Dumas G, Curthoys IS, Baguant A
… +2 more, Perrin P, Schmerber S
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Nov · PMID 41046239
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Vibrations applied to the cranium induce, in 55%-92% of patients with CT-verified superior canal dehiscence (SCD), a perstimulatory nystagmus most often ipsilaterally beating when the vertex location is stimulated at 100...Vibrations applied to the cranium induce, in 55%-92% of patients with CT-verified superior canal dehiscence (SCD), a perstimulatory nystagmus most often ipsilaterally beating when the vertex location is stimulated at 100Hz. The skull vibration-induced nystagmus (SVIN) test is a bone-conducted (BC) Tullio phenomenon in patients with a 3rd mobile window syndrome (TMWS). Here, we describe the technical cues and procedures to obtain an afternystagmus regularly observed in 55% of a series of 43 patients with SCD chosen as examples and stimulated at 100Hz and higher frequencies by bone-conducted vibrations (BCV). Only 6% of 32 patients with total unilateral vestibular loss (TUVL) show this afternystagmus with a very small slow phase velocity. The SVIN afternystagmus is characterized by a persistent nystagmus with a slow decay after stimulation withdrawal and is associated with dizziness. This distinctive sign in SCD is usually not observed in TUVL patients but only in some other TMWS. Its production likely relies on a cupula deflection secondary to endolymph flow and stimulation of regular discharging neurons by the BCV in SCD but not TUVL patients. It is a simple, specific, robust sign of SCD and TMWS, and its sensitivity is comparable to air-conducted Tullio phenomenon and other compressional tests.
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Nov · PMID 41038737
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In 1403, in the battle of Shrewsbury, young Prince Henry, the future Henry V of England (1387-1422), was seriously wounded by an arrow that struck him under his left eye and reached the base of his skull. That he survive...In 1403, in the battle of Shrewsbury, young Prince Henry, the future Henry V of England (1387-1422), was seriously wounded by an arrow that struck him under his left eye and reached the base of his skull. That he survived was thanks to John Bradmore (date of birth unknown; died 1412), a surgeon and also a metalworker, who designed an original instrument enabling progressive extraction of the arrowhead. He then applied irrigation with wine, honey dressings and a resinous ointment, which achieved healing in 20 days. This story is an illustration of the creativity and experimental attitude at the heart of medical intervention: faced with a desperate situation, Bradmore proved able to invent and apply an adapted solution. The Prince's recovery had major historic consequences: Henry V went on the lead the victorious battle of Agincourt, impose the treaty of Troyes on France and turn relations between the two countries upside down. Little known in France but renowned in Britain, this achievement stands as a reminder that surgical ingenuity can change the destiny not only of a patient but also of nations.
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 May · PMID 40998677
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Subglottic stenosis is a rare but potentially life-threatening condition in pediatric patients. We report the case of a 13-year-old male with a history of neonatal hypoxia, prolonged intubation, and multiple failed airwa...Subglottic stenosis is a rare but potentially life-threatening condition in pediatric patients. We report the case of a 13-year-old male with a history of neonatal hypoxia, prolonged intubation, and multiple failed airway surgeries, presenting with a Myer-Cotton grade IV subglottic stenosis. Imaging and endoscopic evaluation revealed complete subglottic obstruction, absence of the anterolateral cricoid arch, and preoperative apparent absence of either vocal folds. A complex laryngotracheal reconstruction was performed, involving complete laryngofissure, placement of a posterior costal graft, and a horizontally oriented anterior costal graft to address the extensive anterolateral cricoid defect. Additionally, absorbable pediatric osteosynthesis plates were used in a novel fashion to stabilize the lateral laryngeal walls, providing structural support without permanent materials. Postoperative evolution was favorable, with airway patency and spontaneous ventilation achieved through a Montgomery T-tube. This case illustrates the importance of individualized surgical strategies in managing severe airway stenosis and proposes a novel combination of reconstructive techniques for complex pediatric cases with extensive laryngeal deformities.
