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

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Spontaneous resorption of geniculate ganglion arachnoid cyst 膝状神经节蛛网膜囊肿自发吸收。
IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.anorl.2024.02.002
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引用次数: 0
Myomucosal island flaps for oropharyngeal reconstruction 用于口咽重建的粘膜岛状皮瓣
IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.anorl.2023.11.015

The oropharynx represents one of the most challenging areas to reconstruct for the head and neck surgeon. The buccinator myomucosal island flaps pedicled on the facial artery [tunnelized facial artery myomucosal island flap (t-FAMMIF)] or the buccal artery [buccal artery myomucosal island flap (BAMMIF)] are an ideal reconstructive option for moderate size defects measuring up to 8–9 cm. Two fresh specimens have been used to show the step-by-step surgical technique of both island flaps. Design and flap extension, dissection plane, identification of the vascular pedicle, flap rotation and insetting are described. Reconstructive indications and the pros and cons of each one are discussed in this article. Myomucosal island flaps represent a very useful and versatile option for the functional reconstruction of the oropharynx. A detailed knowledge of the vascular anatomy of the cheek is key to obtain a large flap while minimizing the risk of complications.

口咽部是头颈部外科医生重建手术中最具挑战性的部位之一。颊肌粘膜岛状皮瓣迂曲于面动脉[隧道化面动脉粘膜岛状皮瓣(t-FAMMIF)]或颊动脉[颊动脉粘膜岛状皮瓣(BAMMIF)],是8-9厘米中等大小缺损的理想重建选择。我们用两个新鲜的标本来展示这两种岛状皮瓣的逐步手术技巧。描述了皮瓣的设计和延伸、解剖平面、血管蒂的识别、皮瓣旋转和嵌入。本文还讨论了每种皮瓣的重建适应症和利弊。粘膜岛状皮瓣是口咽部功能重建的一种非常有用的多功能选择。对颊部血管解剖的详细了解是获得大皮瓣并将并发症风险降至最低的关键。
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引用次数: 0
Neither hear or see, what's happening? 既听不见也看不见,到底发生了什么?
IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.anorl.2023.12.004
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引用次数: 0
Risk factors for laryngeal lesions in adult acute respiratory distress syndrome: A STROBE-compliant French case-control study 成人急性呼吸窘迫综合征喉部病变的风险因素:符合 STROBE 标准的法国病例对照研究。
IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.anorl.2024.02.011

Introduction

The global SARS-CoV-2 pandemic led to an increased incidence of post-intubation laryngeal injuries in patients with acute respiratory distress syndrome (ARDS). The primary objective of this study was to identify risk factors for symptomatic laryngeal lesions in patients with Covid-19-related ARDS. The secondary objective was to analyze the progression of these laryngeal lesions.

Methods

A 21 month nested case-control study was conducted in 3 university hospital centers of the Hospices Civils de Lyon (France). Cases encompassed all patients intubated for Covid-19-related ARDS who presented symptomatic laryngeal pathology. The control group consisted of all patients enrolled during the same period for Covid-19-related ARDS without evidence of laryngeal lesions (no specific ENT intervention). Uni- and multi-variate analyses were performed to identify risk factors for the occurrence of laryngeal lesions.

Results

Forty-nine patients were included in the case group and 50 in the control group. The only significant risk factor for symptomatic laryngeal injury was the number of reintubations, with an odds ratio of 5.08 (95% CI, 1.40–22.12; P = 0.013). No other predictive factors were identified among the variables analyzed: obesity, number of prone sessions, self-extubation, duration of intubation and number of days of curarization.

Conclusion

The number of reintubations was the sole independent risk factor associated with the development of symptomatic laryngeal lesions in patients managed for Covid-19-related ARDS.

