Maquet C, Willemet A, Francois A
… +2 more, Crampon F, Deneuve S
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 May · PMID 39294070
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INTRODUCTION: Wild-type transthyretin amyloidosis (ATTRwt) is a rare but serious disease that is underestimated due to asymptomatic progression. Cardiac deposits worsen prognosis, highlighting the importance of early det...INTRODUCTION: Wild-type transthyretin amyloidosis (ATTRwt) is a rare but serious disease that is underestimated due to asymptomatic progression. Cardiac deposits worsen prognosis, highlighting the importance of early detection for preventive treatment. CASE REPORT: An elderly patient presented with an osteolytic lesion of the middle ear. Pathology diagnosed amyloid transthyretin deposits associated with cholesteatoma. DISCUSSION: Identifying reliable markers to screen for risk of cardiac amyloidosis is important, due to poor prognosis. Recent studies found higher prevalence of hearing loss in ATTRwt than in the general population. The present case identified the middle ear as a target of ATTR, which could improve our understanding of the pathophysiology.
Lasfargues-Delannoy A, Berland A, Cochard N
… +7 more, Husson H, Calmels MN, Tardieu J, Gaillard P, Barone P, Farrer C, Deguine O
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Jan · PMID 39261125
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INTRODUCTION: Hearing is essential for language acquisition and understanding the environment. Understanding how children react to auditory and visual information is essential for appropriate management in case of hearin...INTRODUCTION: Hearing is essential for language acquisition and understanding the environment. Understanding how children react to auditory and visual information is essential for appropriate management in case of hearing loss. Objective and subjective assessments can diagnose hearing loss, but do not measure natural perception in children. We developed a "sensory room" for complementary assessment of children's perceptions so as to assess behavioral responses to meaningful natural sounds and visual stimuli in an ecologic environment suited to children. MATERIAL AND METHODS: Sixteen normal-hearing children and 10 with congenital hearing loss before cochlear implantation, aged 13 to 32months, were included in this feasibility study. They perceived 18 environmental sounds and 9 visual stimuli, and their behavioral responses were coded accordingly as: stopping, looking, moving, pointing, language or emotional reactions. RESULT: All children completed the task, demonstrating its feasibility in children. Percentage responses to auditory versus visual stimuli did not differ in normal-hearing children; those with congenital hearing loss responded like normal-hearing children to visual stimuli, but did not react to auditory stimuli. Progression in normal-hearing children's behavioral responses corresponded to cognitive and linguistic development according to age. CONCLUSION: The "sensory room" quantified children's responses to various auditory and visual stimuli, providing clinicians with measurable insight into the children's sensory perception and processing.
André M, El Gani N, Lescanne E
… +2 more, Boullaud L, Bakhos D
Eur Ann Otorhinolaryngol Head Neck Dis
· 2024 Nov · PMID 39217053
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AIM: The main aim of this study was to evaluate 6-month closure success in surgery for isolated or non-isolated temporal bone osteomeningeal breach (OMB). Secondary objectives were to analyze complications of closure and...AIM: The main aim of this study was to evaluate 6-month closure success in surgery for isolated or non-isolated temporal bone osteomeningeal breach (OMB). Secondary objectives were to analyze complications of closure and correlations between success and breach, treatment and patient data. MATERIAL AND METHOD: This was a single-center retrospective observational study of patients who underwent surgery for temporal bone OMB via a middle cranial fossa or transmastoid approach in a French university teaching hospital between 2007 and 2022, with follow-up of at least 6months. Patients with superior semicircular canal dehiscence were excluded. Study data comprised gender, age, body mass index, OMB etiology, mode of discovery, audiometric and radiological data, surgical technique, length of hospital stay and postoperative complications. The primary endpoint was absence of a cerebrospinal fluid leak on MRI at 6months. Fisher's exact test or Chi test were used for qualitative data and Student t-test for quantitative data. RESULTS: The closure success rate was 87%: 81% (3 recurrences) in the middle cranial fossa group of 16 patients and 93% in the transmastoid group of 14 patients. Postoperative audiometry showed significant improvement (P=0.0016) for air conduction in the middle cranial fossa group. Five patients (17%) operated on via the middle cranial fossa approach and 1 (7%) operated on via the transmastoid approach had postoperative complications. OMB was in the tegmen mastoideum in 8 patients (29%), tegmen tympani in 7 (25%), tegmen antri in 4 (14%), tegmina antri and tympani in 3 (11%), antri and mastoideum in 1 (8%) and in the whole tegmen in 5 (18%). Eleven OMBs were lateral to the superior semicircular canal, 13 medial and 4 on either side. CONCLUSION: The transmastoid approach is indicated in case of associated middle-ear procedures, patients aged over 75years or OMB lateral to the superior semicircular canal. The middle cranial fossa approach is reserved for OMB located medial to the superior semicircular canal patients under 75years of age without associated ossicular procedures. For patients with OMB medial to the superior semicircular canal who require middle-ear surgery, a combined approach can be used.
