Micaletti F, Marx M, Pelle-Boudeau L
… +3 more, Alfaqan N, Galvin JJ, Bakhos D
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Sep · PMID 40057433
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OBJECTIVE: To assess audiological outcome in adult (>18years) cochlear implant (CI) users with a straight (SA) or perimodiolar electrode array (PMA). MATERIAL AND METHODS: Between 2017 and 2021, medical records of patien...OBJECTIVE: To assess audiological outcome in adult (>18years) cochlear implant (CI) users with a straight (SA) or perimodiolar electrode array (PMA). MATERIAL AND METHODS: Between 2017 and 2021, medical records of patients in 2 French centers who received a Cochlear™ SA (CI522/CI622) or PMA (CI532/CI632) CI were retrospectively analyzed according to the STROBE guidelines. Air-conduction pure-tone audiometry and disyllabic speech audiometry were recorded over a minimum 3-year follow-up. Only patients with thresholds above 90dB at low frequencies (500Hz) before surgery were considered to have residual hearing (RH). Surgery-related complications (e.g., vertigo, peripheral facial palsy, meningitis) were assessed. The significance threshold was set at P<0.005. RESULTS: We included 185 adult patients: 94 SA and 91 PMA. Median age at CI was 64.5±11.5years for SA and 60.9±12.2years for PMA. Preoperative unaided pure-tone averages (PTA) were comparable between SA and PMA (100 and 102dB, respectively; P=0.32), as were postoperative aided free-field air-conduction PTAs at 3months (30.9±6.0 and 31.3±8.8dB, respectively; P=0.68). Percentage correct dissyllabic word responses at 60dB HL did not significantly differ between SA and PMA before CI (P=0.483), or 1year (P=0.775), 2years (P=0.441) or 3years (P=0.785) post-CI, although there was a significant difference at 3months post-CI (P=0.001) in favor of PMA. Fifty-one patients (21 SA, 30 PMA) had RH prior to surgery; after 12months' CI experience, 14.2% of these had RH in the SA group and 13.3% in the PMA group. One peripheral facial palsy occurred in the SA group but resolved completely (P>0.99). Twenty patients experienced transient postoperative vertigo (10 SA [10.6%], 10 PMA [10.9%]; P=0.93). No meningitis was noted. CONCLUSION: CI with straight or perimodiolar electrodes provided similar improvement in audiological performance.
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Sep · PMID 40016006
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Nasal septal perforations (SP) are common yet challenging conditions encountered in otorhinolaryngology. Endoscopic repair of nasal septal perforations using nasal pedicle mucosal flaps has become an important treatment...Nasal septal perforations (SP) are common yet challenging conditions encountered in otorhinolaryngology. Endoscopic repair of nasal septal perforations using nasal pedicle mucosal flaps has become an important treatment method. However, there are no established guidelines for selecting the appropriate mucosal flaps for repair, and the choice largely depends on the surgeon's experience. This study outlines the procedure and benefits of utilizing a unilateral inverted mucosal flap from the nasal septum, along with criteria for selecting suitable cases for this surgical approach. The technique is best suited for moderate-sized perforations located in the anterior nasal septum, with a diameter of less than 2cm. The mucosa around the perforation is thicker. It is essential that the nasal mucosa is healthy and that the perforation edges have sufficient bony and cartilaginous support to prevent mucosal adhesion on both sides of the septum, which could hinder the complete separation of the inverted mucosal flap. Our findings suggest that, with careful case selection, the repair technique involving a unilateral inverted mucosal flap combined with stitching methods is a feasible option. This approach not only simplifies the surgical procedure but also significantly reduces its complexity, making it more accessible to those new to the field.
Vergez S, Malard O, Jegoux F
… +12 more, Blanc J, Marie JP, Faure F, Baujat B, Albert S, Fuchsmann C, Morelon E, Soldea V, Badet L, Philouze P, Céruse P, ECLAT group
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Mar · PMID 39984348
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The authors detail the harvesting, revascularization and innervation technique in the first French laryngeal transplant. To our knowledge, the detailed technique for harvesting the graft, probably the most important stag...The authors detail the harvesting, revascularization and innervation technique in the first French laryngeal transplant. To our knowledge, the detailed technique for harvesting the graft, probably the most important stage in laryngeal transplantation, has never before been described in the literature.
