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

英文中文

Awake stapedectomy under hypnoanalgesia: Efficacy and safety in the treatment of otosclerosis 催眠镇痛下清醒镫骨切除术治疗耳硬化的疗效和安全性。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-07-01 Epub Date: 2025-04-16 DOI: 10.1016/j.anorl.2025.04.001

E. Caillaud , L. Pellé-Boudeau , M. Férrandière , D. Bakhos , E. Lescanne , F. Micaletti

Objective

To evaluate the efficacy and safety of awake stapedectomy under hypnoanalgesia (HA) compared to general anesthesia (GA) and local anesthesia (LA) in patients with otosclerosis.

Methods

A single-center retrospective study included 131 adult patients (mean age: 49 years; 78% female) who underwent laser stapedectomy between 2020 and 2022: 58 GA, 23 LA, 50 HA. Primary outcome measures comprised operative room occupancy time, anesthetic consumption, and postoperative audiometric results.

Results

HA significantly reduced operative room occupancy time (73.5 ± 18.6 min vs 103.7 ± 24.6 min in GA, P < 0.001; vs 81.8 ± 20.5 min in LA, P = 0.092), stapedectomy duration (39.9 ± 12.4 min vs 48.9 ± 21.5 min in GA, P = 0.0252; vs 38.9 ± 13.2 min in LA, P = 0.4601), preoperative time (30.2 ± 9.5 min vs 45.7 ± 9.5 min in GA, P < 0.001; vs 38.6 ± 12.2 min in LA, P = 0.0022), and recovery room time (26 ± 15.1 min vs 67.5 ± 20.7 min in GA, P < 0.001; vs 47.4 ± 20.7 min in LA, P < 0.001). HA also significantly reduced remifentanil consumption (169.8 ± 101.6 μg vs 848.6 ± 308.8 μg in GA, P < 0.001; vs 323.9 ± 94.4 μg in LA, P < 0.001). Postoperative audiometric outcomes showed no significant differences between groups.

Conclusion

Hypnoanalgesia for awake stapedectomy provided significantly greater efficacy compared to general anesthesia, reducing operative time and anesthetic consumption, with comparable audiometric outcomes.

目的：比较催眠镇痛（HA）与全麻（GA）、局麻（LA）对耳硬化患者行清醒镫骨切除术的疗效和安全性。方法：单中心回顾性研究纳入131例成人患者(平均年龄49岁；在2020年至2022年间接受激光镫骨切除术的患者（78%为女性）：58名GA， 23名LA， 50名HA。主要指标包括手术室占用时间、麻醉消耗和术后听力学结果。结果：透明质酸显著减少了手术时间（73.5±18.6min vs 103.7±24.6min）。结论：与全麻相比，醒时镫骨切除术的催眠镇痛效果明显更好，减少了手术时间和麻醉消耗，听力指标相当。

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引用次数: 0

Trigeminal cervical complex: A neural network affecting the head and neck 三叉神经颈复合体：影响头颈部的神经网络。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-07-01 Epub Date: 2024-10-11 DOI: 10.1016/j.anorl.2024.09.008

F. Bou Malhab , J. Hosri , G. Zaytoun , U. Hadi

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.

目的：介绍三叉神经颈复合体（TCC），将其作为一个综合框架，用于理解三叉神经影响和效应的解剖和功能范围，并解释常见的耳鼻喉科症状，包括头颈部肌筋膜疼痛综合征。此外，它还探讨了神经递质的双向传递如何导致三叉神经丛和运动核的敏感化：本研究以叙述性综述的形式进行。作者对 Medline/OVID、Embase、Scopus 和 PubMed 等多个数据库进行了全面检索，涵盖了从开始到 2023 年 8 月的出版物。检索中使用了与 TCC 相关的关键词和医学主题词。根据预先确定的纳入和排除标准，提取了 66 项研究的信息：本综述讨论了从颅神经（特别是第七、第九、第十和第十一颅神经）到 TCC 的多种传入连接及其各自的传出通路。这些联系可以解释头颈部的各种临床表现，而这些临床表现无法归因于其他疾病。此外，这篇综述还强调了颅神经的感觉和运动双重性质，强调了头颈部神经递质的双向传递，这导致了 TCC 和支配颈面部肌肉的运动神经核的敏感化：作者推测，TCC 的中枢和外周敏化以及错综复杂的联系可以阐明耳痛、耳鸣、听力损失、眩晕、头痛、颈源性头晕、磨牙症等影响头颈部症状的病理生理学。

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引用次数: 0

Assessing the diagnostic capacity of artificial intelligence chatbots for dysphonia types: Model development and validation 评估人工智能聊天机器人对发音障碍类型的诊断能力：模型开发与验证。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-07-01 Epub Date: 2025-02-18 DOI: 10.1016/j.anorl.2025.01.001

S. Saeedi , M. Aghajanzadeh

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.

