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Ammar H, Le Beller C, Bouccara D, Malinvaud D, Jouffroy R, Lillo-Le Louet A. Vestibular disorders following BNT162b2 mRNA COVID-19 vaccination: A retrospective case series. Fundam Clin Pharmacol 2024; 38:192-204. [PMID: 37473782 DOI: 10.1111/fcp.12942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/18/2023] [Accepted: 07/05/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND There are few publications regarding manifestations of vestibular disorders (VDs) following BNT162b2 mRNA COVID-19 vaccination. PURPOSE We describe cases of VD potentially related to BNT162b2 vaccination and calculate its reporting rate, in order to enlarge knowledge about this adverse effect. METHODS A retrospective analysis of cases of VD following BNT162b2 vaccination reported to the pharmacovigilance centre of Georges-Pompidou European Hospital (France), in 2021 was performed. In order to identify these cases from the pharmacovigilance database containing all our registered cases, we used the Standardised MedDRA Query (SMQ) 'vestibular disorders'. Then we analysed cases with vestibular symptoms, based on the association of typical manifestations. The reporting rate was calculated based on the number of VD cases and the number of vaccinated patients. RESULTS Among 6608 cases reported to our centre related to COVID-19 vaccines during 2021, 34 VDs associated with BNT162b2 administration were included. They were mainly reported in females (79%), 62% occurred after the first dose and 32% were serious. Symptoms had completely resolved in 13 cases (38%). Vertigo was the most common symptom followed by balance disorders. Three patients received second dose without reappearance of VD. The final diagnosis was reported in 10 patients (six cases of vestibular neuritis, two cases of central VD, two cases of benign paroxysmal positional vertigo). The regional reporting rate was 26 [95% CI: 17-34] cases of VD per 1 million persons vaccinated. CONCLUSION Although the relationship between vaccination and VD cannot be established, clinicians should be aware of this rare adverse effect.
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Affiliation(s)
- Helmi Ammar
- Pharmacovigilance Regional Centre, Hôpital Européen Georges Pompidou, AP-HP-Université Paris Cité, Paris, France
| | - Christine Le Beller
- Pharmacovigilance Regional Centre, Hôpital Européen Georges Pompidou, AP-HP-Université Paris Cité, Paris, France
| | - Didier Bouccara
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, Hôpital Européen Georges Pompidou, AP-HP, Université Paris Cité, Paris, France
- Unité CNRS UMR 8002, INCC - Integrative Neuroscience and Cognition Group, Université Paris Cité, Paris, France
| | - David Malinvaud
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, Hôpital Européen Georges Pompidou, AP-HP, Université Paris Cité, Paris, France
- Unité CNRS UMR 8002, INCC - Integrative Neuroscience and Cognition Group, Université Paris Cité, Paris, France
| | - Romain Jouffroy
- Intensive Care Unit, Ambroise Paré Hospital, Assistance Publique Hôpitaux Paris and Paris Saclay University, Paris, France
- Institut de Recherche bioMédicale et d'Epidémiologie du Sport - EA7329, INSEP - Paris University, Paris, France
- Centre de recherche en Epidémiologie et Santé des Populations - U1018 INSERM - Paris Saclay University, Paris, France
- EA 7525 Université des Antilles, Fort de France, France
| | - Agnès Lillo-Le Louet
- Pharmacovigilance Regional Centre, Hôpital Européen Georges Pompidou, AP-HP-Université Paris Cité, Paris, France
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Malinvaud D, Shenouda K, Laccourreye L, Guiquerro S, Rubin F, Laccourreye O. Aural tuberculosis at the start of the 21st century. Literature review according to SWiM guidelines. Part 2: Treatment. Eur Ann Otorhinolaryngol Head Neck Dis 2022; 139:351-356. [PMID: 35778340 DOI: 10.1016/j.anorl.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Systematic review of the scientific literature dedicated to treatment modalities and results for aural tuberculosis published since the start of the 21st century. MATERIAL AND METHODS Search of the Medline, Cochrane and Embase databases for the period 2000 - 2020. Selection of articles in English, French and Spanish devoted to clinical cases and series documenting treatment of auricular tuberculosis. Extraction of data on pre-established files documenting treatment modalities and results. Reading of articles by two authors. Analysis performed according to SWiM guidelines, evaluating cure, tuberculosis-related death, treatment-related complications, improvement in facial palsy, and hearing sequelae rates. RESULTS One hundred and twenty eight articles: 118 case reports (159 patients) and 10 cohorts (177 patients) from 42 countries were analyzed. Female/male sex ratio was 1.2 with ages ranging from 1 month to 87 years. Medical treatment consisted in 5 to 24 months' antitubercular antibiotic treatment using 2 to 8 antibiotics. Mastoidectomy, tympanoplasty and facial nerve decompression were associated to medical treatment in 64.7%, 17.4% and 6.2% of cases, respectively. Overall rates of cure, death, treatment-related complications, facial sequelae and hearing sequelae were 96.8%, 2%, 9.5%, 35.8% and 75.5%. In case reports, BCG vaccination did not appear to protect against facial palsy and severe intracranial complications (P>0.6). There was no significant correlation (P>0.3) between death and the clinical variables tested, and facial nerve decompression did not appear to influence outcome for facial function (P=0.4). CONCLUSION Medical treatment is very effective but not without risk of death, complications and sequelae. It is the same as for pulmonary tuberculosis. Indications for and benefit of major auricular surgery during medical treatment deserve further studies.
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Affiliation(s)
- D Malinvaud
- Université Paris Cité, service d'otorhinolaryngologie et de chirurgie cervico-faciale, HEGP, Assistance Publique des hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France; Unité CNRS UMR 8002, INCC - Integrative Neuroscience and Cognition Group, France
| | - K Shenouda
- Université Paris Cité, service d'otorhinolaryngologie et de chirurgie cervico-faciale, HEGP, Assistance Publique des hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France
| | - L Laccourreye
- Institut Arthur Vernes, service d'Otorhinolaryngologie et de chirurgie cervico-faciale, 36 rue D'Assas, 75006, Paris, France
| | - S Guiquerro
- Université Paris Cité, bibliothèque universitaire Necker, 160 rue de Vaugirard, 75015, Paris, France
| | - F Rubin
- Clinique St-Vincent, 8, rue de Paris, CS 71027, Saint-Denis Cedex 97404, La Réunion, France
| | - O Laccourreye
- Université Paris Cité, service d'otorhinolaryngologie et de chirurgie cervico-faciale, HEGP, Assistance Publique des hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France.
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Malinvaud D, Shenouda K, Laccourreye L, Guiquerro S, Rubin F, Laccourreye O. Aural tuberculosis at the start of the 21st century. Literature review according to SWiM guidelines. Part 1: Clinical and diagnostic data. Eur Ann Otorhinolaryngol Head Neck Dis 2022; 139:343-349. [PMID: 35701295 DOI: 10.1016/j.anorl.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Review of the scientific literature dedicated to clinical data and diagnosis modalities for aural tuberculosis published since the start of the 21st century. MATERIAL AND METHODS Search of the Medline, Cochrane and Embase databases for the period 2000-2020. Selection of articles in English, French and Spanish devoted to clinical cases and series documenting clinical data and diagnosis for aural tuberculosis of articles by two authors. Analysis performed according to SWiM guidelines. Extraction of data on pre-established files documenting clinical and diagnostic data. RESULTS In total, 173 articles: 163 case reports (228 patients) and 10 cohorts (177 patients) from 49 countries were analyzed. Female/male sex ratio was 1.05, with ages ranging from less than 1 month to 87 years. Tuberculosis involved another site in 35.1% of cases. Aural involvement was bilateral in 19.7% of cases. Clinical presentation corresponded to otitis media (prior antibiotic treatment and auricular surgery in 41.4% and 10.1% of cases, respectively) without any pathognomonic symptoms or signs. Associated severe locoregional complications were seen in 32% of cases, with 23.2% and 13% incidence of peripheral facial palsy and severe intracranial complications, respectively. Time to diagnosis ranged from less than 1 month to 384 months, and was longer than 12 months in 26.5% of case reports, without significant correlation (P=0.29) with severe revelatory locoregional complications. Incidence of Mycobacterium tuberculosis detection ranged from 33.4% of documented cases in auricular secretions to 64.6% in polyps, granulomas, and/or biopsies. In the case reports, diagnosis with certainty was done in 58.3% of cases, while it was based on involvement of another site and on indirect criteria or positive clinical progression after treatment in the other 10.1% and 31.6%, respectively. CONCLUSION Aural tuberculous must always be considered in case of unfavorable progression of otitis. Definitive diagnosis is based on multiple auricular sample sites, polymerase chain reaction, and γ interferon blood assay.
