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In our study, pedicled nasal flap (NF) did not provide better results than free nasal graft (NG) for primary closure of cerebrospinal fluid (CSF) rhinorrhea. In the future, a multicenter randomized study would be needed to confirm this result. The choice of surgical technique will depend on the surgeon's experience, and the position and size of the defect.To evaluate our results in repairing CSF leaks, comparing the two techniques we used: free NG and pedicled NF.A total of 33 patients diagnosed with CSF rhinorrhea were operated on between June 2000 and May 2010; 17 were women. The mean age was 44.7 years (± 13.0). Twenty-two (66.6%) NFs of the middle and lower turbinate and septum were performed, the rest being NGs of the middle and lower turbinate only. A descriptive statistical analysis and a Kaplan-Meier survival analysis were carried out and the log-rank statistic was used to compare both techniques.In the present study, 78% of defects were closed in all cases; NF was used in 86% (19) and NG in 63.63% (7). The mean follow-up was 71.5 (95% confidence interval (CI), 56.9-86.1) months. There were no statistically significant differences (p0.05).

Objectives:We report an extremely rare case of a large solitary fibroma of the paranasal sinus, which we treated by sinonasal endoscopic surgery. We describe its clinical and histopathological features, and we report the endoscopic technique used to deal with such a large sinonasal mass (penetrating the pterygomaxillary and infratemporal fossae); we also offer a brief survey of the literature.Case report:A woman presented with an approximately one-year history of nasal obstruction. Nasal endoscopy revealed an irregularly shaped, friable, reddish mass that occupied the whole of the right nasal fossa. Magnetic resonance imaging of the paranasal sinuses revealed a large mass that occupied the anterior and posterior ethmoids and the maxillary and sphenoid sinuses, displacing the septum and penetrating the pterygomaxillary fossa, having destroyed the lateral wall of the right nasal fossa. The tumour was resected by means of sinonasal endoscopic surgery; an endoscopic medial maxillectomy with extension to the pterygomaxillary and infratemporal regions was performed. Histological analysis confirmed the diagnosis of solitary fibrous tumour. During follow up, we performed regular nasal endoscopies, as well as computed tomography scans one and six months post-operatively.Conclusions:Endoscopic techniques are currently the approach of choice for the treatment of such tumours of the sinonasal cavity and pterygomaxillary and infratemporal regions. The size of the lesion did not contraindicate endoscopic sinonasal surgery as a curative treatment.

Background : Dysphonia is a common clinical symptom in children. Methods and results : A seven-year-old boy presented with a chronic dysphonia that was secondary to a subglottal inflammatory pseudotumor. The patient was treated by means of endoscopic microsurgery and is currently asymptomatic and without signs of recidivism. Conclusions : Inflammatory pseudotumor of the larynx is seldom encountered in the pediatric age range, and it is diagnosed by means of specific immunohistochemical techniques. The treatment of choice is endoscopic resection by CO 2 laser. Due to its capacity for recidivism and metastasis, the syndrome requires stringent follow-up.

A study of the objective evaluation of voice was made of 100 voices of healthy adults and 60 with disphonia (nodules and polyps). A laryngostroboscopy and an acoustic analysis was made to everyone. A sustained vowel "a" was carried out and digitalized with Dr. Speech Science software. These parameters were estimated: fundamental frequency (Fo, according to gender), Jitter, Shimmer and glottic noise (NNE, HNR, SNR). In the healthy group Fo was 139.72 in men and 267.33 in women, jitter 0.24 and shimmer 2.10. In disphonic patients (nodules) Fo was 126.96 in men and 240.72 in women, jitter 0.35 and shimmer 3.25. In disphonic patients (polyps) Fo was 119.75 in men and 218.26 in women, jitter 0.50 and shimmer 4.34. These difference were statistically significant. Glottic Noise in healthy group was: NNE -13.62, HNR 24.07 and SNR 24.49; in disphonic patients (nodules) was: NNE -10.65, HNR 25.21 and SNR 25.55; in disphonic patients (polyps) was: NNE -8.24, HNR 29.63 and SNR 28.22. Only the difference in the NNE was statistically significant. We highlight the importance of objective evaluation of voice disorders.

A new surgical technique for the treatment of cholesteatoma is reported. The technique involvesautoexclusion for exteriorization of the attic and tympanic box only. The resulting cavity is rather small.The technique allows visual post-operative control of the attic and tympanic membrane. There isno visual access to the mastoid cavity which, however, is the most unlikely site for occurrenceof a residual cholesteatoma.The proposed technique was applied to 102 patients and both the anatomic and functional resultsobtained are reported.

