Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 May · PMID 42106206
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Sinonasal adenoid cystic carcinoma (ACC) is a rare seromucosal gland tumor, accounting for 7.5% of sinonasal cavity cancers. It is a distinct entity, with slow progression, strong perineural tropism and high risk of late...Sinonasal adenoid cystic carcinoma (ACC) is a rare seromucosal gland tumor, accounting for 7.5% of sinonasal cavity cancers. It is a distinct entity, with slow progression, strong perineural tropism and high risk of late recurrence. Since the time of the 2009 French guidelines, large multicenter studies have been reported, enabling more precise clinical, pathologic and therapeutic analysis. To update the previous guidelines, a systematic review was performed, using PRISMA guidelines and the PubMed, Scopus and Web of Science databases for the period 2009-2020. English and French language articles were selected on strict inclusion criteria, resulting in 23 studies analyzed out of 283. Data were classified according to the French Health Authority levels of evidence, as a scientific basis for the new REFCOR guidelines published in 2022. We here present a short version of the scientific rationale. Results confirmed frequently late clinical presentation, with most tumors staged T3 or T4 at diagnosis. Histologically, solid tumors and perineural or bone infiltration were of poorer prognosis. Overall 5-year survival ranges from 61% to 87%, but risk of recurrence beyond 20 years requires prolonged monitoring. Treatment is based on complete surgical resection. Adjuvant radiotherapy, preferably with intensity modulation, is indicated in case of risk factors. In unresectable or recurrent forms, exclusive hadron therapy is a good option. Systemic treatments show limited efficacy, with no neoadjuvant forms or current recommendations for concomitant chemoradiotherapy. Targeted therapies, on the other hand, are promising.
Schmidl B, Walter R, Hoch CC
… +6 more, Huetten T, Pigorsch S, Stögbauer F, Hussain T, Wollenberg B, Wirth M
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Apr · PMID 42062131
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OBJECTIVES: Early and accurate detection of head and neck squamous cell carcinoma and the subset of oropharyngeal squamous cell carcinoma (OPSCC) is essential for the therapy and the prognosis of patients. Computer tomog...OBJECTIVES: Early and accurate detection of head and neck squamous cell carcinoma and the subset of oropharyngeal squamous cell carcinoma (OPSCC) is essential for the therapy and the prognosis of patients. Computer tomography (CT) is the primary imaging modality and is currently evaluated manually by radiologists and head and neck oncologists. Since image recognition in the form of artificial intelligence (AI) was introduced recently with the large language model (LLM) ChatGPT-4V, this exploratory study for the first time evaluates the application of image recognition by ChatGPT in interpreting neck CT and MRI scans for OPSCC detection, and corresponding images without any oropharyngeal lesion. MATERIALS AND METHODS: The most likely diagnosis based on the CT images for 100 CT cases (50 OPSCC, 50 without lesion) and the available corresponding 62 MRI cases (31 OPSCC, 31 without an oropharyngeal lesion) by ChatGPT-4V was rated by two independent reviewers and the overall performance was evaluated in terms of accuracy, sensitivity, and specificity. RESULTS: In this study, ChatGPT-4V reached a sensitivity of 72% and a specificity of 78% in identifying OPSCC from CT images. For MRI scans, sensitivity was 80.6% and specificity 83.9%. Human papillomavirus-positive and more advanced lesions were detected more reliably. DISCUSSION: In this exploratory study of CT and MRI neck scans of the oropharynx, ChatGPT-4V demonstrated a mediocre performance for detecting OPSCC. Continued research and advancements in AI are essential to improve the reliability and clinical utility of LLMs for the interpretation of neck scans.
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 May · PMID 42049649
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In the 19th century, human anatomy was badly taught, in poorly suited run-down premises, by teachers with very uneven levels of knowledge. Louis Hubert Farabeuf came from a poor family, and abandoned his ambition to trai...In the 19th century, human anatomy was badly taught, in poorly suited run-down premises, by teachers with very uneven levels of knowledge. Louis Hubert Farabeuf came from a poor family, and abandoned his ambition to train as a surgeon, due to poor health. He turned his focus to anatomy, and had modern premises constructed in the Paris Medical School. He also set out the operating rules of anatomy labs that have come down to us today. He was a brilliant anatomist and an exceptional teacher of operative medicine, wrote several books and developed several surgical instruments that are still in use. His career was no bed of roses, but distinctly thorny - which by no means prevented his legacy from enduring.
