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Based on the American Speech-Language-Hearing Association (ASHA) Consensus Statement on central auditory processing and models for their exploration, a battery of audiological tests (Bilan Auditif Central--BAC) has been designed in French. The BAC consists of four types of psycho-acoustic tests: a speech-in-noise test, a dichotic test, a temporal processing test and a binaural interaction test. We briefly describe the rationale of these tests. The BAC is available in digital format. Descriptive statistics were computed on data obtained from 668 subjects divided into 15 age-groups ranging from 5 to 85 years old or over. All subjects had no complaints regarding hearing loss, normal tonal audiometry, and normal intelligence. Tests scores of the speech-in-noise test, the dichotic test and the binaural interaction test showed a normal distribution. Test scores of the temporal processing test did not follow a normal distribution. Effects of maturation and involution were clearly visible for all tests. The low correlation between scores obtained from the four tests pointed to the need for a battery of several tests to assess central auditory processing. We claim that the reported scores represent standard norms for the normal French-speaking population, and believe that the tests will be useful for evaluation of central auditory processing.

Bilateral facial paralysis or paresis of peripheral origin is a rare condition and therefore represents a diagnostic challenge. We here present a case of a previously healthy woman who was hospitalized for symptoms of meningitis. On the second day of her hospital stay, she developed bilateral facial paresis. Later, the patient developed also tachycardia and dysrhythmias. A thorough diagnostic procedure including lumbar puncture, routine blood investigation with serological tests, MRI of the brain, Holter monitoring and transoesophageal echocardiographia, revealed meningitis with radiculitis, facial paresis and myocarditis. The clinical triad of meningitis, radiculitis and facial palsy is known as the Bannwarth Syndrome (Lyme disease). The patient was treated with ceftriaxone and recovered well. Despite repeatedly taken serological tests, Borrelia burgdorferi immunoglobulins were not detected. Acquired bilateral facial paralysis can occur in several diseases of infectious, neurological, idiopathic, iatrogenic, toxic, neoplastic or traumatic origin. In this article, we review the differential diagnoses and treatment options of bilateral facial paresis and present a scheme that is helpful in the diagnostic evaluation of this condition.

Macrolides are used primarily as antibiotics, but they may have other effects. This was first suggested after clinical experience showed that macrolides have an important therapeutic role some inflammatory airway diseases in which infection is not considered as an important etiologic factor. In vitro, ex vivo and in vivo experiments revealed that macrolides reinforce local defense mechanisms in the upper respiratory tract such as mucociliary clearance and epithelial impermeability. In addition, macrolides influence acute inflammation, by altering concentrations of cytokines and changing leucocyte functions. This paper aims to review the current knowledge on the non-antibiotic effects of macrolides on local defense mechanisms and acute inflammation in the upper respiratory tract.

Solitary extramedullary plasmacytomas are rare tumors that often affect head and neck region. Because of the non-specific associated symptomatology, they frequently are misdiagnosed. We briefly describe a 69-year-old woman who developed solitary plasmacytoma in the left maxillary sinus and was initially treated as having sinusitis. We also report the diagnostic work-up that is necessary to establish a correct diagnosis in such cases. This case highlights that an appropriate investigation for neoplastic disease should be performed in patients presenting with persistent symptoms that resemble those of sinusitis, especially if these do not resolve after conservative medical treatment.

The yellow nail syndrome is a rare clinical entity which combines three main features: yellow discolouration of the nails, chronic lymphedema, and pleural effusion. Since 1994, chronic rhinosinusitis is associated in this syndrome. A lot of other pathologic conditions are often present. The most frequent are: bronchiectasis, recurrent pneumonia, pericardic effusion, humoral immunity deficiencies. Among the etiopathogeneses advocated, the more credible ones deal with changes of the lymphatic network with hypoplastic vessels leading to inadequate adaptation, after local damage of the tissues. When this syndrome is suspected on the basis of the examination of the nails, an extensive investigation (dermatologic, pneumologic, lymphographic, biologic) has to be launched to exclude underlying neoplasma, or autoimmune disease, frequently associated with this syndrome. The treatment is controversial and poorly effective. Vitamin A and E, Zn sulfate and itraconazole are drugs the most often advised. Spontaneous healing is reported in 30% of the cases. Endoscopic endonasal surgery in such cases, when the sinusal mucosa is involved, is controversial and its outcome is not yet documented.

The development of auditory perception in the infant starts in utero and continues up to the age of 9-10 years. We shall examine the various stages, the various acoustic parameters and the segmental level. Three stages are important: from 7 months onwards: first perceptual reorganization; between 7 and 12 months: second perceptual reorganization; from 10 to 24 months: segmentation of the spoken word. We will note the evolution between 2 and 6 years and between 6 and 9 years: 9 years being the critical age--switching from global treatment to analytic treatment of utterances. We will then examine musical perception and we note that at the prelinguistic level it is the same perceptive units that handle verbal sequences and musical sequences. The stages of musical perception are parallel to those for speech. Bigand posed the question: "should we see in these hierarchies, and in their importance to perception, the manifestation of an overall cognitive constraint restricting the handling of long sequences of acoustic events (including language) and why not even for all processes dealing with symbolic information".

This paper presents an overview of the use of a French-speaking battery for the assessment of a central auditory processing disorder (CAPD) in a variety of clinical populations: prematurely born children; 8 years old children who had otitis media with effusion in early infancy; children with learning problems and dyslexia; French-speaking children attending Dutch and English schools; adults with King-Kopetzky syndrome and elderly hearing aids users. Population characteristics of each of these groups are presented and discussed.

Several aspects of Shrapnell's career are still little known or erroneously typed. 1. Some historians of Medicine profess that Dr. Shrapnell was the inventor of a shell which bears his name. 2. Others neglect the negative points of Shrapnell's paper published in 1832 on the pars flaccida. To be able to comment on these different aspects of Shrapnell's life and work we compared the biographies of the anatomist and of the artillery officer. We noticed the positive and also the negative points of his paper. We conclude that: 1. Dr. Shrapnell was not an artillery officer, but the two men were present in the British Army; their surnames, their names and the period when they lived were about the same. 2. Errors in Shrapnell's paper were due to the philosophy and lack of anatomical and pathological knowledge of the time. 3. Otologists' reception was better than that of the Anatomists because for the Otologists, Shrapnell's membrane was recognized as an important original area of cholesteatoma, whereas for the Anatomists it was just a detail.

A case of a patient, presenting with a granulomatous lesion of the anterior nasal septum mucosa spreading to the columella and the nasal floor, whereby leishmaniasis was diagnosed, is presented. The clinical and pathological aspects of this pathology, its diagnosis and treatment are reviewed.