi a été clinique avec un recul moyen de 26 mois.Résultats : Il s’agissait de 14 hommes et de 2 femmes. L’âge moyen était de 27 ans (6-73 ans). La PF était d’installation immédiate après le traumatisme chez 10 patients et tardive dans 6 cas. La TDM des rochers a montré une fracture extra-labyrinthique dans 7 cas (43,7%), trans-labyrinthique dans 5 cas (31,2%) et mixte dans 4 cas (25%). L’atteinte du canal facial a été notée chez 12 patients. L’EMG de détection a été pratiquée dans 4 cas. Tous nos patients ont bénéficié d’un traitement médical, consistant en une corticothérapie par voie générale, des vasodilatateurs et une rééducation motrice. Sept patients ont bénéficié d’une décompression du nerf facial. L’indication a été retenue devant l’installation d’une PF immédiate et complète. En per-opératoire, nous avons découvert un trait de fracture du canal facial dans 5 cas, mais la continuité du nerf était conservée dans tous les cas. Nous avons réalisé une décompression de la 2e portion, du coude et de la 3e portion. La décompression était étendue au ganglion géniculé dans 2 cas. Sur les 7 patients opérés, 4 ont été améliorés. Un des 3 patients non améliorés a gardé un grade V et a bénéficié d’une anastomose VII-XII. Pour les 9 patients non opérées, une amélioration a été notée dans 5 cas. Au total, le pourcentage d’amélioration de la PF était de 55,5% après traitement médical et de 71,4% après traitement médico-chirurgical.Conclusion : Les paralysies faciales constituent une complication assez fréquente des traumatismes de l’os temporal. L’imagerie est indispensable pour le diagnostic topographique des lésions. La conduite à tenir thérapeutique dépend aussi bien de la sévérité et du délai de l’installation de la paralysie que des données électrophysiologiques et évolutives.Mots-clés : paralysie faciale, traumatisme, fracture, os temporal, tomodensitométrie, corticoïdes, décompression.Introduction : Peripheral facial palsy (PFP) complicating temporal bone traumas have become more frequent due to the development of human activity. The purpose of this study is to report our results in management of these PFP, and through a review of the literature, to clarify clinical, paraclinical characteristics and to propose an adequate management in front of this pathology.Materials and methods : This is a retrospective about 16 patients, treated in our department over a period of 12 years (2001-2012). All patients underwent anamnesis and complete ENT examination. A petrous bone CT was performed in all cases. Explorations of the facial nerve were based primarily on detection EMG. Treatment was medical or medico-surgical. Follow-up was clinical with a mean period of 26 months.Results : There were 14 men and 2 women. Average age was 27 years (6-73 years). FP was installed immediately after the trauma in 10 patients and late in 6 cases. Petrous bone CT showed extra- labyrinthine fracture in 7 cases ( 43.7%) , trans-labyrinthine in 5 cases (31.2%) and mixed in 4 cases (25%). Involvement of the facial canal was noted in 12 patients. Detection EMG was performed in 4 cases. All patients received medical treatment consisting of corticosteroids, vasodilators and motor rehabilitation. Seven patients underwent decompression of the facial nerve. Indication was retained in front of immediate and complete FP. Intraoperatively, we have discovered a fracture of the facial canal in 5 cases, but the continuity of the nerve was conserved in all cases. We performed a decompression of the 2nd portion, the elbow and the 3rd portion. Decompression was extended to the geniculate ganglion in 2 cases. Of the 7 patients who underwent surgery, 4 were improved. One of the 3 unimproved patients kept a grade V and underwent VII-XII anastomosis. For the 9 not operated patients, an improvement was noted in 5 cases. Overall, the percentage of improvement of FP was 55.5% after medical treatment and 71.4% after medico-surgical treatment.Conclusion : Facial palsy is a fairly common complication of trauma to the temporal bone. Imaging is essential for topographic diagnosis of lesions. Therapeutic management depends on both the severity and the delay of the palsy onset and also on electrophysiological and evolutive data.Keywords : facial palsy, trauma, fracture, temporal bone, computed tomography, corticosteroids , decompression.
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- 2015
8. L’ectopie des glandes parathyroides dans la chirurgie de l’hyperparathyroidie
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Ben Salah, M, Khamassi, K, Dhaouadi, A, Lahiani, R, Brahem, E, Ben Gharbia, D, Najeh, D, Kaffel, N, and Ferjaoui, M
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glande parathyroïde, ectopie, hyperparathyroïdie, imagerie, parathyroïdectomie - Abstract
Introduction : L’ectopie parathyroïdienne est la cause d’échec la plus fréquente de la chirurgie de l’hyperparathyroïdie, entrainant le plus souvent des reprises chirurgicales. Son diagnostic topographique pré-opératoire reste difficile malgré le progrès dans les différentes explorations radiologiques. Le diagnostic per-opératoire doit être guidé par une stratégie de dissection de référence. Le but de travail est d’étudier la stratégie de recherche des parathyroides lors de leur chirurgie.Matériels et méthodes : Il s’agit d’une étude rétrospective à propos de 137 patients (162 glandes parathyroïdes ectopiques) parmi 572 patients opérés d’une hyperparathyroïdie, colligés sur une période de 11 ans (Janvier 2001-Décembre 2011). Tous les patients ont bénéficié d’une imagerie pré-opératoire et ont été opérés sous anesthésie générale.Résultats : L’âge moyen était de 49 ans (11-71 ans) et le sex-ratio de 1,04. Une hyperparathyroïdie primaire était présente chez 26 patients (18,98%) et une hyperparathyroïdie secondaire à une insuffisance rénale chronique chez 111 patients (81,02%).Une cervicotomie par voie classique avec exploration des 2 loges thyroïdiennes a été réalisée dans 136 cas. Dans les cas où la parathyroïde n’a pas été retrouvée, un geste opératoire a été associé. Ce geste consistait en un curage médiastino-récurrentiel (15 cas), une thymectomie (12 cas) et une lobectomie thyroïdienne (9 cas). Un seul patient a eu une thoracotomie en chirurgie thoracique, sans abord cervical classique. Sur les 162 glandes parathyroïdes ectopiques retenues dans l’étude, 68 étaient des glandes parathyroïdes inférieures. Les localisations de celles-ci étaient par ordre de fréquence le thymus (26 cas), le ligament thyro-thymique (14 cas), le médiastin antéro-supérieur (5 cas) et la gaine carotidienne (3 cas). Vingt glandes parathyroïdes inférieures n’ont pas été retrouvées sur les 68 (29,41%). Le nombre des glandes parathyroïdes supérieures ectopiques était de 94 sur 162. Leurs localisations étaient par ordre de fréquence le pôle supérieur (33 cas), le pédicule supérieur (20 cas), la région rétro-oesophagienne (15 cas), la gaine carotidienne (11 cas), intra-thyroïdienne (5 cas) et le médiastin postéro-supérieur (2 cas). Huit glandes parathyroïdes supérieures n’ont pas été trouvées sur les 94 (8,51%). Au total, sur les 162 glandes parathyroïdes ectopiques, 28 n’ont pas été retrouvées (17,28%).Conclusion : L’imagerie est un moyen incontournable à la recherche d’une glande parathyroïde ectopique. Lorsqu’elle n’est pas retrouvée dans sa localisation habituelle, la stratégie de dissection chirurgicale doit être méthodique.Mots-clés : glande parathyroïde, ectopie, hyperparathyroïdie, imagerie, parathyroïdectomieIntroduction: The ectopic parathyroid is the most common cause of failure of hyperparathyroidism surgery, resulting often in reoperations. Its preoperative topographic diagnosis remains difficult despite advances in various imaging studies. The intraoperative diagnosis should be guided by a reference strategy of dissection.Materials and Methods: This is a retrospective study of 137 patients (162 ectopic parathyroid glands) among 572 patients undergoing hyperparathyroidism surgery, collected over a 11-year period (January 2001-December 2011). All patients underwent preoperative imaging and were operated under general anesthesia.Results: The mean age was 49 years (11-71 years) and the sex-ratio 1.04. Primary hyperparathyroidism was present in 26 patients (18.98%) and hyperparathyroidism secondary to chronic renal failure in 111 patients (81.02%). Cervicotomy through traditional approach with bilateral exploration was performed in 136 cases. In cases where the parathyroid was not found, a surgical procedure was performed. This act consisted in mediastinal-recurrential lymphadenectomy (15 cases), thymectomy (12 cases) and thyroid lobectomy (9 cases). One patient had a thoracotomy in thoracic surgery department without conventional cervical approach. Among the 162 ectopic parathyroid glands included in the study, 68 were inferior parathyroid glands. The locations of these were in order of frequency the thymus (26 cases), the thyro-thymic ligament (14 cases), the antero-superior mediastinum (5 cases) and the carotid sheath (3 cases). Twenty inferior parathyroid glands were not found among the 68 (29,41%). The number of ectopic superior parathyroid glands was 94 of 162. Their locations were in order of frequency the upper pole (33 cases), the superior pedicle (20 cases), the retro-esophageal region (15 cases), the carotid sheath (11 cases), intra-thyroid (5 cases) and the postero-superior mediastinum (2 cases). Eight superior parathyroid glands were not found among the 94 (8.51%). In total, among 162 ectopic parathyroid glands, 28 were not found (17,28%).Conclusion: Imaging is essential to search an ectopic parathyroid gland. When not found in its usual location, the strategy of surgical dissection should be methodical.Keywords: parathyroid gland, ectopia, hyperparathyroidism, imaging, parathyroidectomy
- Published
- 2015
9. Leiomyome agressif naso-sinusien : a propos d’un cas et revue de la litterature
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Khamassi, K, Kesraoui, I, Smaili, A, Lahiani, R, Bougacha, L, Kaffel, N, Boubaker, A, Ben Salah, M, and Ferjaoui, M
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léiomyome, fosses nasales, sinus, tomodensitométrie, imagerie par résonance magnétique, chirurgie sinusienne - Abstract
Introduction : Les léiomyomes sont des tumeurs bénignes issues des fibres musculaires lisses. La localisation au niveau des cavités nasosinusiennes est très rare.Cas clinique : Il s’agit d’une patiente âgée de 59 ans, qui a consulté pour obstruction nasale et épistaxis gauches. L’endoscopie nasale a montré une formation comblant totalement la fosse nasale gauche. L’imagerie (TDM, IRM) a objectivé un volumineux processus expansif tissulaire naso-ethmoïdo-maxillaire, avec extension intra-orbitaire et endocrânienne. La biopsie confirmé qu’il s’agit d’un léiomyome à localisation nasosinusienne. La patiente a été opérée par voie paralatéronasale élargie. Elle a eu une exérèse tumorale complète et une reconstruction de la perte de substance osseuse par autogreffe. Les suites opératoires étaient simples. Aucune récidive n’a été notée après un recul de 1 an.Conclusion : La localisation nasosinusienne du léiomyome est très rare. L’imagerie est indispensable dans le cadre du bilan d’extension loco-régional. Seul une exérèse chirurgicale complète permettra d’éviter toute récidive aussi bien à court qu’à long terme.Mots-clés : léiomyome, fosses nasales, sinus, tomodensitométrie, imagerie par résonance magnétique, chirurgie sinusienneIntroduction: Leiomyomas are benign tumors arising from smooth muscle fibers. The location at the sinonasal cavities is very rare.Case report: This is a female patient aged 59, who consulted for left nasal obstruction and epistaxis. Nasal endoscopy showed a tumor completely filling the left nasal cavity. Imaging (CT, MRI) has objectified a large expansive tissularnaso-maxillary-ethmoidal process with intraorbital and intracranial extension. The biopsy confirmed that this was a leiomyoma with sinonasal localization. The patient was operated by extended paralatéronasale approach. She had a complete tumor resection and reconstruction of the bone defect with autograft. The postoperative course was uneventful. No recurrence was observed after a follow-up period of 1 year.Conclusion: The sinonasal location of leiomyoma is very rare. Imaging is essential for locoregional staging. Only a complete surgical resection will prevent any recurrence both in short and long term.Keywords : leiomyoma, nasal fossae, sinus, computed tomography, magnetic resonance imaging, sinusal surgery
- Published
- 2015
10. Fistule et kyste nasofrontaux : a propos d’un cas
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Zaim, H, Chkili, R, Harbaoui, A, Achoura, S, Yeadeas, M, Khamassi, K, Ben Salah, M, and Ferjaoui, M
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fistule nasofrontale, kyste nasofrontal, tomodensitométrie, imagerie par résonance magnétique, craniotomie frontale - Abstract
Introduction : Les fistules nasofrontales correspondent à la persistance d’une communication anormale d’origine embryologique entre la couche profonde de la peau et le système nerveux. Ils peuvent être associés à un kyste dermoïde ou épidermoïde.Ils peuvent être révélés par une infection loco-régionale et surtout neuro-méningée qui fait toute la gravité de cette malformation congénitale. Notre objectif est d’insister sur les caractéristiques de cette pathologie pour un diagnostic précoce.Observation : Il s’agit d’un enfant âgé de 2 ans, qui présente depuis sa naissance une fistule cutanée au niveau du dos du nez laissant sourdre du pus de façon intermittente. L’imagerie a objectivée une formation kystique basi-frontale médiane, associée à une déhiscence de l’os frontal gauche avec défaut de développement de l’apophyse crista galli. Le diagnostic de fistule associée à un kyste nasofrontal a été retenu. Le patient a été opéré par voie bicoronale. En per-opératoire, nous avons découvert un kyste extra-dural mais adhérant au feuillet externe de la dure-mère. La paroi kystique a été disséquée puis enlevée en totalité. Le défect osseux de l’os frontal gauche a été colmaté par de la poudre d’os et du surgicel. Les suites opératoires étaient simples et l’examen anatomopathologique a confirmé qu’il s’agit d’un kyste dermoïde nasofrontal. Une fistulectomie a été réalisée 6 mois plus tard avec bonne évolution.Conclusion : L’apport de l’imagerie est indispensable pour le diagnostic positif et topographique desfistules et kystes nasofrontaux. Le risque de complications infectieuses impose un traitement chirurgical. Le but de la chirurgie doit être une résection totale, seule garante de l’absence de récidive à long terme.Mots-clés : fistule nasofrontale, kyste nasofrontal, tomodensitométrie, imagerie par résonance magnétique, craniotomie frontaleIntroduction : Naso frontal fistula correspond to the persistence of an abnormal communication of embryological origin between the deep layer of the skin and the nervous system. They can be associated with dermoid or epidermoid cyst. They can be revealed by a locoregional and especially neuro-meningeal infection, wich makes all the severity of this malformation.Case-report : A 2 year-old child presents since birth cutaneous fistula at the nasal dorsum with intermittent purulent effuse. Imaging showed medial basi-frontal cyst, associated with dehiscence of the left frontal bone and defective development of the crista galli. The diagnosis of fistula associated with nasofrontal cyst was retained. The patient was operated by bicoronal approach. Intraoperatively, we found an extradural cyst but adhering to the outer layer of the dura mater. The cyst wall was dissected and removed totally. The bone defect of the left frontal bone was clogged with bone powder and surgicel. The postoperative course was uneventful and pathologic examination confirmed that this is a nasofrontal dermoid cyst. Fistulectomy was performed 6 months later with good evolution.Conclusion : Contribution of imaging is essential for positive and topographic diagnosis of nasofrontal fistulas and cysts. The risk of infectious complications requires surgical treatment. The goal of surgery should be a total resection, the only guarantee of the absence of long-term recurrence.Keywords : nasofrontal fistula, nasofrontal cyst, computed tomography, magnetic resonance imaging, frontal craniotomy
- Published
- 2015
11. Les tumeurs benignes de la parotide
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Khamassi, K, Dhaoudi, A, Lahiani, R, Sellami, H, Gaied, K, Najeh, D, Kaffel, N, Ben Salah, M, and Ferjaoui, M