Villarmé A, Culié D, Poissonnet G
… +3 more, Poudenx C, Grazzi C, Bozec A
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Apr · PMID 42049648
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AIM: Voice prostheses are one of the main vocal rehabilitation techniques following total laryngectomy. However, leakage requires frequent replacement and availability of physicians. This study explores a task delegation...AIM: Voice prostheses are one of the main vocal rehabilitation techniques following total laryngectomy. However, leakage requires frequent replacement and availability of physicians. This study explores a task delegation protocol between physicians and nurses for voice prosthesis exchange. The objective was to evaluate feasibility and impact on patient care. METHODS: After validating and implementing the protocol, we conducted a prospective study from March to October 2024 to assess its impact for nurses, physicians and patients, on a satisfaction questionnaire. RESULTS: Fifty-six of the first 60 voice prosthesis replacements were successfully performed by delegated nurses. Physicians were consulted for 4 unsuccessful procedures, mainly due to difficult access to the tracheoesophageal fistula. Three patients expressed concerns about the protocol, but overall, 93% reported high satisfaction with the care received. CONCLUSION: The success of this collaborative protocol helped reduce physician workload and highlighted the valuable role of nurses, while ensuring high-quality care for laryngectomized patients with voice prostheses.
Friedrichsen Marques B, Mendes Figueiredo A, Catherine Quispe Rohling Gómez S
… +1 more, Vaz Teixeira G
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Apr · PMID 42049647
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BACKGROUND: Adenotonsillectomy is the treatment of choice for pediatric obstructive sleep apnea. Although tracheal intubation remains the standard method of airway management, the laryngeal mask (LM) has been proposed as...BACKGROUND: Adenotonsillectomy is the treatment of choice for pediatric obstructive sleep apnea. Although tracheal intubation remains the standard method of airway management, the laryngeal mask (LM) has been proposed as an effective alternative for reducing operative time, despite longstanding controversy. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of LM use compared to tracheal intubation in adenotonsillectomies. METHODS: The search was performed in PubMed, Embase, and Cochrane up until January 14, 2025, for RCTs comparing LM with tracheal tube (TT) in patients undergoing adenotonsillectomies. Adverse events (bronchospasm, laryngospasm, desaturation, and coughing), conversion, blood aspiration and surgical time were the researched outcomes. The analysis included risk of bias assessment, publication bias, and Harbord regression test. RESULTS: Six studies totaling 765 participants undergoing adenotonsillectomies were included. The LM was associated with a longer surgical time (MD 3.35minutes; P<0.01), a smaller blood aspiration rate (LM 3.6% vs. TT 17.1%) and a conversion from LM to intubation of 4.7%. There was no difference between the two ventilation types regarding total adverse events (RR 0.98; P=0.96). Results of the individual outcomes, related to adverse events for the use of the LM, were bronchospasm (RR 0.89; P=0.80), laryngospasm (RR 0.68; P=0.40), desaturation (RR 1.40; P=0.35), and coughing (RR 1.08; P=0.92). CONCLUSION: For adenotonsillectomies, the LM is an alternative to the TT, without differences concerning adverse events associated to both methods, although it is associated with a prolonged operation time.
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Apr · PMID 42049646
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OBJECTIVES: Bibliometric analysis provides a detailed analysis of the research trends and identify the preferred journals, patterns in collaborations, research topics. Till date, no such bibliometric analysis has been ca...OBJECTIVES: Bibliometric analysis provides a detailed analysis of the research trends and identify the preferred journals, patterns in collaborations, research topics. Till date, no such bibliometric analysis has been carried out in pediatric hearing impairment. The aim of the present study was to conduct a bibliometric analysis to determine the evolution of research in the area of pediatric hearing impairment including key institutions, journals and authors, collaborative links, and top research priorities areas based on author keywords. METHODS: A bibliometric analysis was conducted to identify publications on pediatric hearing impairment in Scopus database. The identified studies were exported from Scopus into Microsoft Excel and VOSviewer for further analysis. Visualization and bibliometric analyses were performed using VOSviewer. RESULTS: A total of 5996 studies were identified for detailed analysis. The results revealed a growing trend in publications over the years. In all, 118 countries being involved in research on pediatric hearing impairment with maximum papers published in the United States (33.89%) with Harvard Medical School, USA being the leading contributor. The International Journal of Pediatric Otorhinolaryngology emerged as the most common choice. The keyword co-occurrences revealed five clusters with interconnections. CONCLUSION: The study provides an overview of the evolution and research trends in pediatric hearing impairment. These findings provide valuable insights to plan future research in this area.