目的：用户友好的人工智能（AI）聊天机器人被越来越多地用于帮助医疗团队进行决策过程。由于所有医学领域的准确诊断对于治疗计划至关重要，因此本研究旨在探索两种特定的AI聊天机器人ChatGPT和Perplexity AI在区分各种类型的语音障碍（器质性，功能性和神经性）方面的功能。材料与方法：实验1将语音自评估与声学分析相结合的脚本，实验2仅将37例发声障碍患者的声学分析输入ChatGPT和Perplexity AI聊天机器人中指定类型，并要求开发基于人工智能的复杂模型来确定发声障碍类型。然后，从另外27名患者的样本数据中重新进行了同样的过程作为测试。结果：ChatGPT虽然不能对数据进行分析，只能提供指导，但在实验1 （P=0.773）和实验2 （P=0.067）中，专家诊断与Perplexity AI诊断之间的Cohen’s Kappa一致性缺乏统计学意义。结论：由于AI聊天机器人在语音障碍类型鉴别诊断中的初步表现较差，目前尚不建议在临床应用。然而，未来人工智能聊天机器人的改进可能会在确定语音障碍类型方面提供更有希望的结果。需要进一步研究人工智能聊天机器人在语音诊所的能力。

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引用次数: 0

Scientific and skeptical medical writing 科学和怀疑的医学写作。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-07-01 Epub Date: 2024-12-03 DOI: 10.1016/j.anorl.2024.11.002

F. Simon

引用次数: 0

Acute intestinal obstruction due to duodenal metastasis of laryngeal squamous cell carcinoma: A CARE case report 喉鳞癌十二指肠转移致急性肠梗阻1例。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-07-01 Epub Date: 2025-03-13 DOI: 10.1016/j.anorl.2025.02.004

Y. Lelonge , A. Havasi , N. Williet , B. Le Roy

Objective

To report a case of duodenal metastasis of laryngeal squamous cell carcinoma revealed by acute intestinal obstruction.

Case report

A 55-year-old male was initially treated for cT4N1M0 laryngeal squamous cell carcinoma, with total laryngectomy, bilateral neck dissection, total thyroidectomy and pectoralis major flap. Subsequently, he received radiotherapy and chemotherapy. Then, he was periodically monitored, with clinical examination and cervicothoracic CT, according to guidelines. Three years later, he presented acute intestinal obstruction. Abdominal CT revealed a 35 mm obstructive duodenal tumor involving the head of the pancreas. Gastroscopy enabled biopsies, which confirmed metastasis of the laryngeal carcinoma. After gastro-entero-anastomosis, a first line treatment with cisplatin, 5-fluorouracile and pembrozilumab was started. It was complicated by abdominal bleeding, which required inferior duodenopancreatic artery embolization and colic perforation requiring colectomy. Due to deterioration in general health, 2 injections of pembrozilumab alone were made. Then, because of progression, the patient received 1 second-line injection of docetaxel. He finally died of acute pancreatitis, 7 months after diagnosis.

Conclusion

Duodenal metastasis of squamous cell carcinoma of the larynx is rare but possible. This case report highlights the importance of clinical and radiological monitoring, particularly in locally advanced tumor.

目的：报告一例因急性肠梗阻而发现的喉鳞癌十二指肠转移病例：报告一例因急性肠梗阻而发现的喉鳞癌十二指肠转移病例：一名 55 岁男性最初因 cT4N1M0 喉鳞状细胞癌接受全喉切除术、双侧颈部切除术、全甲状腺切除术和胸大肌皮瓣术。随后，他接受了放疗和化疗。之后，他根据指南定期接受临床检查和颈胸部 CT 监测。三年后，他出现了急性肠梗阻。腹部 CT 发现了一个 35 毫米的十二指肠阻塞性肿瘤，肿瘤累及胰腺头部。胃镜活检证实了喉癌转移。胃肠吻合术后，患者开始接受顺铂、5-氟尿嘧啶和培美曲塞单抗的一线治疗。腹部出血使病情复杂化，需要进行十二指肠胰下动脉栓塞术，结肠穿孔需要进行结肠切除术。由于全身健康状况恶化，又单独注射了 2 次彭布罗齐单抗。随后，由于病情进展，患者接受了一次多西他赛二线注射。最终，他在确诊 7 个月后死于急性胰腺炎：结论：喉鳞癌的十二指肠转移虽然罕见，但却有可能发生。本病例报告强调了临床和放射学监测的重要性，尤其是对局部晚期肿瘤的监测。

