INTRODUCTION Necrotizing otitis externa remains a severe and sometimes life-threatening disease i... more INTRODUCTION Necrotizing otitis externa remains a severe and sometimes life-threatening disease in diabetic patient. Many therapeutic approaches have been described but what about the real benefit of hyperbaric oxygenotherapy in the management of this disease? METHODS The authors reported a retrospective study about 42 patients treated for necrotizing external otitis over a period of 9 years (2006 to 2014). The patients were treated either by only antibiotherapy (23 cases) or with both antibiotherapy and hyperbaric oxygenotherapy (19 cases). The evolution under treatment was appreciated in the two groups through clinical, biological and radiological parameters. RESULTS The study included 42 diabetic patients with a mean age of 67 years (50 to 84 years). The sex-ratio M/F was 0.82. The diagnosis of necrotizing otitis externa was assessed through clinical and bacteriologic criteria in diabetic patients. A temporal bone CT-scan and a technetium scintigraphy were performed in order to p...
INTRODUCTION The consequence of an exposure to intense sounds can be a temporary or permanent hea... more INTRODUCTION The consequence of an exposure to intense sounds can be a temporary or permanent hearing loss and even with a rapid therapeutic management, severe sensorineural sequelae may persist. METHODS the authors report a retrospective study about 64 patients followed for an acute acoustic trauma during a period of 8 years (2006 to 2013). For all the cases, a clinical examination associated to a pure-tone audiometry was conducted. Hearing levels were measured at the frequencies 500, 1000, 2000 and 3000 Hertz. Auditory evoked potentials were performed in 17 cases. The therapeutic and evolutive data were detailed and discussed. RESULTS All our patients were male with a mean age of 34 years. The cause of acoustic trauma was a firing of a gun near the ear in 48 cases, an explosion near the ear in 5 cases and a sudden exposure to loud noises near military planes in 11 cases. Clinical complaints were acute hearing loss with tinnitus. Audiometric exams found a sensorineural hearing loss...
Idiopathic or Bell's palsy is an acute peripheral-nerve palsy involving the facial nerve. The... more Idiopathic or Bell's palsy is an acute peripheral-nerve palsy involving the facial nerve. The disorder is quite infrequent under the age of 10 years. The proposed etiologies of Bell's palsy include ischemic neuropathy and vascular diseases. This case series presents five children with Bell's palsy. The epidemiologic, diagnostic and therapeutic measures were summarized. The evolution regarding especially the facial motricity was detailed. The results about the role of some thrombophilic polymorphisms suggest a probable involvement of factor V haplotype, MTHFR and factor XIII in the etiology of Bell's palsy in five Tunisian children.
INTRODUCTION Combat-related facial injuries involve various lesions of the mouth, the eye sockets... more INTRODUCTION Combat-related facial injuries involve various lesions of the mouth, the eye sockets and the facial bones. The goal of this study is to precise the particularities of these affections and their therapeutic management. METHODS A retrospective study was performed about 56 cases of combat-related facial injuries over a period of 5 years (2010 - 2014). RESULTS Our study included 56 male patients with an average age of 29 years (20-37). The trauma occurred during a real security intervention in all the cases. It was isolated in 18 cases and associated to other lesions in 38 cases. Clinical examination revealed facial edema (57%), facial cuts and lacerations (74%), broken teeth (14%), nasal deformation (26%), skin defect (16%) and periorbital ecchymosis (32%). The diagnosis retained after clinical examination and imaging exams were: fractures of the mandible (34 cases), of the eye sockets (18 cases), of the nasal bones (15 cases), parotid gland injury (5 cases) and facial ar...
Le kyste de Thomwald est une formation kystique benigne de la paroi postero superieure du rhinoph... more Le kyste de Thomwald est une formation kystique benigne de la paroi postero superieure du rhinopharynx due a l'occlusion de la bourse pharyngienne. Il s'agit d'une affection rare qui est generalement asymptomatique. Nous rapportons le cas d'un pilote helicoptere âge de 27 ans qui a presente des barotraumatismes auriculaires et sinusiens recidivants. Le diagnostic de kyste de Thomwald est retenu sur les donnees des examens endoscopique et tomodensitometrique. Le traitement est chirurgical par marsupialisation du kyste par voie endonasale. L'inaptitude totale a ete pour ce pilote de 87 jours. L'evolution a ete favorable avec une recuperation permanente de la permeabilite des fosses nasales et de la fonction de la trompe auditive. Le recul est de 4 ans.
