Houda Chahed

Faculty of Medecine of Tunis, Tunis-Ville, Tūnis, Tunisia

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Publications (11)4.18 Total impact

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    ABSTRACT: To discuss clinical presentation and therapeutic approaches of facial paralysis in acute otitis media. We present five cases of facial palsy in children with acute otitis media managed in our ENT department during a period of 12 years (2001-2012). The mean age was 14.2years; sex ratio was 0.66. All patients presented with a facial asymmetry, but only 3 of them had otalgia before the onset of facial asymmetry. The facial palsy delay was 3.3days. The ear examination showed that the tympanic membrane was congestive in 4 patients, associated with a bulging in 2 patients, and a small perforation in one patient. Our patients presented grade III to IV initial facial palsy according to House and Brackmann staging. Computed tomography scan revealed a dehiscence of the bony facial canal in one patient. Antibiotic therapy associated with intravenous corticosteroids was administered in all patients. All patients underwent a facial kinesis therapy. A progressive improvement of facial palsy was observed in 4 patients and complete recovery of facial function in one case. Conservative treatment associating intravenous antibiotic and corticosteroids with or without myringotomy is the standard approach.
    La Presse Médicale 04/2014; · 0.87 Impact Factor
  • La Tunisie médicale 04/2014; 92(4):286-7.
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    ABSTRACT: A nasosinus mucocele is a pseudocystic process filled with mucus arising within the sinus. Despite its benign histology, potential ophthalimic risks are related to mass effect and expansion to the orbit by bone destruction with compression of optic nerves. We describe mechanisms of ophthalimic involvement in patients with paranasal sinus mucoceles, radiological appearance, treatment and prognosis of this disease. We report 5 cases of paranasal sinus mucocele with ophthalmic complications seen between January 2007 and December 2011 on the ENT and MFS service of La Rabta University hospital. The reason for consultation was: unilateral proptosis in 4 patients, diplopia in 2 patients and medial canthal swelling in 3 patients. Facial computed tomography showed a mucocele in the frontal sinus in two patients, in the ethmoid-frontal sinuses in two patients and in the ethmoid-maxillary sinuses in one patient. We found erosion of the orbital walls and displacement of the globe in all cases, extra-axial proptosis in one case, compression of the extraocular muscles in 4 cases and stretching of the optic nerve in three cases. All patients were treated initially with antibiotics then surgery. The postoperative course was uneventful with no recurrence. It is necessary to diagnose mucoceles as early as possible and plan surgical excision before growth of the mass irreversibly compromises visual function.
    Journal francais d'ophtalmologie 02/2014; · 0.51 Impact Factor
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    ABSTRACT: Objects To discuss clinical presentation and therapeutic approaches of facial paralysis in acute otitis media. Methods We present five cases of facial palsy in children with acute otitis media managed in our ENT department during a period of 12 years (2001–2012). Results The mean age was 14.2 years; sex ratio was 0.66. All patients presented with a facial asymmetry, but only 3 of them had otalgia before the onset of facial asymmetry. The facial palsy delay was 3.3 days. The ear examination showed that the tympanic membrane was congestive in 4 patients, associated with a bulging in 2 patients, and a small perforation in one patient. Our patients presented grade III to IV initial facial palsy according to House and Brackmann staging. Computed tomography scan revealed a dehiscence of the bony facial canal in one patient. Antibiotic therapy associated with intravenous corticosteroids was administered in all patients. All patients underwent a facial kinesis therapy. A progressive improvement of facial palsy was observed in 4 patients and complete recovery of facial function in one case. Discussion Conservative treatment associating intravenous antibiotic and corticosteroids with or without myringotomy is the standard approach.
    La Presse Médicale. 01/2014;
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    ABSTRACT: Introduction A nasosinus mucocele is a pseudocystic process filled with mucus arising within the sinus. Despite its benign histology, potential ophthalimic risks are related to mass effect and expansion to the orbit by bone destruction with compression of optic nerves. Purpose We describe mechanisms of ophthalimic involvement in patients with paranasal sinus mucoceles, radiological appearance, treatment and prognosis of this disease. Materials and methods We report 5 cases of paranasal sinus mucocele with ophthalmic complications seen between January 2007 and December 2011 on the ENT and MFS service of La Rabta University hospital. Results The reason for consultation was: unilateral proptosis in 4 patients, diplopia in 2 patients and medial canthal swelling in 3 patients. Facial computed tomography showed a mucocele in the frontal sinus in two patients, in the ethmoid-frontal sinuses in two patients and in the ethmoid-maxillary sinuses in one patient. We found erosion of the orbital walls and displacement of the globe in all cases, extra-axial proptosis in one case, compression of the extraocular muscles in 4 cases and stretching of the optic nerve in three cases. All patients were treated initially with antibiotics then surgery. The postoperative course was uneventful with no recurrence. Conclusion It is necessary to diagnose mucoceles as early as possible and plan surgical excision before growth of the mass irreversibly compromises visual function.
    Journal francais d'ophtalmologie 01/2014; · 0.51 Impact Factor
