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Laryngeal tuberculosis in the early 21st century. Literature review of clinical, diagnostic and therapeutic data, according to SWiM guidelines. Eur Ann Otorhinolaryngol Head Neck Dis 2024; 141:147-152. [PMID: 38238187 DOI: 10.1016/j.anorl.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2024]
Abstract
OBJECTIVES Review of the scientific medical literature dedicated to clinical data, diagnosis and treatment for laryngeal tuberculosis published since the turn of the 21st century. MATERIAL AND METHODS Search of the Medline, Cochrane and Embase databases for the period 2000-2022. Selection of cohorts and case reports documenting clinical data, diagnosis and treatment for laryngeal tuberculosis. RESULTS In total, 119 articles were analyzed. Immunodepression, HIV infection, history of lung tuberculosis, general symptoms suggesting tuberculosis, smoking and associated laryngeal cancer were noted in 18%, 3%, 20% and 41% of cases, respectively. No pathognomonic symptoms or signs emerged. Voice impairment, of various types and severity, isolated and/or associated with other signs, was the most frequent laryngeal symptom, in 86% of cases. All laryngeal sites were involved, with numerous and various associations. Impaired laryngeal motion and tracheotomy were noted in 6% and 1% of cases, respectively. Time to diagnosis varied from less than 1month to 36months, for a median 3months, in case reports. Laryngeal tuberculosis was diagnosed bacteriologically with certainty in 28% of cases while diagnosis was based on indirect criteria and/or involvement of another site in the other 72%, with lung involvement in 54%. Treatment duration ranged from 6 to 24months (median, 6months), using 3 to 5 (median: 4) antitubercular antibiotics, with 4 used in 80% of cohorts and 77% of case reports. Overall rates of cure, death, treatment resistance, adverse events, and laryngeal sequelae were 99%, 0.5%, 0.5%, 6% and 5%, respectively. CONCLUSION The clinical presentation and diagnostic difficulty in laryngeal tuberculosis did not change since the end of the 20th century. Quadritherapy is highly effective, with a low resistance rate and few adverse effects or laryngeal sequelae.
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Analysis of endonasal sinus surgery in a private outpatient setting in a tropical environment: A STROBE analysis. Eur Ann Otorhinolaryngol Head Neck Dis 2024:S1879-7296(24)00023-1. [PMID: 38401995 DOI: 10.1016/j.anorl.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2024]
Abstract
OBJECTIVES To evaluate results and failure factors in endonasal surgery in a private outpatient setting in a tropical environment. MATERIAL AND METHOD A single-center observational study included 337 patients consecutively undergoing endonasal surgery in a private hospital on Réunion Island, a French overseas administrative Département in the Indian Ocean between 2019 and 2021. The main objective was to assess the success rate of the outpatient pathway. Secondary objectives comprised analysis of complications and identification and management of factors for failure of outpatient management. The study was conducted according to the STROBE editorial guideline. RESULTS The 337 surgeries notably comprised 112 septoplasties (37.5%), 104 meatotomies (30.3%), 15 unilateral total ethmoidectomies (4.6%), 48 bilateral total ethmoidectomies with sphenoidotomy (14.3%), and 18 Draf procedures (5.5%). Seventy-five percent of patients (252/337) were operated on as outpatients, with a success rate of 90% (227/252 patients). The rate of severe intraoperative complications was 1.5% (5/337). On multivariate analysis, 3 variables were identified as influencing risk of failure of the outpatient pathway: emergency analgesia in the operating room [odds ratio (OR): 91.61; 95% confidence interval (CI): 22.8-540.3], operating time (OR: 1.05; 95% CI: 1.01-1.09), and recovery room time (OR: 1.02; 95% CI: 1.01-1.03). CONCLUSION Our study in a tropical environment found eligibility and success rates for outpatient endonasal surgery similar to those in metropolitan France. This makes surgical and anesthesiological training a key factor in the success of outpatient care, while the location of the care structure and the climate seem to have little impact.