El-Ozairy HS, Naguib MR, Abd-Elmaksoud AM
… +1 more, Mady OM
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Jan · PMID 40858443
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PURPOSE: Middle ear surgeries are better executed under controlled hypotension. Reverse-Trendelenburg (RTP) position has been used in endoscopic sinus surgeries as a safe and cost-free method to reduce intraoperative ble...PURPOSE: Middle ear surgeries are better executed under controlled hypotension. Reverse-Trendelenburg (RTP) position has been used in endoscopic sinus surgeries as a safe and cost-free method to reduce intraoperative bleeding. However, it has not been tried in ear surgery due to surgical field accessibility concerns. The primary aim of this study was to evaluate the effect of two RTP angles (10 and 20 degrees) on quality of surgical field and surgical position accessibility. METHODS: In total, 225 adult patients of both sexes, aged between 18 and 50years, ASA I-II, scheduled for elective middle ear surgery were enrolled in this randomized, prospective, controlled study. All patients were anesthetized using the same protocol. Patients were randomly and evenly allocated to one of three groups, 75 patients each; group I (control) patients were positioned supine, group II patients were positioned 10̊ RTP position and group III patients were positioned 20̊ RTP position. The surgeons were asked to assess the surgical field using a 5-point scale. The surgeon satisfaction concerning surgical position accessibility was evaluated using a 5-point scale. Total dexmedetomidine consumption, recovery time, surgical time and analgesia time were recorded. RESULTS: The quality of surgical field was significantly different among the three groups (P-value<0.001), being best in group III. Surgeon's satisfaction score was found to be statistically insignificant among the three study groups (P-value=0.251). CONCLUSION: This study showed that 10 and 20-degree RTP provided a significantly better surgical field quality without considerably affecting accessibility and decreased intraoperative dexmedetomidine consumption shortening the recovery time.
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Jan · PMID 40858442
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This case report details the innovative use of transoral robotic surgery (TORS) for cricopharyngeal (CP) myectomy, a procedure that has never been documented for this condition. Our patient, who was previously treated fo...This case report details the innovative use of transoral robotic surgery (TORS) for cricopharyngeal (CP) myectomy, a procedure that has never been documented for this condition. Our patient, who was previously treated for tongue cancer by total glossectomy, experienced persistent dysphagia and received gastric tube feeding despite multiple rehabilitations. After botulinum toxin injection confirmed CP muscle spasm, a TORS CP myectomy was performed using the da Vinci Si robotic system. The procedure involved a minimally invasive transoral approach, providing high-magnified 3D panoramic visualization, precise resection of a CP muscle segment and re-approximation of the post-hypopharyngeal mucosa. Postoperatively, the patient showed significant improvement in swallowing function, evidenced by successful removal of the feeding tube and improved videofluoroscopy results. This case report explains why we think TORS CP myectomy could be a feasible alternative to other existing methods.
Ferney A, Ferney T, Lazard A
… +3 more, Schmerber S, Gay E, Quatre R
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Jan · PMID 40858441
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AIM: This study aimed to assess long-term progression of residual tumor and facial function after primary partial resection of large vestibular schwannoma. MATERIALS AND METHODS: This retrospective study was performed in...AIM: This study aimed to assess long-term progression of residual tumor and facial function after primary partial resection of large vestibular schwannoma. MATERIALS AND METHODS: This retrospective study was performed in a tertiary reference center between January 2008 and December 2021. Patients with vestibular schwannoma exceeding 25mm on the long axis underwent partial tumor resection, leaving a residual fragment, and were followed up for at least 3 years. The residue was confirmed on MRI at 6 months. Facial grade was assessed on the House-Brackmann classification at the immediate postoperative time-point and at 1 year. RESULTS: Fifty-seven patients were included: 10 (17%) showed tumor regrowth, at a mean 53±25.5 months. Forty (70%) showed facial grades≤III at the immediate postoperative time, and 51 (89%) at 1 year. Mean residual tumor size was 13.6±7.2mm in patients with regrowth and 7.4±5mm in those without (P<0.01). On multivariate analysis, only residual tumor size was significantly associated with regrowth (OR=1.263; 95% CI [1.050-1.677]; P=0.04). ROC analysis identified a 6.5mm threshold for residual tumor size, beyond which risk of regrowth increased, with 90% sensitivity, 53% specificity and 0.78 AUC. CONCLUSION: Partial resection of large vestibular schwannoma provided satisfactory control and only mild postoperative facial palsy. Small residual tumor size was the main factor for success.