Gargula S, Babin E, Tuset MP
… +3 more, Daval M, Mattei A, Ayache D
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Mar · PMID 39122589
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OBJECTIVE: Patient-Reported Outcome Measures (PROMs) are now an integral part of clinical and academic practice in ENT, and it is essential to have tools with a validated French version. However, there are no guidelines...OBJECTIVE: Patient-Reported Outcome Measures (PROMs) are now an integral part of clinical and academic practice in ENT, and it is essential to have tools with a validated French version. However, there are no guidelines on ENT questionnaires available in French or those that could have transcultural adaptation. METHODS: The present study, under the auspices of the ENT National Professional Council and the French Society of ENT, inventoried PROMs, for each super-specialty and pathology, meeting one of the following inclusion criteria: validated French version, not translated but used internationally (i.e., translated into other languages and widely cited since 2017), or subjectively deemed useful by experts in the super-specialty in question. RESULTS: In total, 103 questionnaires were identified. To encourage and accompany their intercultural adaptation and statistical validation, this article presents the rationale and methodology of such an undertaking. CONCLUSION: PROMs either already validated in French or which it would be useful to translate were inventoried. The methodology of translation and validation to guarantee reliability and relevance is presented.
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Jan · PMID 39117480
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PURPOSE: We report the second case of bilateral sudden sensorineural hearing loss with intracochlear fibrosis due to chronic myeloid leukemia. CASE REPORT: A 44-year-old man presented to the emergency department with rap...PURPOSE: We report the second case of bilateral sudden sensorineural hearing loss with intracochlear fibrosis due to chronic myeloid leukemia. CASE REPORT: A 44-year-old man presented to the emergency department with rapidly progressive bilateral hearing loss, tinnitus and vertigo, associated with dyspnea. Chronic myeloid leukemia complicated by pulmonary and cochleovestibular leukostasis was diagnosed, and cytoreductive treatment was started. Despite this treatment, bilateral total hearing loss and complete vestibular deficit persisted. MRI showed bilateral labyrinthitis, and emergency cochlear implantation was indicated. During surgery, inflammatory intracochlear tissue made electrode array insertion possible only against resistance. One year after implantation, there was significant improvement in speech recognition and communication scores. CONCLUSION: In case of sudden sensorineural hearing loss induced by chronic myeloid leukemia, treatment should be as fast as possible, with prompt cochlear implantation in case of definitive profound hearing loss, because of the risk of cochlear fibrosis and ossification.
Ten Harkel TC, Bielevelt F, Marres HAM
… +3 more, Ingels KJAO, Maal TJJ, Speksnijder CM
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Jan · PMID 39117479
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OBJECTIVE: The Sunnybrook Facial Grading System (SFGS) is a well-established grading system to assess the severity and progression of a unilateral facial palsy. The automation of the SFGS makes the SFGS more accessible f...OBJECTIVE: The Sunnybrook Facial Grading System (SFGS) is a well-established grading system to assess the severity and progression of a unilateral facial palsy. The automation of the SFGS makes the SFGS more accessible for researchers, students, clinicians in training, or other untrained co-workers and could be implemented in an eHealth environment. This study investigated the impact on the reliability of the automated SFGS by adding a facial landmark layer in a previously developed convolutional neural network (CNN). METHODS: An existing dataset of 116 patients with a unilateral peripheral facial palsy and 9 healthy subjects performing the SFGS poses was used to train a CNN with a newly added facial landmark layer. A separate model was trained for each of the 13 elements of the SFGS and then used to calculate the SFGS subscores and composite score. The intra-class coefficient of the automated grading system was calculated based on three clinicians experienced in the grading of facial palsy. RESULTS: The inter-rater reliability of the CNN with the additional facial landmarks increased in performance for all composite scores compared to the previous model. The intra-class coefficient for the composite SFGS score increased from 0.87 to 0.91, the resting symmetry subscore increased from 0.45 to 0.62, the symmetry of voluntary movement subscore increased from 0.89 to 0.92, and the synkinesis subscore increased from 0.75 to 0.78. CONCLUSION: The integration of a facial landmark layer into the CNN significantly improved the reliability of the automated SFGS, reaching a performance level comparable to human observers. These results were attained without increasing the dataset underscoring the impact of incorporating facial landmarks into a CNN. These findings indicate that the automated SFGS with facial landmarks is a reliable tool for assessing patients with a unilateral peripheral facial palsy and is applicable in an eHealth environment.
