European Annals of Otorhinolaryngology-Head and Neck Diseases最新文献

英文中文

Audiometry results in adult cochlear implant patients according to the electrode array.

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-03-07 DOI: 10.1016/j.anorl.2025.02.005

F Micaletti, M Marx, L Pelle-Bouleau, N Alfaqan, J J Galvin, D Bakhos

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.

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引用次数: 0

Treatment of epistaxis in Osler-Weber-Rendu disease by bevacizumab nasal spray. The EROSB study: Determining the effective dose 贝伐珠单抗鼻喷雾剂治疗奥斯勒-韦伯-伦杜病鼻衄。EROSB研究：确定有效剂量。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-03-01 DOI: 10.1016/j.anorl.2024.10.006

L. Vincent , L. Robard , C. Creveuil , E. Babin , M. Perreard , M. Humbert

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 64 mg 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.

治疗奥斯勒-韦伯-伦杜病（OWRD）鼻出血是一项治疗难题。鼻内抗血管生成喷雾剂是一种很有前景的解决方案，但需要科学验证，因此我们开展了本研究：主要目的是确定贝伐珠单抗鼻内喷雾剂治疗OWRD鼻衄的最小有效剂量：即与纳入前一个月相比，60%的患者在治疗1个月后鼻出血次数减少≥50%的剂量。次要目标是评估 3 个月和 6 个月的疗效以及鼻出血次数和影响的进展，并记录药代动力学：这项名为EROSB（使用贝伐珠单抗鼻内喷雾剂治疗OWRD患者鼻衄）的研究属于法国医院临床研究计划（PHRC-I 2013），由地区间临床研究与创新小组（GIRCI）选定。这是一项I/II期前瞻性单盲研究，以10个队列为基础，每个队列3名患者，采用持续再评估法（CRM）确定贝伐珠单抗的最小有效剂量：由于难以招募到足够的患者，研究在纳入 15 名受试者后停止。CRM 方法确定 64 毫克为最小有效剂量。然而，由于受试者人数较少，这一结果无法解释：EROSB研究并未成功确定贝伐珠单抗鼻内喷雾剂的最小有效剂量，与纳入前一个月相比，该剂量可减少鼻出血次数。不过，初步结果表明，该物质几乎没有通过全身。

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引用次数: 0

Relevance of anatomical remnants for revision sinus surgery 解剖残留物与鼻窦翻修手术的相关性。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-03-01 DOI: 10.1016/j.anorl.2024.09.009

D. Martin-Jimenez , R. Moreno-Luna , C. Gago-Torres , J. Maza-Solano , S. Sanchez-Gomez

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.

目的：回顾致力于研究残留结构如何影响慢性鼻窦炎（CRS）患者手术效果的科学文献，提供有关内窥镜鼻窦手术（ESS）后解剖残留物频率的信息：本综述根据 SWiM 指南的建议进行报告。对 PubMed、Cochrane Library、Embase 和 Web of Science 进行了检索，检索期至 2024 年 4 月。采用牛津循证医学中心的证据等级和 STROBE 评估了系统综述所选研究的质量和偏倚风险。根据 EPOS 和 ICAR 指南，对研究结果进行了描述性和定性分析：结果：14 项相关研究符合定性综合的纳入标准。这些研究采用了前瞻性和回顾性横断面设计，重点关注修订版 ESS。四项研究检查了全室功能性ESS（FESS），三项研究侧重于额窦手术，四项研究侧重于传统FESS，三项研究未说明手术类型。对偏倚风险进行评估后发现，研究质量存在显著差异，证据水平较低。研究发现，ESS术后残留的解剖结构存在很大差异，最明显的是保留的弓形突（29.6%-64%）、agger nasi细胞（4.5%-83.33%）和前齿状突细胞（40.7%-96.8%）。在纳入的研究中，对中鼻甲圆锥体、鼻中隔偏曲和侧位的观察显示了不同的模式：本系统综述强调了在 CRS 翻修手术中解剖结构切除不彻底这一长期存在的难题。关键结构保留的差异性凸显了手术结果的复杂性以及进一步完善手术技术的必要性。

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引用次数: 0

Laryngotracheal mucormycosis in children: Therapeutic challenges 儿童喉气管粘液瘤病：治疗难题。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-03-01 DOI: 10.1016/j.anorl.2024.10.005

É. Moreddu , M. Dallemagne , D. Rousseau , F. Blanc

引用次数: 0

External auditory canal chondroid syringoma with bone erosion: A CARE case report 外耳道软骨样鼓膜瘤伴骨侵蚀：一例CARE报告。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-03-01 DOI: 10.1016/j.anorl.2024.11.004

J. Connesson, C. Beck, C. Vincent, P. Toulemonde

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.

软骨样腺瘤是一种良性混合性皮肤肿瘤。它是外耳道中第二常见的腺体病变，但在PubMed搜索中没有发现与骨侵蚀相关的病例。病例报告：目前的CARE病例报告详细介绍了外耳道软骨样淋巴瘤伴骨溶解及其处理。讨论：软骨样淋巴瘤是外耳道其他肿瘤的鉴别诊断。引起骨侵蚀的形式是罕见的，但不应该挑战诊断。由于有复发和恶性转化的危险，目前的治疗包括全面和广泛的手术切除和长期随访。

引用次数: 0

Environmental impact of pediatric ENT surgery: A STROBE analysis 儿童耳鼻喉外科手术的环境影响：一个频闪分析。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-03-01 DOI: 10.1016/j.anorl.2024.11.005

M. Martin , S. Ayraud-Thevenot , X. Dufour , J.-P. Lebreton , J. Guihenneuc , F. Carsuzaa

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 (CO₂eq) 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 57.86 kgCO₂eq. Disposable MDs were the most polluting item with 30.82 kgCO₂eq (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 CO₂, 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.