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引用次数: 0

Cervical resection of Zenker's diverticulum 宫颈Zenker憩室切除术。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-07-01 Epub Date: 2025-05-29 DOI: 10.1016/j.anorl.2025.05.001

C.-A. Righini , C. Fabre , M. Makeieff

Treatment for symptomatic Zenker's diverticulum is surgical. This has greatly progressed in recent years and two surgical approaches are possible: the external or cervical approach, and the other, more recent, endoscopic approach. Both are based on sectioning the cricopharyngeal muscle. The majority of authors recommend an endoscopic approach in first line, reserving open surgery for cases in which exposure of the diverticular collar is impossible or endoscopic surgery has failed. There are therefore still indications for open surgery, and this technique must be perfectly mastered.

对症性Zenker憩室的治疗是手术。近年来有了很大的进展，有两种手术入路：外入路或颈椎入路，以及最近的内窥镜入路。两者都是基于环咽肌的切片。大多数作者建议在一线采用内窥镜入路，对于不可能暴露憩室环或内窥镜手术失败的病例保留开放手术。因此，仍然有开放手术的适应症，这项技术必须完全掌握。

引用次数: 0

IgG4-related disease of the middle ear in a pediatric patient 一名儿童患者的中耳 IgG4 相关疾病。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-07-01 Epub Date: 2025-04-05 DOI: 10.1016/j.anorl.2025.03.002

L. Kusevic , M. Ulamec , T. Greguric , J. Ajduk

引用次数: 0

A case of recalcitrant epistaxis 顽固性鼻出血1例。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-07-01 Epub Date: 2025-04-07 DOI: 10.1016/j.anorl.2025.03.003

E. Al Hakim , P. Beyssen , X. Dufour , F. Carsuzaa

引用次数: 0

Asthenia, insomnia, malaise and high blood pressure during nasal spray corticotherapy in an adult 成人鼻喷皮质治疗期间的虚弱、失眠、不适和高血压。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-05-01 Epub Date: 2025-03-19 DOI: 10.1016/j.anorl.2025.03.001

J. De Mestier, J.-B. Lecanu, O. Laccourreye

引用次数: 0

Audiometric results of tympanoplasty with stapedectomy and synthetic total ossicular replacement prosthesis: A STROBE analysis 鼓室成形术合并镫骨切除术和人工全听骨置换术的听力学结果：一个STROBE分析。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-05-01 Epub Date: 2024-12-06 DOI: 10.1016/j.anorl.2024.11.006

C. Guigou , M. Folia , B. Reliquet , A. Lalande , M. Brisson , A. Bozorg Grayeli

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 25 dB, mean: 10 dB; P = 0.001), ABG (−8 to 26 dB, mean: 10 dB), SRT (2 to 30 dB, mean: 13 dB; 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.

目的：评价镫骨切除鼓室成形术置入人工全听骨置换术（TORP）的听力学效果。材料与方法：对慢性中耳炎（COM）合并鼓室硬化（9例）、镫骨前叶强直（3例）、轻度发育不全（3例）、创伤后听骨脱位（1例）患者15例（16耳），年龄10 ~ 58岁（平均36岁）进行回顾性观察研究。2012年12月1日至2023年1月30日，在法国一所大学医院进行鼓室成形术、镫骨切除术和TORP放置，随访时间为2至92个月（平均24个月）。主要终点是术后空气传导（AC）阈值和气骨间隙（ABG）的变化。次要终点包括语音识别阈值（SRT）和语音识别评分（SDS）的变化以及并发症分析。遵循STROBE编辑线，显著性阈值设置于：结果：交流阈值显著改善(-2至25dB，平均值：10dB；P=0.001), ABG (-8 ~ 26dB，平均值：10dB), SRT (2 ~ 30dB，平均值：13dB；结论：本研究表明，对于镫骨足板固定合并其他听骨异常的病例，该技术是一种可能且安全的治疗选择。

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