Senol MC, Bastit V, Humbert M
… +2 more, Babin E, Perréard M
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Jan · PMID 38926042
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Reconstructive frontal anterior laryngectomy (RFAL) is a partial laryngeal surgery technique for resecting early-stage (T1-T2) glottic squamous cell carcinoma. Indications comprise a lesion of the anterior commissure of...Reconstructive frontal anterior laryngectomy (RFAL) is a partial laryngeal surgery technique for resecting early-stage (T1-T2) glottic squamous cell carcinoma. Indications comprise a lesion of the anterior commissure of the larynx that cannot be adequately exposed by endoscopy, and cases in which radiotherapy is refused or contraindicated. The initial RFAL technique included epiglottoplasty. Here we propose a technique without epiglottoplasty, with the advantage of avoiding need for tracheotomy in most cases. After the first stage of surgical excision, reconstruction consists in placing a vertical brace transepiglottically and below the cricoid. The epiglottis is thus left at its original height and secured in place to prevent flapping in the pharyngolaryngeal lumen. Transverse bracing is then performed through the thyroid wings: one of the key points of this surgery is to control tension to avoid risk of stenosis. The subhyoid muscles are sutured together to achieve satisfactory sealing. This technique offers satisfying functional results and oncological control. The most frequent complications are (1) secondary tracheotomy, which can be avoided by selecting patients who require a primary tracheotomy and optimizing the seal, and (2) stenosis, which can be limited by not bringing the cartilaginous structures too close together during bracing.
Eur Ann Otorhinolaryngol Head Neck Dis
· 2024 Nov · PMID 38897905
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INTRODUCTION: Flight staff are at particular risk of iterative sinus barotrauma. We here report a case of barotraumatic atelectasic frontal sinusitis with dynamic radiologic change in frontal sinus volume. CASE REPORT: A...INTRODUCTION: Flight staff are at particular risk of iterative sinus barotrauma. We here report a case of barotraumatic atelectasic frontal sinusitis with dynamic radiologic change in frontal sinus volume. CASE REPORT: A 46-year-old air pilot was referred for right frontal pain occurring at each landing. Two sinus CT scans were taken: one after a period of intense flying and the other after a month without flying. In the right frontal sinus, a type-3 Kuhn cell changed in volume from 6×11×12mm to 13×18×19mm. The alteration involved a modification in the medial wall, which was demineralized and changed position within the frontal sinus. Removal during endoscopic frontal sinusotomy allowed complete resolution of pain. DISCUSSION: This article reports radiologic change in a frontal sinus wall in a setting of repeated barotraumatic frontal sinusitis with a dynamic atelectasic component. In iterative barotrauma, we advocate imaging at different time points. When the ostial obstruction is identified, functional aeration surgery can be applied.
Eur Ann Otorhinolaryngol Head Neck Dis
· 2025 Jan · PMID 38890073
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INTRODUCTION: Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare low-grade malignant mesenchymal neoplasm. It commonly occurs in the limbs and trunk, with limited occurrences in the head and neck region. Only fiv...INTRODUCTION: Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare low-grade malignant mesenchymal neoplasm. It commonly occurs in the limbs and trunk, with limited occurrences in the head and neck region. Only five cases of PHAT occurring in the head and neck have been reported in the literature to date. The etiology of PHAT remains unclear. We described a case of nasal cavity PHAT following CARE guidelines. CASE SUMMARY: A 32-year-old male with PHAT originating in the nasal cavity recurred after two surgeries. Adjuvant radiotherapy was performed after the third surgery. The patient has been regularly followed up for 36months, and no tumor recurrence or metastasis has been observed. DISCUSSION: PHAT is a rare soft tissue tumor known for its local aggressiveness. Because of a high risk of recurrence, extensive resection should be implemented, possibly completed by radiotherapy if resection cannot be complete because of proximity to at-risk structures.
Gatignol P, Hervochon R, Lannadère E
… +3 more, Calvo M, Tankéré F, Picard D
Eur Ann Otorhinolaryngol Head Neck Dis
· 2024 Nov · PMID 38811321
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OBJECTIVE: The esthetic problems inherent to peripheral (PFP) are frequent causes of complaint. Make-up is advocated as a form of therapy and can alleviate symptoms of depression. The aim of the present study was to coll...OBJECTIVE: The esthetic problems inherent to peripheral (PFP) are frequent causes of complaint. Make-up is advocated as a form of therapy and can alleviate symptoms of depression. The aim of the present study was to collect data on make-up habits in female PFP patients and assess links with esthetic and/or functional complaints. MATERIAL AND METHODS: Two questionnaires were drawn up to compare make-up habits in female PFP patients and women in the general population. The first was sent out between September and December 2019, to 39 House-Brackmann grade III PFP patients (group A), and the second on-line questionnaire was sent to a control population of 1385 women (group B). RESULTS: PFP patients used make-up more often than controls at weekends (χ=16.38; P=0.0009) and while at home (χ=8.21; P=0.042), and more often with foundation (χ=17.21; P=0.0006) and lip make-up (χ=59.31; P<0.0001). The greater their functional complaint, the less they made up their eyes. The greater their self-confidence and the more they felt attractive, the less they made up their lips. CONCLUSION: The differences in make-up use found in the present study aimed to mask facial palsy and were related to the esthetic complaint, impacting social life.