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tumeur bénigne, glande parotide, imagerie par résonance magnétique, cytoponction, parotidectomie, nerf facial - Abstract
Introduction : Les tumeurs parotidiennes bénignes sont caractérisées par une grande diversité histologique. Les indications thérapeutiques ne sont pas encore bien codifiées et restent un sujet de controverse.Matériel et méthodes : Nous rapportons une étude rétrospective à propos de 48 cas de tumeurs parotidiennes bénignes, colligés sur une période de 7 ans (2004-2010). Tous les patients ont bénéficié d’un examen ORL complet, d’un bilan biologique et radiologique. Le traitement était chirurgical dans tous les cas.Résultats : L’âge moyen était de 46 ans et le sex-ratio 1,52. Le motif de consultation était dans tous les cas une tuméfaction au niveau de la région parotidienne. L’échographie cervicale a confirmé le siège intra-parotidien dans tous les cas. L’IRM était pratiquée chez 28 patients. Le cystadénolymphome était évoqué dans 6 cas et l’adénome pléomorphe dans 22 cas. Une cytoponction a été pratiquée chez 8 patients et a montré un aspect en faveur d’adénome pléomorphe dans 6 cas et de cystadénolymphome dans 2 cas. Tous les patients ont été opérés sous anesthésie générale. La tumeur était au dépends du lobe superficiel dans 43 cas et du lobe profond dans 5 cas. Une parotidectomie totale a été pratiquée chez les 5 patients ayant une tumeur au dépends du lobe profond. Parmi les 43 patients ayant une tumeur au dépends du lobe superficiel, une parotidectomie totale a été pratiquée chez 5 patients, une parotidectomie exofaciale chez 35 patients et une simple énucléation tumorale dans 3 cas. L’examen anatomopathologique définitif était concordant avec l’examen extemporané dans 100% des cas. Au total, nous avions 31 cas d’adénome pléomorphe et 17 cas de cystadénolymphome. Des complications post-opératoires étaient présentes dans 9 cas. L’évolution ultérieure a été marquée par l’absence de récidive dans tous les cas, avec un recul moyen de 28 mois.Conclusion : Le développement des techniques de l’imagerie a permis actuellement d’évoquer le diagnostic de bénignité d’une tumeur parotidienne et même d’évoquer fortement un diagnostic anatomopathologique. Le choix de l’intervention chirurgicale est guidé par la localisation et l’étendue de la tumeur et par le type histologique.Mots-clés : tumeur bénigne, glande parotide, imagerie par résonance magnétique, cytoponction, parotidectomie, nerf facialIntroduction: Benign parotid tumors are characterized by high histological diversity. Therapeutic indications are not well codified and remain a subject of controversy.Materials and Methods: We report a retrospective study of 48 cases of benign parotid tumors, collected over a period of 7 years (2004-2010). All patients underwent complete ENT examination, biological and radiological assessment. Treatment was surgical in all cases.Results : The mean age was 46 years and the sex ratio 1.52. Tumefaction in the parotid region was the presenting symptom in all cases. Cervical ultrasound confirmed the intra-parotid location in all cases. MRI was performed in 28 patients. Cystadenolymphoma was suggested in 6 cases and pleomorphic adenoma in 22 cases. A fine-needle aspiration was performed in 8 patients and showed pleomorphic adenoma in 6 cases and cystadenolymphoma in 2 cases. All patients were operated under general anesthesia. The tumor was at the expense of the superficial lobe in 43 cases and the deep lobe in 5 cases. A total parotidectomy was performed in 5 patients having a deep lobe tumor. Among the 43 patients having a superficial lobe tumor, a total parotidectomy was performed in 5 patients, an exofacialparotidectomy in 35 patients and a single tumor enucleation in 3 cases. The final histological examination was consistent with the frozen section in 100% of cases. In total, we had 31 cases of pleomorphic adenoma and 17 cases of cystadenolymphoma. Postoperative complications were present in 9 cases. The subsequent evolution was marked by the absence of recurrence in all cases, with a mean follow-up period of 28 months.Conclusion : The development of imaging techniques has currently allowed to suggest the diagnosis of benignity of a parotid tumor, and even to highly evoke the pathological diagnosis. The choice of surgical procedure is guided by the location and extent of the tumor and by the histological type.Keywords : benign tumor, parotid gland, magnetic resonance imaging, fine-needle aspiration, parotidectomy, facial nerve
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- 2015
12. Castelman´s disease of the neck: a case report and literature review
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Amel El Korbi, Jellali Sondes, Jguirim Mahbouba, Bellalah Ahlem, Ferjaoui Mehdi, Bouatay Rachida, Kolsi Naourez, Harrathi Khaled, and Koubaa Jamel
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castleman´s disease ,lymphadenopathy ,surgery ,Medicine - Abstract
Castleman’s disease is a rare pathology, poorly understood. It is considered as a lymphoproliferative disorder, described for the first time in 1954, which may be confused with other causes of lymphadenopathy. We report in this paper the case of a young women presenting with left latero-cervical lymphadenopathy. All the investigations were negative except a large high-vascularized level II cervical lymphadenopathy. We performed a cervicotomy. The extemporaneous histological exam was non-contributive. We decided to perform a complete level II and III left cervical lymphadenectomy. The diagnosis of unicentric Castleman´s disease was confirmed based on the final histological study of the specimen, and the absence other cervical and extra-cervical lymphadenopathy. The patient is free of recurrence at the time of reporting this article.
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- 2020
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13. Pediatric naso-sinusal inverted papilloma: report of a case and literature review: a case report
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Amel El Korbi, Jellali Sondes, Kolsi Naourez, Bouatay Rachida, Njim Leila, Berguaoui Emna, Ferjaoui Mehdi, Harrathi Khaled, and Koubaa Jamel
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inverted ,papilloma ,pediatric ,endoscopic surgery ,case report ,Medicine - Abstract
Inverted papilloma is a rare nasosinusal tumor that mainly occurs in adults during the 5thdecade. The occurrence in children is exceptional and only few cases have been reported in the litterature. Clinical and radiological findings mimic other benign nasosinusal pathologies; therefore, diagnosis is based on histopathology either via biopsy or following surgical excision. Here we present a rare case of pediatric inverted papilloma in a 11-year-old child and we discuss clinical, radiological, therapeutic and evolutionary features through a literature review.
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- 2020
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14. Submucosal myomas and fertility in a Tunisian population
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Ferjaoui Mohamed Aymen, Hannachi Mohamed Amine, Marzougui Ali, Abdessamia Kais, Azri Raja, Khedheri Slim, Malek Monia, and Neji Khaled
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submucosal myoma ,infertility ,hysteroscopic resection ,Medicine - Abstract
INTRODUCTION: Infertility associated with submucosal myomas may be treated by hysteroscopic resection. Aim: this retrospective study is aimed to analyze 50 subfertile patients who underwent hysteroscopic myomectomy with particular regard to their post procedure pregnancy outcome. METHODS: the patient group (n=50) underwent the procedure between January 2012 and January 2017. The submucosal were G0 (n=37), G1 (n=12) and G2 (n=4). The mean size was 3.2 cm, while the mean duration of the procedure was 26 minutes and the mean follow-up was 18 months (9 months to 5 years). Eight cases had one or more associated infertility factors. RESULTS: eighteen patients (36%) conceived after procedure, at 12 months ±2.6 months after procedure. The pregnancy rate was better when myomas was the exclusive etiology of infertility (42.85%). The complication rate was 7%. CONCLUSION: hysteroscopic myomectomy is a safe procedure to enhance infertility essentially in case of unexplained infertility.