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Affiliation(s)
- D Malinvaud
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, HEGP, université Paris Cité, AP-HP, 20, rue Leblanc, 75015 Paris, France
| | - K Shenouda
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, HEGP, université Paris Cité, AP-HP, 20, rue Leblanc, 75015 Paris, France
| | - L Laccourreye
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, institut Arthur-Vernes, 36, rue d'Assas, 75006 Paris, France
| | - S Guiquerro
- Bibliothèque universitaire Necker, université Paris Cité, 160, rue de Vaugirard, 75015 Paris, France
| | - F Rubin
- Clinique Saint-Vincent, 8, rue de Paris, CS 71027, 97404 Saint-Denis cedex, France
| | - O Laccourreye
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, HEGP, université Paris Cité, AP-HP, 20, rue Leblanc, 75015 Paris, France.
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Laccourreye O, Gaultier AL, Haroun F, Lepine C, Malinvaud D, Mirghani H. Positive predictive values of MRI and ultrasound-guided fine-needle aspiration biopsy for isolated parotid swelling in adults: A STARD comparative analysis. Eur Ann Otorhinolaryngol Head Neck Dis 2022; 139:269-274. [DOI: 10.1016/j.anorl.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Laccourreye O, Bonfils P, Malinvaud D, Ménard M, Giraud P. Survival and laryngeal preservation tradeoff in advanced laryngeal cancer: From the otorhinolaryngology patient to the managing physician. Head Neck 2017; 39:1984-1989. [PMID: 28786181 DOI: 10.1002/hed.24833] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 02/27/2017] [Accepted: 04/17/2017] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The purpose of this study was to document the tradeoff between survival and laryngeal preservation in advanced-stage laryngeal cancer amenable to chemoradiation or total laryngectomy. METHODS We conducted a prospective analysis based on a questionnaire completed by 209 laryngeal cancer specialists and 269 volunteers from an otorhinolaryngology clinic. RESULTS Of the responders, 34.5% would not consider any decrease in survival to preserve their larynx. This percentage varied from 52% in otorhinolaryngologists to 27.3% in radiotherapists and 28.6% in volunteers (P < .001). Among the responders prepared to trade, the percentage of survival they were willing to trade to preserve their larynx varied from 5% to 100% (median 30%). On univariate analysis, 3 variables significantly affected this percentage: (1) the living status (single or not); (2) the existence of children; and (3) the study group (volunteers, radiation therapists, or otorhinolaryngologists) to whom the responders belong. CONCLUSION The significant variations noted should develop modes of practice that cater to this and stimulate further research in this field.
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Affiliation(s)
- Ollivier Laccourreye
- Department of Otorhinolaryngology - Head Neck Surgery, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Pierre Bonfils
- Department of Otorhinolaryngology - Head Neck Surgery, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - David Malinvaud
- Department of Otorhinolaryngology - Head Neck Surgery, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Madeleine Ménard
- Department of Otorhinolaryngology - Head Neck Surgery, Université Paris Descartes Sorbonne Paris Cité, Paris, France
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Malinvaud D, Londero A, Niarra R, Peignard P, Warusfel O, Viaud-Delmon I, Chatellier G, Bonfils P. Auditory and visual 3D virtual reality therapy as a new treatment for chronic subjective tinnitus: Results of a randomized controlled trial. Hear Res 2016; 333:127-135. [PMID: 26773752 DOI: 10.1016/j.heares.2015.12.023] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 12/03/2015] [Accepted: 12/22/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Subjective tinnitus (ST) is a frequent audiologic condition that still requires effective treatment. This study aimed at evaluating two therapeutic approaches: Virtual Reality (VR) immersion in auditory and visual 3D environments and Cognitive Behaviour Therapy (CBT). METHODS This open, randomized and therapeutic equivalence trial used bilateral testing of VR versus CBT. Adult patients displaying unilateral or predominantly unilateral ST, and fulfilling inclusion criteria were included after giving their written informed consent. We measured the different therapeutic effect by comparing the mean scores of validated questionnaires and visual analog scales, pre and post protocol. Equivalence was established if both strategies did not differ for more than a predetermined limit. We used univariate and multivariate analysis adjusted on baseline values to assess treatment efficacy. In addition of this trial, purely exploratory comparison to a waiting list group (WL) was provided. RESULTS Between August, 2009 and November, 2011, 148 of 162 screened patients were enrolled (VR n = 61, CBT n = 58, WL n = 29). These groups did not differ at baseline for demographic data. Three month after the end of the treatment, we didn't find any difference between VR and CBT groups either for tinnitus severity (p = 0.99) or tinnitus handicap (p = 0.36). CONCLUSION VR appears to be at least as effective as CBT in unilateral ST patients.
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Affiliation(s)
- D Malinvaud
- Department of ENT and CNRS UMR 8119, Hôpital Européen Georges Pompidou, Faculté de médecine Paris Descartes, Université Paris 5, Paris, France; Center of Neurophysics, Physiology and Pathology (CN2P), CNRS UMR 8119, Université Paris Descartes, Paris, France.
| | - A Londero
- Department of ENT and CNRS UMR 8119, Hôpital Européen Georges Pompidou, Faculté de médecine Paris Descartes, Université Paris 5, Paris, France
| | - R Niarra
- Assistance Publique-Hôpitaux de Paris, European Georges Pompidou Hospital, Epidemiology and Clinical Research Unit, Paris, France; INSERM, Epidemiological Investigation Center 4, Paris, France
| | - Ph Peignard
- Department of ENT and CNRS UMR 8119, Hôpital Européen Georges Pompidou, Faculté de médecine Paris Descartes, Université Paris 5, Paris, France
| | - O Warusfel
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, IRCAM, Sciences et Techniques de la Musique et du Son, Paris, France
| | - I Viaud-Delmon
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, IRCAM, Sciences et Techniques de la Musique et du Son, Paris, France
| | - G Chatellier
- Assistance Publique-Hôpitaux de Paris, European Georges Pompidou Hospital, Epidemiology and Clinical Research Unit, Paris, France; INSERM, Epidemiological Investigation Center 4, Paris, France
| | - P Bonfils
- Department of ENT and CNRS UMR 8119, Hôpital Européen Georges Pompidou, Faculté de médecine Paris Descartes, Université Paris 5, Paris, France; Cognition and Action Group, CNRS MD 8257, SSA and University Paris 5, Paris, France
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Laccourreye O, Malinvaud D, Holostenco V, Ménard M, Garcia D, Bonfils P. Value and limits of non-robotic transoral oropharyngectomy for local control of T1-2 invasive squamous cell carcinoma of the tonsillar fossa. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132:141-6. [DOI: 10.1016/j.anorl.2015.03.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Devars du Mayne M, Gratacap M, Malinvaud D, Grenouillet F, Bonfils P. An uncommon cause of allergic fungal sinusitis: Rhizopus oryzae. Ear Nose Throat J 2015; 94:E17-E20. [PMID: 25606840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
We report what we believe is the first case of allergic fungal rhinosinusitis (AFRS) caused by the fungus Rhizopus oryzae. Our patient was a 32-year-old woman who presented with unilateral nasal polyps and chronic nasal dysfunction. Computed tomography of the sinuses detected left-sided pansinusitis and bone erosion. T2-weighted magnetic resonance imaging demonstrated a signal void that suggested the presence of a fungal infection. The patient underwent unilateral ethmoidectomy. Histologic examination of the diseased tissue identified allergic mucin with 70% eosinophils and no fungal hyphae. Mycologic culture detected R oryzae. After a short period of improvement, the patient experienced a recurrence, which was confirmed by radiology. A second surgery was performed, and the same fungal hyphae were found in the mucus and on culture, which led us to suspect AFRS. Since no IgE test for R oryzae was available, we developed a specific immunologic assay that confirmed the presence of specific IgG, which identified a high degree of immunologic reaction against our homemade R oryzae antigens. With a long course of systemic antifungal treatment, the patient's symptoms resolved and no recurrence was noted at 5 years of follow-up.