Pan African Medical Journal Conference Proceedings, 2018
Introduction : les infections sexuellement transmissibles (IST) continuent a predominer en Afriqu... more Introduction : les infections sexuellement transmissibles (IST) continuent a predominer en Afrique sub-saharienne constituant un reel probleme de sante publique et un reservoir important de propagation. En Tunisie, tout militaire etranger beneficie systematiquement d’une serologie virale et syphilitique dans le cadre d’une visite d’aptitude au stage realisee au Centre d’Expertise de Medecine Aeronautique (CEMEDA). Methodes : il s’agit d’une etude retrospective effectuee au CEMEDA sur une periode de 5 ans (Mai 2011-Mai 2016) portant sur 226 militaires africains originaire de 11 pays differents candidats pour un stage en Tunisie. Nous avons collige et analyse les resultats des serologies de l’hepatite B, C, du VIH et de la syphilis chez cette population afin de determiner leur prevalence totale, par region et par pays. Les tests serologiques ont ete realises au centre militaire de transfusion sanguine (CMTS) par: methode immuno-enzymatique ELISA 3eme Generation pour l’hepatite B et C, ELISA 4eme Generation pour le VIH, et reaction d’inhibition de l’hemagglutination comme test treponemique. Un test rapide par technique immuno-chromatographique associe a un test non treponemique (RPR Charbon) ont ete realises en parallele au CEMEDA pour la serologie syphilitique.
Patients with incapacitating Meniere Disease (MD) suffer in their daily lives and activities beca... more Patients with incapacitating Meniere Disease (MD) suffer in their daily lives and activities because of the dizziness and anxiety induced by MD. Minimally Invasive Vestibular Neurotomy (MIVN) is a safe and effective surgical treatment for these individuals, and improved their dizziness and anxiety. This study aimed to assess the state of dizziness and anxiety of patients with incapacitating MD and its improvement through MIVN. A total of 118 patients with incapacitating MD who underwent MIVN in France and Japan were evaluated. The DHI (Dizziness Handicap Inventory), SAST (Short Anxiety Screening Test), and STAI (State Trait Anxiety Index) questionnaires were used to evaluate disequilibrium and anxiety. The MIVN method appears safe and effective for patients with incapacitating MD. Pre-operative assessment results by DHI and SAST were significantly related to each other, and were influenced by lifestyle and profession. This prospective study showed that MIVN improved dizziness and an...
Le gliome du tronc cérébral : cause rare de vertige central de l'adulte Brain stem glioma: a rare... more Le gliome du tronc cérébral : cause rare de vertige central de l'adulte Brain stem glioma: a rare cause of central vertigo in adults
Nova Journal of Medical and Biological Sciences, 2016
Introduction: Tuberculosis remains a real public health problem in Tunisia. Extrapulmonary locali... more Introduction: Tuberculosis remains a real public health problem in Tunisia. Extrapulmonary localizations account for 20 to 30% of tuberculosis disease, dominated by the node, osseous and urogenital localization. Case Report: The authors present three cases of nasosinusal tuberculosis, an unusual and rare localization of the disease, in a man and 2 women aged respectively of 30, 65 and 36 years. Results: The main symptoms were dominated by nasal obstruction, posterior throwing and dental pain. CT-scan showed a filling of the nasosinusal cavities with various stages of bony lysis. In all the cases, tuberculosis was confirmed histologically after an endoscopic middle meatotomy. Investigations looking for tuberculosis elsewhere were negative in all cases. Treatment was based on anti-tuberculosis drugs during 9 to 12 months. The evolution was favourable in all the cases. Conclusions: Nasosinusal tuberculosis is a rare chronic infection associating often variable levels of bony lysis. Histological exam remains the best way to confirm it. Therapy is based on anti-tuberculosis drugs. Medical investigations must usually search other localizations of the disease.