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- 2020
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15. Traitement médical des fausses couches incomplètes en ambulatoire
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Monia Malek, Ferjaoui Mohamed Aymen, Garci Mariem, Ali Marzougui, Khaoula Samaali, Khedheri Slim, and Khaled Neji
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fausse couche ,misoprostol ,aspiration ,Medicine - Abstract
Introduction: évaluer la faisabilité du traitement médical des fausses couches par misoprostol en ambulatoire et préciser ses avantages en comparaison avec la révision utérine instrumentale classique. Méthodes: étude prospective comparative au service B du centre de maternité de Tunis (CMNT) s´étalant sur une période de 12 mois (Juillet 2015-Juin 2016), colligeant 50 patientes sélectionnées ayant des constantes hémodynamiques stables et ayant consulté pour fausses couches incomplètes et traitées par misoprostol en ambulatoire, à un groupe de 50 patientes qui avaient eu une révision utérine pour le même motif au cours de la même période d´étude. Le misoprostol a été administré à la dose de 400 µg, soit 2 comprimés, par voie sublinguale (25 cas) et par voie vaginale (25 cas). Résultats: chez les 25 patientes qui avaient reçu 400 µg (soit 2 cp) de misoprostol par voie vaginale, le taux d´expulsion complète de la grossesse avait atteint 88% (22 patientes). Chez les 25 femmes ayant reçu le misoprostol par la voie sublinguale, le taux d´expulsion a chuté à 84% (21 patientes), la différence n´est pas statistiquement significative. Six patientes ont eu secondairement une aspiration utérine et une patiente a expulsé suite à une dose supplémentaire de misoprostol 400 µg. Dans le groupe des 50 patientes ayant eu une aspiration chirurgicale pour fausse couche incomplète, nous avons noté des complications hémorragiques chez 5 patientes (10% des cas) et 3 cas de rétention trophoblastique. La durée moyenne d´hospitalisation a varié de 1 à 3 jours; 80% des patientes ont été hospitalisées pendant 48 heures. La révision instrumentale a coûté en moyenne 73 Dinar tunisien (DT) soit environ 3 fois plus cher en comparaison avec le traitement de la fausse couche incomplète par misoprostol. Ainsi, cette approche médicale s´est avérée plus économique en termes de coût de santé publique. Conclusion: le traitement des fausses couches incomplètes par misoprostol est une méthode efficace, sûre, à condition qu´elle soit prescrite chez des femmes sélectionnées au préalable.
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- 2020
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16. Kyste hydatique appendiculaire simulant un kyste ovarien compliqué: à propos d’un cas
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Ferjaoui Mohamed Aymen, Hannachi Mohamed Amine, Marzougui Ali, Fathalla Mehdi, Khedheri Slim, Malek Monia, and Neji Khaled
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kyste de l´ovaire ,hydatidose ,appendice ,Medicine - Abstract
Le kyste hydatique est une zoonose causée par l´ingestion accidentelle de l´Echinococcus granulosus. Cette parasitose est un problème de santé en Tunisie où elle constitue une endémie. Les organes les plus touchés sont essentiellement les poumons et le foie. La localisation appendiculaire est exceptionnelle. La rareté de la localisation appendiculaire peut être à l´origine de confusion diagnostique avec les masses latéro-utérines. Nous rapportons dans cet article le cas d´un kyste hydatique appendiculaire chez une jeune femme de 36 ans pris à tort initialement comme un kyste ovarien compliqué. Il s´agit d´une femme âgée de 36 ans, sans antécédents pathologiques, qui a été hospitalisée dans un tableau de suspicion de torsion d´annexe. L´échographie pelvienne a montré une formation kystique latéro-utérine droite. En per-opératoire on découvre une formation kystique qui dépend de l´appendice. La patiente a eu une appendicectomie avec la résection de la masse. L´examen anatomo-pathologique était en faveur d´un kyste hydatique appendiculaire. Les suites opératoires étaient simples. La localisation appendiculaire, dans l´hydatitose, est certainement exceptionnelle. Cependant, ce diagnostic doit être évoqué devant toute lésion kystique abdomino-pelvienne, surtout dans les pays où l´hydatidose est une endémie.
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- 2019
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17. Spontaneous pregnancy after vaginoplasty in a patient presenting a congenital vaginal aplasia
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Ferjaoui Mohamed Aimen, Youssef Atef, Gharrad Majed, Achour Radhouane, Mbarki Manel, Malek Monia, Néji Khaled, and Reziga Hedi
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Vaginal aplasia ,Vaginoplasty ,Fertility ,Medicine - Abstract
The vaginal aplasia is a rare Mullerian duct malformation characterized by the absence of the vagina. The management of this malformation is based on surgery to restore a normal sexual life and eventually to hope having a normal fertility. In this case, we presented a spontaneous pregnancy in a 15 year-old girl who underwent a vaginoplasty with re-implantation of the uterus corpus in the neovagina.
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- 2016
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18. A rare cause of infertility: A late complication of female genital mutilation
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Ferjaoui Mohamed Aimen, François Monneins, Gharrad Majed, and Belaiba Amine
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Female genital mutilation ,Epidermal inclusion cyst ,Clitoral reconstruction ,Vulvoplasty ,Medicine - Abstract
Female genital mutilation is a cultural practice in many African and Asian societies based usually on religious beliefs. This practice made by a non medical and traditional practitioner with non sterile instruments is a source of many complications such as infection, acute and chronic pain, life-threatening hemorrhage, sexual dysfunction, and rarely epidermal inclusion cysts. We report a case of a large epidermal inclusion cyst in a 36-year-old patient, 30 years after a female genital mutilation (FGM). The patient complains of a two-year-secondary infertility with a self-imaging alteration and a sexual dysfunction. The managment of this complication was based on surgery with a psychological support and sexual therapies.
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- 2016
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19. La grossesse cornuale, aspect laparoscopique
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Ferjaoui Mohamed Aymen and Gharrad Majed
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grossesse extra utérine ,grossesse cornuale ,methotrexate ,Medicine - Abstract
La grossesse cornuale est définie par le developpement d'une grossesse au niveau de la corne utérine. C'est une forme rare de la grossesse utérine anormale. Son incidence est 1%. Son risque majeur est la rupture utérine pouvant mettre en danger le pronostic vital maternel. Notre patiente est âgée de 28 ans. Elle présentait des douleurs pelvienne depuis 24 heures avec à l'examen une sensibilité hypogastrique et un état hémodynamique stable. La bandelette de la détection de la ßHCG sérique est positive. L'échographie pelvienne endovaginale a objectivé un utérus vide, un endomètre épais, et une grossesse cornuale droite non rompue. Le taux initial du dosage sérique de la ßHCG était à 2800 UI/L. La décision était de procéder à un traitement conservateur. La patiente a eu une coelioscopie diagnostique et thérapeutique. En per opératoire, on trouve une corne utérine droite augmentée de taille, hypervascularisée, les deux trompes étaient belles et fines. La patiente a eu une injection de Methotrexate (0,5 mg/kg soit 35 mg) et en intra musculaire (35 mg). L'évolution était marquée par la chute du taux sérique de la ßHCG jusqu'à leur négativation.
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- 2016
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20. Interest of computer tomography in the study of prognostic factors of otosclerosis.