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Affiliation(s)
- Marie Devars du Mayne
- Department of Otorhinolaryngology-Head and Neck Surgery, HEGP, 20 Rue Leblanc, 75015 Paris, France
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Laccourreye O, Malinvaud D, Garcia D, Ménard M, Hans S, Cauchois R, Bonfils P. Postoperative Hemorrhage After Transoral Oropharyngectomy for Cancer of the Lateral Oropharynx. Ann Otol Rhinol Laryngol 2014; 124:361-7. [DOI: 10.1177/0003489414558109] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Assessment of incidence, risk factors, management, and outcome of postoperative hemorrhage after transoral oropharyngectomy for cancer of the lateral oropharynx. Methods: Retrospective review of a cohort of 514 cancers of the lateral oropharynx consecutively resected. Results: Incidence of postoperative hemorrhage was 3.6%. In 31.5% of cases, onset was after hospital discharge. No hemorrhages occurred after the end of the fourth postoperative week. Variables associated with increased risk of hemorrhage were advanced age ( P = .004), antithrombotic treatment ( P = .012), and robotic assistance ( P = .009). When the source of hemorrhage could be identified, hemostasis, performed transorally in most cases, was highly effective; no patients in this subgroup showed recurrence. In spontaneously resolved hemorrhage under observation or when no active site of bleeding was found on exploration under general anesthesia, the recurrence rate was 18.1%. Overall, hemorrhage resulted in death in 2 patients. Conclusion: Exploration under general anesthesia in case of active bleeding and observation with discussion of arterial exploration of the ipsilateral external carotid system in patients in whom no source of bleeding can be identified are the keys to successful management of this potentially lethal complication.
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Affiliation(s)
| | - David Malinvaud
- Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | | | | | - Stéphane Hans
- Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Régis Cauchois
- Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Pierre Bonfils
- Université Paris Descartes Sorbonne Paris Cité, Paris, France
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Giraud P, Malinvaud D, Ménard M, Consoli S, Bonfils P, Laccourreye O. [Which choice would the radiation oncologist consider if facing an advanced stage laryngeal cancer?]. Cancer Radiother 2014; 18:649-54. [PMID: 25304064 DOI: 10.1016/j.canrad.2014.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Revised: 05/08/2014] [Accepted: 05/20/2014] [Indexed: 11/15/2022]
Abstract
PURPOSE To analyse the therapeutic decision considered by radiation oncologists put in a position of being diagnosed with an advanced stage cancer of the larynx accessible either to a total laryngectomy or to an organ preservation protocol. MATERIALS AND METHODS Prospective analysis based on an anonymous survey filled by 104 radiation oncologists. RESULTS A total of 30.7% of radiation oncologists surveyed did not consider any trade in their cure rate to preserve their larynx. The median percentage of cure that they were willing to trade was 10% (2-100%); and 0.9% of them were willing to trade 100% of their chance for cure in order to "avoid" total laryngectomy. A total of 16.3% of radiation oncologists would like to receive more information before making their decision. The additional information most frequently requested concerned the precise stage of the tumour and the potential remedial treatment in case of failure of the laryngeal preservation protocol. None of the analysed demographic variables influenced the choice to trade or not survival chance to preserve the larynx, the percentage of chance that radiation oncologists would consider exchanging, and/or the wish to receive additional information. CONCLUSION This prospective study highlights that larynx preservation protocol is not the main therapeutic goal shared by all radiation oncologists put in a position of being diagnosed with an advanced stage cancer of the larynx. Total laryngectomy should remain a treatment option that as organ preservation protocols to be proposed and discussed.
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Affiliation(s)
- P Giraud
- Service d'oncologie-radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, Paris Cité Sorbonne, 75015 Paris, France.
| | - D Malinvaud
- Université Paris Descartes, Paris Cité Sorbonne, 75015 Paris, France; Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - M Ménard
- Université Paris Descartes, Paris Cité Sorbonne, 75015 Paris, France; Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - S Consoli
- Université Paris Descartes, Paris Cité Sorbonne, 75015 Paris, France; Service de psychiatrie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - P Bonfils
- Université Paris Descartes, Paris Cité Sorbonne, 75015 Paris, France; Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - O Laccourreye
- Université Paris Descartes, Paris Cité Sorbonne, 75015 Paris, France; Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
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Laccourreye O, Malinvaud D, Ménard M, Consoli S, Giraud P, Bonfils P. Otorhinolaryngologists' personal treatment preferences (total laryngectomy or laryngeal preservation) when faced with advanced stage laryngeal cancer. Eur Ann Otorhinolaryngol Head Neck Dis 2014; 131:339-343. [PMID: 24993784 DOI: 10.1016/j.anorl.2014.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 01/20/2014] [Accepted: 01/29/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To analyse the treatment options that otorhinolaryngologists would consider if faced with advanced stage laryngeal cancer amenable to total laryngectomy or an organ preservation protocol. MATERIAL AND METHODS Prospective study conducted in a French Teaching Hospital based on questionnaires filled in by 163 otorhinolaryngologists in 2012, studying the percentage chance of cure that they would be prepared to trade-off to preserve their larynx, defining the additional information that they would like to receive and identifying any statistical associations between these parameters and various medical and socioeconomic variables. RESULTS A total of 42.3% of otorhinolaryngologists would not consider the slightest trade-off to preserve their larynx and preferred to undergo total laryngectomy. In the group of otorhinolaryngologists who would consider a larynx preservation protocol (57.6%), the percentage chance of cure that they would be willing to trade-off to preserve their larynx ranged between 5 to 100% (median: 15%) and 4.2% of them were willing to trade-off all chances of cure (100%) to avoid total laryngectomy. The percentage of otorhinolaryngologists who would not consider trading off the slightest chance of survival to preserve their larynx increased from 29.3 to 49.5% (P=0.01) when they participated in multidisciplinary consultation meetings. In the group of otorhinolaryngologists who would consider a larynx preservation protocol, the median percentage survival trade-off that they would consider in order to preserve their larynx (i) decreased from 20 to 10% (P=0.004) when they participated in multidisciplinary consultation meetings and (ii) increased regularly with their number of years of practice (P=0.03) and their age (P=0.025). Finally, 25.1% of otorhinolaryngologists wanted to receive additional information, although none of the variables analysed affected this desire for more information. CONCLUSION Treatment options considered by otorhinolaryngologists faced with advanced stage laryngeal cancer were almost equally divided between total laryngectomy and larynx preservation. Number of years of practice and regular participation in head and neck cancer multidisciplinary consultation meetings were variables that significantly influenced this choice.
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Affiliation(s)
- O Laccourreye
- Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, université Paris Descartes Sorbonne Paris Cité, hôpital européen Georges-Pompidou, AP-HP, 20-40, rue Leblanc, 75015 Paris, France.
| | - D Malinvaud
- Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, université Paris Descartes Sorbonne Paris Cité, hôpital européen Georges-Pompidou, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
| | - M Ménard
- Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, université Paris Descartes Sorbonne Paris Cité, hôpital européen Georges-Pompidou, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
| | - S Consoli
- Service de psychiatrie, université Paris Descartes Sorbonne Paris Cité, hôpital européen Georges-Pompidou, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
| | - P Giraud
- Service d'oncologie-radiothérapie, université Paris Descartes Sorbonne Paris Cité, hôpital européen Georges-Pompidou, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
| | - P Bonfils
- Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, université Paris Descartes Sorbonne Paris Cité, hôpital européen Georges-Pompidou, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
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Laccourreye O, Malinvaud D, Ménard M, Bonfils P. Paralysies laryngées unilatérales de l’adulte : épidémiologie, symptomatologie, physiopathologie et traitement. Presse Med 2014; 43:348-52. [DOI: 10.1016/j.lpm.2013.07.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 07/16/2013] [Indexed: 11/25/2022] Open
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Laccourreye O, Malinvaud D, Ménard M, Consoli S, Giraud P, Bonfils P. Total laryngectomy or laryngeal preservation for advanced laryngeal cancer. Impact of the functional risk upon the patient's preferences. Eur Ann Otorhinolaryngol Head Neck Dis 2014; 131:93-7. [PMID: 24529928 DOI: 10.1016/j.anorl.2013.06.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2012] [Revised: 12/27/2012] [Accepted: 06/10/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To analyse, based on an anonymous questionnaire, the treatment decision envisaged and the impact of the medical information delivered in patients facing the diagnosis of an advanced laryngeal cancer amenable to total laryngectomy or a laryngeal preservation protocol. MATERIAL AND METHODS Prospective study conducted in a French teaching hospital based on questionnaires filled in by 269 patients attending the otorhinolaryngology clinic. RESULTS A total of 28.6% of patients would not consider any trade-off of cure to preserve their larynx; 1.4% of patients were willing to trade all chances of cure in order to avoid total laryngectomy. The median percentage of cure that patients were ready to loose in order to preserve their larynx was 33% (range: 5 to 100%); 47.9% of patients wanted to receive additional information before making their decision with a significant increase among patients with a level of education beyond secondary school (P=0.0006) and among patients with a family history of cancer (P=0.038). The additional information most frequently requested concerned the complications related to the laryngeal preservation protocol (34.1%) and the cure rate (28.6%). After receiving information about the risk of tracheostomy and permanent gastrostomy following the laryngeal preservation protocol, the percentage of subjects who would not consider any trade-off in order to preserve their larynx increased to 31.2% and 56.1%, respectively. CONCLUSION Laryngeal preservation is not a major objective of treatment shared by patients filling a questionnaire devoted to the choice of treatment when facing an advanced laryngeal cancer. Specific information concerning the expected results and the inherent risks involved in the various treatment options must be provided in every case.