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    ABSTRACT: Mutations in GJB2 are found to be responsible for 50% of congenital autosomal recessive non-syndromic hearing loss, one of the most important mutations in this gene is the c.35delG, which is responsible for the majority of GJB2 related deafness in the Tunisian population. The aim of this study was to determine the molecular etiology of hearing loss in two Tunisian individuals. We screened two Tunisian individuals affected by congenital, bilateral, profound, sensorineural hearing loss for mutations in GJB2 gene using PCR and direct sequencing. We identified a novel frameshift mutation in the GJB2 gene, the c.405delC resulting in a truncated protein (p.Tyr136Thrfs*32). It was found in compound heterozygosity with the c.35delG in two non-consanguineous unrelated families from Tunisia. One patient underwent a cochlear implant at 4 years. Initial evaluations post-implantation indicate a successful cochlear implant outcome since the patient began to acquire language abilities and auditory sensation. With this novel GJB2 mutation, the mutational spectrum of this gene continues to broaden in our population. The occurrence of biallelic GJB2 mutations for the other deaf girl, despite the neonatal pain and hypotension due to complicated delivery, led us to confirm the importance of GJB2 screening for cochlear implant candidates regardless of the etiology of deafness in populations with a relatively high frequency of GJB2 mutation carriers.
    International journal of pediatric otorhinolaryngology 07/2013; · 0.85 Impact Factor
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    Egyptian Journal of Ear, Nose, Throat and Allied Sciences. 03/2013; 14(1):51–53.
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    ABSTRACT: Arteriovenous malformation (AVM) of the head and neck is rare but a life threatening benign condition. This paper reports a case of arteriovenous malformation located in the maxillary sinus, in a 16-year-old girl. Her main complaints were nasal obstruction and rhinorrhea. Computed tomography (CT) scan and magnetic resonance imaging (MRI) evoked this entity. Complete tumor removal was performed by the Degloving approach without significant bleeding. The clinical features, therapeutic approaches and the differential diagnosis are discussed.
    Egyptian Journal of Ear, Nose, Throat and Allied Sciences. 03/2013; 14(1):47–50.
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    ABSTRACT: Granulomatous invasive aspergillosis rhinosinusitis is a rare disease. Anatomopathologic and mycological examination allows the diagnosis. Treatment must be rapidly started in order to avoid orbital and intracranial complications. To analyze the main clinical, radiological, histopathological, mycological and therapeutic aspects of granulomatous invasive aspergillosis rhinosinusitis. This is a retrospective study included five patients operated for granulomatous invasive aspergillosis rhinosinusitis at the Otorhinolaryngology Head and Neck Department of La Rabta Hospital from 2000 to 2011. These are four women and one man with mean age of 24.8 years. Functional symptoms were dominated by nasal obstruction and purulent rhinorrhea. Imaging showed a unilateral pansinusien filling extended to the nasal cavity with bone lysis. An orbital and endocranial extension was noted in two cases. Endonasal approach was performed in four patients and external approach in one patient. Anatomopathologic and mycological examination confirmed the diagnosis. All patients were started on antifungal therapy. One reccurence had been noted. Endonasal approach was performed. Granulomatous invasive aspergillosis rhinosinusitis is a rare infection. The prognosis is particularly serious which warrants a rapid therapeutic care to avoid complications.
    Journal de Mycologie Médicale/Journal of Medical Mycology 12/2012; 22(4):316-21. · 0.74 Impact Factor
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    ABSTRACT: INTRODUCTION: Paranasal sinuses mucoceles are extremely rare in children and adolescents. The objective of this study was to assess their clinical presentations and the contribution of endoscopic surgery in their management. MATERIAL AND METHODS: we retrospectively reviewed 11 children with paranasal sinus mucoceles who were managed during a period of 15 years (1995-2009). RESULTS: The mean age was 11.8 years with a sex ratio of 2.66. One patient had a history of nasal polyposis surgery. The symptomatology was dominated by ophthalmological complains. The ethmoïd sinus was the main localization. Orbital extension was found in eight cases, pyomucocele in one case. The surgical management was endoscopic (nine cases), and by an external approach (two cases). Two cases of recurrence were assessed. The mean follow-up was 22.3 months. DISCUSSION: Paranasal sinuses mucocele is exceptional in children. Cystic fibrosis is the main etiologic factor. The symptoms depend on the location and size of the mucocele. The treatment is surgical and most authors prefer the endoscopic approach.
    Revue de stomatologie et de chirurgie maxillo-faciale 07/2012; · 0.35 Impact Factor
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    ABSTRACT: Nasolabial cysts (NLC) are a rare condition presenting as cystic epithelial lesion. We report the clinical and radiological (CT scan) aspects of this rare clinical entity and we assess the various available surgical treatment. Fifty-four patients presenting with NLC underwent surgery between 2000 and 2009. The diagnosis was made on clinical and radiological arguments and confirmed by histological examination after surgical excision. The studied parameters were: gender, functional signs having led to consultation, localization, results of radiological exploration, treatment modalities, anatomopathology and postoperative evolution. The average age of the 30 men and 24 women was 38 years with extremes ranging between 24 and 53 years. The reason for consultation was swelling of the anterior nasal floor in every case and a nasal obstruction for 33 patients. The average time between initial swelling and consultation was 18 months. Swelling was unilateral for 52 patients. CT scan was prescribed for 20 patients and revealed a cystic mass with an average diameter of 23 mm. Cyst excision was made under general anesthesia in every case. Most of the patients (52) were operated via a vestibular approach. Histological examination confirmed the diagnosis of nasolabial cyst in every case. NLC is a rare condition which must be suggested when a cystic mass is found in the anterior nasal floor. CT scan confirms the diagnosis and cyst extension. Cyst excision is performed by vestibular approach. The endoscopic marsupialization is an interesting new therapeutic alternative.
    Revue de stomatologie et de chirurgie maxillo-faciale 06/2011; 112(3):151-4. · 0.35 Impact Factor