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Bouatay R, Benelhaj C, Saad J, Zrig A, Ferjaoui M, Elkorbi A, Kolsi N, Harrathi K, and Koubaa J
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- Humans, Male, Female, Adult, Middle Aged, Retrospective Studies, Prognosis, Young Adult, Stapes Surgery methods, Audiometry, Hearing Loss, Conductive etiology, Hearing Loss, Conductive diagnostic imaging, Otosclerosis diagnostic imaging, Otosclerosis surgery, Tomography, X-Ray Computed methods
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Background: Otosclerosis is a primary osteodystrophy of the otic capsule that causes stapedo-vestibular ankylosis. Its diagnosis is suspected on the basis of clinical and audiometric elements, basically in the presence of conductive hearing loss with a normal eardrum. The CT-scan is an essential examination for the preoperative evaluation of otosclerosis. The aim of our study was to evaluate the use of CT-scanning in predicting the functional outcome of otosclerosis surgery by correlating postoperative audiometric results and preoperative CT findings., Methods: We conducted a retrospective study at the ENT Department in association with the Medical Imaging Department of our hospital, over a period of 8 years, from January 2014 to December 2022 and involving 90 patients (104 ears)., Results: The average age of our patients was 40 years with extremes ranging from 22 to 61 years. We noted a sex ratio of 0.38. The preoperative CT-scan showed signs of otosclerosis in 87% of the cases and infra-radiological forms in 13% of the cases. Veillon stage II was the most frequent radiological stage encountered with a percentage of 48%. A good audiometric evolution, defined by a closure of postoperative Air Bone Gap (ABG ≤ 20 dB) and by an improvement of Bone Conduction (BC gain ≥ 0), was recorded in 86 cases (82.7%) for ABG and in 84 cases (80.8%) for BC gain. Scanographic predictive factors of poor postoperative outcome for ABG and BC gain were: advanced stages (Veillon stage III and IV), endosteal effraction, and round window involvement. According to multivariate analysis, only the extent of otosclerotic foci was directly and independently associated with the postoperative audiometric outcome., Conclusion: The CT-scan is an essential examination in the preoperative evaluation of otosclerosis. It allows a positive diagnosis to be made and evaluate the extension of otosclerosis. Moreover, thanks to the analysis of the extent of the otosclerosis foci, mainly by the Veillon classification, the CT-scan allows to predict the postoperative audiometric prognosis., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2024
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21. [Thyroglossal duct cysts in adult : clinical and therapeutic features].
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Bouatay R, Bhar S, Bouaziz N, El Korbi A, Ferjaoui M, Kolsi N, Harrathi K, and Koubaa J
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- Humans, Adult, Adolescent, Retrospective Studies, Iodine Radioisotopes therapeutic use, Thyroid Neoplasms diagnosis, Thyroglossal Cyst diagnosis, Thyroglossal Cyst surgery, Carcinoma, Papillary diagnosis
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Thyroglossal duct cysts (TDCs) are rare congenital cervical malformations in adults, which expose to two major risks: infection and malignant degeneration which remains the most dreaded complication in adults., Aims of the Study: This study aims to establish the clinical, management of TDC during adulthood, as well as the evolutionary aspects of these malformations in this age group., Patients Et Methods: This is a retrospective study on 61 adults over 18 years old, undergoing TDC surgery in our department., Results: The average age was 33.7 years with a sex ratio M/F of 1.10.The circumstances of discovery were dominated by a median cervical swelling in 53 patients (86,9%). The swelling was median in 28 cases and located in ad-hyoid in 32 cases. Cervical ultrasound confirmed the diagnosis of TDC in all patients. CT scans were performed on 15 patients. Surgical excision according to the Sistrunk method was performed on all patients. Three of our patients have experienced a degenerated TDC requiring total thyroidectomy with central neck dissection, followed by radioactive iodine therapy., Conclusion: CT scan keeps indications in adults. The treatment is surgical in order to prevent the risks degeneration, which is specific complication in adulthood.
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- 2023
22. [Atypical presentation of a polyp of Killian].
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Ferjaoui M, Bergaoui E, and Koubaa J
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- Humans, Tomography, X-Ray Computed, Magnetic Resonance Imaging, Endoscopy, Nasal Polyps diagnosis, Nasal Polyps surgery, Nasal Polyps pathology
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The antrochoanal polyp or polyp of Killian is a benign nasal tumour that arises from the maxillary sinus. The polyp originating from the middle turbinate is an entity rarely described in the literature. We report here a rare case of Killian polyp originating from the middle turbinate which was explored by computed tomography and magnetic resonance imaging of the facial bone. The polyp was removed by an endoscopic surgical technique. The extraction was made from the oropharynx. Preoperative recognition of these anatomical variations is particularly important to avoid intraoperative surprises.
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- 2023
23. 2022 TUNISIAN NATIONAL CONGRESS OF MEDICINE ABSTRACTS.