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Affiliation(s)
- O Laccourreye
- Université Paris Descartes Sorbonne Paris Cité, Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, Hôpital européen Georges-Pompidou, AP-HP, 20-40, rue Leblanc, 75015 Paris, France.
| | - D Malinvaud
- Université Paris Descartes Sorbonne Paris Cité, Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, Hôpital européen Georges-Pompidou, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
| | - M Ménard
- Université Paris Descartes Sorbonne Paris Cité, Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, Hôpital européen Georges-Pompidou, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
| | - S Consoli
- Université Paris Descartes Sorbonne Paris Cité, Service de psychiatrie, Hôpital ruropéen Georges-Pompidou, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
| | - P Giraud
- Université Paris Descartes Sorbonne Paris Cité, Service de radiothérapie-oncologie, Hôpital européen Georges-Pompidou, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
| | - P Bonfils
- Université Paris Descartes Sorbonne Paris Cité, Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, Hôpital européen Georges-Pompidou, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
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Malinvaud D, Mukundan S, Crevier-Buchman L, Bonfils P, Laccourreye O. Glottic bamboo nodules from systemic lupus erythematosus. Ann Otol Rhinol Laryngol 2013; 122:496-9. [PMID: 24027859 DOI: 10.1177/000348941312200804] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Bamboo nodules of the glottis are of late being described as a distinct entity seen in patients with autoimmune diseases. We report the symptoms, clinical features, and management of a case of bamboo nodules of the glottis in a patient with systemic lupus erythematosus. We discuss the pathogenesis and management of this condition on the basis of a review of the medical literature.
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Affiliation(s)
- David Malinvaud
- Department of Otorhinolaryngology-Head and Neck Surgery, Université Paris Descartes Sorbonne Paris Cité, HEGP, AP-HP, Paris, France
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Laccourreye O, Werner A, Garcia D, Malinvaud D, Tran Ba Huy P, Bonfils P. First bite syndrome. Eur Ann Otorhinolaryngol Head Neck Dis 2013; 130:269-73. [DOI: 10.1016/j.anorl.2012.11.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 11/25/2012] [Accepted: 11/28/2012] [Indexed: 11/29/2022]
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Laccourreye O, Benito J, Menard M, Garcia D, Malinvaud D, Holsinger C. Lateral pharyngotomy for selected invasive squamous cell carcinoma of the lateral oropharynx-part I: How. Laryngoscope 2013; 123:2712-7. [DOI: 10.1002/lary.24161] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Ollivier Laccourreye
- Department of Otorhinolaryngology Head & Neck Surgery , HEGP; University Paris Descartes Sorbonne Paris Cité; Paris France
| | - José Benito
- Department of Oto-Rhino-Laryngology; Sant Joan University teaching Hospital; Reus Spain
| | - Madeleine Menard
- Department of Otorhinolaryngology Head & Neck Surgery , HEGP; University Paris Descartes Sorbonne Paris Cité; Paris France
| | | | - David Malinvaud
- Department of Otorhinolaryngology Head & Neck Surgery , HEGP; University Paris Descartes Sorbonne Paris Cité; Paris France
| | - Christopher Holsinger
- Department of Head and Neck Surgery; The University of Texas M. D. Anderson Cancer Center; Houston Texas U.S.A
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Laccourreye O, Malinvaud D, Holsinger FC, Consoli S, Ménard M, Bonfils P. Trade-off between Survival and Laryngeal Preservation in Advanced Laryngeal Cancer: The Otorhinolaryngology Patient's Perspective. Ann Otol Rhinol Laryngol 2012; 121:570-5. [DOI: 10.1177/000348941212100902] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: We performed a prospective study to evaluate, from the patient's perspective, the trade-off between speech and survival that individuals face when given a diagnosis of advanced-stage laryngeal cancer amenable to either total laryngectomy or a laryngeal preservation protocol using chemotherapy and radiotherapy. Methods: Volunteers (309) consecutively seen at the otorhinolaryngology clinic of a university teaching hospital in France completed an anonymous questionnaire designed to determine their position if they faced the diagnosis of an advanced-stage laryngeal cancer. Univariate analysis was performed for potential statistical relationships with various variables. Results: We found that 12.9% of patients were unable to determine their position regarding the two treatment options offered, and this group had a significant statistical relationship with four variables (age, education, professional status, and history of cancer among relatives). We found that 24.6% of patients made survival their main consideration and would not consider any trade-off. Among the 62.5% who considered the trade-off, the percentage of cure that patients were ready to lose in order to preserve their larynx varied from 5% to 100% (mean, 33%; SD, 23%). Aside from the undecided group, none of the variables analyzed was related either to the decision as to whether to consider a trade-off or to the percentage of cure that patients agreed to trade to preserve their larynx. Conclusions: In patients with advanced-stage laryngeal cancer, treatment should be initiated only after careful evaluation of the patient's attitude toward both laryngeal preservation and survival.
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Rubin F, Badoual C, Moya-Plana A, Malinvaud D, Laccourreye O, Bonfils P. Inverted papilloma of the middle ear. Eur Ann Otorhinolaryngol Head Neck Dis 2012; 129:207-10. [PMID: 22921721 DOI: 10.1016/j.anorl.2012.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 01/18/2012] [Accepted: 02/06/2012] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Inverted papilloma (IP) of the middle ear is a very rare lesion, as less than 20 cases have been reported in the literature. CASE REPORT The authors report the case of a 73-year-old male with IP of the middle and external ear that had already been operated many times. Treatment consisted of creating a large resection cavity. No recurrence was observed on clinical examination or MRI with a follow-up of 2 years. DISCUSSION AND CONCLUSION This case is analysed in the light of a review of published cases with a discussion of the pathophysiological and treatment problems raised by these lesions.
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Affiliation(s)
- F Rubin
- Service d'ORL et de chirurgie cervicofaciale, faculté de médecine Paris-Descartes, université Paris V, hôpital européen Georges-Pompidou, 20 rue Leblanc, Paris, France
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Laccourreye O, Malinvaud D, Alzahrani H, Ménard M, Garcia D, Bonfils P, Holsinger FC. Conventional transoral surgery for stage I-II squamous cell carcinoma of the tonsillar region. Head Neck 2012; 35:653-9. [DOI: 10.1002/hed.23018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2012] [Indexed: 11/11/2022] Open
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Devars du Mayne M, Moya-Plana A, Malinvaud D, Laccourreye O, Bonfils P. Sinus mucocele: natural history and long-term recurrence rate. Eur Ann Otorhinolaryngol Head Neck Dis 2012; 129:125-30. [PMID: 22227069 DOI: 10.1016/j.anorl.2011.10.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Revised: 09/29/2011] [Accepted: 10/06/2011] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To define the natural history, clinical signs, treatment and the modalities of medium- and long-term follow-up of patients operated for sinus mucocele. PATIENTS AND METHOD Retrospective study of all patients operated for sinus mucocele between January 1993 and December 2009 (n=68). Demographic data, symptoms, medical imaging findings, surgical treatment and results were recorded. RESULTS The mean age of patients in this series was 53 years (range: 27-82 years, sex ratio: 3/2). The most common site was fronto-ethmoidal. Fifty-one patients (75%) had a history of sinus surgery, essentially for nasal polyposis. Only 15% of mucoceles occurred spontaneously. Presenting symptoms, in decreasing order of frequency, were facial pain or headache (38%), ocular or orbital complications (28%), while 20% of patients were asymptomatic. Surgery was performed by endonasal endoscopic sinus surgery (n=57, 84%) or via a combined, transfacial and endonasal approach, associated with navigation after January 2003. The mean follow-up was 7 years (range: 4 months-16 years). During this follow-up period, 23.5% of patients developed recurrence or a second mucocele after a mean interval of 4 years. CONCLUSION This study demonstrates the high recurrence rate of mucocele, particularly in multi-operated patients with chronic sinusitis. Long-term, regular, clinical and radiological follow-up is necessary to detect asymptomatic lesions prior to the onset of complications.