Yanagi N, Takeda T, Akutsu T
… +5 more, Maeda M, Nakashima D, Omura K, Mori E, Otori N
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Nov · PMID 39984346
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AIM: This study aimed to investigate the impact of residual ethmoidal laminae after endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). MATERIALS AND METHODS: This retrospec...AIM: This study aimed to investigate the impact of residual ethmoidal laminae after endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). MATERIALS AND METHODS: This retrospective cohort included 66 patients with CRSwNP who received 300mg of dupilumab every 2weeks for 16weeks between August 2020 and March 2022. Patients were categorized into the no-lamina or residual-lamina groups based on postoperative sinus computed tomography scans. Clinical parameters, including the Lund-Mackay score (primary endpoint), nasal polyp score, T&T olfactometer threshold, and SNOT-22 scores (secondary endpoints), were assessed at baseline and 16weeks posttreatment. RESULTS: Of 66 patients who received dupilumab, 51 met the inclusion criteria. The no-lamina (n=23) and residual-lamina (n=28) groups exhibited similar baseline characteristics. At 16weeks, the Lund-Mackay Score significant improved in the no-lamina group compared with the residual-lamina group (5±4 vs. 9±4; P=0.004). Non-significant differences were observed in nasal polyp score (2.6±1.6 vs. 3.3±2.0; P=0.22), T&T olfactometer threshold test score, (3.2±1.8 vs. 3.3±1.4; P=0.78) SNOT-22 score, (18±11 vs. 24±13; P=0.15). CONCLUSION: This study suggests an association between the absence of residual ethmoidal laminae and an enhanced dupilumab response in CRSwNP. Residual laminae in the anterior ethmoid affect the effectiveness of dupilumab in targeting inflammatory pathways. Meticulous clearance, particularly in the anterior ethmoidal region, optimizes the efficacy of dupilumab. Understanding the influence of residual ethmoidal laminae on dupilumab outcomes is crucial for refining post-ESS treatment strategies for patients with CRSwNP.
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Jul · PMID 39971639
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PURPOSE: User-friendly artificial intelligence (AI) chatbots are increasingly being explored to assist healthcare teams in their decision-making processes. As accurate diagnosis in all medical fields is vital in treatmen...PURPOSE: User-friendly artificial intelligence (AI) chatbots are increasingly being explored to assist healthcare teams in their decision-making processes. As accurate diagnosis in all medical fields is vital in treatment planning, this research seeks to explore the function of two specific AI chatbots, ChatGPT and Perplexity AI, in distinguishing the various types of dysphonia (organic, functional, and neurological). MATERIAL AND METHODS: In experiment 1, a script combining voice self-assessments plus the acoustic analysis, and in experiment 2, only the acoustic analysis of 37 dysphonic patients was fed into the ChatGPT and Perplexity AI chatbots specifying the type and asked to develop a complex AI-based model to determine dysphonia type. Then, the same process was redone with data from a sample of 27 other patients as a test. RESULTS: Although ChatGPT could not analyze the data and only provided guidance, the Cohen's Kappa agreement between experts' diagnoses and Perplexity AI diagnoses in experiment 1 (P=0.773) and experiment 2 (P=0.067) lacked statistically significance. CONCLUSION: Regarding the preliminary poor performance of AI chatbots in differential diagnosis of dysphonia type, it is not currently recommended to use them in clinical settings. However, modifications in AI chatbots in the future might provide more promising results in determining the dysphonia type. Further research is needed to shed light on AI chatbots ability in voice clinics.