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The worrying demoralization of hospital physicians. Eur Ann Otorhinolaryngol Head Neck Dis 2023; 140:57. [PMID: 36253319 DOI: 10.1016/j.anorl.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Délai opératoire après infection Covid : évolution des recommandations de la Société française d’anesthésie et de réanimation ☆. ANNALES FRANC?AISES D'OTO-RHINO-LARYNGOLOGIE ET DE PATHOLOGIE CERVICO-FACIALE 2022. [PMCID: PMC9576865 DOI: 10.1016/j.aforl.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Bravo TIRO! Eur Ann Otorhinolaryngol Head Neck Dis 2022; 140:103. [DOI: 10.1016/j.anorl.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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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] [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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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] [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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Montgomery® implant extrusion after type I thyroplasty. A CARE case report. Eur Ann Otorhinolaryngol Head Neck Dis 2022; 139:357-359. [DOI: 10.1016/j.anorl.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Economic analysis of the contribution of sialendoscopy in managing non-tumoral principal salivary gland pathology in the Réunion Island: Economic evaluation following the CHEERS methodology. Eur Ann Otorhinolaryngol Head Neck Dis 2021; 139:129-134. [PMID: 34772642 DOI: 10.1016/j.anorl.2021.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
GOALS Cost analysis of the contribution of sialendoscopy in the treatment of non-tumoral pathologies of the main salivary glands, in Réunion Island, a French overseas territory. OBJECTIVES Calculation and comparison of median pricing (i.e., median payment to the healthcare establishment) per patient before and after the introduction of sialendoscopy, in the only regional establishment practicing sialendoscopy and in the whole of Réunion Island. Material and method A multicenter retrospective cost study was conducted over an 8-year period, before and after the introduction of sialendoscopy (period A: 2011-2014 and period B: 2015-2018), according to the CHEERS guidelines for economic studies, and included inpatients with non-tumoral pathology of the main salivary glands, whether treated by sialendoscopy or not. RESULTS Two hundred sixty-five patients were included, 139 of whom were treated by sialendoscopy: 74 in 2011-2014 and 191 in 2015-2018. Between the two periods, median pricing in the only center practicing sialendoscopy did not vary significantly: €3468 vs. €3368 (i.e., +2.9% (P=0.1)). In the Island as a whole, pricing increased significantly: €598 vs. €2332, (i.e., +390% (P<0.0001)). CONCLUSION Sialendoscopy is cost-effective in France in the public healthcare sector if outpatient management is optimal, but significantly increases the public health budget. It makes it possible to recruit and manage previously untreated patients (small stones, salivary strictures, etc.).
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Medical analysis of the contribution of sialendoscopy in managing non-tumoral main salivary gland pathology in Reunion Island: Observational study following STROBE guidelines. Eur Ann Otorhinolaryngol Head Neck Dis 2021; 139:135-139. [PMID: 34772641 DOI: 10.1016/j.anorl.2021.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
GOALS To perform a medical analysis of the contribution of sialendoscopy in the treatment of non-tumoral pathologies of the main salivary glands, in Reunion Island, a French overseas territory. MATERIAL AND METHOD A multicenter retrospective observational study was conducted for an 8-year period, before and after introduction of sialendoscopy (2011-2014 and 2015-2018), following STROBE guidelines. OBJECTIVES To compare populations treated before (period A) and after (period B) the introduction of sialendoscopy in terms of clinical characteristics, and analyze the characteristics of patients treated by sialendoscopy. RESULTS Two hundred and sixty-five patients were included: 74 in 2011-2014 and 191 in 2015-2018; 139 had sialendoscopy. Populations A and B were comparable except for the proportion of parotids treated (9% vs. 31%, respectively; P<0.0001), and smaller stones (11mm vs. 7.4mm, respectively; P=0.003). One hundred and ten pure sialendoscopies and 29 combined routes (20.8%) were performed: 63% submandibular and 37% parotid. Median age was 46 years. The M/F sex ratio was 0.96. Thirty-seven patients presented stenosis. There were 10 cases of papillary catheterization failure (7.1%), and 16 false routes or creation of false channels (11.5%), including 9 during the learning period. The rate of crossover to gland resection decreased: 10.45% for 2015-2016 and 5.56% for 2017-2018. CONCLUSION Although follow-up ranged between 12 and 55months (median, 30months), sialendoscopy appeared to be a useful and reliable technique, with a role in therapeutic strategy for the management of non-tumoral salivary pathologies in Reunion Island.
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Keys to successful type-1 thyroplasty with Montgomery® implant for unilateral laryngeal immobility in adults. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 138:191-194. [PMID: 33158759 DOI: 10.1016/j.anorl.2020.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Based on a review of the medical literature, the authors document the key technical points and pitfalls in type I thyroplasty with Montgomery® implant, and the main results and indications in unilateral laryngeal immobility.