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Affiliation(s)
- M Devars du Mayne
- Service d'ORL et de chirurgie cervico-faciale, hôpital européen Georges-Pompidou, faculté de médecine Paris-Descartes, université Paris V, 20, rue Leblanc, 75015 Paris, France
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Mahut B, Plantier L, Malinvaud D, Chevalier-Bidaud B, Bonfils P, Delclaux C. Pathophysiology of airway hyperresponsiveness in patients with nasal polyposis. Respir Med 2012; 106:68-74. [DOI: 10.1016/j.rmed.2011.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 07/28/2011] [Accepted: 08/01/2011] [Indexed: 10/17/2022]
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Malinvaud D, Badoual C, Rubio MT, Halimi P, Bonfils P. Extraosseous plasmacytoma of the lacrimal duct. B-ENT 2012; 8:285-288. [PMID: 23409559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE Extraosseous plasmacytoma (EOP) is a rare plasma cell proliferative disorder that commonly affects the head and neck region. We report the first case of a plasmacytoma of the lacrimal duct. METHODS A 66-year-old man presented with an isolated plasmacytoma of the right lacrimal duct and was treated surgically. RESULTS The tumour grew slowly for a few months. CT scan and MRI showed a right lateral nasal mass extending from the right lacrimal duct toward the floor of the right maxillary sinus. The lesion was removed completely by endoscopic nasal surgery. DISCUSSION EOP accounts for up to 3% of all plasma cell tumours. Management of this rare lesion involves surgery and radiotherapy with or without adjuvant chemotherapy. Guided by a literature review, we discuss the diagnostic and therapeutic management of EOP.
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Affiliation(s)
- D Malinvaud
- Department of ENT and Auditory Research Laboratory, Formation Associée Claude Bernard and CNRS UMR 8194, Hôpital Européen Georges Pompidou, Faculté de médecine Paris V, Université René Descartes, Paris, France.
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Bonfils P, Laccourreye O, Durand FX, Malinvaud D, Bensimon JL. Sudden deafness following a sternutatory attack. Eur Ann Otorhinolaryngol Head Neck Dis 2011; 128:103-5. [PMID: 21388908 DOI: 10.1016/j.anorl.2011.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 12/24/2010] [Accepted: 01/04/2011] [Indexed: 11/15/2022]
Affiliation(s)
- P Bonfils
- Service d'ORL et de chirurgie cervicofaciale, faculté de médecine Paris Descartes, université Paris V, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
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Laccourreye O, Malinvaud D, Ménard M, Bonfils P. [Unilateral laryngeal paralysis in the adult patient]. Rev Prat 2011; 61:308-311. [PMID: 21563400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Based on a review of the recent medical literature, the authors document the epidemiological evolution, pathophysisology diagnosis and recent advances in treatment for adult patients with unilateral laryngeal paralysis. Speech therapy, which used to be the only therapeutic option, is nowadays complemented by efficient surgical techniques, which have modified the management of many patients.
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Affiliation(s)
- Ollivier Laccourreye
- Université Paris-Descartes, faculté de médecine, AP-HP, Hôpital européen Georges-Pompidou, 75908 Paris Cedex 15.
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Soudry Y, Lemogne C, Malinvaud D, Consoli SM, Bonfils P. Olfactory system and emotion: common substrates. Eur Ann Otorhinolaryngol Head Neck Dis 2011; 128:18-23. [PMID: 21227767 DOI: 10.1016/j.anorl.2010.09.007] [Citation(s) in RCA: 210] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2010] [Revised: 07/13/2010] [Accepted: 09/20/2010] [Indexed: 11/19/2022]
Abstract
THE AIM OF THE REVIEW: A large number of studies suggest a close relationship between olfactory and affective information processing. Odors can modulate mood, cognition, and behavior. The aim of this article is to summarize the comparative anatomy of central olfactory pathways and centers involved in emotional analysis, in order to shed light on the relationship between the two systems. ANATOMY OF THE OLFACTORY SYSTEM: Odorant contact with the primary olfactory neurons is the starting point of olfactory transduction. The glomerulus of the olfactory bulb is the only relay between the peripheral and central olfactory system. Olfactory information is conducted to the secondary olfactory structures, notably the piriform cortex. The tertiary olfactory structures are the thalamus, hypothalamus, amygdala, hippocampus, orbitofrontal cortex and insular cortex. THE IMPACT OF ODORS ON AFFECTIVE STATES: Quality of life is commonly impaired in dysosmic patients. There have, however, been few publications on this topic. EMOTION AND OLFACTION: COMMON BRAIN PATHWAYS: There are brain structures common to emotion and odor processing. The present review focuses on such structures: amygdala, hippocampus, insula, anterior cingulate cortex and orbitofrontal cortex. The physiology and anatomy of each of these systems is described and discussed.
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Affiliation(s)
- Y Soudry
- Service de psychologie clinique et de liaison, de psychiatrie, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 75015 Paris, France
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Malinvaud D, Halimi P, Bonfils P. Pneumosinus dilatans associated with nasal polyposis. B-ENT 2011; 7:283-287. [PMID: 22338242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
OBJECTIVE Pneumosinus dilatans (PSD) and pneumocele involve the expansion of one or more paranasal sinuses. We present the first cases of frontal PSD and pneumocele associated with nasal polyposis. We also attempt to explain the development of these rare pathologies through this unexpected association. METHODS Two cases are described. A 31-year-old man presented with chronic rhinosinusitis for many years and a left frontal protrusion. Physical examination found nasal polyposis and CT scan showed an abnormally enlarged left frontal sinus without bone destruction. The second patient was a 17-year-old man who presented with a left frontal protrusion and orbital encroachment associated with chronic rhinosinusitis. Physical examination also found nasal polyposis and CT scan showed an abnormally enlarged left frontal sinus with focal thinning of the bony sinus walls. DISCUSSION Focal or generalized thinning of the bony sinus walls differentiates pneumocele from PSD; otherwise, these two entities share the same physiopathological and clinical courses. Many explanations have been proposed for their development including increases in intra-sinus pressure, weakening of bone by tumor invasion, intracranial hypotension, spontaneous drainage of a mucocele, and congenital or hormonal causes. Yet, its physiopathology remains unknown. These two cases support the pressure mechanism of development.
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Affiliation(s)
- D Malinvaud
- Department of ENT and Auditory Research Laboratory, Formation Associée Claude Bernard and CNRS UMR 8194, Hôpital Européen Georges Pompidou, Faculté Paris V, Universitê René Descartes, Paris, France.
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Laccourreye O, Delas B, Bonfils P, Malinvaud D. [Isolated unilateral laryngeal nerve paralysis in adults. An inception cohort of 591 patients managed in a French--university--teaching hospital]. Bull Acad Natl Med 2010; 194:805-818. [PMID: 21568053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
UNLABELLED We analyzed an inception cohort of 591 adults with isolated unilateral laryngeal paralysis managed at a French teaching hospital during the period 1990-2008. Symptoms, causes, treatment and outcome were compared between two periods (1990-2000 vs 2001-2008), using the Chi squared test and Mann Whitney U test. Dysphonia, swallowing impairment and respiratory impairment were present in respectively 98.3%, 34.8% and 4.1% of cases, The causes of paralysis were surgical and non surgical in respectively 65.1% and 21.1% of cases. Cancer (mainly lung cancer) was present in 59.6% of cases, and 22% of these patients were receiving palliative treatment. Thoraco-mediastinal surgery and thyroid-parathyroid surgery accounted for 79.4% of surgical causes. Malignancies accounted for 76.8% of non surgical causes. Within the idiopathic group (13.8% of the cohort), a tumor lying along the path of the paralyzed nerve was detected in 3.7% of cases. Larynx motion was recovered in 19.6% of cases; nerve transection, the etiology, and the time since symptom onset were predictive factors for motion recovery. Treatment consisted of laryngeal medialisation and isolated speech therapy in 40.1% and 59.9% of cases, respectively. The current success rate of laryngeal medialisation is 90.3%. CONCLUSIONS The three main causes of unilateral laryngeal nerve paralysis were tumors, surgery and cardiovascular disorders (surgical and non surgical). Laryngeal medialisation is now a major component of rehabilitation in our center.
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Affiliation(s)
- Ollivier Laccourreye
- Oto-rhino-laryngologie et de chirurgie cervico-faciale, Hôpital Européen Georges Pompidou, 20-40 rue Leblanc 75015 Paris cedex, France.
