Publications by authors named "M Mahtar"

123 Publications

Impact of asthma on endoscopic sinus surgery outcomes for chronic rhinosinusitis with polyposis - A cohort study.

Ann Med Surg (Lond) 2021 Jun 14;66:102386. Epub 2021 May 14.

ENT Department, Face and Neck Surgery, Hospital August, 20'1953, University Hospital Center IBN ROCHD, Casablanca, Morocco.

Introduction: Chronic rhinosinusitis with polyposis (CRSwNP) is a multifactorial naso-sinusal inflammatory disease that affects 2-4% of the adult population. It highly affects the patient quality of life (QoL) in many levels making it a public health issue. The management of CRSwNP is based on a detailed clinical history, a complete endoscopic examination and a precise computed tomographic (CT) analysis. The aim of this study is to evaluate the prevalence and severity of the various CRS clinical manifestations as well as to highlight the potential relationship between symptom scores, asthma and ESS outcomes.

Patients And Methods: A retrospective cohort study was performed in the 20 August hospital, between January 2017 and December 2018, on patients diagnosed with CRS according to guidelines recommendations, and were beforehand refractory to initial medical therapy and elected to FESS. The patients were divided into two groups, the first group (G1) of patients with asthma and the second (G2) without asthma in order to expose an eventual significant difference in the improvement of symptoms after surgery. The Sino Nasal Outcome Test-22 (SNOT-22) was used to evaluate QOL.

Results: A total of 100 patients participated in the study with an average age of 44.53 years. The sex ratio was 1.04 (51% men). Asthma was present in 48% of patients while 20% of patients were intolerant to aspirin with a significant difference between the asthmatic and non-asthmatic group (p < 0.05). It appears that asthma was not objectively correlated with a higher Lund Mackay radiological score (p > 0.05). A higher significant improvement was observed between preoperative and postoperative SNOT-22 scores in group with asthma [42.7 ± 16.3 versus 11.8 ± 9.1] and in group without asthma [38.3 ± 15.1 versus 10.5 ± 14.2].

Conclusion: Asthma in CRS is an additional symptom in these patients, mainly reflected in the subset of nasal symptoms in SNOT-22. However, it did not significantly affect the quality of life of the CRSwNP population.
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http://dx.doi.org/10.1016/j.amsu.2021.102386DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8175276PMC
June 2021

Head and neck paragangliomas: Ten years of experience in a third health center. A cohort study.

Ann Med Surg (Lond) 2021 Jun 20;66:102412. Epub 2021 May 20.

Otorhinolaryngology and Head and Neck Surgery Department, 20 August 1953 Hospital, Casablanca, Morocco.

Head and neck paragangliomas are rare vascular tumors derived from the paraganglionic system, located at the carotid body, jugular vein, tympanic cavity and vagal nerve. From 2010 to 2020, a cohort of 26 patients divided in two groups, 15 with cervical paragangliomas and 11 with temporal bone paragangliomas, was reviewed by analysing the medical history, the epidemiological and clinical parameters, the imaging results and classification, the modality of treatment and outcome. Cervical paragangliomas present as firm and pulsatile mass with the characteristic aspect of "salt and pepper" on MRI T1 weighted sequences. The most common type on Shamblin classification was the type II. Total surgical resection was performed in 93,33% of cases. The sensitivity of MRI in the diagnosis of vagal paragangliomas was up to 75%, with a specificity of 90,91% and the correlation of the MRI results and the findings of surgical exploration is significant with p ⩽ 0.02. Temporal bone paragangliomas appear as pulsatile mass behind the tympanic membrane, causing variable hearing loss in 90,90% of the cases. The facial nerve is the most frequently affected cranial nerve, in 36,36% of the cases. The main type according to FISH classification is the type B. Embolization was performed in all type C tumors. Surgery was the first line treatment while the inoperable patients were considered for radiotherapy. The aim of this study is to report the main clinical features of head and neck paragangliomas, the imaging tools and findings evaluating their sensitivity and specificity and the treatment protocol and outcome.
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http://dx.doi.org/10.1016/j.amsu.2021.102412DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8166645PMC
June 2021

Left sinus pyriform fistula treated by minimally invasive approach: A case report.