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Yacoub A, Ayadi A, Ayed W, Ayari S, Chebbi S, Magroun I, Ben Afia L, Mersni M, Mechergui N, Brahim D, Ben Said H, Bahri G, Youssef I, Ladhari N, Mziou N, Grassa A, M'rad M, Khessairi N, Krir A, Chihaoui M, Mahjoub S, Bahlous A, Jridi M, Cherif Y, Derbal S, Chebbi D, Hentati O, Ben Dahmen F, Abdallah M, Hamdi I, Sahli F, Ouerdani Y, Mnekbi Y, Abaza H, Ajmi M, Guedria A, Randaline A, Ben Abid H, Gaddour N, Maatouk A, Zemni I, Gara A, Kacem M, Maatouk I, Ben Fredj M, Abroug H, Ben Nasrallah C, Dhouib W, Bouanene I, Sriha A, Mahmoudi M, Gharbi G, Khsiba A, Azouz M, Ben Mohamed A, Yakoubi M, Medhioub M, Hamzaoui L, Azouz M, Ben Attig Y, Hamdi S, Essid R, Ben Jemia E, Rezgui B, Boudaya MS, Hassine H, Dabbabi H, Fradi Y, Cherif D, Lassoued I, Yacoub H, Kchir H, Maamouri N, Khairi W, Ben Ammar H, Abaza H, Chelbi E, Merhaben S, Neffati W, Ajmi M, Tarchalla S, Boughzala S, Gazzeh M, Gara S, Labidi A, Touati H, Nefzi AM, Ben Mustpha N, Fekih M, Serghini M, Boubaker J, Zouiten L, Driss A, Meddeb N, Driss I, Walha S, Ben Said H, Bel Hadj Mabrouk E, Zaimi Y, Mensi A, Trad N, Ayadi S, Said Y, Mouelhi L, Dabbèche R, Belfkih H, Bani M, Moussa A, Souissi S, Trabelsi Werchfeni B, Chelly S, Ezzi O, Ammar A, Besbes M, Njah M, Mahjoub M, Ghali H, Neffati A, Bhiri S, Bannour R, Ayadi S, Khouya FE, Kamel A, Hariz E, Aidani S, Kefacha S, Ben Cheikh A, Said H, Dogui S, Atig A, Gara A, Ezzar S, Ben Fradj M, Bouanène I, M'kadmi H, Farhati M, Dakhli N, Nalouti K, Chanoufi MB, Abouda SH, Louati C, Zaaimi Y, Dabbeche R, Hermi A, Saadi A, Mokaddem S, Boussaffa H, Bellali M, Zaghbib S, Ayed H, Bouzouita A, Derouiche A, Allouche M, Chakroun M, Ben Slama R, Gannoun N, Kacem I, Tlili G, Kahloul M, Belhadj Chabbah N, Douma F, Bouhoula M, Chouchene A, Aloui A, Maoua M, Brahem A, Kalboussi H, El Maalel O, Chatti S, Jaidane M, Naija W, Mrizek N, Sellami I, Feki A, Hrairi A, Kotti N, Baklouti S, Jmal Hammami K, Masmoudi ML, Hajjaji M, Naaroura A, Ben Amar J, Ouertani H, Ben Moussa O, Zaibi H, Aouina H, Ben Jemaa S, Gassara Z, Ezzeddine M, Kallel MH, Fourati H, Akrout R, Kallel H, Ayari M, Chehaider A, Souli F, Abdelaali I, Ziedi H, Boughzala C, Haouari W, Chelli M, Soltani M, Trabelsi H, Sahli H, Hamdaoui R, Masmoudi Y, Halouani A, Triki A, Ben Amor A, Makni C, Eloillaf M, Riahi S, Tlili R, Jmal L, Belhaj Ammar L, Nsibi S, Jmal A, Boukhzar R, Somai M, Daoud F, Rachdi I, Ben Dhaou B, Aydi Z, Boussema F, Frikha H, Hammami R, Ben Cheikh S, Chourabi S, Bokri E, Elloumi D, Hasni N, Hamza S, Berriche O, Dalhoum M, Jamoussi H, Kallel L, Mtira A, Sghaier Z, Ghezal MA, Fitouri S, Rhimi S, Omri N, Rouiss S, Soua A, Ben Slimene D, Mjendel I, Ferchichi I, Zmerli R, Belhadj Mabrouk E, Debbeche R, Makhloufi M, Chouchane A, Sridi C, Chelly F, Gaddour A, Kacem I, Chatti S, Mrizak N, Elloumi H, Debbabi H, Ben Azouz S, Marouani R, Cheikh I, Ben Said M, Kallel M, Amdouni A, Rejaibi N, Aouadi L, Zaouche K, Khouya FE, Aidani S, Khefacha S, Jelleli N, Sakly A, Zakhama W, Binous MY, Ben Said H, Bouallegue E, Jemmali S, Abcha S, Wahab H, Hmida A, Mabrouk I, Mabrouk M, Elleuch M, Mrad M, Ben Safta N, Medhioub A, Ghanem M, Boughoula K, Ben Slimane B, Ben Abdallah H, Bouali R, Bizid S, Abdelli MN, Ben Nejma Y, Bellakhal S, Antit S, Bourguiba R, Zakhama L, Douggui MH, Bahloul E, Dhouib F, Turki H, Sabbah M, Baghdadi S, Trad D, Bellil N, Bibani N, Elloumi H, Gargouri D, Ben Said M, Hamdaoui R, Chokri R, Kacem M, Ben Rejeb M, Miladi A, Kooli J, Touati S, Trabelsi S, Klila M, Rejeb H, Kammoun H, Akrout I, Greb D, Ben Abdelghaffar H, Hassene H, Fekih L, Smadhi H, Megdiche MA, Ksouri J, Kasdalli H, Hayder A, Gattoussi M, Chérif L, Ben Saida F, Gueldich M, Ben Jemaa H, Dammak A, Frikha I, Saidani A, Ben Amar J, Aissi W, Chatti AB, Naceur I, Ben Achour T, Said F, Khanfir M, Lamloum M, Ben Ghorbel I, Houman M, Cherif T, Ben Mansour A, Daghfous H, Slim A, Ben Saad S, Tritar F, Naffeti W, Abdellatif J, Ben Fredj M, Selmi M, Kbir GH, Maatouk M, Jedidi L, Taamallah F, Ben Moussa M, Halouani L, Rejeb S, Khalffalah N, Ben Ammar J, Hedhli S, Azouz MM, Chatti S, Athimni Z, Bouhoula M, Elmaalel O, Mrizak N, Maalej M, Kammoun R, Gargouri F, Sallemi S, Haddar A, Masmoudi K, Oussaifi A, Sahli A, Bhouri M, Hmaissi R, Friha M, Cherif H, Baya C, Triki M, Yangui F, Charfi MR, Ben Hamida HY, Karoui S, Aouini F, Hajlaoui A, Jlassi H, Sabbah M, Fendri MN, Kammoun N, Fehri S, Nouagui H, Harzalli A, Snène H, Belakhal S, Ben Hassine L, Labbene I, Jouini M, Kalboussi S, Ayedi Y, Harizi C, Skhiri A, Fakhfakh R, Jelleli B, Belkahla A, Fejjeri M, Zeddini M, Mahjoub S, Nouira M, Frih N, Debiche S, Blibech H, Belhaj S, Mehiri N, Ben Salah N, Louzir B, Kooli J, Bahri R, Chaka A, Abdenneji S, Majdoub Fehri S, Hammadi J, Dorgham D, Hriz N, Kwas H, Issaoui N, Jaafoura S, Bellali H, Shimi M, Belhaj Mabrouk E, Sellami R, Ketata I, Medi W, Mahjoub M, Ben Yacoub S, Ben Chaabene A, Touil E, Ben Ayed H, Ben Miled S, El Zine E, Khouni H, Ben Kadhi S, Maatoug J, Boulma R, Rezgui R, Boudokhane M, Jomni T, Chamekh S, Aissa S, Touhiri E, Jlaiel N, Oueslati B, Maaroufi N, Aouadi S, Belkhir S, Daghfous H, Merhaben S, Dhaouadi N, Ounaes Y, Chaker K, Yaich S, Marrak M, Bibi M, Mrad Dali K, Sellami A, Nouira Y, Sellami S, Anane I, Trabelsi H, Ennaifer R, Benzarti Z, Bouchabou B, Hemdani N, Nakhli A, Cherif Y, Abdelkef M, Derbel K, Barkous B, Yahiaoui A, Sayhi A, Guezguez F, Rouatbi S, Racil H, Ksouri C, Znegui T, Maazaoui S, Touil A, Habibech S, Chaouech N, Ben Hmid O, Ismail S, Chouaieb H, Chatti M, Guediri N, Belhadj Mohamed M, Bennasrallah C, Bouzid Y, Zaouali F, Toumia M, El Khemiri N, El Khemiri A, Sfar H, Farhati S, Ben Chehida F, Yamoun R, Braham N, Hamdi Y, Ben Mansour A, Mtir M, Ayari M, Toumia M, Rouis S, Sakly H, Nakhli R, Ben Garouia H, Chebil D, Hannachi H, Merzougui L, Samet S, Hrairi A, Mnif I, Hentati O, Bouzgarrou L, Souissi D, Boujdaria R, Kadoussi R, Rejeb H, Ben Limem I, Ben Salah I, Greb D, Ben Abdelghaffar H, Smadhi H, Laatiri H, Manoubi SA, Gharbaoui M, Hmandi O, Zhioua M, Taboubi F, Hamza Y, Hannach W, Jaziri H, Gharbi R, Hammami A, Dahmani W, Ben Ameur W, Ksiaa M, Ben Slama A, Brahem A, Elleuch N, Jmaa A, Kort I, Jlass S, Benabderrahim S, Turki E, Belhaj A, Kebsi D, Ben Khelil M, Rmadi N, Gamaoun H, Alaya Youzbechi F, Brahim T, Boujnah S, Abid N, Gader N, Kalboussi S, Ben Sassi S, Loukil M, Ghrairi H, Ben Said N, Mrad O, Ferjaoui M, Hedhli L, Ben Kaab B, Berriche A, Charfi R, Mourali O, Smichi I, Bel Haj Kacem L, Ksentini M, Aloui R, Ferchichi L, Nasraoui H, Maoua M, Chérif F, Belil Y, Ayed MA, Alloulou Y, Belhadj S, Daghfous J, Mehiri N, Louzir B, Abbes A, Ghrab A, Chermiti A, Akacha A, Mejri O, Debbiche A, Yahiaoui C, Binous M, Tissaoui A, Mekni K, El Fekih C, Said MA, Chtioui S, Mestiri S, Smaoui H, Ben Hamida S, Haddar A, Mrizek N, Gares N, Zaibi A, Bouazizi N, Gallas S, Lachhab A, Belhadj M, Hadj Salem N, Garrouch A, Mezgar Z, Khrouf M, Abbassi H, Souissi D, Hamra I, Ben Mustapha N, Abessi I, Boubaker F, Bouchareb S, ElOmma Mrabet H, Touil I, Boussoffara L, Knani J, Boudawara N, Alaya W, Sfar MH, Fekih S, Snène H, Boudawara N, Gargouri I, Benzarti W, Knaz A, Abdelghani A, Aissa S, Hayouni A, Mejri I, Kacem M, Mhamdi S, Daboussi S, Aichaouia C, Moatemri Z, Chaachou A, Fsili R, Ben Ghezala H, Ben Jazia A, and Brahmi N
