Vincent L, Robard L, Creveuil C
… +3 more, Babin E, Perreard M, Humbert M
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Mar · PMID 39510938
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UNLABELLED: Treatment of nosebleeds in Osler-Weber-Rendu disease (OWRD) is a therapeutic challenge. Intranasal anti-angiogenic sprays are a promising solution, requiring scientific validation, leading us to conduct the p...UNLABELLED: Treatment of nosebleeds in Osler-Weber-Rendu disease (OWRD) is a therapeutic challenge. Intranasal anti-angiogenic sprays are a promising solution, requiring scientific validation, leading us to conduct the present study. OBJECTIVE: The main objective was to determine the minimum effective dose of bevacizumab by intranasal spray to treat epistaxis in OWRD: i.e., the dose resulting in≥50% reduction in the number of nosebleeds at 1 month of treatment compared to the month prior to inclusion for 60% of patients. The secondary objectives were to assess treatment efficacy at 3 and 6 months and progression in the number and impact of nosebleeds, and to document pharmacokinetics. MATERIALS AND METHODS: The study, named EROSB (treatment of epistaxis in patients with OWRD using a bevacizumab intranasal spray), under the French Hospitals Clinical Research Program (PHRC-I 2013), was selected by the Inter-regional Clinical Research and Innovation Group (GIRCI). It was a phase I/II prospective single-blind study based on 10 cohorts of 3 patients each, using the Continual Reassessment Method (CRM) to determine the minimum effective dose of bevacizumab. RESULTS: Due to difficulties in recruiting enough patients, the study was stopped after inclusion of 15 subjects. The CRM method identified 64mg as the minimum effective dose. However, this result is not interpretable due to the small number of subjects. CONCLUSION: The EROSB study did not succeed in identifying a minimum effective dose of bevacizumab, administered as intranasal spray that could reduce the number of nosebleeds compared to the month prior to inclusion. However, the initial results indicated almost no systemic passage of the substance.
Piccin O, Contedini F, Sciarretta V
… +1 more, Pinto V
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Jul · PMID 39472234
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The main goal for treatment of locally advanced thyroid carcinoma invading the laryngotracheal and esophageal complex, is radical surgical excision and reconstruction of a functional aerodigestive tract. We describe a ch...The main goal for treatment of locally advanced thyroid carcinoma invading the laryngotracheal and esophageal complex, is radical surgical excision and reconstruction of a functional aerodigestive tract. We describe a challenging surgical technique in which a wide laryngotracheal and esophageal defect was functionally reconstructed using a single anterolateral thigh flap. This can represent a good option for a tailored functional reconstruction of extended defects of the aerodigestive tract.
Nguyen DH, Garcia D, Mirghani H
… +2 more, Giraud P, Laccourreye O
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Jan · PMID 39443220
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OBJECTIVES: To document conservative laryngeal treatment for cT12N0M0 glottic squamous cell carcinoma (SCC) in octogenarians in France in the 21st century. MATERIAL AND METHODS: Retrospective observational study comparin...OBJECTIVES: To document conservative laryngeal treatment for cT12N0M0 glottic squamous cell carcinoma (SCC) in octogenarians in France in the 21st century. MATERIAL AND METHODS: Retrospective observational study comparing a cohort of 38 octogenarians (Group A) to a control cohort of 107 septuagenarians (Group B), with isolated cT12N0M0 glottic SCC, consecutively managed between 2000 and 2018 at a single French university hospital center. The main endpoints were 5-year actuarial overall and disease-free survival and causes of death, compared between groups. Accessory endpoints were 5-year actuarial local control and laryngeal preservation. 93% of patients were followed until death or for a minimum 5years. The STROBE guideline was used. The significance threshold was set at P<0.005. RESULTS: The only significant difference in demographic, oncologic and treatment variables between groups was a higher mean Charlson index in Group A (P=0.004). Five-year actuarial survival, at 79% overall, did not significantly differ between groups A and B (80% and 79%, respectively; P=0.30). Five-year actuarial disease-free survival, at 74% overall, did not significantly differ between groups (77% and 73%; P=0.42). Intercurrent disease accounted for 44% of causes of death, with cardiovascular etiology in 71% of cases. Five-year actuarial local control, at 76% overall, did not significantly differ between groups (80% and 75%; P=0.41). Salvage treatment for local recurrence yielded a 94% overall local control rate: 98% in Group A and 93% in Group B. Five-year actuarial laryngeal preservation rate, at 92%, did not significantly differ between groups (90% and 98%; P=0.20). CONCLUSION: Conservative laryngeal treatment for cT12N0M0 SCC in octogenarians yielded the same results as in septuagenarians. Improvement in survival will depend on management and monitoring of comorbidity, and particularly cardiovascular comorbidity.