Sanabria A, Bradley P, de Bree R
… +7 more, Guntinas-Lichius O, Hamoir M, Kowalski LP, Rodrigo JP, Strojan P, Vander Poorten V, Ferlito A
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 May · PMID 39966080
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AIM: The treatment of salivary gland cancers with clinically negative neck is controversial, with divergent guidelines about elective neck dissection (END). Even though these guidelines are widely used, they mostly rely...AIM: The treatment of salivary gland cancers with clinically negative neck is controversial, with divergent guidelines about elective neck dissection (END). Even though these guidelines are widely used, they mostly rely on retrospective research that are subject to methodological flaws and selection bias. METHODS: A critical narrative review. Problem description, identification of likely clinical scenarios, appraisal of previous recommendations, critical examination of available data, and presentation of clinical decision-making options comprised the article creation. RESULTS: One of the most important factors is the rate of occult lymph node metastases, which ranges from 2-30% and varies greatly depending on the kind and grade of tumor. The use of risk classification according to preoperative findings, such as tumor size, grade, and clinical signs such involvement of the facial nerve, offers some guidance. Nevertheless, unanticipated cancers are frequently discovered by intraoperative and postoperative histological results, which makes decision-making even more difficult. Alternatives to END, including elective neck irradiation, have similar effectiveness in reducing regional recurrence in high-risk scenarios. Although END may enhance regional control, it carries risks of surgical complications, such as injury to nerves and functional impairment. No prospective randomized studies have definitively demonstrated the advantage of END regarding survival or recurrence. CONCLUSION: END may be appropriate in certain high-risk situations, but its regular use in cN0 salivary gland cancers is still up for debate. A personalized strategy that accounts for tumor-specific and patient-related variables, together with careful use of adjuvant treatments, is advised until substantial prospective data is available.
Seuthe IMC, Van Ackeren K, Dazert S
… +3 more, Eichhorn S, Veleva T, Park JJ
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 May · PMID 39966079
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OBJECTIVE: Conducting a prospective pilot study to investigate the effect of temperature-controlled radiofrequency treatment of the nasal valve in endurance athletes with internal nasal valve collapse. MATERIAL AND METHO...OBJECTIVE: Conducting a prospective pilot study to investigate the effect of temperature-controlled radiofrequency treatment of the nasal valve in endurance athletes with internal nasal valve collapse. MATERIAL AND METHODS: Twenty-five endurance athletes with nasal valve collapse were recruited from 2018 to 2020. Eight of the 25 patients dropped out of the study due to different reasons (injured due to non-nasal causes before postoperative measurement, refusal of surgery in the short term, termination due to corona pandemic), so that 17 study participants completed the study. We investigated NOSE questionnaire and rhinomanometry before and after radiofrequency treatment of the internal nasal valve (Vivaer radiofrequency probe). In addition, an exhaustive treadmill test before and after radiofrequency treatment was performed. The collected measurements were registered and compared with paired t-test. A Cohen's dz was performed for significant results. The normal distribution was confirmed by using the Kolmogorov-Smirnov test and Q-Q plots. RESULTS: There was a significant improvement in the NOSE score (P<0.001, Cohen's dz=1.03) and no serious side effects. No significant differences were seen before and after the treatment in rhinomanometry and spiroergometry. CONCLUSION: Due to the low side effects and the subjective improvement in nasal breathing according to the NOSE score, the technique could perhaps represent a promising non-invasive therapy for improving nasal breathing in endurance athletes. However, no significant improvement was observed in the objective parameters. Larger study cohorts are required to investigate the effect in more detail.
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Mar · PMID 39706764
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Research and knowledge in human embryology greatly progressed during the second half of the 19th century. This allowed optimization of surgical treatment of branchial deformities and cervical cysts in the light of their...Research and knowledge in human embryology greatly progressed during the second half of the 19th century. This allowed optimization of surgical treatment of branchial deformities and cervical cysts in the light of their embryological development. In 1920, Walter Ellis Sistrunk described an embryologically-based technique for resection of thyroglossal duct fistulae and cysts. A century later, the procedure is still being performed as originally described.
Thibault C, Mailly M, Debry C
… +2 more, Schultz P, Fath L
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Sep · PMID 39701874
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Retrograde cricopharyngeal dysfunction (RCPD) syndrome renders patients unable to belch, causing disabling symptoms that impact quality of life. Injection of botulinum toxin into the cricopharyngeal muscle has been repor...Retrograde cricopharyngeal dysfunction (RCPD) syndrome renders patients unable to belch, causing disabling symptoms that impact quality of life. Injection of botulinum toxin into the cricopharyngeal muscle has been reported as a trial treatment for both therapeutic and diagnostic purposes. We describe the injection technique, under general anesthesia using endoscopy or by transcutaneous injection with electromyographic control.