Endoscopic medial maxillectomy (EMM) is a safe, effective method for the treatment of inverted papillomas (IPs) of the paranasal sinuses.To evaluate the efficacy of EMM as a surgical technique in the treatment of IP compared with non-endoscopic techniques.This was a retrospective study of 52 patients with an IP diagnosed by biopsy from 1990 to 2004. EMM was performed in 34 patients (65.4%), whereas non-endoscopic techniques were used in 18 (34.6%). The mean duration of follow-up was 54.2 months.Recurrence occurred in 4 of the 34 patients who underwent EMM (11.8%; 95% confidence intervals (CI) = 39 at 26%) and in 8 of the 18 patients treated using non-endoscopic techniques (44.4%; 95% CI = 23.2 at 67.3%). There was a statistically significant difference (p0.05) between treatments, assessed by Kaplan-Meier estimator and log-rank testing. Of the 12 patients who suffered a recurrence, 6 (50%) were treated with endoscopic surgery, 4 (33%) with mediofacial degloving and 2 (17%) were merely followed up; no malignant degeneration occurred.

A study of the objective evaluation of voice was made of 100 voices of healthy adults and 60 with disphonia (nodules and polyps). A laryngostroboscopy and an acoustic analysis was made to everyone. A sustained vowel "a" was carried out and digitalized with Dr. Speech Science software. These parameters were estimated: fundamental frequency (Fo, according to gender), Jitter, Shimmer and glottic noise (NNE, HNR, SNR). In the healthy group Fo was 139.72 in men and 267.33 in women, jitter 0.24 and shimmer 2.10. In disphonic patients (nodules) Fo was 126.96 in men and 240.72 in women, jitter 0.35 and shimmer 3.25. In disphonic patients (polyps) Fo was 119.75 in men and 218.26 in women, jitter 0.50 and shimmer 4.34. These difference were statistically significant. Glottic Noise in healthy group was: NNE -13.62, HNR 24.07 and SNR 24.49; in disphonic patients (nodules) was: NNE -10.65, HNR 25.21 and SNR 25.55; in disphonic patients (polyps) was: NNE -8.24, HNR 29.63 and SNR 28.22. Only the difference in the NNE was statistically significant. We highlight the importance of objective evaluation of voice disorders.

A case of osteoma of the ethmoidal sinuses associated with nasal polyposis was treated by endoscopic nasal surgery. The pathophysiology of both diseases is reviewed. The therapeutic strategy is described and the bibliography is reviewed.

In otorhinolaryngology, the relationship between gastroesophageal reflux (GER) and pharyngolaryngeal disorders is well-known. In fact, many patients with GER debut with head and neck symptoms or are first seen by an otolaryngologist. We proposed to identify the ENT symptoms most frequently associated with GER, to differentiate between physiological and pathological GER, and to confirm the effectiveness of antacid treatment. Our study included 20 ambulatory patients who presented pharygolaryngeal symptoms and clinical manifestations of GER (heartburn and regurgitation). The patients underwent a complete ENT examination and were referred to a gastroenterologist for esophagoscopy, manometry, and 24-hour pH monitoring. All patients received antireflux therapy for one month (ranitidine 150 mg given twice daily). We conclude that GER produces a variety of manifestations, but the most frequent pharyngolaryngeal symptoms and physical findings were globus pharyngeus and erythema of the arytenoids, respectively. Pathological GER was found in only one third of our patients and 90% responded well to treatment.

The rate of occurrence of neoplasma arising from the parapharyngeal space is scarce, about 0.5 percent of neck and face tumors. In the paper is reported our 10-year experience on its clinical diagnosis and therapeutical management as well. We have found 13 percent (3/23) malignancies and 87 percent (20/30) benign growth. 35 percent were paragangliomas and 22 percent represent salivary tumors. Diagnostic procedures, ways of approach and surgical complications are considered.

We carried out a clinical study on the manifestations of various connective tissue pathologies of the head and neck. The need to suspect the presence of these pathological entities from non-specific ENT symptoms and performing early diagnoses of cochleovestibular diseases on the basis of a clinical and examination protocol is emphasized.

We present a case of rhinocerebral mucormycosis in a 47 years old woman without diabetic or immunodepression past. The diagnosis was confirmed through a histological study of the material obtained after surgery. The treatment with amphotericin B and radical surgery showed ineffective. The patient died two weeks after entrance. We make an evaluation of the etiopathological, clinical and therapeutic aspects and also a revision of the relevant literature.

The AA. present a review of the expansive processes of the cerebellopontine angle (CPA) diagnosed at their Department, during the six last years. Emphasis is made upon the clinic findings gained through neuro-otological explorations and imaging, both helpful for preoperative diagnosis of the nature of the tumor.