Les plasmocytomes solitaires sont des tumeurs rares qui appartiennent au groupe des dysplasies my... more Les plasmocytomes solitaires sont des tumeurs rares qui appartiennent au groupe des dysplasies myéloides de type B et se développent assez souvent au niveau des voies aérodigestives supérieures et des os cranio-faciaux (1). Ils représentent moins de 1% des cancers de la tête et du cou et moins de 0,4% des cancers des voies aéro-digestives supérieures (2). La localisation naso-sinusienne est exceptionnelle (3). Conclusion Le plasmocytome des fosses nasales de diagnostic essentiellement histologique, est une tumeur rare. Son traitement repose sur des compétences techniques avancées nécessitant la mise en place d'une multidisciplinarité à toutes les étapes de la prise en charge. La chirurgie complète associée à la radiothérapie postopératoire apporte la meilleure probabilité de contrôle local. Références
To compare preoperative CT scan finding and per-operative lesions in patients operated for middle... more To compare preoperative CT scan finding and per-operative lesions in patients operated for middle ear cholesteatoma, A retrospective study including 60 patients with cholesteatoma otitis diagnosed and treated within a period of 5 years, from 2001 to 2005, at ENT department of Military Hospital of Tunis. All patients had computed tomography of the middle and inner ear. High resolution CT scan imaging was performed using millimetric incidences (3 to 5 millimetres). All patients had surgical removal of their cholesteatoma using down wall technic. We evaluated sensitivity, specificity and predictive value of CT-scan comparing otitic damages and CT finding, in order to examine the real contribution of computed tomography in cholesteatoma otitis. CT scan analysis of middle ear bone structures shows satisfaction (with 83% of sensibility). The rate of sensibility decrease (63%) for the tympanic raff. Predictive value of CT scan for the diagnosis of cholesteatoma was low. However, we have no...
INTRODUCTION Necrotizing otitis externa remains a severe and sometimes life-threatening disease i... more INTRODUCTION Necrotizing otitis externa remains a severe and sometimes life-threatening disease in diabetic patient. Many therapeutic approaches have been described but what about the real benefit of hyperbaric oxygenotherapy in the management of this disease? METHODS The authors reported a retrospective study about 42 patients treated for necrotizing external otitis over a period of 9 years (2006 to 2014). The patients were treated either by only antibiotherapy (23 cases) or with both antibiotherapy and hyperbaric oxygenotherapy (19 cases). The evolution under treatment was appreciated in the two groups through clinical, biological and radiological parameters. RESULTS The study included 42 diabetic patients with a mean age of 67 years (50 to 84 years). The sex-ratio M/F was 0.82. The diagnosis of necrotizing otitis externa was assessed through clinical and bacteriologic criteria in diabetic patients. A temporal bone CT-scan and a technetium scintigraphy were performed in order to p...
INTRODUCTION The consequence of an exposure to intense sounds can be a temporary or permanent hea... more INTRODUCTION The consequence of an exposure to intense sounds can be a temporary or permanent hearing loss and even with a rapid therapeutic management, severe sensorineural sequelae may persist. METHODS the authors report a retrospective study about 64 patients followed for an acute acoustic trauma during a period of 8 years (2006 to 2013). For all the cases, a clinical examination associated to a pure-tone audiometry was conducted. Hearing levels were measured at the frequencies 500, 1000, 2000 and 3000 Hertz. Auditory evoked potentials were performed in 17 cases. The therapeutic and evolutive data were detailed and discussed. RESULTS All our patients were male with a mean age of 34 years. The cause of acoustic trauma was a firing of a gun near the ear in 48 cases, an explosion near the ear in 5 cases and a sudden exposure to loud noises near military planes in 11 cases. Clinical complaints were acute hearing loss with tinnitus. Audiometric exams found a sensorineural hearing loss...