Int J Surg Case Rep 2021 May 3;83:105953. Epub 2021 May 3.

ENT and Head and Neck Surgery, Hospital August 20, 1953, Ibn Rochd Teaching Hospital, Casablanca, Morocco.

Introduction: Abnormalities of the fourth branchial arch are less common than those of the second arch and usually present with inflammation of the left thyroid lobe.

Case Presentation: We report the case of a 10 years old girl who presented to our department with recurrent cervical cellulitis, and who was diagnosed, upon endoscopic exploration, with a left sinus pyriform fistula. The patient was treated using mini-invasive surgery by electrocoagulation, with good clinical outcome.

Conclusion: Branchial arch malformations are rare congenital malformations. The diagnosis is mainly based on clinical examination, imaging and, endoscopic investigations. The conservative attitude may be the treatment of choice, especially if the cervical mass is not well individualized.
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http://dx.doi.org/10.1016/j.ijscr.2021.105953DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8141756PMC
May 2021

Primary laryngeal T-cell lymphoma: A case report and review of the literature.

Int J Surg Case Rep 2021 May 2;82:105858. Epub 2021 Apr 2.

University Hassan II Casablanca, Morocco.

Introduction: Primary lymphoma of the larynx is extremely rare, representing less than 1% of all primary laryngeal neoplasms. It consists mainly of non-Hodgkin lymphomas (NHLs), represented particularly by diffuse large B-cell. Extranodal natural killer/T-cell lymphoma, presented in larynx is a rare condition that accounts for less than 11% of all lymphomas without distinctive clinicopathologic features, as well as challenging pathologic diagnosis.

Case Report: We report here a case of a 64-years-old man who presented with primary lymphoma type T of the subglottic larynx. A histopathological examination of the biopsy confirmed non-Hodgkin T cell lymphoma. Given his age, he underwent chemotherapy and radiation therapy. The patient was disease-free after 18 months follow up.

Conclusion: The clinicopathological characteristics and rational treatment of primary laryngeal lymphoma are still unclear and need to be further defined due to the paucity of this pathology.
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http://dx.doi.org/10.1016/j.ijscr.2021.105858DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045033PMC
May 2021

A rare case of a laryngeal leiomyosarcoma with a lymph node metastasis.

Int J Surg Case Rep 2021 May 23;82:105830. Epub 2021 Mar 23.

ENT and Head and Neck Surgery, Hospital August 20, 1953, Ibn Rochd Teaching Hospital, Casablanca, Morocco. Electronic address:

Introduction: Leiomyosarcoma is a rare mesenchymal tumor that originates from smooth muscle cells. Head and neck LMSs represent only 3% of all leiomyosarcomas with less than 50 cases of laryngeal LMS reported in the literature till now.

Case Presentation: We report a case of 50-year-old male presented at our ENT department for a chronic hoarseness. Clinical examination investigations found small submucosal lesion in the right vocal cord. Treatment consisted of CO2 Laser excision of the lesion. The evolution was marked by the appearance of a tumefaction in the left submandibular region and a severe dyspnea requiring an emergency tracheotomy. Paraclinical examination investigations found a supraglottis-glottis-subglottis tumor. A total laryngectomy with bilateral functional neck dissection was performed and the histopathological examination found a laryngeal leiomyosarcoma.

Conclusion: LMS of the larynx a very rare malignancy. The accurate diagnosis is histological. Surgery is the mainstay of treatment. Its prognosis is correlated to local recurrence and distant metastases.
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http://dx.doi.org/10.1016/j.ijscr.2021.105830DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045042PMC
May 2021