- Published
- 2023
24. Management of jugular tympanic paraganglioma: a case report.
- Author
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Ferjaoui M, Kolsi N, Boughzala W, Kharrat O, Bouatay R, Harrathi K, Elkorbi A, and Koubaa J
- Subjects
- Male, Humans, Adult, Paraganglioma diagnosis, Paraganglioma surgery, Glomus Jugulare Tumor, Paraganglioma, Extra-Adrenal, Glomus Tympanicum Tumor, Head and Neck Neoplasms
- Abstract
Paragangliomas could be localized from the skull base to the pelvic floor. Tympanic localization represents the most common benign tumor of the middle ear. Diagnosis is based on clinical signs with a great contribution of radiology. A 40-year-old male presented with isolated tinnitus of the right ear evolving for 18 months. Examination revealed a red bulging right-sided tympanic membrane and a conductive hearing loss. Tomodensitometry and Magnetic resonance imagery showed findings in favor of a right jugular tympanic paraganglioma. The tumor was classified type B according to FISCH classification. The patient underwent surgery consisting in tympanotomy using a retro auricular access route. The postoperative course was uneventful. There was no recurrence during the one-year follow-up. Jugular tympanic paraganglioma diagnosis is guided by a combination of epidemiological, clinical and radiological features. Treatment is still not consensual, but surgery still have its indications in localized forms of head and neck paragangliomas (HNP´s)., Competing Interests: The authors declare no competing interests., (Copyright: Mehdi Ferjaoui et al.)
- Published
- 2022
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25. Cartilage Graft in Myringoplasty: What Are the Factors Influencing Hearing Gain?
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Kolsi N, Bouaziz N, Ferjaoui M, Harrathi K, Bouatay R, and Koubaa J
- Abstract
Background and Objectives: We present the anatomical and functional results on the use of cartilage in myringoplasty and use the data to analyze the factors influencing hearing gain., Subjects and Methods: This retrospective study included 161 cases of cartilage myringoplasties collected over an 11-year period (2010-2020). Of the 161 cases, the etiology of the tympanic perforations was simple chronic otitis media in 154 (95.65%) ears and traumatic in 7 (4.35%) ears. The mean preoperative Rinne was 26.20±7.05 dB. The most commonly used approach was retroauricular, and the common graft material was tragal or conqual cartilage., Results: After the follow-up period (mean:15 months), the anatomical success rate was 93.2%; there were nine cases of reperforation, of which three were reoperated with a good final result. The hearing success rate (residual Rinne ≤20 dB) was 91.9% with an average gain of 11.48±8.62 dB. The only factor significantly influencing the anatomical outcome was the history of chronic rhinosinusitis. In univariate studies, several factors influencing the functional result were revealed; the only one retained after elimination of bias was the anatomical result., Conclusions: We recommend cartilage as the material of choice for myringoplasties as it has been shown to be resistant to predictive factors of failure after tympanic repair surgery. We recommend the adequate management of all chronic rhinosinusitis before performing myringoplasty.
- Published
- 2022
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26. Fungal necrotizing external otitis: diagnosis, management and outcomes of 15 cases.
- Author
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Korbi AE, Houas J, Kolsi N, Bouatay R, Ferjaoui M, Toumi A, Harrathi K, and Koubaa J
- Subjects
- Male, Humans, Aged, Female, Antifungal Agents therapeutic use, Abscess drug therapy, Voriconazole therapeutic use, Candida, Otitis Externa diagnosis, Otitis Externa drug therapy, Otitis Externa microbiology, Otomycosis diagnosis, Otomycosis drug therapy
- Abstract
Fungal necrotizing external otitis (NEO) is a rare disease. It is an aggressive and potentially fatal infection. The most commonly reported pathogen is Candida. We aim through this study to share our experience in the management of fungal necrotizing external otitis and discuss its diagnosis tools, anti-fungal treatment choice, and outcomes. We included fifteen patients with diagnosis criteria of fungal NEO; clinical features of NEO with positive culture swabs and/or positive serologic test to a fungal pathogen. The mean age was of 70 years with a prevalence of males. The main symptoms were otalgia (n=15) and otorrhea (n=7). Facial palsy was observed in four cases. Fungal pathogens were Candida(n=10) and Aspergillus (n=5). Complications were observed in eight cases: extension to the temporo-mandibular (n=4), abscess in the retropharyngeal space (n=2), abscess in the parapharyngeal space (n=1) and thrombophlebitis of the internal jugular vein (n=1). Six patients were treated with fluconazole, eight with voriconazole, and one patient with itraconazole. After a mean duration of 52 days of antifungal therapy, fourteen patients have been cured with normalization of the ear symptoms, biological, and imaging features. One patient died of septic shock. No recurrence of the disease was observed after a follow-up of 12 months in all cases., Competing Interests: The authors declare no competing interests., (Copyright: Amel El Korbi et al.)
- Published
- 2022
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27. [Odontogenic cervical-facial cellulitis: report of 87 cases].
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Ferjaoui M, Kolsi N, Bergaoui E, Naouar M, Bouatay R, Harrathi K, Elkorbi A, and Koubaa J
- Subjects
- Anti-Bacterial Agents therapeutic use, Face, Female, Humans, Male, Neck, Retrospective Studies, Young Adult, Cellulitis drug therapy, Cellulitis therapy, Drainage methods
- Abstract
Cervical-facial cellulitis are infections of the cellular fatty spaces of the face and neck with a tendency towards locoregional extension, septic and thromboembolic complications that can affect the patient's vital and/or functional prognosis. The management is multidisciplinary including a medical component, surgical drainage associated with the treatment of the causal tooth. This is a retrospective study including 87 cases of odontogenic head and neck cellulitis hospitalized in the ENT and head and neck surgery department at Fattouma Bourguiba Monastir hospital over a period of 4 years between January 2017 and December 2020. The study included 48 women and 39 men. The most affected age group was young adults (54 %). The main contributing factors were poor oral hygiene (76 %), tobacco (41 %) and alcohol (19 %). Anti-inflammatory medicines intake was found in 31 % of cases. The average consultation time was 5 days. The main reason for consultation was painful head and neck swelling associated with trismus (70 %) and fever (52 %). The cervical-facial scan was performed in 93 % of patients. It revealed suppurative cellulitis (64 %), extension to upper aerodigestive ways (20 %), compression of upper aero-digestive tract (11,5 %), Lemierre syndrome (4,6 %) and gangrenous cellulitis with mediastinal extension (1,1 %). All patients received large spectrum antibiotic, associated in 25 % of cases with surgical drainage. Treatment of the dental cause was performed in all patients. The evolution was favourable in 98,9 % of cases. There is only one death due to a septic shock (1,1 %), which is consistent with most of the results reported in the literature. Head and neck cellulitis can affect the functional and vital prognosis of the patient in the absence of rapid and adequate management. The treatment remains primarily preventive.
- Published
- 2022
28. [Therapeutic outcomes of nasopharyngeal carcinomas: a single-center study conducted at the Fattouma Bourguiba University Hospital in Monastir, Tunisia].
