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

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.

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.

A report book unearthed in our archives contained 352 operative reports from the otorhinolaryngology department of the Armand-Trousseau Children's Hospital in Paris, dated from January 1912 to August 1920. These documents provide a snapshot of surgical activity in this field at the time. Mastoidectomy for mastoiditis was by far the most common procedure. This incomplete but original snapshot bears witness to the habits and working conditions of our predecessors, as well as to the progress made in just over a century.

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.

Behind the retro auricular groove, hidden by the pinna, on the surface of the mastoid, there is, a bony outgrowth, known by any otorhinolaryngologist worthy of the name, located above and behind the entrance to the external auditory canal in front of the supra meatic fossa: Henle's spine. In this historical note the authors retrace the moment of the dicovery of this primordial relief of otological surgery and the life of its discoverer, the German anatomis Jakob Henle, a true malesrtom which mixes science, art politics, and love.

Objectives: The aim of the present study was to assess greenhouse gas emissions for the main current subtotal tonsillectomy techniques.

Materials and methods: A retrospective study was conducted in 2 French university hospital pediatric ENT departments in 2022. The target techniques were radiofrequency with single-use or reusable needle, coblation, and dissection by cold instruments or by bipolar forceps. The medical devices required by each technique were listed and respective greenhouse gas emissions (carbon footprint, in kg eCO₂) were calculated, according to weight, energy consumption and place of production.

Results: Coblation generated a carbon footprint of 8.6kg eCO₂, versus 0.1-0.2kg eCO₂ for the other techniques.

Conclusion: Greenhouse gas emissions in subtotal tonsillectomy differ greatly according to technique. Bipolar dissection and radiofrequency have a smaller footprint than coblation. This type of data, which needs to be weighed over time according to medical benefit, should be systematically taken into account in choosing hardware for surgery.