Goudsmit K, Tran A, Tauziède-Espariat A
… +1 more, Veyrat M
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Sep · PMID 39701873
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INTRODUCTION: Progressive anosmia, unlike sudden-onset viral or traumatic anosmia, requires endoscopic screening for nasal polyps. In the absence of polyposis, radiological work-up should diagnose and treat any curable p...INTRODUCTION: Progressive anosmia, unlike sudden-onset viral or traumatic anosmia, requires endoscopic screening for nasal polyps. In the absence of polyposis, radiological work-up should diagnose and treat any curable pathology. Here, we report the case of a patient treated for olfactory cleft actinomycosis. RESULTS: A 72 year-old man, without relevant medical history, was referred for progressive hyposmia and unilateral greenish rhinorrhea resistant to well-conducted medical treatment. Nasal endoscopy and imaging suggested a fungus ball in the left olfactory cleft. Endoscopic surgery fully restored olfaction, with histologic confirmation of actinomycetes. DISCUSSION: The present case highlights the importance of prompt diagnosis in progressive anosmia, and demonstrates the efficacy of exclusively surgical management.
Debry C, Brenet E, Martinod E
… +4 more, Lavalle P, Dupret-Bories A, Schultz P, Fath L
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 May · PMID 39658501
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CASE DESCRIPTION: A 70 year-old woman presenting T4aN2cM0 laryngeal carcinoma first underwent total laryngectomy with airway reconstruction by cryopreserved aortic allograft. Six months after chemoradiotherapy, she under...CASE DESCRIPTION: A 70 year-old woman presenting T4aN2cM0 laryngeal carcinoma first underwent total laryngectomy with airway reconstruction by cryopreserved aortic allograft. Six months after chemoradiotherapy, she underwent endoscopic surgery to create a neo-laryngopharynx. RESULTS: At 13 months after primary surgery, day- and night-time breathing was effectively restored, with a little persistent salivary false passage, and a whispering but comprehensible voice after tracheostomy closure. Swallowing was possible for small amounts of soft food, thanks to sustained rehabilitation, although normal feeding was not achieved. The patient showed no episodes of pneumopathy. General health status was good, with no oncologic relapse. DISCUSSION: This was the first case of laryngeal replacement by cryopreserved aortic allograft, showing progress in the decades-long aim of final tracheostomy closure. The ultimate objective is to achieve swallowing without false passage, by improving various aspects of surgical technique,without, so far as possible, making the procedures more complex by active airway protection systems.
Saro-Buendía M, Mansilla-Polo M, García-Piñero A
… +1 more, Armengot-Carceller M
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Sep · PMID 39658500
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INTRODUCTION: To document through a case report the ENT manifestations of the STING-associated vasculopathy with onset in infancy (SAVI) syndrome, remarking their value to achieve the diagnosis. CASE SUMMARY: A man in hi...INTRODUCTION: To document through a case report the ENT manifestations of the STING-associated vasculopathy with onset in infancy (SAVI) syndrome, remarking their value to achieve the diagnosis. CASE SUMMARY: A man in his forties presented with exercise-related dyspnoea and cold-exacerbated painful lesions over the nasal tip, cheeks, ears, and feet since his early childhood. The ENT manifestations included cartilaginous necrosis (both auricles and nasal tip) and a 1-cm anterior septal perforation. A familiar inheritance pattern was evident and genetic studies confirmed the diagnosis of a SAVI syndrome. Therapy with JAK inhibitors was implemented, resulting in a favorable response. DISCUSSION: SAVI syndrome is a recently described disease with recognizable otolaryngologic manifestations that may be key to clinical suspicion and genetic diagnosis.