Idiopathic or Bell's palsy is an acute peripheral-nerve palsy involving the facial nerve. The... more Idiopathic or Bell's palsy is an acute peripheral-nerve palsy involving the facial nerve. The disorder is quite infrequent under the age of 10 years. The proposed etiologies of Bell's palsy include ischemic neuropathy and vascular diseases. This case series presents five children with Bell's palsy. The epidemiologic, diagnostic and therapeutic measures were summarized. The evolution regarding especially the facial motricity was detailed. The results about the role of some thrombophilic polymorphisms suggest a probable involvement of factor V haplotype, MTHFR and factor XIII in the etiology of Bell's palsy in five Tunisian children.
INTRODUCTION Combat-related facial injuries involve various lesions of the mouth, the eye sockets... more INTRODUCTION Combat-related facial injuries involve various lesions of the mouth, the eye sockets and the facial bones. The goal of this study is to precise the particularities of these affections and their therapeutic management. METHODS A retrospective study was performed about 56 cases of combat-related facial injuries over a period of 5 years (2010 - 2014). RESULTS Our study included 56 male patients with an average age of 29 years (20-37). The trauma occurred during a real security intervention in all the cases. It was isolated in 18 cases and associated to other lesions in 38 cases. Clinical examination revealed facial edema (57%), facial cuts and lacerations (74%), broken teeth (14%), nasal deformation (26%), skin defect (16%) and periorbital ecchymosis (32%). The diagnosis retained after clinical examination and imaging exams were: fractures of the mandible (34 cases), of the eye sockets (18 cases), of the nasal bones (15 cases), parotid gland injury (5 cases) and facial ar...
Le kyste de Thomwald est une formation kystique benigne de la paroi postero superieure du rhinoph... more Le kyste de Thomwald est une formation kystique benigne de la paroi postero superieure du rhinopharynx due a l'occlusion de la bourse pharyngienne. Il s'agit d'une affection rare qui est generalement asymptomatique. Nous rapportons le cas d'un pilote helicoptere âge de 27 ans qui a presente des barotraumatismes auriculaires et sinusiens recidivants. Le diagnostic de kyste de Thomwald est retenu sur les donnees des examens endoscopique et tomodensitometrique. Le traitement est chirurgical par marsupialisation du kyste par voie endonasale. L'inaptitude totale a ete pour ce pilote de 87 jours. L'evolution a ete favorable avec une recuperation permanente de la permeabilite des fosses nasales et de la fonction de la trompe auditive. Le recul est de 4 ans.
Pan African Medical Journal Conference Proceedings, 2018
Introduction : les infections sexuellement transmissibles (IST) continuent a predominer en Afriqu... more Introduction : les infections sexuellement transmissibles (IST) continuent a predominer en Afrique sub-saharienne constituant un reel probleme de sante publique et un reservoir important de propagation. En Tunisie, tout militaire etranger beneficie systematiquement d’une serologie virale et syphilitique dans le cadre d’une visite d’aptitude au stage realisee au Centre d’Expertise de Medecine Aeronautique (CEMEDA). Methodes : il s’agit d’une etude retrospective effectuee au CEMEDA sur une periode de 5 ans (Mai 2011-Mai 2016) portant sur 226 militaires africains originaire de 11 pays differents candidats pour un stage en Tunisie. Nous avons collige et analyse les resultats des serologies de l’hepatite B, C, du VIH et de la syphilis chez cette population afin de determiner leur prevalence totale, par region et par pays. Les tests serologiques ont ete realises au centre militaire de transfusion sanguine (CMTS) par: methode immuno-enzymatique ELISA 3eme Generation pour l’hepatite B et C, ELISA 4eme Generation pour le VIH, et reaction d’inhibition de l’hemagglutination comme test treponemique. Un test rapide par technique immuno-chromatographique associe a un test non treponemique (RPR Charbon) ont ete realises en parallele au CEMEDA pour la serologie syphilitique.
