Publications by authors named "A Lachkar"

79 Publications

Nasosinusal chondrosarcoma with orbito-cerebral extension.

J Surg Case Rep 2022 Jun 22;2022(6):rjac286. Epub 2022 Jun 22.

Otorhinolaryngology and Head and Neck Surgery Department, Mohammed VI University Hospital of Oujda, Oujda, Morocco.

Chondrosarcoma is a highly aggressive malignant tumor originating from cartilaginous and mesenchymal tissues. The aim of this report is to describe a rare case of nasosinusal chondrosarcoma with orbito-cerebral extension. Our patient was a 55-year-old with a right cheek swelling evolving over a year, with unilateral right nasal obstruction gradually becoming bilateral associated with hyposmia, bilateral exophthalmos, reduced bilateral deep visual acuity and permanent headaches. The clinical examination found a tumor obstructing the two nasal cavities. Imaging showed a lobulated heterogeneous tissue process occupying the paranasal sinuses, with calcifications and enhancement at its periphery, extending to the orbito-cerebral area. The histopathological analysis was in favor of chondrosarcoma. The patient was first treated with an incomplete surgical resection by an endonasal route due to the extension to the orbit and the brain and received adjuvant radiotherapy. Surgical excision is a prognostic factor in this type of sarcomas and reduces recurrence rates.
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http://dx.doi.org/10.1093/jscr/rjac286DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9216040PMC
June 2022

Terrible triad injury of the elbow: A PROCESS-compliant surgical case series from Eastern Morocco.

Ann Med Surg (Lond) 2022 Jun 4;78:103914. Epub 2022 Jun 4.

Department of Traumatology and Orthopedics, Mohammed VI University Hospital, Oujda, Morocco.

Introduction: The terrible triad of the elbow (TTE) is a lesion associating a dislocation of the elbow, a fracture of the radial head, and a fracture of the coronoid process, with a high potential of complication. The treatment is based on the restoration of bone lesions and external capsular ligament repair. The systematic repair of the medial collateral ligament (MCL) is still debated in the literature. The aim of this study is to evaluate the clinical and functional results of the surgical treatment in a real-world series from Easter Morocco.

Patients And Methods: This was a retrospective study of 6 cases of TTE operated by isolated external approach or combined approach (internal or anterior) of the elbow in the department of Traumatology-Orthopedics of the Mohammed VI University Hospital (Oujda Morocco), over a period of 7 years from 2013 to 2020. Radial head and coronoid process fractures were classified according to the Mason and Morrey-Regan classifications, respectively. The following clinical parameters were evaluated: Mayo Clinic Elbow Performance Score (MEPS), Quick Disabilities of the Arm, Shoulder and Hand (DASH), Visual Analog Scale (VAS), and arc of mobility in flexion-extension and prono-supination.

Results: 6 male patients treated between May 2013 and December 2020 were included. The median follow-up was 48 months. All patients had frontal and lateral standard X-ray of over and under joints, and computed tomography (CT)-scan was delivered for 5 cases. The elbow dislocation was posterolateral in five cases, and posteromedial in only one patient. Radial head fractures were classified as type I in one case, type II in two cases, and type III in three cases. Coronoid fractures were type I in three cases, type II in one case, and type III in two cases. At the last follow up, the mean MEPS, Quick DASH, and VAS was 81, 28, 0.8, respectively. The mean arc of mobility in flexion was 120° and it was deficient by 20° in extension. In addition, the mean arc of mobility in protonation was 80°, while in supination it was 75°. Regarding complications, we noticed an instability of the elbow on valgus in a single case, elbow stiffness with heterotopic ossification in a single case, ulnar nerve damage in a single case during medial collateral ligament anchoring, and elbow hygroma in one single case.

Conclusion: The surgical management of TTE can provide good and long-term functional results after restoration of the stabilization of bone structures and the lateral ligament complex, without the need to repair the medial collateral ligament.
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http://dx.doi.org/10.1016/j.amsu.2022.103914DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9207080PMC
June 2022

Middle ear neuroendocrine tumor: a case report.

J Surg Case Rep 2022 Jun 17;2022(6):rjac257. Epub 2022 Jun 17.

ENT and Head and Neck Surgery Department, University Hospital Center Mohammed VI, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco.

Neuroendocrine tumors are extremely rare in the middle ear. These tumors represent a spectrum of tumors with a diverse range of molecular abnormalities, functionality and anatomical locations. We present a rare case of middle ear neuroendocrine tumor, review the pathology and differential diagnosis of the tumors, and discuss the management and follow-up of patients with these tumors. We suspect that the middle ear neuroendocrine tumor is underdiagnosed and more cases can be detected through education and personal experience. Treatment is surgical resection, and long follow-up is recommended.
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http://dx.doi.org/10.1093/jscr/rjac257DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9205677PMC
June 2022

Cervical sympathetic chain schwannoma masquerading as a vagus nerve: a case report.

J Surg Case Rep 2022 May 22;2022(5):rjac228. Epub 2022 May 22.

ENT and Head and Neck Surgery Department, University Hospital Center Mohammed VI, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco.

Schwannoma arising from the cervical sympathetic chain are rare slow-growing tumors which represent a diagnostic challenge. We report a 80-year-old female patient presented with anterior neck triangle swelling. The radiological assessment was based on computed tomography and magnetic resonance imaging, which led to a preoperative diagnosis of vagus nerve schwannoma. However, surgical treatment revealed a cervical sympathetic chain mass rather than a vagus nerve mass. A complete removal was performed, and the anatomopathological examination was in favor of a schwannoma. In post-operative state, the patient presented a well-tolerated Horner's syndrome.
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http://dx.doi.org/10.1093/jscr/rjac228DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9124568PMC
May 2022

Bilateral blindness following a stabbing assault: A case report.

Int J Surg Case Rep 2022 Jun 4;95:107162. Epub 2022 May 4.

ENT and head and neck surgery department, University hospital Center Mohammed VI, Faculty of medicine and Pharmacy, Mohammed First University, Oujda, Morocco.

Introduction: Stabbing is relatively frequent in Morocco and constitutes a major public health concern. Our observation is interesting by the particularity and the aggressiveness of the trauma leading to an irreversible bilateral blindness.

Case Presentation: The present observation relates to a patient who was victim of a stabbing assault. The examination objectified a facial wound in front of the right lateral canthus with a broken weapon in place. An urgent craniofacial CT scan was performed showing a hyperdense penetrating path of the stabbing from the lateral wall of the right orbit, associated with a bursting of the globe, obliquely crossing the anterior ethmoid cells and severing the optic nerve on the left side. Surgical exploration was made with an extraction of the remaining part of the knife. Bilateral blindness was irreversible and the patient had a psychiatric follow up.

Conclusion: Aggressions are a sad reality, expressing anger and violence on the part of a young adult, present in any society with often dreaded consequences.
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http://dx.doi.org/10.1016/j.ijscr.2022.107162DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9127568PMC
June 2022
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