Carrichon H, Favier V, Cammaroto G
… +28 more, Dos Santos H, de Vito A, Zancanella E, Cahali MB, Moniri A, Carrasco-Llatas M, Ravesloot M, Alkan U, Cheong RCT, Lechien JR, Maniaci A, O'Connor C, Salamanca F, Jacobowitz O, Abedipour D, Decotte A, Schmitt D, Lestang P, Yona L, Huth J, Bastier PL, Dufour X, De Vries N, Winck JC, Olszewska E, Allali L, Lisan Q, Carsuzaa F
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Apr · PMID 42049645
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INTRODUCTION: Isolated snoring (IS), defined by nocturnal upper airway vibration without apneas, remains a prevalent yet underrecognized condition lacking standardized definitions for severity and management. Despite its...INTRODUCTION: Isolated snoring (IS), defined by nocturnal upper airway vibration without apneas, remains a prevalent yet underrecognized condition lacking standardized definitions for severity and management. Despite its significant impact on bed partners' sleep quality and social life, no consensus exists on severity criteria or follow-up practices. This international Delphi consensus aimed to define IS severity, address the management of nasal comorbidity, and establish follow-up protocols to support personalized patient care. METHODS: A two-round Delphi process was conducted from December 2024 to April 2025, involving 35 otolaryngology experts from 16 countries. Thirty-nine initial statements were developed by a steering committee and evaluated using a 9-point Likert scale. Consensus was defined as≥75% agreement. RESULTS: Of 58 evaluated statements, 44 reached consensus. IS severity was associated with frequency of snoring, bed partner's complaints, and impact on the couple's quality of life, while objective acoustic parameters alone were not deemed reliable indicators. Nasal obstruction was recognized as a treatable comorbidity that may be assessed before snoring management. Personalized management using validated subjective tools was strongly recommended. For follow-up, expert consensus supported a 3- to 6-month reassessment using smartphone apps or quality-of-life metrics, with distinctions made between clinical and research goals. CONCLUSION: This consensus supports a patient- and partner-centered approach to IS. It discourages reliance on isolated acoustic data for severity grading, promotes proactive management of nasal factors, and highlights the need for individualized treatment strategies. Future research should aim to validate objective and subjective tools to further standardize care pathways for IS.
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Apr · PMID 42025528
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INTRODUCTION: Auditory neuropathy is a hearing disorder characterized by impaired temporal coding of acoustic signals in the auditory nerve fibers, resulting in abnormal auditory perceptions relying on temporal cues. We...INTRODUCTION: Auditory neuropathy is a hearing disorder characterized by impaired temporal coding of acoustic signals in the auditory nerve fibers, resulting in abnormal auditory perceptions relying on temporal cues. We describe the case of a woman with a history of cancer who developed auditory neuropathy as the first manifestation of leptomeningeal metastasis. CASE SUMMARY: A woman in her sixties complained of severe difficulties in understanding speech despite preserved sensitivity to sounds, which had begun two months before audiological assessment. Her past medical history was remarkable for an occult cancer, possibly breast cancer, diagnosed seven years earlier. Pure-tone audiometry showed mild bilateral sensorineural hearing loss associated with markedly reduced speech intelligibility. Otoacoustic emissions were normal, indicating preserved outer hair cell function, whereas auditory brainstem responses (ABRs) were absent despite preserved hearing thresholds. Contrast-enhanced brain magnetic resonance imaging (MRI) only demonstrated bilateral enhancement of the eighth cranial nerve. However, a brain MRI performed one month later revealed diffuse leptomeningeal enhancement, while cerebrospinal fluid (CSF) cytology was positive for atypical malignant cells, both findings consistent with leptomeningeal metastasis. DISCUSSION: This case illustrates that the onset of auditory neuropathy in a patient with a clinical history of cancer may represent an early clinical sign of leptomeningeal metastasis, highlighting the importance of prompt neuroimaging and CSF analysis.