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Day N, Mainardi JL, Malinvaud D, Bonfils P. [Bacteriological study of ethmoid specimens from patients with nasal polyposis after ethmoidal surgery]. ACTA ACUST UNITED AC 2009; 126:196-202. [PMID: 19595291 DOI: 10.1016/j.aorl.2009.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2009] [Accepted: 06/08/2009] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To compare the bacteriological and clinical findings in ethmoid specimens from patients with nasal polyposis after radical ethmoidal surgery. PATIENTS AND METHODS From June to November 2008, 60 patients were prospectively included. For each patient, two samples for each ethmoidal cavity were taken. Aerobic and anaerobic bacterial cultures and fungal cultures were processed and the antibiotic susceptibility was evaluated for each isolated bacterial strain. RESULTS Pathogenic bacteria were isolated in 48 patients (80%) including predominantly Staphylococcus aureus (60%) or a Gram-negative bacterium. The microorganisms were nearly all susceptible to antibiotics, including the aminoglycosides. No correlation between the presence of pathogenic bacteria and the clinical status of the patients was found. CONCLUSION In this study, a great number of patients was colonized with pathogenic bacteria. However, the presence of pathogenic bacteria was not correlated with the clinical status of the patients.
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Affiliation(s)
- N Day
- Service de microbiologie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
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Laccourreye O, Malinvaud D, Ménard M, Bonfils P. Immobilités laryngées unilatérales après chirurgie de la glande thyroïde. ACTA ACUST UNITED AC 2009; 146:553-8. [DOI: 10.1016/j.jchir.2009.09.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Elrahman HA, Malinvaud D, Bonfils NA, Daoud R, Mimoun M, Bonfils P. Endoscopic Management of Idiopathic Spontaneous Skull Base Fistula Through the Clivus. Arch Otolaryngol Head Neck Surg 2009; 135:311. [DOI: 10.1001/archoto.2008.550] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Bonfils P, Malinvaud D, Soudry Y, Devars du Maine M, Laccourreye O. Surgical therapy and olfactory function. B-ENT 2009; 5 Suppl 13:77-87. [PMID: 20084808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
This report provides an overview of the relationship between olfaction and surgery. Surgery can be considered as treatment for some olfactory dysfunctions. Moreover, olfactory dysfunction can be analysed as a complication of some surgical procedures. An impaired sense of smell is a common problem affecting approximately 65% of patients with chronic sinusitis. Much of the literature about the effect of surgery on the olfactory system is based on subjective reports of olfactory function, which do not accurately assess objective smell dysfunction. A small number of prospective studies have been published. All studies looking at the sense of smell have found overall post-operative improvement compared with pre-operative symptoms. The range of improvement compared with pre-operative scores ranged from 13 to 91%, with a median of 31%. Olfaction dysfunction can be a complication of various surgical procedures such as laryngectomy, septoplasty, rhinoplasty, ethmoidectomy, and some neurosurgical procedures.
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Affiliation(s)
- P Bonfils
- ENT Department, European Hospital Georges Pompidou, Faculty of Medicine Paris-Descartes, University Paris V, Paris, France.
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Delclaux C, Malinvaud D, Chevalier-Bidaud B, Callens E, Mahut B, Bonfils P. Nitric oxide evaluation in upper and lower respiratory tracts in nasal polyposis. Clin Exp Allergy 2008; 38:1140-7. [PMID: 18477018 DOI: 10.1111/j.1365-2222.2008.03006.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND A decrease in nasal nitric oxide (NO) and an increase in exhaled NO have been demonstrated in patients with nasal polyposis (NP). OBJECTIVES The aims were to evaluate the flux of NO from the three compartments of the respiratory tract, namely, upper nasal, lower conducting and distal airways, and to search for relationships between NO parameters and indexes of upper and lower disease activity (bronchial reactivity and obstruction). The effect of medical treatment of polyposis was also evaluated. METHODS Seventy patients with polyposis were recruited. At baseline, pulmonary function tests (spirometry, plethysmography, bronchomotor response to deep inspiration using forced oscillation measurement of resistance of respiratory system, methacholine challenge, multiple flow rates of exhaled NO and nasal NO measurements) were performed together with an assessment of polyposis [clinical, endoscopic and computed tomography (CT) scores]. RESULTS Statistical relationships were demonstrated between nasal NO flux and severity scores (clinical: rho=-0.31, P=0.015; endoscopic: rho=-0.57, P<0.0001; CT: rho=-0.46, P=0.0005), and between alveolar NO concentration and distal airflow limitation (FEF(25-75), rho=-0.32, P=0.011). Thirty-six patients were assessed after 11 [7-13] (median [interquartile]) months of medical treatment, demonstrating an improvement in clinical and endoscopic scores, an increase in nasal NO flux, a decrease in NO flux from conducting airways, an improvement in the mild airflow limitation (forced expiratory volume in 1 s, FEF(25-75), even in non-asthmatic patients) and a decrease in the bronchoconstrictor effect of deep inspiration. CONCLUSIONS The medical treatment of NP improves both airway reactivity and obstruction, whatever the presence of asthma, suggesting a functional link between upper and lower airway functions.
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Affiliation(s)
- C Delclaux
- Faculté de Médecine Paris Descartes, Assistance Publique, Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Physiologie, Clinique de la dyspnée, Paris, Cedex, France.
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Daoud R, Malinvaud D, Meatchi T, Rahman HA, Halimi P, Bonfils P. [Paranasal sinus localization of Rosai Dorfman disease: long-term evolution and importance of magnetic resonance imaging]. J Otolaryngol Head Neck Surg 2008; 37:E49-E54. [PMID: 19137658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Affiliation(s)
- Rabii Daoud
- Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale, Université Paris V, Hôpital Européen Georges Pompidou, Paris, France
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Bonfils P, Faulcon P, Tavernier L, Bonfils NA, Malinvaud D. [Home accidents associated with anosmia]. Presse Med 2008; 37:742-5. [PMID: 18329839 DOI: 10.1016/j.lpm.2007.09.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2007] [Revised: 09/17/2007] [Accepted: 09/24/2007] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To assess the risk of home accidents related to severe hyposmia. METHODS A questionnaire, completed by 57 hyposmic patients and 49 control subjects with a normal sense of smell, asked about four specific types of olfactory-related home accidents: undetected fires, undetected gas leaks, consumption of spoiled food, and incidents of food burning. Level of olfactory function was determined by olfactory testing (Biolfa). RESULTS Olfactory testing revealed that 60% of the patients were anosmic and 40% had severe hyposmia. They reported cooking-related accidents most often (63%), followed by eating spoiled food (51%), inability to detect a gas leak (47%) and inability to smell a fire (26%). All these accidents were significantly more frequent than in the control population (p<10(-4)). DISCUSSION AND CONCLUSION This paper, the first in the European literature and the second in the international literature, shows that patients with severely impaired olfaction are more likely to experience related accidents than those with normal olfactory function.
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Affiliation(s)
- Pierre Bonfils
- Département d'ORL et de chirurgie cervicofaciale, Hôpital européen Georges Pompidou, F-75015 Paris, France.
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Bonfils >P, Tavernier L, Abdel Rahman H, Mimoun M, Malinvaud D. Evaluation of combined medical and surgical treatment in nasal polyposis - III. Correlation between symptoms and CT scores before and after surgery for nasal polyposis. Acta Otolaryngol 2008; 128:318-23. [PMID: 17917840 DOI: 10.1080/00016480701551760] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CONCLUSION Computed tomography (CT) in nasal polyposis (NP) patients has three functions before any treatment. CT provides objective evidence of the disease and precise topography of the disease, and is an indicator of the disease severity. After functional endoscopic sinus surgery (FESS), CT is an indicator of the residual disease severity and permits detection of asymptomatic mucoceles. OBJECTIVE NP affects nearly 4% of the population. CT has become the examination of choice for the exploration of NP. FESS is accepted for NP treatment in the setting of failure of medical management. The aim of this study was to find out whether any correlation exists between symptom severity and CT scan score before and after FESS. PATIENTS AND METHODS A total of 114 CT scans were performed in NP patients without contrast medium before and after FESS (mean follow-up 5 years), and were scored according to the Lund-MacKay system. RESULTS Lund-MacKay scores before treatment ranged from 8 to 24. There was a correlation between symptom and CT scores before any treatment. Postoperative Lund-MacKay scores ranged from 0 to 24. There was a correlation between symptom and CT scores after surgery. There was no correlation between postoperative symptom and baseline CT scores. Eleven asymptomatic mucoceles were found.