- Author
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Korbi AE, Tkhayat SB, Bouatay R, Ferjaoui M, Kolsi N, Harrathi K, and Koubaa J
- Subjects
- Adolescent, Adult, Aged, Child, Female, Follow-Up Studies, Humans, Lymphatic Metastasis pathology, Male, Middle Aged, Nasopharyngeal Carcinoma pathology, Nasopharyngeal Neoplasms pathology, Neoplasm Recurrence, Local, Neoplasm Staging, Prognosis, Retrospective Studies, Survival Rate, Treatment Outcome, Tunisia, Young Adult, Nasopharyngeal Carcinoma therapy, Nasopharyngeal Neoplasms therapy
- Abstract
Introduction: nasopharyngeal carcinomas (NPCs) are relatively common in the Mediterranean basin. Survival has been greatly improved by new radiation techniques and new molecular-targeted chemotherapy. The purpose of our study was to analyze the therapeutic outcomes and to describe the prognostic factors of NPCs., Methods: we conducted a retrospective study of patients with nasopharyngeal carcinoma on treatment and follow-up in our department between January 1995 and December 2014. Data were collected using a standardized sheet. Statistical analysis was performed using SPSS software. Kaplan-Meier method was used to determine patient´s overall survival., Results: seventy-three cases of NPC were reported. The average age of patients was 48 years. A male predominance was noted. The majority of cancers (56%) were locally advanced tumors (T3-T4). After an average follow-up of 45.5 months, the rate of locoregional recurrences was 19.4%. Three patients (4%) had bone metastases. Five-year overall survival was 65%. Factors positively influencing overall survival were early-stage tumor (TNM classification) and 1.8 Gy single fraction radiotherapy. Local and lymph node recurrence rates were 13.8% and 5.5% respectively, mainly for T4 N2 tumors. Therapeutic sequelae were dominated by seromucous otitis (42.7%), trismus (38.7%), and xerostomia (32%)., Conclusion: overall survival in patients with NPC has improved, in particular with the advent of concomitant radiotherapy and chemotherapy; however, disabling late toxicity is significant. Good prognostic factors reported in this study include early tumor stage as well as radiotherapy fractionation., Competing Interests: Les auteurs ne déclarent aucun conflit d´intérêts., (Copyright: Amel El Korbi et al.)
- Published
- 2021
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29. Pediatric naso-sinusal inverted papilloma: report of a case and literature review.
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Korbi AE, Jellali S, Kolsi N, Bouatay R, Njim L, Berguaoui E, Ferjaoui M, Harrathi K, and Koubaa J
- Subjects
- Biopsy, Child, Humans, Male, Nose Neoplasms pathology, Nose Neoplasms therapy, Papilloma, Inverted pathology, Papilloma, Inverted therapy, Paranasal Sinus Neoplasms diagnosis, Paranasal Sinus Neoplasms pathology, Paranasal Sinus Neoplasms therapy, Nose Neoplasms diagnosis, Papilloma, Inverted diagnosis
- Abstract
Inverted papilloma is a rare nasosinusal tumor that mainly occurs in adults during the 5
th decade. The occurrence in children is exceptional and only few cases have been reported in the litterature. Clinical and radiological findings mimic other benign nasosinusal pathologies; therefore, diagnosis is based on histopathology either via biopsy or following surgical excision. Here we present a rare case of pediatric inverted papilloma in a 11-year-old child and we discuss clinical, radiological, therapeutic and evolutionary features through a literature review., Competing Interests: The authors declare no competing interests., (Copyright: Amel El Korbi et al.)- Published
- 2020
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30. Castelman's disease of the neck: a case report and literature review.
- Author
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Korbi AE, Jellali S, Jguiri M, Bellalah A, Ferjaoui M, Bouatay R, Kolsi N, Harrathi K, and Koubaa J
- Subjects
- Castleman Disease physiopathology, Female, Humans, Young Adult, Castleman Disease diagnosis, Lymphadenopathy diagnosis, Neck pathology
- Abstract
Castleman's disease is a rare pathology, poorly understood. It is considered as a lymphoproliferative disorder, described for the first time in 1954, which may be confused with other causes of lymphadenopathy. We report in this paper the case of a young women presenting with left latero-cervical lymphadenopathy. All the investigations were negative except a large high-vascularized level II cervical lymphadenopathy. We performed a cervicotomy. The extemporaneous histological exam was non-contributive. We decided to perform a complete level II and III left cervical lymphadenectomy. The diagnosis of unicentric Castleman's disease was confirmed based on the final histological study of the specimen, and the absence of other cervical and extra-cervical lymphadenopathy. The patient is free of recurrence at the time of reporting this article., Competing Interests: The authors declare no competing interests., (Copyright: Amel El Korbi et al.)
- Published
- 2020
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31. Accuracy of fine-needle aspiration cytology of head and neck masses.
- Author
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Rammeh S, Romdhane E, Sassi A, Belhajkacem L, Blel A, Ksentini M, Lahiani R, Farah F, Salah MB, and Ferjaoui M
- Subjects
- Biopsy, Fine-Needle methods, Biopsy, Fine-Needle standards, Diagnostic Errors, Female, Head and Neck Neoplasms classification, Humans, Male, Middle Aged, Sensitivity and Specificity, Head and Neck Neoplasms pathology
- Abstract
Background: Head and neck masses are a common presentation in daily practice and can be challenging to both clinicians and cytopathologists. Fine needle aspiration cytology (FNAC) is a widely used method for the diagnosis of head and neck masses. The aim of the study was to assess our institutional experience of the accuracy of FNAC in the diagnosis of head and neck masses., Methods: A total of 1262 FNACs were conducted from January 2013 to December 2016 and subdivided into benign and malignant categories. The thyroid and salivary glands FNACs were classified according to the Bethesda System for Reporting Thyroid cytopathology and to the Milan System for Reporting Salivary Gland Cytopathology respectively. The measures of diagnostic accuracy of FNAC were determined taking histology as a gold standard., Results: A total of 7 false negative (FN) and 6 false positive (FP) FNACs were identified. Overall sensitivity and specificity of FNAC for a malignant diagnosis were 92% and 94.4%, respectively. Accuracy of FNACs of head and neck masses was 93.5% for all sites. The salivary gland group had the highest rate of FN (2.8%). All FP were reported in the thyroid group. These cases were cytologically classified suspicious for malignancy (n = 3) and papillary carcinoma (n = 3) and proved to be lymphocytic thyroiditis on final histology. Among the most common locations, cytology of lymph nodes provided the best sensitivity (98.2%). Salivary glands as well as lymph nodes had the best specificity (100%)., Conclusion: FNAC of head and neck masses has a high accuracy allowing a correct therapeutic management. However, this accuracy depends on the anatomic location of the mass., (© 2018 Wiley Periodicals, Inc.)
- Published
- 2019
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32. Efficacy of Fine-Needle Aspiration Cytology in the Diagnosis of Tuberculous Cervical Lymphadenitis.
- Author
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Rammeh S, Romdhane E, Arfaoui Toumi A, Houcine Y, Lahiani R, Sassi A, Mardassi H, Ben Salah M, and Ferjaoui M
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Bacteriological Techniques, Biopsy, Fine-Needle, Child, Child, Preschool, Female, Humans, Infant, Lymph Nodes microbiology, Male, Middle Aged, Mycobacterium tuberculosis isolation & purification, Necrosis, Predictive Value of Tests, Reproducibility of Results, Retrospective Studies, Tuberculosis, Lymph Node microbiology, Young Adult, Lymph Nodes pathology, Tuberculosis, Lymph Node pathology
- Abstract
Objective: This study assesses the role of fine-needle aspiration cytology (FNAC) in the diagnosis of tuberculous lymphadenitis (TL) in comparison with histology and bacteriology findings., Study Design: We undertook a descriptive retrospective study of 937 FNAC specimens from 851 patients with cervical lymph nodes. The FNAC findings were then compared to histopathology and bacteriology., Results: Of the 937 aspirates, the cytopathological diagnoses consisted of 426 (55.9%) TL, 185 (24.3%) reactive lymphoid hyperplasia, 18 (2.3%) suppurative inflammation, 78 (10.2%) malignant metastatic tumor, and 54 (7%) lymphoma. Of the 426 TL cases, 171 were diagnosed by FNAC combined with bacteriological examination. In this group, 22 cases were found to be positive on Ziehl-Neelsen stain and 16 by culture. A histopathology report was available for 62 cases. Compared to histopathology, the overall diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FNAC in the diagnosis of cervical TL were, respectively, 96.77, 100, 100, and 96.67%. When comparing bacteriology to histopathology, these values were 97.44, 100, 100, and 91.67%., Conclusion: Our study shows that FNAC is a sensitive and specific tool for the diagnosis of cervical TL., (© 2018 S. Karger AG, Basel.)
- Published
- 2018
- Full Text
- View/download PDF
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