Patients with incapacitating Meniere Disease (MD) suffer in their daily lives and activities beca... more Patients with incapacitating Meniere Disease (MD) suffer in their daily lives and activities because of the dizziness and anxiety induced by MD. Minimally Invasive Vestibular Neurotomy (MIVN) is a safe and effective surgical treatment for these individuals, and improved their dizziness and anxiety. This study aimed to assess the state of dizziness and anxiety of patients with incapacitating MD and its improvement through MIVN. A total of 118 patients with incapacitating MD who underwent MIVN in France and Japan were evaluated. The DHI (Dizziness Handicap Inventory), SAST (Short Anxiety Screening Test), and STAI (State Trait Anxiety Index) questionnaires were used to evaluate disequilibrium and anxiety. The MIVN method appears safe and effective for patients with incapacitating MD. Pre-operative assessment results by DHI and SAST were significantly related to each other, and were influenced by lifestyle and profession. This prospective study showed that MIVN improved dizziness and an...
Le gliome du tronc cérébral : cause rare de vertige central de l'adulte Brain stem glioma: a rare... more Le gliome du tronc cérébral : cause rare de vertige central de l'adulte Brain stem glioma: a rare cause of central vertigo in adults
Nova Journal of Medical and Biological Sciences, 2016
Introduction: Tuberculosis remains a real public health problem in Tunisia. Extrapulmonary locali... more Introduction: Tuberculosis remains a real public health problem in Tunisia. Extrapulmonary localizations account for 20 to 30% of tuberculosis disease, dominated by the node, osseous and urogenital localization. Case Report: The authors present three cases of nasosinusal tuberculosis, an unusual and rare localization of the disease, in a man and 2 women aged respectively of 30, 65 and 36 years. Results: The main symptoms were dominated by nasal obstruction, posterior throwing and dental pain. CT-scan showed a filling of the nasosinusal cavities with various stages of bony lysis. In all the cases, tuberculosis was confirmed histologically after an endoscopic middle meatotomy. Investigations looking for tuberculosis elsewhere were negative in all cases. Treatment was based on anti-tuberculosis drugs during 9 to 12 months. The evolution was favourable in all the cases. Conclusions: Nasosinusal tuberculosis is a rare chronic infection associating often variable levels of bony lysis. Histological exam remains the best way to confirm it. Therapy is based on anti-tuberculosis drugs. Medical investigations must usually search other localizations of the disease.
Les plasmocytomes solitaires sont des tumeurs rares qui appartiennent au groupe des dysplasies my... more Les plasmocytomes solitaires sont des tumeurs rares qui appartiennent au groupe des dysplasies myéloides de type B et se développent assez souvent au niveau des voies aérodigestives supérieures et des os cranio-faciaux (1). Ils représentent moins de 1% des cancers de la tête et du cou et moins de 0,4% des cancers des voies aéro-digestives supérieures (2). La localisation naso-sinusienne est exceptionnelle (3). Conclusion Le plasmocytome des fosses nasales de diagnostic essentiellement histologique, est une tumeur rare. Son traitement repose sur des compétences techniques avancées nécessitant la mise en place d'une multidisciplinarité à toutes les étapes de la prise en charge. La chirurgie complète associée à la radiothérapie postopératoire apporte la meilleure probabilité de contrôle local. Références
To compare preoperative CT scan finding and per-operative lesions in patients operated for middle... more To compare preoperative CT scan finding and per-operative lesions in patients operated for middle ear cholesteatoma, A retrospective study including 60 patients with cholesteatoma otitis diagnosed and treated within a period of 5 years, from 2001 to 2005, at ENT department of Military Hospital of Tunis. All patients had computed tomography of the middle and inner ear. High resolution CT scan imaging was performed using millimetric incidences (3 to 5 millimetres). All patients had surgical removal of their cholesteatoma using down wall technic. We evaluated sensitivity, specificity and predictive value of CT-scan comparing otitic damages and CT finding, in order to examine the real contribution of computed tomography in cholesteatoma otitis. CT scan analysis of middle ear bone structures shows satisfaction (with 83% of sensibility). The rate of sensibility decrease (63%) for the tympanic raff. Predictive value of CT scan for the diagnosis of cholesteatoma was low. However, we have no...
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Papers by Ali MARDASSI