Toulemonde P, Giraudet F, Macario J
… +2 more, Krause V, Vincent C
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Jan · PMID 40841284
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OBJECTIVE: This study aimed to evaluate the psychometric function curve and signal-to-noise ratio (SNR) loss values during the "Vocale Rapide dans le Bruit" (VRB) speech-in-noise test with speech level presentations at 6...OBJECTIVE: This study aimed to evaluate the psychometric function curve and signal-to-noise ratio (SNR) loss values during the "Vocale Rapide dans le Bruit" (VRB) speech-in-noise test with speech level presentations at 65dB SPL (VRB65) and 45dB SPL (VRB45) in normal-hearing subjects. MATERIALS AND METHODS: Adult normal-hearing subjects underwent an audiological evaluation including tympanometry, pure-tone audiometry, speech recognition threshold in silence and speech-in-noise audiometry following the recommended protocol (65dB SPL, VRB), followed by a second series of tests with a lower sentence presentation level (45dB SPL, VRB). RESULTS: Among the 29 normal-hearing subjects, there was no significant variation in the psychometric function curves or SNR loss values for VRB or VRB. CONCLUSION: The "Vocale Rapide dans le Bruit" speech-in-noise test is a relevant tool for assessing auditory difficulties in noisy environments. In normal-hearing subjects, presenting sentences at different intensity levels did not show a significant difference. This was an essential prerequisite for its use at various signal presentation levels, which could enable the evaluation of the functional state of high- and low-threshold auditory nerve fibers. This, in turn, would refine clinical diagnosis and improve the management of hearing disorders associated with hidden hearing loss.
Martellosio JP, Deroche L, Garcia M
… +1 more, Carsuzaa F
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Jan · PMID 40835525
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INTRODUCTION: Nasal infection caused by Mycobacterium avium is rare and is a diagnostic challenge due to the non-specific symptoms and absence of pathognomonic signs. CASE REPORT: We report the case of a 72-year-old pati...INTRODUCTION: Nasal infection caused by Mycobacterium avium is rare and is a diagnostic challenge due to the non-specific symptoms and absence of pathognomonic signs. CASE REPORT: We report the case of a 72-year-old patient with chronic rhinitis persisting for 4years and refractory to conventional treatments. ENT examination revealed irregular nasal mucosa with an inflammatory nasopharyngeal polyp. Histological analysis showed epithelioid granuloma, and Ziehl-Neelsen staining highlighted acid-fast bacilli. Mycobacterial culture confirmed M. avium infection. Treatment with rifampin, azithromycin and ethambutol led to significant clinical improvement, with resolution of local inflammation. DISCUSSION: Nasal infection by M. avium is exceptional, with only a few cases reported in the literature. Diagnosis relies on histological examination and mycobacterial culture. Treatment combines surgical resection of the polypoid tumor and prolonged antibiotic therapy. CONCLUSION: M. avium infection should be considered in cases of atypical chronic rhinitis resistant to treatment. Thorough microbiological evaluation is essential for accurate diagnosis and appropriate management.
Oishi N, Rodríguez-Prado C, Reboll R
… +2 more, Alba JR, Zapater E
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Jan · PMID 40830003
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INTRODUCTION: Vestibulectomy prior to Transoral microelectrodes surgery (TOMES) cordectomies improves the tumor exposure, enables precise oncological surgery ensuring minimal invasiveness. The finding of dysplasia in non...INTRODUCTION: Vestibulectomy prior to Transoral microelectrodes surgery (TOMES) cordectomies improves the tumor exposure, enables precise oncological surgery ensuring minimal invasiveness. The finding of dysplasia in non-oncologic ventricular fold (VF) resections led us to analyze the histopathological results in all the samples. MATERIAL AND METHODS: We present a retrospective study analyzing 64 T1/T2 glottic carcinoma patients treated with TOMES cordectomy and uni/bilateral vestibulectomy. The bleeding rate and presence of dysplasia were evaluated. The procedure using microelectrodes is explained in the video (supplementary material). RESULTS: Among 64 patients (97% male, mean age 65), 83 non-oncological VF resection were analyzed. Vestibulectomy does not increase the risk of hemorrhage in our series. Total of 37% of dysplasia was found, low-grade dysplasia in 19% and high-grade dysplasia in 18% (high-grade in 6% and carcinoma in situ in 12%). CONCLUSION: The vestibulectomy in TOMES cordectomy enhances surgical exposure without increasing bleeding risk or surgery. Dysplastic lesions of the ventricular bands seem to occur quite frequently even when the assessment is normal.