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Mar · PMID 39443219
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AIMS: To determine the optimal stimulation intensity for frontal stimulation with a modified slit lamp holder and to compare the reliability and symmetry of bone-conducted ocular vestibular evoked myogenic potentials (oV...AIMS: To determine the optimal stimulation intensity for frontal stimulation with a modified slit lamp holder and to compare the reliability and symmetry of bone-conducted ocular vestibular evoked myogenic potentials (oVEMPs) using two stimulation sites: frontal medial and mastoid. METHODS: This observational study included 33 healthy volunteers (15 women, 18 men; mean age 24.5years) at the University Hospital of Lausanne. Participants underwent otoneurological assessments, and those with normal results were included. Bone-conducted oVEMPs were recorded using a Brüel and Kjaer mini-shaker type 4810. A modified slit lamp holder was used for frontal stimulation to ensure consistent application pressure, freeing the examiner's hands. Mastoid stimulation was performed manually. RESULTS: The best reproducibility of oVEMP recordings was observed at 70dB nHL. Frontal stimulation demonstrated lower dispersion of data and lower asymmetry ratios of latencies (up to 7%) and amplitudes (up to 50%) compared to mastoid stimulation (up to 40% for latencies). Single stimulations at both frontal and mastoid sites were sufficient to obtain reliable measurements of both utricles. CONCLUSION: Frontal stimulation at 70dB nHL using a modified slit lamp holder is recommended for bone-conducted oVEMP recordings due to its superior reproducibility, comfort, and reliability. This study establishes a new standard for optimal stimulation intensity and supports the use of frontal stimulation in clinical practice.
Favier V, Agunaoun M, Ferret C
… +1 more, François C
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 May · PMID 39438205
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Drug-induced sleep endoscopy (DISE), performed in the operating room, improves airway obstruction phenotyping in obstructive sleep apnea syndrome (OSAS). It pharmacologically approximates human sleep and allows dynamic m...Drug-induced sleep endoscopy (DISE), performed in the operating room, improves airway obstruction phenotyping in obstructive sleep apnea syndrome (OSAS). It pharmacologically approximates human sleep and allows dynamic maneuvers, notably including mandibular advancement, the results of which are predictive of those with a mandibular advancement device (MAD): when obstruction is resolved by mandibular advancement under DISE, a MAD may be indicated. However, individual maximal mandibular advancement in the waking state has to be taken into account, and the MAD should not exceed 75% of this value (MA75), in order to respect temporomandibular joint tolerance. Thus, MA75 needs to be measured and reproduced exactly during DISE in order to assess the clinical indication for MAD in terms of both efficacy and tolerance. The present technical note describes a method for measuring MA75 and reproducing it during DISE with an adapted device so as to select candidates for MAD.