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Apr · PMID 42014248
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INTRODUCTION: Anatomical variations of the cervical internal carotid artery (ICA), including a retropharyngeal submucosal trajectory, may mimic submucosal pharyngeal lesions and produce atypical upper aerodigestive sympt...INTRODUCTION: Anatomical variations of the cervical internal carotid artery (ICA), including a retropharyngeal submucosal trajectory, may mimic submucosal pharyngeal lesions and produce atypical upper aerodigestive symptoms. Failure to recognize these variants carries significant risk, as inadvertent injury during pharyngeal surgery, endoscopy, or intubation can result in catastrophic hemorrhage. CASE SUMMARY: We report the case of a 73-year-old woman with several years of persistent cough and progressive dysphagia. Flexible fiber-optic nasopharyngolaryngoscopy revealed a smooth, pulsatile submucosal bulge of the posterior pharyngeal wall with associated salivary stasis. Contrast-enhanced CT confirmed a retropharyngeal course of the right cervical ICA of normal caliber. Given the absence of alarming features, conservative management with annual endoscopic follow-up was recommended. DISCUSSION: This case represents a rare presentation in which a submucosal retropharyngeal ICA manifested predominantly as chronic cough, likely due to repetitive mechanical stimulation of supraglottic sensory pathways. Only two similar cases have been reported. The case expands the recognized symptomatic spectrum of ICA medialization and highlights the importance of targeted endoscopic examination and selective imaging when encountering unexplained chronic cough or atypical pharyngeal anatomy. Awareness of this vascular variant is essential to avoid misdiagnosis and prevent life-threatening iatrogenic injury.
Pastor-Benavente B, Hernández-Lucas P, González-Castro A
… +1 more, Leirós-Rodríguez R
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Apr · PMID 42014247
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PURPOSE: Strokes may cause some swallowing difficulty or associated dysphagia in 25-80% of patients, increasing morbidity and mortality associated with nutritional and respiratory disorders. Therefore, the aim of this re...PURPOSE: Strokes may cause some swallowing difficulty or associated dysphagia in 25-80% of patients, increasing morbidity and mortality associated with nutritional and respiratory disorders. Therefore, the aim of this research was to evaluate the efficacy of swallowing muscle training in patients with dysphagia in post-stroke patients. METHODS: A systematic search was carried out in PubMed, Scopus, Web of Science and MEDLINE. RESULTS: Of the 13 investigations analyzed, four evaluated the effects of Shaker exercise, tongue training and chin flexion against resistance; two investigations applied mandibular opening exercises against resistance; and only one, the effect of training with forced swallows was evaluated. Meta-analysis confirmed their significant effect on reducing the risk of penetration and aspiration. CONCLUSION: Swallowing muscle training has beneficial effects on swallowing function in patients with post-stroke dysphagia and reduced the risk of penetration and aspiration.
Sayah C, Bertin E, Philouze P
… +2 more, Céruse P, Fuchsmann C
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Mar · PMID 41966067
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AIM: Airway management and evaluation of functional and aesthetic results after total maxillectomy and chimeric osteo-musculo-cutaneous scapula tip flap reconstruction without tracheotomy. MATERIALS AND METHODS: A single...AIM: Airway management and evaluation of functional and aesthetic results after total maxillectomy and chimeric osteo-musculo-cutaneous scapula tip flap reconstruction without tracheotomy. MATERIALS AND METHODS: A single-center retrospective study of patients with malignant or benign maxillary bone or sinus tumors managed by total maxillectomy and free scapula tip flap reconstruction between January 2015 and July 2023 was performed. Data collected allowed postoperative airway management analysis. The EORTC QLQ-C30 and H&N43 questionnaires, DASH, UW-QOL-V4 and the FOIS scale were used for functional and aesthetic assessments. OBJECTIVES: Analyze the perioperative data of patients operated on. Secondary objective was to evaluate functional and aesthetic results. RESULTS: Sixteen patients underwent total maxillectomy with scapula tip free flap reconstruction during the study period. Twelve (75%) patients spent an average of one day in the intensive care unit (ICU), 12 patients (75%) were extubated immediately at the end of surgery, the remaining 4 patients were extubated on day 1. No patient required re-intubation or tracheotomy. The pulmonary complication rate was low (6.2%). The mean time to resumption of feeding was 7.3 (±1.8) days, and the mean hospital stay was 14 (±3.8) days. Functional analysis was performed on 11 patients. More than half the patients had a normal diet. No patients limited their activities because of their appearance. CONCLUSION: This series shows that it is possible to perform this surgery without systematic tracheotomy. A good aesthetic result and satisfactory recovery of functional and swallowing abilities is possible.