简介全球 SARS-CoV-2 大流行导致急性呼吸窘迫综合征(ARDS)患者插管后喉部损伤的发生率增加。本研究的主要目的是确定 Covid-19 相关 ARDS 患者出现无症状喉损伤的风险因素。次要目标是分析这些喉部病变的进展情况:在法国里昂临终关怀医院(Hospices Civils de Lyon)的 3 所大学医院中心进行了为期 21 个月的巢式病例对照研究。病例包括所有因Covid-19相关ARDS而插管并出现无症状喉部病变的患者。对照组包括同期因Covid-19相关ARDS而入院的所有患者,但无喉部病变证据(无特定耳鼻喉科干预)。研究人员进行了单变量和多变量分析,以确定发生喉部病变的风险因素:病例组中有 49 名患者,对照组中有 50 名患者。无症状喉损伤的唯一重要风险因素是再次插管的次数,其几率比为 5.08(95% CI,1.40-22.12;P=0.013)。在肥胖、俯卧位次数、自行拔管、插管持续时间和拔管天数等分析变量中,未发现其他预测因素:结论:在接受Covid-19相关ARDS治疗的患者中,重新插管次数是唯一与喉部症状性病变发展相关的独立风险因素。
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引用次数: 0
Total laryngectomy in children: Madness or method? 儿童全喉切除术:疯狂还是方法?
IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.anorl.2023.11.013
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引用次数: 0
Autologous fat injection for empty-nose syndrome 自体脂肪注射治疗空鼻综合征。
IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.anorl.2023.10.017

Aims

Inferior meatus augmentation by injection or implants is one of the treatments for empty-nose syndrome (ENS), but levels of evidence of efficacy are low. We present the technique and evaluate our experience. The primary objective was to analyze changes in Empty Nose Syndrome 6-item Questionnaire (ENS6Q) scores after treating patients with ENS by autologous fat injection. Secondary objectives were the analysis of the evolution of each of the six ENS6Q items and identification of complications. Eleven patients underwent a minimally invasive approach to limit nasal airflow using fat injection between March 2021 and December 2022.

Results

Ten of the 11 patients showed a decrease in overall ENS6Q score (P = 0.0058); 6 had a final ENS6Q score < 11. Ten were satisfied with the procedure, but remained symptomatic. The procedure did not result in any complications.

Conclusion

These encouraging results confirm the data in the literature suggesting that fat injection improves symptomatology in empty nose syndrome. However, like other minimally invasive approaches to limit nasal airflow, it does not eliminate all symptoms. These results need to be confirmed by studies on larger cohorts with longer follow-up, preferably in a multicenter setting.

目的:注射或植入下鼻道是治疗空鼻综合征(ENS)的方法之一,但疗效证据水平较低。我们展示技术并评估我们的经验。主要目的是分析自体脂肪注射治疗ENS患者后,空鼻综合征6项问卷(ENS6Q)评分的变化。次要目标是分析六个ENS6Q项目中每一个项目的演变情况并确定并发症。在2021年3月至2022年12月期间,11名患者接受了脂肪注射限制鼻腔气流的微创方法。结果:11名患者中有10名患者的总体ENS6Q评分下降(P=0.0058);结论:这些令人鼓舞的结果证实了文献中的数据,表明脂肪注射可以改善空鼻综合征的症状。然而,与其他限制鼻腔气流的微创方法一样,它并不能消除所有症状。这些结果需要通过对更大队列进行更长随访的研究来证实,最好是在多中心环境中。
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引用次数: 0
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 2.5 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-05-07 DOI: 10.1016/j.anorl.2024.04.007
H Mirghani, A Boghossian
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引用次数: 0
Surgery of major salivary gland cancers: REFCOR recommendations by the formal consensus method 主要唾液腺癌的手术:REFCOR通过正式共识方法推荐。
IF 2.5 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-05-01 DOI: 10.1016/j.anorl.2023.11.005
B. Barry , B. Verillaud , F. Jegoux , N. Pham Dang , B. Baujat , E. Chabrillac , S. Vergez , N. Fakhry

Objective

To determine the role of surgery of the primary tumor site in the management of primary major salivary gland cancer.

Material and methods

The French Network of Rare Head and Neck Tumors (REFCOR) formed a steering group, which drafted a non-systematic narrative review of the literature published on Medline, and proposed recommendations. The level of adherence to the recommendations was then assessed by a rating group, according to the formal consensus method.

Results

Treatment of salivary gland tumor is mainly surgical. The gold standard for parotid cancer is a total parotidectomy, to obtain clear margins and remove all intraparotid lymph nodes. For low-grade tumors, partial parotidectomy with wide excision of the tumor is acceptable in the case of postoperative diagnosis on definitive histology. In the event of positive margins on definitive analysis, revision surgery should be assessed for feasibility, and performed if possible.