Cachi-Pouyenne M, Haddad R, Robert D
… +3 more, Michel J, Giovanni A, Mattei A
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Jan · PMID 40783347
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BACKGROUND: In France, speech therapists are not authorized to perform fiberoptic endoscopic or other instrumental evaluations of swallowing to detect silent penetration or aspiration and to guide rehabilitation. Even so...BACKGROUND: In France, speech therapists are not authorized to perform fiberoptic endoscopic or other instrumental evaluations of swallowing to detect silent penetration or aspiration and to guide rehabilitation. Even so, regulations allow local cooperation protocols to be set up. AIMS: To assess the feasibility of the first interprofessional cooperation protocol for fiberoptic endoscopic evaluation of swallowing by speech therapists in hospitalized patients. METHOD: Between April 2023 and November 2024, 100 patients from various departments in our hospital underwent bedside evaluation of swallowing by a speech therapist, including functional fiberoptic endoscopy. RESULTS: There were no severe adverse effects and no additional discomfort associated with fiberoptic endoscopic evaluation of swallowing performed by a speech therapist as compared to head-and-neck surgery residents (95% CI, 0.114-2.922; P>0.05). After checking the assessment report, the delegating ENT physicians did not alter the speech therapist's recommendations. CONCLUSION: This first interprofessional cooperation protocol between ENT specialists and speech therapists for fiberoptic endoscopic evaluation of swallowing in France contributed to management of hospital patients with swallowing disorder, without adverse effects.
Eur Ann Otorhinolaryngol Head Neck Dis
· 2026 Jan · PMID 40780996
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INTRODUCTION: HEC® phenazone-tannin-witch hazel ointment is widely used in the treatment of epistaxis, with few adverse effects. Anaphylactic shock after packing with HEC® ointment has, to the authors' knowledge, never p...INTRODUCTION: HEC® phenazone-tannin-witch hazel ointment is widely used in the treatment of epistaxis, with few adverse effects. Anaphylactic shock after packing with HEC® ointment has, to the authors' knowledge, never previously been reported. CASE REPORT: A 53 year-old male presented with massive epistaxis requiring packing after cauterization. After packing with HEC® ointment, the patient experienced grade 5 anaphylactic shock, requiring admission to intensive care. The outcome was ultimately favorable. CONCLUSION: Potential allergy to the ingredients of HEC® ointment should be ascertained before application, to avoid serious reactions.
Marx M, Taoui S, Mosnier I
… +16 more, Venail F, Mondain M, Uziel A, Bakhos D, Lescanne E, NGuyen Y, Bernardeschi D, Sterkers O, Godey B, Creff G, Schmerber S, Bonne NX, Vincent C, Fraysse B, Deguine O, Lepage B
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Nov · PMID 40544031
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OBJECTIVES: To estimate the proportion of subjects with single-sided or asymmetric profound hearing loss who achieve normal binaural performance, and to identify their specific demographic and audiological characteristic...OBJECTIVES: To estimate the proportion of subjects with single-sided or asymmetric profound hearing loss who achieve normal binaural performance, and to identify their specific demographic and audiological characteristics. MATERIAL AND METHODS: A French nationwide multicenter cross-sectional study included 155 subjects with single-sided or asymmetric profound hearing loss between 2014 and 2018. Speech-in-noise reception was assessed on the FraMatrix test in diotic, dichotic and reverse dichotic conditions to determine the signal-to-noise ratio allowing 50% correct reception. Sound localization was evaluated using a 180° 7-speaker horizontal array around the subject, to measure the root mean square error. The article was written following STROBE guidelines. RESULTS: Nineteen of the 155 subjects with single-sided (n=104) or asymmetric profound hearing loss (n=51) achieved normal scores for diotic speech reception in noise (i.e., critical signal-to-noise ratio better than -4.8dB), and 9 subjects (7.1%) had normal sound localization (i.e.,<30° error). In the 44 subjects (28.4%) with normal or near-normal diotic signal-to-noise ratio (better than -3dB), had significantly better hearing thresholds in the better ear, and notably for high frequencies between 2 and 4kHz. CONCLUSION: In this cross-sectional study, 7.1% to almost 30% of subjects with single-sided or asymmetric profound hearing loss showed normal or near-normal binaural performance. Their main distinguishing audiological feature was better hearing thresholds in the better ear, which suggests compensatory strategies based on monaural spectral cues.