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Biesdorf S, Malinvaud D, Reichenberger I, Pfanzelt S, Straka H. Differential inhibitory control of semicircular canal nerve afferent-evoked inputs in second-order vestibular neurons by glycinergic and GABAergic circuits. J Neurophysiol 2008; 99:1758-69. [PMID: 18256163 DOI: 10.1152/jn.01207.2007] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Labyrinthine nerve-evoked monosynaptic excitatory postsynaptic potentials (EPSPs) in second-order vestibular neurons (2 degrees VN) sum with disynaptic inhibitory postsynaptic potentials (IPSPs) that originate from the thickest afferent fibers of the same nerve branch and are mediated by neurons in the ipsilateral vestibular nucleus. Pharmacological properties of the inhibition and the interaction with the afferent excitation were studied by recording monosynaptic responses of phasic and tonic 2 degrees VN in an isolated frog brain after electrical stimulation of individual semicircular canal nerves. Specific transmitter antagonists revealed glycine and GABA(A) receptor-mediated IPSPs with a disynaptic onset only in phasic but not in tonic 2 degrees VN. Compared with GABAergic IPSPs, glycinergic responses in phasic 2 degrees VN have larger amplitudes and a longer duration and reduce early and late components of the afferent nerve-evoked subthreshold activation and spike discharge. The difference in profile of the disynaptic glycinergic and GABAergic inhibition is compatible with the larger number of glycinergic as opposed to GABAergic terminal-like structures on 2 degrees VN. The increase in monosynaptic excitation after a block of the disynaptic inhibition in phasic 2 degrees VN is in part mediated by a N-methyl-d-aspartate receptor-activated component. Although inhibitory inputs were superimposed on monosynaptic EPSPs in tonic 2 degrees VN as well, the much longer latency of these IPSPs excludes a control by short-latency inhibitory feed-forward side-loops as observed in phasic 2 degrees VN. The differential synaptic organization of the inhibitory control of labyrinthine afferent signals in phasic and tonic 2 degrees VN is consistent with the different intrinsic signal processing modes of the two neuronal types and suggests a co-adaptation of intrinsic membrane properties and emerging network properties.
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Affiliation(s)
- Stefan Biesdorf
- Laboratoire de Neurobiologie des Réseaux Sensorimoteurs, Centre National de la Recherche Scientifique, Unité Miste de Recherche 7060, Université Descartes, Paris, France
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Abstract
CONCLUSION Allergy does not modify the symptoms and steroid consumption (oral and local) of nasal polyposis (NP) patients after functional endoscopic sinus surgery (FESS). OBJECTIVES To assess the role of allergy in the evolution after FESS of patients presenting with the diagnosis of NP. PATIENTS AND METHODS This was a prospective study of 63 consecutive patients with NP (57% males, mean age 45.8 years), who were analyzed to detect whether the results of a surgical treatment of NP were influenced by the presence of positive allergic tests (Phadiatop). Three nasal criteria were scored: nasal obstruction, posterior rhinorrhea, and the loss of smell. The frequency of asthma was evaluated. Medical treatment of NP after FESS consisted of washing of the nasal cavities, steroid spray, and oral steroid administration. The amount of consumption of steroids (prednisolone and beclomethasone) was studied. RESULTS Decrease of all nasal symptoms was not statistically different in the two groups of patients with and without allergy. Cumulative consumption of prednisolone and beclomethasone after surgery was similar in the two groups.
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Affiliation(s)
- Pierre Bonfils
- Department of ENT-Head and Neck Surgery, European Hospital Georges Pompidou Faculty of Medicine, University Paris-Descartes, Paris, France.
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Moya PA, Malinvaud D, Mimoun M, Huart J, Bonfils P. [Tuberculous otomastoiditis: advantage of MRI in the treatment survey]. Rev Laryngol Otol Rhinol (Bord) 2008; 129:301-304. [PMID: 19408515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
PURPOSE Mycobacterium tuberculosis is a rare cause of otomastoiditis, accounting for less than a percent of chronic otitis media. The diagnosis is difficult and typically delayed because most physicians are unfamiliar with its presenting features and special laboratory requirements. Such delayed diagnosis leads to delayed treatment onset, and thus, increases complications frequency as irreversible hearing loss, facial palsy or meningo-encephalitis complications. Moreover non specific CT findings do not allow any accurate evaluation of inner ear lesions initially and under treatment. CASE REPORT We described the first case of MRI of tuberculous mastoiditis and the evolution over a 2-years follow-up period. A patient with a clinical history of chronic otorrhea, resistant to conventional therapy, was referred to our department. CT and MRI permitted to describe the initial lesions and to appreciate the medical treatment efficiency (in order to perform surgery in case of failure or complications). Under medical treatment, MRI showed abscess volume decrease at three months while CT was still unchanged. Remineralization only was observed on CT at 12 months. The patient's healing was obtained after 15 months of antituberculous medication. CONCLUSION MRI has the advantage over CT to demonstrate directly abscess collections that superimposed to areas of bone destructions within the temporal bone. Initially, MRI allows an accurate evaluation of abscess collections and possible meningo-encephalitis complications. Moreover, MRI precises earlier than CT the improvement of lesions and the efficacy of medical treatment, and thus, permitting us to postpone surgery where it is unnecessary.
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Affiliation(s)
- Plana A Moya
- Hôpital Européen Georges Pompidou, Faculté de Mèdecine Paris-Descartes, Université Paris V, Service d'ORL et de Chirurgie Cervico-Faciale, 20 rue Leblanc, 75015 Paris, France
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Bonfils P, Chatellier G, Malinvaud D, Consoli SM. [Evaluating the knowledge of nasal polyposis in patients, GPs, and ENT specialists]. ACTA ACUST UNITED AC 2007; 124:215-21. [PMID: 17803953 DOI: 10.1016/j.aorl.2007.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2006] [Accepted: 06/11/2007] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To evaluate education for adults with nasal polyposis (NP) and compare their knowledge and opinions on NP to those of a group of general practitioners and a group of ENT specialists. MATERIAL AND METHODS Prospective study conducted on 87 consecutive subjects (33 patients with NP, 20 GP, and 34 ENT) using a questionnaire to evaluate the knowledge on NP (general, medical, and surgical information). RESULTS The results obtained from the three groups of subjects (patients, GP, ENT) differed significantly on "overall knowledge of the disease." Patients and GPs showed similar results. The ENT group had significantly better results. CONCLUSION Education in a this type of chronic disease of the upper respiratory tract seems necessary for the management of NP. This study also underscores the need for information transfer on NP from ENT specialists and GPs.
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Affiliation(s)
- P Bonfils
- Service d'ORL et de chirurgie cervicofaciale, CNRS UPRESSA 7060, hôpital européen Georges-Pompidou, faculté de médecine Paris-Descartes, université Paris-V, 20, rue Leblanc, 75015 Paris, France.
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Mathilde R, Gael P, Martins-Carvalho C, Valette G, Malinvaud D, Marianowski R. P044: Parathyroid Adenoma: Minimally Invasive Approach. Otolaryngol Head Neck Surg 2007. [DOI: 10.1016/j.otohns.2007.06.555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bonfils P, Avan P, Palimi P, Malinvaud D. Evaluation of mucosal surface reduction after ethmoidal surgery in nasal polyposis. J Laryngol Otol 2007; 121:e8. [PMID: 17470312 DOI: 10.1017/s0022215107007967] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/01/2007] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To assess the reduction of mucosal surface after total sphenoethmoidectomy. STUDY DESIGN Prospective study. METHODS Twelve normal, consecutive computed tomography scans were used. Computed tomography measurements were made at two different levels: the cribriform plate, and the upper level of the maxillary antrum. The length of the lateral wall of the ethmoid sinus and the perimeter of each ethmoid cell were measured at each level and on each side. The whole perimeter of the ethmoid sinus was evaluated for each CT scan level. For each side and each level, the ratio between the ethmoid sinus perimeter and the lateral ethmoid wall length was calculated. RESULTS The mean length of the lateral ethmoid sinus wall was 61.7+/-1.3 mm and 59.9+/-1.6 mm at the upper and lower parts of the ethmoid sinus, respectively. The mean ethmoid sinus perimeter was 263.2+/-11.5 mm and 250.4+/-11.1 mm at the upper and lower parts of the ethmoid sinus, respectively. No significant statistical difference was observed between measurements as a function of side (right or left) or level (upper or lower). The mean ratio between the ethmoid sinus perimeter and the lateral ethmoid wall length was 4.2. CONCLUSION After total sphenoethmoidectomy, the mucosal surface of the ethmoid sinuses is reduced by a factor of 4.2; about 76 per cent of the mucosa is removed during total sphenoethmoidectomy.
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Affiliation(s)
- P Bonfils
- Department of Oto-rhino-laryngology--Head Neck Surgery, European Hospital Georges Pompidou, Assistance Publique--Hôpitaux de Paris, Faculty of Medicine, University Paris-Descartes, Paris, France.