Miura T, Kessoku H, Kobayashi T
… +2 more, Nagaoka M, Kojima H
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Apr · PMID 41956865
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AIMS: To evaluate the relationship between changes in the prognostic nutritional index (PNI), which is an indicator of nutritional status, and outcomes in patients with head and neck cancer who underwent surgery at our h...AIMS: To evaluate the relationship between changes in the prognostic nutritional index (PNI), which is an indicator of nutritional status, and outcomes in patients with head and neck cancer who underwent surgery at our hospital. MATERIAL AND METHODS: We retrospectively reviewed the medical records of 148 patients (128 men and 20 women) who underwent surgery from 2015 to 2022. The median age was 68.5 (range: 40-88) years. Overall survival (OS) was calculated using the Kaplan-Meier method. The PNI was calculated preoperatively and postoperatively. Based on changes in pre- and post-treatment, patients were categorized as having high PNI both before and after surgery (high-to-high [HTH]), low PNI before and high PNI after surgery (low-to-high [LTH]), high PNI before and low PNI after surgery (high-to-low [HTL]), and low PNI both preoperatively and postoperatively (low-to-low [LTL]). OBJECTIVES: The effects of pre- and post-treatment changes in the PNI on patient outcomes were determined using the Cox proportional hazards model. RESULTS: The median PNI was 49 and 48 before and after surgery, respectively. In the multivariate analysis, preoperative PNI was an independent poor prognostic factor for disease-free survival (DFS) and OS (P=0.037 and P=0.039). The postoperative PNI was an independent poor prognostic factor for DFS and OS (P<0.01). In the univariate analysis, the HTL and LTL groups showed poorer patient outcomes when the HTH group was used as a reference. CONCLUSION: Changes in PNI could be a useful indicator of postoperative outcomes in patients with head and neck cancer.
Škerková M, Mrázková E, Kovalová M
… +2 more, Kocurková L, Gottfriedová N
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 May · PMID 41945086
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Personal listening devices (PLDs) are widely used among young adults, raising concern about early noise-induced hearing loss (NIHL). Conventional audiometry (≤8kHz) may not detect the earliest signs of cochlear damage. E...Personal listening devices (PLDs) are widely used among young adults, raising concern about early noise-induced hearing loss (NIHL). Conventional audiometry (≤8kHz) may not detect the earliest signs of cochlear damage. Extended high-frequency audiometry (EHFA, ≥9kHz) has been suggested as a more sensitive approach for identifying early auditory changes. This narrative review examined the potential role of EHFA in detecting PLD-related hearing effects. A structured search of PubMed and Academic Search Ultimate through 30 September 2024 identified nine eligible studies (sample sizes 20-282; ages 13-31 years). Most studies reported significantly elevated thresholds in the 9-16kHz range, particularly at 12-14kHz, among participants with prolonged PLD use (>4-5 years) or higher listening levels (≥75 dBA). These threshold shifts often occurred despite normal conventional audiograms, suggesting that EHFA may capture early changes not identified by standard testing. Two studies, however, found no significant group differences, likely due to small control samples, short exposure duration, or limited statistical power. Considerable heterogeneity in exposure definitions, calibration, and reliance on self-reported listening habits further limits comparability. Current evidence indicates that EHFA may hold promise as an early indicator of NIHL in young adult PLD users, but further methodological refinements, objective exposure monitoring, and longitudinal research are required to establish normative data and clarify its prognostic and clinical utility.
