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Copyright is owned by the Société Tunisienne d’ORL & de chirurgie cervico-faciale.
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Mal de pott révelé par un abcès latéropharyngien chez un pilote
Abstract
Introduction: Pott's disease is the most frequent localisation of osteoarticular tuberculosis. The authors report a case of cervical Pott's disease with lateropharyngeal abscess.
Observation: Our patient is a 44 years old pilot; he presented since 6 months cervicalgy, dysphagia and weighting loss. Clinical findings showed a swelling of posterior and lateral oropharyngeal wall extending to hypopharynx. A palsy of the XI th nerve and an abolition of the bicipital reflex were also noticed. CT scan showed a lateropharyngeal collection extending from C4 to D1. It was also noticed a subtotal destruction of C6.
However, there were no medullar lesions in the cervical spine MRI.
Tuberculosis was confirmed thanks to histological analysis of caseum taken during cervical biopy. The patient was operated using anterior approach. He had surgical removal of C6 which was replaced by iliac prothesis. Medical treatment was based on antituberculosis drugs used during 12 months. After three years of follow up, the out come was favourable with no recurrence and satisfying consolidation. For aeronautic considerations, the patient was declared unable for flying mission.
Conclusion: Tuberculosis constitutes a problematic infectious disease in Tunisia which may have serious consequences on publish health. We insist on preventing measurements because there are neither specific clinical findings nor radiological characterising features.
Keywords: Tuberculosis, Pott's disease, lateropharyngeal abscess
Observation: Our patient is a 44 years old pilot; he presented since 6 months cervicalgy, dysphagia and weighting loss. Clinical findings showed a swelling of posterior and lateral oropharyngeal wall extending to hypopharynx. A palsy of the XI th nerve and an abolition of the bicipital reflex were also noticed. CT scan showed a lateropharyngeal collection extending from C4 to D1. It was also noticed a subtotal destruction of C6.
However, there were no medullar lesions in the cervical spine MRI.
Tuberculosis was confirmed thanks to histological analysis of caseum taken during cervical biopy. The patient was operated using anterior approach. He had surgical removal of C6 which was replaced by iliac prothesis. Medical treatment was based on antituberculosis drugs used during 12 months. After three years of follow up, the out come was favourable with no recurrence and satisfying consolidation. For aeronautic considerations, the patient was declared unable for flying mission.
Conclusion: Tuberculosis constitutes a problematic infectious disease in Tunisia which may have serious consequences on publish health. We insist on preventing measurements because there are neither specific clinical findings nor radiological characterising features.
Keywords: Tuberculosis, Pott's disease, lateropharyngeal abscess
