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La myiase est une maladie causee par les larves de mouches. La localisation auriculaire (otomyiase) est une affection rare, causee frequemment par les especes de la famille des sarcophages. Elle survient souvent sur des lesions chroniques negligees chez des personnes dont l´hygiene est precaire. Depuis longtemps au Maroc la myiase a ete decrite. Cependant, peu d´etudes epidemiologiques ont ete consacrees a cette affection. Nous rapportons dans ce travail l´observation de deux patientes recues et prises en charge aux Urgences d´Oto-rhino-laryngologie et de Chirurgie Cervico-faciale a l´Hopital des Specialites (CHIS), Rabat, Maroc.

Le syndrome de Lemierre « SL » est une maladie rare qui prend son origine tres souvent d´une infection oropharyngee se compliquant d´une thrombose septique de la veine jugulaire interne et d´emboles septiques a predominance pulmonaire dans sa forme typique. Dans notre cas, le SL n´est qu´un tableau revelateur d´un carcinome epidermoide de la bouche œsophagienne surinfecte. Tout retard diagnostic ou de prise en charge peut etre responsable d´une morbi-mortalite elevee. Son diagnostic repose sur : un faisceau d´arguments cliniques, radiologiques dont la TDM cervico thoracique avec injection du produit de contraste trouve tout son interet ainsi que sur des examens bacteriologiques surtout dans les formes atypiques. Le traitement est principalement medical base sur une antibiotherapie ciblee urgente et prolongee, l´anticoagulation reste tres discutee cas par cas, et le traitement chirurgical est reserve a des cas bien particuliers.

Kikuchi-Fujimoto's disease KFD is a rare and benign cause of cervical lymphadenopathy. It is an anatomoclinical entity of unknown etiology. The confirmation of the diagnosis is always provided by histological lymph node study. The clinical picture sometimes evokes lymphoma or tuberculosis. The evolution is generally favorable with spontaneous healing after a few weeks. We report the case of a 26-year-old woman who had consulted for cervical lymphadenopathy associated with fever. The cervical lymph node biopsy concluded to Kikuch-Fujimoto's disease. The evolution was marked by rapid regression of lymphadenopathy under corticosteroid treatment.

Tuberculosis is a chronic granulomatous infection caused by Mycobacterium tuberculosis or bovis that can affect all organs. However being located in the salivary glands is rare, affecting mainly adults between 20 and 50 years, although a few cases were described in children. We reported a series of 4 children with parotid TB diagnosed and treated at the ENT department of the hospital of specialties of Rabat.The average age was 9.25 years and sex ratio M/F was 1. All children were admitted for parotid swelling evolving over an average period of 6 months which fistulized afterwards, a child had also facial paralysis. Histological analysis of the fine-needle aspiration or the sample taken from the fistula confirmed the diagnosis of tuberculosis with the presence of giant cell granuloma with caseous necrosis. All children received anti-bacillary treatment during 6 months, and showed good evolution.Although being rare, the parotid TB in children remains a condition to be considered at the occurrence of any chronic parotid swelling, especially in endemic countries.

Introduction: Cervical lymph node involvement has a major impact on prognosis and treatment decisions in patients with upper aerodigestive tract (UADT) cancer.Objective: The aim of this study was to assess the incidence and pattern of cervical lymph node (LN) metastases in cancers of the upper aerodigestive tractMethods: This prospective study was conducted by the Department of ENT and Maxillofacial Surgery at Specialities University Hospital of Rabat, collecting data between October 2009 and December 2011. Lymph nodes were counted, clinically and radiologically localized, excised, then studied histologically.Results: During this period, 106 patients have been treated surgically with a recent diagnosis of UADT cancer. The average age of our patients was 55±13.3 years, while male/female ratio was 3.5 to 1. More than half of our patients were operated with cancer of the larynx (58.5%, n=62); 27.4% (n=29) of patients suffered from oral cavity cancer and 14.2% (n=15) had cancer of the hypopharinx. Cervical lymph node invasion was estimated at 31.2% clinically, and 38.7% radiologically and histologically, distributed in different sites.Although the percentage of the invasion is almost similar clinically, radiologically and histologically, the high number of false positives and true negatives according to clinical and radiological exams confirms that specificity and sensitivity of these two exams is still poor compared to histology.Conclusion: Thus, cervical metastases have to be diagnosed histologically. Moreover, the low percentage of lymph node invasions in the case of a UADT cancer suggests that the use of sentinel lymph node technique could be important, as it has been validated for small T1T2N0 tumors in the oral cavity. Further studies are needed to confirm its validity in case of other UADT tumor types.

Introduction: Synovial sarcoma is a highly malignant tumor affecting mostly extremities of young adult. The nasal location represents less than 1% cases. Only a few sporadic cases have been reported. Its treatment is not well established. Case report: We report the case of a synovial sarcoma of nasal cavity in a 16 years old patient characterized by its recurrent character being controlled by a treatment combining surgery and chemoradiotherapy. Discussion: We will discuss the various radio-clinical, histological and therapeutic particularities referring to a literature review.

Le syndrome de Gorlin et Goltz est une affection hereditaire, a transmission autosomique dominante, due a une mutation du gene PTCH ayant pour localisation chromosomique 9q 22.3-q31. C’est un syndrome rare qui se caracterise par un spectre d’anomalies du developpement et par une predisposition a differents cancers. La complexite des signes cliniques a conduit a etablir des criteres specifiques pour faciliter le diagnostic. La prise en charge therapeutique est symptomatique, avec une surveillance carcinologique rigoureuse. Nous rapportons une nouvelle observation de syndrome de Gorlin et Goltz chez un adolescent de 17 ans et, a travers une revue de litterature, nous discutons les principales caracteristiques de cette rare affection. Med Buccale Chir Buccale 2007 ; 13 : 97-101.