Guigou C, Folia M, Reliquet B
… +3 more, Lalande A, Brisson M, Bozorg Grayeli A
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 May · PMID 39645452
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AIM: To evaluate the audiometric results of tympanoplasty with stapedectomy and insertion of a synthetic total ossicular replacement prosthesis (TORP). MATERIAL AND METHODS: Retrospective observational study conducted on...AIM: To evaluate the audiometric results of tympanoplasty with stapedectomy and insertion of a synthetic total ossicular replacement prosthesis (TORP). MATERIAL AND METHODS: Retrospective observational study conducted on a cohort of 15 patients (16 ears) aged 10 to 58 years (mean: 36 years) with chronic otitis media (COM) and tympanosclerosis (n=9), stapediovestibular ankylosis (n=3), minor aplasia (n=3) or post-traumatic ossicular dislocation (n=1). Treatment consisted in tympanoplasty with stapedectomy and TORP placement by the same operator, between December 1, 2012 and January 30, 2023, in a French university hospital department, with follow-up ranging from 2 to 92 months (mean: 24 months). The primary endpoint was postoperative change in air conduction (AC) threshold and air-bone gap (ABG). Secondary endpoints comprised change in speech recognition threshold (SRT) and speech discrimination score (SDS) and analysis of complications. The STROBE editorial line was followed and the significance threshold was set at P<0.005. RESULTS: There was significant improvement in AC threshold (-2 to 25dB, mean: 10dB; P=0.001), ABG (-8 to 26dB, mean: 10dB), SRT (2 to 30dB, mean: 13dB; P<0.0001) and SDS (P=0.001). No patients showed vestibular symptoms postoperatively. CONCLUSION: This study suggests that this technique is a possible and safe therapeutic option in selected cases of stapes footplate fixation associated with other ossicular anomalies.
Connesson J, Beck C, Vincent C
… +1 more, Toulemonde P
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Mar · PMID 39632221
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INTRODUCTION: Chondroid syringoma or ceruminous pleomorphic adenoma is a benign mixed cutaneous tumor. It is the second most frequent glandular lesion in the external auditory canal, but no cases associated with bone ero...INTRODUCTION: Chondroid syringoma or ceruminous pleomorphic adenoma is a benign mixed cutaneous tumor. It is the second most frequent glandular lesion in the external auditory canal, but no cases associated with bone erosion were found in a PubMed search. CASE REPORT: The present CARE case report details a chondroid syringoma in the external auditory canal with associated bone lysis, and its management. DISCUSSION: Chondroid syringoma is a differential diagnosis for other external auditory canal tumors. Forms causing bone erosion are rare, but should not challenge the diagnosis. Current treatment consists in complete and broad surgical resection and prolonged follow-up due to the risk of recurrence and of malignant transformation.
Martin M, Ayraud-Thevenot S, Dufour X
… +3 more, Lebreton JP, Guihenneuc J, Carsuzaa F
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Mar · PMID 39632220
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INTRODUCTION: Increasing emissions of greenhouse gases contribute to climate change. The healthcare sector, and particularly the operating room, is a significant emitter of greenhouse gases. In head-and-neck surgery, ped...INTRODUCTION: Increasing emissions of greenhouse gases contribute to climate change. The healthcare sector, and particularly the operating room, is a significant emitter of greenhouse gases. In head-and-neck surgery, pediatric procedures are very common, but few studies have assessed their ecological impact. Our objective was to quantify the carbon footprint of common pediatric head-and-neck surgeries (tonsillectomy, adenoidectomy, and transtympanic tube placement). METHODS: An eco-epidemiological study was conducted in December 2022 in a tertiary hospital center. The carbon footprint of 10 pediatric head-and-neck surgeries (tonsillectomies, adenoidectomies, transtympanic tube placements) was calculated, as the sum of carbon dioxide (COeq) emissions generated by patient and medical staff transport, waste production, energy consumption in operating rooms, manufacturing and transport of disposable and reusable medical devices (MDs), medication production, and sterilization of reusable MDs. RESULTS: The carbon footprint of 1 pediatric head-and-neck surgery was 57.86kgCOeq. Disposable MDs were the most polluting item with 30.82kgCOeq (53.3%). Patient transport accounted for 27.4%, medication for 12.6% and reusable MDs for 2.9%. CONCLUSIONS: Pediatric head-and-neck surgeries generate a significant quantity of CO, mostly due to the production and delivery of disposable MDs. These observations could serve as a starting point for ecological actions consistent with an environmentally sustainable and climate-resilient health system.