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

英文中文

The challenge of de-escalating adjuvant therapy in HPV-positive patients HPV 阳性患者辅助治疗降级的挑战。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-05-01 DOI: 10.1016/j.anorl.2024.04.007

H. Mirghani, A. Boghossian

引用次数: 0

Deciding whether to do elective neck dissection in patients with salivary gland tumors with no evidence of neck lymph node metastasis 无颈部淋巴结转移证据的涎腺肿瘤患者择期是否行颈部清扫。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-05-01 DOI: 10.1016/j.anorl.2025.02.001

A. Sanabria , P. Bradley , R. de Bree , O. Guntinas-Lichius , M. Hamoir , L.P. Kowalski , J.P. Rodrigo , P. Strojan , V. Vander Poorten , A. Ferlito

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.

目的：涎腺癌临床阴性颈部的治疗是有争议的，关于选择性颈部清扫（END）的指南存在分歧。尽管这些指导方针被广泛使用，但它们大多依赖于回顾性研究，容易受到方法缺陷和选择偏差的影响。方法：批判性叙事回顾。问题描述，确定可能的临床情况，评估以前的建议，对现有数据的批判性检查，以及临床决策选择的呈现，包括文章的创建。结果：隐匿性淋巴结转移率是影响肿瘤转移的重要因素之一，隐匿性淋巴结转移率在2-30%之间，随肿瘤种类和分级的不同而有很大差异。根据术前发现，如肿瘤大小、分级和临床症状（如累及面神经），使用风险分类提供了一些指导。然而，术中和术后的组织学结果经常发现意想不到的癌症，这使得决策更加困难。替代END的方法，包括选择性颈部放疗，在减少高风险病例的局部复发方面具有相似的效果。尽管END可以增强局部控制，但它有手术并发症的风险，如神经损伤和功能障碍。没有前瞻性随机研究明确证明END在生存或复发方面的优势。结论：END可能适用于某些高危情况，但其在cN0唾液腺癌中的常规应用仍存在争议。在获得大量前瞻性数据之前，建议采用考虑肿瘤特异性和患者相关变量的个性化策略，并谨慎使用辅助治疗。

{"title":"Deciding whether to do elective neck dissection in patients with salivary gland tumors with no evidence of neck lymph node metastasis","authors":"A. Sanabria , P. Bradley , R. de Bree , O. Guntinas-Lichius , M. Hamoir , L.P. Kowalski , J.P. Rodrigo , P. Strojan , V. Vander Poorten , A. Ferlito","doi":"10.1016/j.anorl.2025.02.001","DOIUrl":"10.1016/j.anorl.2025.02.001","url":null,"abstract":"<div><h3>Aim</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"142 3","pages":"Pages 135-142"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reproduction of physiological mandibular advancement during adult drug-induced sleep endoscopy 成人药物诱导睡眠内窥镜检查时下颌骨生理性前移的再现。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-05-01 DOI: 10.1016/j.anorl.2024.10.003

V. Favier , M. Agunaoun , C. Ferret , C. François

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.

在手术室进行的药物诱导睡眠内窥镜检查（DISE）可改善阻塞性睡眠呼吸暂停综合症（OSAS）的气道阻塞表型。它在药理上接近人体睡眠，并允许进行动态操作，特别是下颌前突，其结果可预测下颌前突装置（MAD）的效果：如果在 DISE 下通过下颌前突解决了阻塞，则可能需要使用下颌前突装置。然而，必须考虑到个人在清醒状态下的最大下颌前突，为了尊重颞下颌关节的耐受性，MAD 不应超过该值的 75%（MA75）。因此，需要在 DISE 期间精确测量和再现 MA75，以便从疗效和耐受性两方面评估 MAD 的临床适应症。本技术说明介绍了一种测量 MA75 的方法，该方法可在 DISE 期间使用经调整的设备再现 MA75 值，从而选择 MAD 的候选者。

引用次数: 0

Efficacy of partial tonsillectomy in periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome: a STROBE retrospective observational study 扁桃体部分切除术对周期性发热、口腔炎、咽炎和腺炎综合征的疗效：STROBE 回顾性观察研究。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-05-01 DOI: 10.1016/j.anorl.2024.07.010

T. Banh Chong , O. Sagot , M. Alexis , C. Brehin , K. Brochard , Y. Gallois

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.