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Bonfils P, Malinvaud D, Halimi P, Tavernier L. [Inflammatory pathology and rhinosinusal CT scan: the radiologist's report]. Rev Laryngol Otol Rhinol (Bord) 2007; 128:179-185. [PMID: 18323330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE Pave the way to a better management of the chronical rhino-sinusitis diseases: Description and classification of the chronical rhino-sinusitis pathology, its medical and surgical treatments in order to help the radiologist in its CT-scan report. MATERIAL AND METHOD Review of the literature and anatomical considerations. Paranasal sinuses CT-scan analysis. RESULTS AND CONCLUSION The execution and the interpretation of CT-scans, in accordance with the progress made in the past 20 years in the knowledge of the rhino-sinusitis physiology and pathology, are today absolutely necessary for the management of chronical rhino-sinusitis diseases.
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Affiliation(s)
- P Bonfils
- Hôpital Européen Georges Pompidou, Faculté de Médecine Descartes, Université Paris V, Service d'ORL et de Chirurgie Cervico-Faciale, 20 rue Leblanc, 75015 Paris, France
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Abstract
CONCLUSION Patients with severe nasal polyposis (NP) and a high steroid consumption have a high prevalence of glucocorticoid-induced osteoporosis and secondary adrenal insufficiency. OBJECTIVES To evaluate the risk of complications of the medical treatment in patients presenting with the diagnosis of NP. PATIENTS AND METHODS This was a prospective study. A total of 46 consecutive patients with NP were included when the oral steroid consumption during the past year was greater than three short courses of systemic steroid treatment (i.e. more than 21 days per year of treatment, prednisolone 1 mg/kg body weight per day, for 6-10 days). The nasal function was checked on the basis of five criteria: nasal obstruction, anterior rhinorrhea, posterior rhinorrhea, facial pain, and loss of sense of smell. Two tests were carried out for each patient: (i) a bone mineral density evaluation by dual energy X-ray absorptiometry (DXA) at three different sites in the lumbar spine and femur, and (ii) an evaluation of the hypothalamic-pituitary-adrenal (HPA) axis by the synacthen test. RESULTS Most of the patients had a severe NP associated with asthma (78.3% of the population), and aspirin idiosyncrasy (28.3%). In all, 10.9% and 43.5% of patients had osteoporosis and osteopenia at the lumbar spine site. Twenty patients (48.8% of the tested patients) had an asymptomatic adrenal insufficiency.
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Affiliation(s)
- Pierre Bonfils
- Department of ENT-Head and Neck Surgery, European Hospital Georges Pompidou, Faculty of Medicine, University Paris-Descartes, Paris, France.
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Abstract
OBJECTIVES The purpose of this study is to reach a better understanding in the handling of parathyroid adenomas, and to emphasize the importance of pre-operatory explorations in order to establish the best surgical approach and its cost. MATERIAL AND METHODS We are using a retrospective study of 51 patients that underwent surgery in our department between the years 1997 and 2002, for the treatment of primary hyperparathyroidism. Every patient received to a pre-operatory exploration in order to localize the parathyroid tumors, including cervical echography in 51 of the cases, and a sestamibi scintigraphy in 49 of the cases. Two surgical procedures were performed: unilateral approach, and bi-lateral approach. RESULTS The implementation of a systematic pre-surgical checkup allowed for unilateral surgery in 76% of the patients (39 out of 51), from which 31% (12 out of 39) under local anesthesia. CONCLUSIONS The accuracy of the pre-operatory explorations in order to localize the parathyroidian tumors in regard to HPTP, allows for precise surgery via unilateral approach under local anesthesia. The benefits are significant with shorter procedure time, shorter patient hospitalization, and lower risks for complications. The pre-operatory explorations also decrease the total cost of the procedure and are a critical tool for the surgeon.
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Affiliation(s)
- D Malinvaud
- Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75908 Paris cedex 15, France.
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Abstract
INTRODUCTION Tinnitus is a common auditory symptom that interferes with activities of daily living and is often associated with anxiety and depression. METHOD This study included consecutive patients with chronic intense tinnitus for more than six months who were treated with Tinnitus Retraining Therapy (TRT), a cognitive-behavioral therapy, after previous treatment failed and after a clinical evaluation based on standardized questionnaires, including the Tinnitus Handicap Questionnaire (THQ). One year after the end of the TRT, the treatment was evaluated by the same standardized questionnaires. RESULTS This prospective study included 96 consecutive patients (49 women, 47 men, mean age: 48 years). Tinnitus improved significantly in 75%, where significant improvement was defined as a final THQ score of less than 500 after CBT. This improvement varied according to initial THQ scores and was seen in: all patients with moderate (THQ<500), 70.3% of the patients with intermediate (500<THQ>1001), and 34.8% of patients with severe (THQ>1000) tinnitus. CONCLUSION CBT shows promise as a treatment of tinnitus-related distress.
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Affiliation(s)
- Alain Londero
- Laboratoire de Recherche sur l'Audition, Unité CNRS UPRESSA 7060, Département d'ORL et de Chirurgie Cervico-Faciale, Université Paris-Descartes, Faculté de Médecine, Hôpital Européen Georges Pompidou, Paris
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Affiliation(s)
- P Bonfils
- Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Européen Georges Pompidou, Université Paris-Descartes, Faculté de Médecine, Paris.
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Malinvaud D, Couloigner V, Badoual C, Halimi P, Bonfils P. Pleomorphic adenoma of the nasal septum and its relationship with Epstein-Barr virus. Auris Nasus Larynx 2006; 33:417-21. [PMID: 16895748 DOI: 10.1016/j.anl.2006.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2005] [Revised: 04/03/2006] [Accepted: 05/26/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Pleomorphic adenoma is the most common benign tumor of the major salivary glands, especially of the parotid gland. It is much less common in the minor salivary glands of the oral cavity, and it rarely occurs in others sites in the head and neck. Even if virus involvement in salivary glands tumor has been many times discuted, the etiology of this tumor keeps being unknown. As compared to other nasal tumors, we tried to prove if Epstein-Barr virus (EBV) could be involved in the development of pleomorphic adenoma in this particular nasal localization. METHODS Three cases of pleomorphic adenomas of the nasal septum (two women and a man in age of 23-59 years) were retrospectively studied. All had positive rate of EBV-related blood antibodies. All the patients had undergone endoscopic surgery to remove the complete tumor. We used hybridation technique in the search for EBV-DNA in the three tumors. RESULTS AND CONCLUSION We had positive EBV-DNA detection in the tumor in one case, which seemed to prove relationship between pleomorphic adenoma and this virus. The literature concerning the subject is reviewed in order to explain EBV involvement in the development of such tumors in this particular localization.
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Affiliation(s)
- David Malinvaud
- Department of Otolaryngology-Head and Neck Surgery, Hôpital Européen Georges Pompidou, Faculté Necker Enfants Malades, Université Paris V, 20 Rue Leblanc, Paris, France.
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Abstract
CONCLUSION Allergy does not modify the symptoms of nasal polyposis, either initially or after a 1-year medical treatment. OBJECTIVES To assess the role of allergy in the symptoms and treatment of patients presenting with the diagnosis of nasal polyposis. PATIENTS AND METHODS Two simultaneous studies were carried out. In the first study, 180 consecutive patients with nasal polyposis (60% males, mean age = 48.4 years) were analyzed to detect whether the severity of their symptoms correlated with the presence of positive allergic tests. In the second study, 74 consecutive patients (57.5% males, mean age = 48.3 years) were analyzed to detect whether the results of a 1-year medical treatment of nasal polyposis were influenced by the presence of positive allergic tests (Phadiatop). Five nasal criteria were scored: nasal obstruction, anterior and posterior rhinorrhea, facial pain, and the loss of sense of smell. The frequency of asthma was evaluated. Treatment of nasal polyposis consisted of washing of the nasal cavities, steroid spray, and oral steroid administration. The amount of steroid consumption (prednisolone and beclomethasone) was studied. RESULTS In the first study, mean scores of nasal symptoms did not differ between the two groups of patients with and without allergy. The prevalence of asthma (p = 0.03) was higher in the group with than without allergy. In the second study, decrease of all nasal symptoms was not statistically different in the two groups. Cumulative consumption of prednisolone and beclomethasone between baseline and year 1 were similar in the two groups.
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Affiliation(s)
- Pierre Bonfils
- Department of ENT-Head and Neck Surgery, European Hospital Georges Pompidou, Faculty of Medicine, University Paris-Descartes, Paris, France.
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