Magri A, Moise A, Ajit-Roger E
… +3 more, Orishchak O, Alosamey F, Daniel SJ
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Apr · PMID 41945085
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OBJECTIVE: ChatGPT has gained popularity for its user-friendly applications in medicine, including otolaryngology. However, concerns have surfaced about accuracy of information, especially in languages other than English...OBJECTIVE: ChatGPT has gained popularity for its user-friendly applications in medicine, including otolaryngology. However, concerns have surfaced about accuracy of information, especially in languages other than English. This study assessed ChatGPT's proficiency in answering questions in English and French about benign paroxysmal positional vertigo (BPPV), a common ENT presentation. We aim to address concerns regarding its performance with medical queries in a language beyond its primary training set. METHODS: ChatGPT 3.5 was tested with questions taken from the guidelines of the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO- HNSF), in English and French. Three users submitted 14 questions twice across distinct sessions, with different user-names and IP addresses. A two-stage translation process was used to ensure linguistic accuracy. A total of 14 questions related to BPPV were presented to ChatGPT. Two independent otolaryngologists, proficient in both English and French, reviewed and graded the responses on a 4-point Likert scale. RESULTS: Responses to all 14 questions were uniform in both English and French, demonstrating high consistency and native language level. Twelve of the 14 questions were comprehensively aligned with established guidelines (grade 4/4). The 2 other responses, although accurate, lacked detail on the risk of falls in older persons with BPPV (grade 3/4). CONCLUSION: ChatGPT can provide patients with detailed guideline-compliant responses to their medical queries in French or English. Using ChatGPT in both official Canadian languages could enhance patients' access to medical information, as a complement to professional otolaryngologic expertise.
Erkal B, Bozacı Kılıçoğlu M, Topçuoğlu OM
… +1 more, Alkan Z
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Apr · PMID 41945084
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INTRODUCTION: Lobular capillary hemangioma is benign vascular lesion commonly encountered in the head and neck region. Although surgical excision remains the standard treatment, management may be challenging in postopera...INTRODUCTION: Lobular capillary hemangioma is benign vascular lesion commonly encountered in the head and neck region. Although surgical excision remains the standard treatment, management may be challenging in postoperative settings or cosmetically sensitive areas such as the nasal vestibule. We present a case of a hypervascular nasal vestibular lesion with clinical and radiological features consistent with lobular capillary hemangioma, managed with intralesional foam embolization. CASE SUMMARY: A 40-year-old woman presented with unilateral nasal obstruction and left alar swelling. MRI showed a hypervascular polypoid lesion filling the left nasal vestibule. Therapeutic angiography revealed vascular blush with venous drainage into the angular and internal jugular veins, without ophthalmic or intracranial involvement. Intralesional polidocanol foam was injected. Mild post-procedural erythema and edema resolved within one week. The lesion progressively regressed, with approximately 50% reduction at one week and nearly two-thirds reduction at one month. At two months, MRI confirmed marked regression and restored nasal patency. At one-year follow-up, serial endoscopic examinations demonstrated stable lesion size without evidence of regrowth. DISCUSSION: While surgical excision remains the gold standard, intralesional embolization may represent an alternative treatment option in carefully selected superficial vestibular vascular lesions when surgical risks, cosmetic concerns, or patient preference limit operative management.
Cunha-Cabral D, Gomes PM, Gonçalves AI
… +3 more, Carção AA, Penêda JF, Lopes G
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Apr · PMID 41935948
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AIMS: Identification of predictors of anatomical and functional success in pediatric type I tympanoplasty. MATERIAL AND METHODS: In this case control study, we reviewed the medical records of children undergoing type I t...AIMS: Identification of predictors of anatomical and functional success in pediatric type I tympanoplasty. MATERIAL AND METHODS: In this case control study, we reviewed the medical records of children undergoing type I tympanoplasty between January 2012 and December 2022 in our hospital. Anatomical success was evaluated at 6 (T1), 12 (T2) months and at the end of follow up (T3). Functional success was defined as a mean postoperative ABG<10dB in ears with sustained tympanic membrane integrity. RESULTS: A total of 79 ears (67 patients) were included. The median age of our sample was 12 years (range, 8-17), and the median follow-up period was 27 months (range, 12-86). The anatomical success rates at T1, T2, and T3 were 88.6%, 83.5%, and 77.2%, respectively. The etiology of the perforation was an independent predictor of anatomical success at T2 and T3. Patients with traumatic or post-ventilation tube perforations were less likely to experience reperforation compared with those with chronic otitis media (P=0.023 and P=0.009, respectively). The presence of tympanosclerosis was an independent predictor of reperforation at T1, T2, and T3. The mean postoperative ABG was 6.45±0.91dB HL. Larger tympanic membrane perforations (>50% of the total TM area) had significant worse functional outcomes (P=0.021). CONCLUSION: Type I tympanoplasty has good anatomical and functional outcomes in the pediatric age. The etiology of the perforation and the presence of tympanosclerosis may be used as predictors of anatomical success. Larger perforations may predict worse postoperative audiometric outcomes.