Conclusion

Treatment of primary major salivary gland cancer is based on surgery with clear resection margins, as far away as possible from the tumor. The type of surgery depends on tumor location, pathologic type and extension.

目的:探讨原发肿瘤部位手术在原发性大涎腺癌治疗中的作用。材料和方法:法国罕见头颈部肿瘤网络(REFCOR)成立了一个指导小组,起草了Medline上发表的文献的非系统叙述性综述,并提出了建议。然后,根据正式的共识方法,由一个评级小组评估对建议的遵守程度。结果:涎腺肿瘤的治疗以手术为主。腮腺癌的金标准是全腮腺切除术,以获得清晰的边缘并切除所有腮腺内淋巴结。对于低级别肿瘤,在术后明确组织学诊断的情况下,可以接受部分腮腺切除术并广泛切除肿瘤。如果最终分析结果为正值,则应评估翻修手术的可行性,并在可能的情况下进行手术。结论:原发性大涎腺癌的治疗应以手术为主,切除边缘清晰,尽量远离肿瘤。手术的类型取决于肿瘤的位置,病理类型和扩展。
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引用次数: 0
Sternohyoid or sternocleidomastoid muscle flap for tracheoesophageal puncture closure in irradiated patients: A CARE case series 胸骨舌骨或胸锁乳突肌瓣用于辐照患者气管食管穿刺闭合:一个CARE病例系列。
IF 2.5 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-05-01 DOI: 10.1016/j.anorl.2023.09.006
P.L. Alexandre , H. Silveira , P. Marques , C. Pinto Moura

Introduction

A novel technique for tracheoesophageal puncture (TEP) closure is described in which the sternohyoid muscles are rotated and interposed between the tracheal and esophageal walls. The results of this technique are reported, following CARE guidelines, and compared with those obtained using the sternocleidomastoid flap. A literature review on the techniques previously described for TEP closure in irradiated patients is presented.

Case series

The novel technique was performed in six patients in whom the infrahyoid muscles were preserved during total laryngectomy. All received adjuvant radiotherapy. Successful closure was achieved in three cases; in one case a small leak was noted after initial closure and was successfully managed with simple sutures; and the other two failures occurred in patients with diabetes. The sternocleidomastoid flap was performed in five patients (only one with previous radiation) and success was achieved in two patients. In another patient a micro-fistular orifice appeared six months after the operation.

Discussion

The sternohyoid muscles pose a low morbidity alternative to be considered in surgical TEP closure. Patient selection is a key factor to surgical success, and this technique should be reserved for small to moderate size fistulas and in the absence of multiple impaired wound healing conditions.

引言:介绍了一种新的气管食管穿刺(TEP)闭合技术,其中胸骨舌骨肌旋转并插入气管和食管壁之间。根据CARE指南,报告了该技术的结果,并与使用胸锁乳突肌瓣获得的结果进行了比较。对先前描述的在辐照患者中进行TEP闭合的技术进行文献综述。病例系列:6例患者在全喉切除术中保留了舌骨下肌,采用了这项新技术。所有患者均接受了辅助放射治疗。有三例成功闭合;在一个病例中,在初次闭合后发现了一个小渗漏,并通过简单缝合成功处理;另外两次失败发生在糖尿病患者身上。胸锁乳突肌瓣在五名患者中进行了手术(只有一名患者曾接受过放射治疗),两名患者获得了成功。另一名患者在术后6个月出现微瘘口。讨论:胸骨舌骨肌是一种低发病率的选择,可用于外科TEP闭合。患者的选择是手术成功的关键因素,这种技术应保留用于中小型瘘管,并且在没有多种受损伤口愈合条件的情况下。
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引用次数: 0
Interest of histological reclassification of poorly differentiated sinonasal carcinoma: Single-center retrospective study 低分化鼻窦癌组织学再分类的意义:单中心回顾性研究。
IF 2.5 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2024-05-01 DOI: 10.1016/j.anorl.2023.09.002
J. Hershkovitch , A. Boyez , A. Coste , S. Bartier
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引用次数: 0
期刊
European Annals of Otorhinolaryngology-Head and Neck Diseases
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