导言：温室气体排放的增加加剧了气候变化。医疗保健部门，尤其是手术室，是温室气体的重要排放源。在头颈外科手术中，儿科手术非常常见，但很少有研究评估其生态影响。我们的目的是量化常见儿科头颈部手术（扁桃体切除术、腺样体切除术和经鼓室管置入）的碳足迹。方法：于2022年12月在某三级医院中心进行生态流行病学调查。计算10例小儿头颈部手术（扁桃体切除术、腺样体切除术、经耳廓管置入）的碳足迹，即患者和医护人员运输、废物产生、手术室能耗、一次性和可重复使用医疗器械（MDs）的制造和运输、药物生产、可重复使用医疗器械灭菌产生的二氧化碳（CO2eq）排放量之和。结果：1例小儿头颈部手术的碳足迹为57.86kgCO2eq。一次性MDs是污染最大的项目，为30.82kgCO2eq（53.3%）。患者转运占27.4%，用药占12.6%，可重复使用MDs占2.9%。结论：小儿头颈部手术产生大量的CO2，主要是由于一次性MDs的产生和输送。这些观察结果可以作为与环境可持续和气候适应型卫生系统相一致的生态行动的起点。

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引用次数: 0

A century ago, W.E. Sistrunk described a surgical technique still relevant today 一个世纪前，西斯特伦克（W.E. Sistrunk）描述了一种今天仍然适用的外科技术。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-03-01 DOI: 10.1016/j.anorl.2024.12.002

C.A. Righini , C. Fabre

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.

人类胚胎学的研究和知识在19世纪下半叶取得了很大的进展。这使得根据胚胎学发育优化鳃裂畸形和宫颈囊肿的手术治疗成为可能。1920年，Walter Ellis Sistrunk描述了一种基于胚胎学的技术，用于切除甲状腺舌管瘘管和囊肿。一个世纪过去了，这个过程仍然按照最初的描述进行。

引用次数: 0

Evaluation of bone-conducted oVEMPs using frontal medial and mastoid stimulations 使用额内侧和乳突刺激评估骨传导的 oVEMPs。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-03-01 DOI: 10.1016/j.anorl.2024.09.010

S. Ghavami , M. Kayal , R. Maire

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 24.5 years) 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 70 dB 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 70 dB 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.

目的：确定使用改良裂隙灯支架刺激额部的最佳刺激强度，并比较使用额部内侧和乳突两个刺激部位的骨传导眼前庭诱发肌源性电位（oVEMPs）的可靠性和对称性：这项观察研究包括洛桑大学医院的 33 名健康志愿者（15 名女性，18 名男性；平均年龄 24.5 岁）。参与者接受了耳神经学评估，结果正常者被纳入研究范围。使用 Brüel and Kjaer 4810 型微型振动器记录骨传导 oVEMPs。额部刺激使用改良的裂隙灯支架，以确保施加压力的一致性，同时解放检查者的双手。乳突刺激是手动进行的：在 70 分贝 nHL 时，oVEMP 记录的再现性最好。与乳突刺激（潜伏期高达 40%）相比，额部刺激的数据分散性较低，潜伏期（高达 7%）和振幅（高达 50%）的不对称比率也较低。在额部和乳突部位的单次刺激足以获得两个耳廓的可靠测量结果：结论：使用改良的裂隙灯支架在 70 分贝 nHL 下刺激额部，因其卓越的再现性、舒适性和可靠性，被推荐用于骨传导 oVEMP 记录。这项研究确立了最佳刺激强度的新标准，并支持在临床实践中使用额部刺激。

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引用次数: 0

Improving post-treatment follow-up of HPV-driven oropharyngeal cancers 改善由 HPV 引起的口咽癌的治疗后随访。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-03-01 DOI: 10.1016/j.anorl.2024.04.003

H. Mirghani , P. Blanchard

引用次数: 0

French-language questionnaires in ENT: Inventory and review 耳鼻喉科法语问卷：盘点与回顾。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-03-01 DOI: 10.1016/j.anorl.2024.07.007

S. Gargula , E. Babin , M.-P. Tuset , M. Daval , A. Mattei , D. Ayache

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.

目的：患者报告结果测量法（PROMs）现已成为耳鼻喉科临床和学术实践中不可或缺的一部分，因此必须拥有经过验证的法文版工具。然而，目前还没有耳鼻喉科调查问卷的法文版指南，也没有可以进行跨文化调整的指南：本研究在耳鼻喉科国家专业委员会和法国耳鼻喉科学会的支持下，对符合以下纳入标准之一的各超专科和病理学的PROM进行了清查：经过验证的法文版；未翻译但在国际上使用（即自2017年以来被翻译成其他语言并被广泛引用）；或有关超专科的专家主观认为有用：总共确定了 103 份问卷。为了鼓励和配合这些问卷的跨文化改编和统计验证，本文介绍了这项工作的原理和方法：结论：本文列出了已通过法语验证或需要翻译的 PROM。本文介绍了为保证可靠性和相关性而进行翻译和验证的方法。

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