Bou Malhab F, Hosri J, Zaytoun G
… +1 more, Hadi U
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Jul · PMID 39395902
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OBJECTIVES: To introduce the trigeminal cervical complex (TCC) as a comprehensive framework for understanding the anatomical and functional scope of the afferences and efferences of the trigeminal nerve and explaining co...OBJECTIVES: To introduce the trigeminal cervical complex (TCC) as a comprehensive framework for understanding the anatomical and functional scope of the afferences and efferences of the trigeminal nerve and explaining common otolaryngologic symptoms, including head and neck myofascial pain syndrome. Additionally, it explores how the bidirectional transmission of neurotransmitters contributes to the sensitization of the TCC and motor nuclei. METHODS: The study was conducted as a narrative review. The authors performed a comprehensive search of multiple databases, including Medline/OVID, Embase, Scopus, and PubMed, covering publications from inception until August 2023. Both keywords and medical subject headings related to the TCC were utilized in the search. Information from 66 studies was extracted based on predetermined inclusion and exclusion criteria. RESULTS: This review discusses the multiple afferent connections from cranial nerves, specifically VII, IX, X, and XI, to the TCC, and their respective efferent pathways. These connections may explain various clinical manifestations in the head and neck that cannot be attributed to other medical conditions. Additionally, the review highlights the dual sensory and motor nature of cranial nerves, emphasizing the bidirectional transmission of neurotransmitters in head and neck areas, which leads to the sensitization of both the TCC and motor nuclei innervating the cervicofacial muscles. CONCLUSION: The authors hypothesize that the central and peripheral sensitization and the intricate connections of the TCC can elucidate the pathophysiology of conditions such as otalgia, tinnitus, hearing loss, vertigo, headache, cervicogenic dizziness, bruxism, and other symptoms affecting the head and neck.
Martin-Jimenez D, Moreno-Luna R, Gago-Torres C
… +2 more, Maza-Solano J, Sanchez-Gomez S
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Mar · PMID 39393936
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OBJECTIVES: Review of the scientific literature dedicated to investigating how residual structures impact surgical outcomes in chronic rhinosinusitis (CRS) patients, providing information on the frequency of anatomical r...OBJECTIVES: Review of the scientific literature dedicated to investigating how residual structures impact surgical outcomes in chronic rhinosinusitis (CRS) patients, providing information on the frequency of anatomical remnants after endoscopic sinus surgery (ESS). MATERIAL AND METHODS: This review has been reported following the recommendations of the SWiM guideline. PubMed, Cochrane Library, Embase, and Web of Science were searched until April 2024. Studies selected for the systematic review were assessed about quality and risk of bias using the Oxford Centre for Evidence-Based Medicine Levels of Evidence and STROBE. The findings were analyzed descriptively and qualitatively, aligning with EPOS and ICAR guidelines. RESULTS: Fourteen relevant studies met the inclusion criteria for qualitative synthesis. Prospective and retrospective cross-sectional designs, focusing on revision ESS, were included. Four studies examined full-house functional ESS (FESS), three focused on frontal sinus surgery, four on conventional FESS and three did not specify the surgery type. The risk of bias was assessed, revealing significant variability in study quality and a low level of evidence. Wide variability was found in anatomical structures remaining after ESS, most notably in retained uncinate process (29.6-64%), agger nasi cell (4.5-83.33%) and frontoethmoidal cells (40.7-96.8%). Observations on concha bullosa, septal deviation and lateralization of the middle turbinate revealed distinct patterns among the included studies. CONCLUSION: This systematic review underscores the persistent challenge of incomplete resection of anatomical structures in revision surgeries for CRS. The variability in the retention of key structures highlights the complexity of surgical outcomes and the need for further refinement in surgical techniques.
Leboulanger N, Celerier C, Parodi M
… +2 more, Denoyelle F, Thierry B
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 May · PMID 39389861
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A report book unearthed in our archives contained 352 operative reports from the otorhinolaryngology department of the Armand-Trousseau Children's Hospital in Paris, dated from January 1912 to August 1920. These document...A report book unearthed in our archives contained 352 operative reports from the otorhinolaryngology department of the Armand-Trousseau Children's Hospital in Paris, dated from January 1912 to August 1920. These documents provide a snapshot of surgical activity in this field at the time. Mastoidectomy for mastoiditis was by far the most common procedure. This incomplete but original snapshot bears witness to the habits and working conditions of our predecessors, as well as to the progress made in just over a century.