简介PFAPA（周期性发热、阿弗他口腔炎、咽炎、腺炎）或马歇尔综合征是儿童反复自身炎症性发热的最常见原因。频繁发作会影响儿童的生活质量和家庭生活。扁桃体全切除术在改善症状方面具有显著疗效，但很少有研究对扁桃体部分切除术在这一适应症中的应用进行评估。本研究旨在评估 PFAPA 综合征扁桃体部分切除术后的疗程，并与全扁桃体切除术进行比较：这项回顾性队列研究遵循了 STROBE 指南。研究对象包括2011年1月1日至2022年12月31日期间在本大学医院中心接受扁桃体部分或全部切除术治疗的符合EUROFEVER标准的PFAPA综合征患儿。比较的显著性阈值设定为PResults：共纳入 36 名儿童：16名儿童接受了扁桃体部分切除术，20名儿童接受了扁桃体全部切除术。扁桃体部分切除术后，每年发病次数减少了 10 次（5-21 次不等）（PC 结论：扁桃体部分切除术显著减少了扁桃体炎的发病率：扁桃体部分切除术明显减少了 PFAPA 综合征术后发作的频率、持续时间和强度。与全扁桃体切除术相比，部分扁桃体切除术的效果可能较差，但并发症风险较低，可在青春期等待缓解。

{"title":"Efficacy of partial tonsillectomy in periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome: a STROBE retrospective observational study","authors":"T. Banh Chong , O. Sagot , M. Alexis , C. Brehin , K. Brochard , Y. Gallois","doi":"10.1016/j.anorl.2024.07.010","DOIUrl":"10.1016/j.anorl.2024.07.010","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Materials and methods</h3><div>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 <em>P</em>  <0.005) over 6 years’ follow-up. The decrease was 50% with partial tonsillectomy and 93% with total tonsillectomy (<em>P</em>  =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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"142 3","pages":"Pages 115-120"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sexual harassment of physicians by patients 病人对医生的性骚扰。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-05-01 DOI: 10.1016/j.anorl.2024.11.001

O. Laccourreye

引用次数: 0

Infraorbital hypoesthesia after diving 潜水后眶下感觉减退。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-05-01 DOI: 10.1016/j.anorl.2024.09.005

J.-B. Morvan , J.-B. Caruhel , M. Chery , V. Maso , A. Crambert

引用次数: 0

The effect of radiofrequency therapy for nasal valve collapse in endurance athletes: A STROBE analysis 射频治疗对耐力运动员鼻瓣膜塌陷的影响：一项频闪分析。

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases

Pub Date : 2025-05-01 DOI: 10.1016/j.anorl.2024.12.004

I.M.C. Seuthe , K. Van Ackeren , S. Dazert , S. Eichhorn , T. Veleva , J.J.-H. Park

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.

目的：开展前瞻性先导研究，探讨温控射频治疗耐力运动员鼻内瓣塌陷的效果。材料与方法：2018 - 2020年招募25例鼻瓣膜塌陷耐力运动员。25例患者中有8例因不同原因退出研究（术后测量前因非鼻腔原因受伤、短期内拒绝手术、冠状病毒大流行终止），17例研究参与者完成研究。我们对鼻内瓣射频治疗前后的鼻部问卷和鼻压测量进行了调查。此外，在射频治疗前后进行了详尽的跑步机测试。对收集到的测量数据进行登记，并用配对t检验进行比较。进行Cohen’s dz，结果显著。利用Kolmogorov-Smirnov检验和Q-Q图证实了正态分布。结论：该技术副作用小，根据鼻呼吸评分主观改善鼻呼吸，可能是一种很有前途的改善耐力运动员鼻呼吸的无创治疗方法。然而，客观参数未见明显改善。需要更大规模的研究队列来更详细地调查其影响。

{"title":"The effect of radiofrequency therapy for nasal valve collapse in endurance athletes: A STROBE analysis","authors":"I.M.C. Seuthe , K. Van Ackeren , S. Dazert , S. Eichhorn , T. Veleva , J.J.-H. Park","doi":"10.1016/j.anorl.2024.12.004","DOIUrl":"10.1016/j.anorl.2024.12.004","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Material and methods</h3><div>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 <em>t</em>-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.</div></div><div><h3>Results</h3><div>There was a significant improvement in the NOSE score (<em>P</em>    <!-->1.03) and no serious side effects. No significant differences were seen before and after the treatment in rhinomanometry and spiroergometry.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"142 3","pages":"Pages 129-134"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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。

{"title":"Treatment of epistaxis in Osler-Weber-Rendu disease by bevacizumab nasal spray. The EROSB study: Determining the effective dose","authors":"L. Vincent , L. Robard , C. Creveuil , E. Babin , M. Perreard , M. Humbert","doi":"10.1016/j.anorl.2024.10.006","DOIUrl":"10.1016/j.anorl.2024.10.006","url":null,"abstract":"<div><div>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.</div></div><div><h3>Objective</h3><div>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.</div></div><div><h3>Materials and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"142 2","pages":"Pages 67-73"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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。

{"title":"Relevance of anatomical remnants for revision sinus surgery","authors":"D. Martin-Jimenez , R. Moreno-Luna , C. Gago-Torres , J. Maza-Solano , S. Sanchez-Gomez","doi":"10.1016/j.anorl.2024.09.009","DOIUrl":"10.1016/j.anorl.2024.09.009","url":null,"abstract":"<div><h3>Objectives</h3><div>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).</div></div><div><h3>Material and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"142 2","pages":"Pages 84-92"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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

首页上一页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

European Annals of Otorhinolaryngology-Head and Neck Diseases

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