Julian T, Bonnard D, Gimenez T
… +1 more, Franco-Vidal V
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Mar · PMID 41820176
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OBJECTIVES: Temporal bone drilling simulators are valuable tools for developing anatomical knowledge and drill handling motor skills. However, there are currently no simulators focusing on learning fine microsurgical ges...OBJECTIVES: Temporal bone drilling simulators are valuable tools for developing anatomical knowledge and drill handling motor skills. However, there are currently no simulators focusing on learning fine microsurgical gestures using micro-instruments. The aim of this study was to validate a training kit and simulation program dedicated to otologic microsurgery. MATERIALS AND METHODS: A prospective single-center comparative study was conducted. The Micro-TRAIN kit comprised a mannequin and six interchangeable exercise modules. Two simulation sessions were conducted two months apart, with debriefing for two selected subgroups after the first session. Progression in performance, assessed by task completion time, execution time and technical skills, was evaluated in three groups: 10 novices, 10 intermediate level and 5 experts. Content validity, face validity and participant satisfaction were also assessed. RESULTS: In session 1, there were significant differences in performance between the three groups (P<0.005). Both the novice and intermediate groups showed improvement between sessions. Improvement in total score in the intermediate group was statistically significant (P=0.0019) and suggestive in the novice group (P=0.0059). Participants who received debriefing tended to improve more (novices: P=0.012; intermediate: P=0.036). Experts rated the simulator's realism and relevance as above 8/10. CONCLUSION: This study confirmed the content, face and construct validity of the Micro-TRAIN simulator. It is an effective tool for acquiring microsurgical skills in otologic surgery.
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Mar · PMID 41791933
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BACKGROUND: Hyperparathyroidism stimulates osteoclasts to increase bone resorption, release skeletal calcium, and cause a reduction of bone mass. Parathyroidectomy remains the only curative treatment however medical ther...BACKGROUND: Hyperparathyroidism stimulates osteoclasts to increase bone resorption, release skeletal calcium, and cause a reduction of bone mass. Parathyroidectomy remains the only curative treatment however medical therapies can also control symptoms and limit osteoporosis. The aim of this study was to compare the impact of parathyroidectomy with medical management on bone mineral density (BMD) in patients with primary hyperparathyroidism. METHODS: An observational study including a total of 82 patients with hyperparathyroidism, comprising the Surgical Group (n=49) and Medical Group (n=33). Patients had BMD assessed at the lumbar spine, hip and forearm using dual-energy X-ray absorptiometry before and after intervention. RESULTS: At a mean follow-up of 4.3 years, BMD increased in the lumbar spine by +6.8% (P=0.004) in the Surgical Group and +3.1% (P=0.016) in the Medical Group. BMD was recovered or maintained in all regions in the Surgical Group, whereas a decrease of -7.1% (P=0.043) was noted in the forearms of the Medical Group. Significant between-group differences in BMD change favouring the Surgical Group in the total hip (+1.6% vs -1.7%, P=0.019), distal one-third radius (+0.3% vs -7.1%, P=0.045) and ultra-distal radius (+2.0% vs -9.1%, P=0.003). A greater proportion of patients in the Medical Group developed osteopenia or osteoporosis (P<0.001). CONCLUSIONS: This study has demonstrated that BMD improved or was preserved more greatly in patients with primary hyperparathyroidism who underwent parathyroidectomy rather than non-surgical management at 4 years follow-up. Greater BMD preservation in both groups, compared to previous studies, may be explained by greater utilisation of available medical therapies.