Banh Chong T, Sagot O, Alexis M
… +3 more, Brehin C, Brochard K, Gallois Y
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 May · PMID 39322492
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INTRODUCTION: PFAPA (Periodic Fever, Aphthous stomatitis, Pharyngitis, Adenitis) or Marshall syndrome is the most frequent cause of recurrent auto-inflammatory fever in children. Frequent episodes impair the child's qual...INTRODUCTION: PFAPA (Periodic Fever, Aphthous stomatitis, Pharyngitis, Adenitis) or Marshall syndrome is the most frequent cause of recurrent auto-inflammatory fever in children. Frequent episodes impair the child's quality of life and family life. Total tonsillectomy demonstrated efficacy in improving symptoms, but few studies assessed partial tonsillectomy in this indication. The aim of the present study was to assess postoperative course after partial tonsillectomy for PFAPA syndrome, with comparison to total tonsillectomy. MATERIALS AND METHODS: This retrospective cohort study adhered to STROBE guidelines. It included children with PFAPA syndrome on EUROFEVER criteria, treated by partial or total tonsillectomy between January 1, 2011 and December 31, 2022 in our university hospital center. For comparisons, the significance threshold was set at P<0.005. RESULTS: Thirty-six children were included: 16 with partial and 20 with total tonsillectomy. With partial tonsillectomy, the number of episodes decreased by 10 per year (range, 5-21) (P<0.005) over 6 years' follow-up. The decrease was 50% with partial tonsillectomy and 93% with total tonsillectomy (P=0.056). The decrease in number was statistically suggestive (P=0.028). There were no complications with partial tonsillectomy and 2 patients with complications (10%) with total tonsillectomy. Two of the 16 patients with partial tonsillectomy (12.5%) required totalization, achieving remission in both cases. CONCLUSION: Partial tonsillectomy significantly reduced the frequency, duration and intensity of postoperative episodes in PFAPA syndrome. It may be less effective than total tonsillectomy, but has a lower risk of complications awaiting remission in adolescence.
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Jan · PMID 39304412
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Behind the retro auricular groove, hidden by the pinna, on the surface of the mastoid, there is, a bony outgrowth, known by any otorhinolaryngologist worthy of the name, located above and behind the entrance to the exter...Behind the retro auricular groove, hidden by the pinna, on the surface of the mastoid, there is, a bony outgrowth, known by any otorhinolaryngologist worthy of the name, located above and behind the entrance to the external auditory canal in front of the supra meatic fossa: Henle's spine. In this historical note the authors retrace the moment of the dicovery of this primordial relief of otological surgery and the life of its discoverer, the German anatomis Jakob Henle, a true malesrtom which mixes science, art politics, and love.
Camhi Y, Cerceau S, Didier M
… +2 more, Hernandez J, Leboulanger N
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Jan · PMID 39304411
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OBJECTIVES: The aim of the present study was to assess greenhouse gas emissions for the main current subtotal tonsillectomy techniques. MATERIALS AND METHODS: A retrospective study was conducted in 2 French university ho...OBJECTIVES: The aim of the present study was to assess greenhouse gas emissions for the main current subtotal tonsillectomy techniques. MATERIALS AND METHODS: A retrospective study was conducted in 2 French university hospital pediatric ENT departments in 2022. The target techniques were radiofrequency with single-use or reusable needle, coblation, and dissection by cold instruments or by bipolar forceps. The medical devices required by each technique were listed and respective greenhouse gas emissions (carbon footprint, in kg eCO) were calculated, according to weight, energy consumption and place of production. RESULTS: Coblation generated a carbon footprint of 8.6kg eCO, versus 0.1-0.2kg eCO for the other techniques. CONCLUSION: Greenhouse gas emissions in subtotal tonsillectomy differ greatly according to technique. Bipolar dissection and radiofrequency have a smaller footprint than coblation. This type of data, which needs to be weighed over time according to medical benefit, should be systematically taken into account in choosing hardware for surgery.