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Impact de l’épidémie SARS-CoV-2 sur les consultations libérales d’otorhinolaryngologie lors du premier mois de confinement de l’île de la Réunion en 2020. ANNALES FRANÇAISES D'OTO-RHINO-LARYNGOLOGIE ET DE PATHOLOGIE CERVICO-FACIALE 2020. [PMCID: PMC7301113 DOI: 10.1016/j.aforl.2020.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectif Analyse de l’impact du premier mois de confinement lié à l’épidémie SARS-CoV-2 sur l’activité de consultation des otorhinolaryngologistes libéraux de l‘île de La Réunion. Méthode Étude observationnelle, multicentrique, prospective analysant l’activité de consultation de douze praticiens. Objectif principal Évaluer le nombre, les caractéristiques et les modalités des consultations réalisées. Objectifs secondaires : préciser les symptômes amenant les patients à consulter, les diagnostics évoqués, les prescriptions instaurées, les éventuelles conséquences néfastes et l’impact sur le chiffre d‘affaire. Résultats 693 consultations étaient réalisées, dont 50 % étaient demandées en urgence. 57,9 % des consultations étaient réalisées en présence du patient, 28,4 % étaient effectuées au téléphone et 13,7 % et en téléconsultation. Lors des consultations présentielles, les otorhinolaryngologistes portaient des gants et un masque respectivement dans 53,8 % et 92,2 % des cas. Le masque porté était de type chirurgical et de type FFP2 dans 71,6 % et 28,4 % de cas, respectivement. Les trois symptômes les plus fréquents (48,5 % des cas) étaient l’otalgie, les troubles de l’audition et les vertiges. Les trois diagnostics les plus fréquents (60,6 % des cas) étaient, les otites, les corps étrangers d’oreille (cérumen inclus) et les infections pharyngées. Les trois examens complémentaires les plus prescrits (74,3 % des cas) étaient l’imagerie, l’audiométrie, et l’avis d’un spécialiste médical. Les trois familles thérapeutiques les plus prescrites (52,7 % des cas) étaient les gouttes auriculaires, les antibiotiques, et les lavages de nez et/ou sprays nasaux. L’incidence des conséquences néfastes était de 0,001 % et aucun des otorhinolaryngologistes ou des patients ne semblait avoir été infecté par la Covid 19. Une baisse de 47,3 % à 91 % (médiane : 75,6 %) du chiffre d’affaire de consultation était notée. Conclusion Cette étude souligne la disponibilité et l’adaptabilité des ORL réunionnais libéraux en contexte épidémique malgré un impact économique très négatif.
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Impact of the SARS-CoV-2 epidemic on private ENT consulting practice during the first month of lockdown in Réunion Island in 2020. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:251-256. [PMID: 32712116 PMCID: PMC7309792 DOI: 10.1016/j.anorl.2020.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To analyze the impact of the first month of lockdown related to the 2020 SARS-Cov-2 epidemic on the consulting activity of private ENT physicians in Réunion Island. Material and methods A multicenter prospective study analyzed the consulting activity of 12 ENT physicians in full-time private practice. The main endpoints were the number, characteristics and conditions of consultations. Secondary endpoints comprised presenting symptoms, diagnosis, prescriptions, adverse effects, and progression of monthly consulting turnover. Results Six hundred and ninety three consultations were performed during the study period (Appendix 1), with 50% emergency consultations. In 57.9% were face-to-face, 28.4% by phone and 13.7% video. In face-to-face consultation, the physician wore gloves in 53.8% of cases and a mask in 92.2%: surgical mask in 71.6% of cases and FFP2 in 28.4%. The three most frequent symptoms (48.5% of cases) were otalgia, hearing impairment, and vertigo. The three most frequent diagnoses (60.6% of cases) were otitis, intra-auricular foreign body (including wax), and pharyngeal infection. The three most frequently prescribed complementary exams (74.3% of cases) were imaging, hearing work-up, and specialist opinion. The three most frequently prescribed treatments (52.7% of cases) were intra-auricular drops, oral antibiotics, and nasal spray. The incidence of adverse effects was 0.001%. None of the physicians or patients seemed to have been infected by Covid-19 during the study period. There was a 47.3-91% (median, 75.6%) drop in monthly consultation turnover. Conclusion The present study underscored the availability and adaptability of ENT physicians in the Réunion Island in an epidemic context, although economic impact was detrimental.
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Enlarged ulcerated tonsil and bilateral multiple enlarged neck nodes. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 137:83-84. [PMID: 31859079 DOI: 10.1016/j.anorl.2019.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Evaluation of robotic surgery for transoral resection of T1-2 squamous cell carcinoma of the tonsillar fossa. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 137:31-36. [PMID: 31561975 DOI: 10.1016/j.anorl.2019.09.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
GOAL To evaluate transoral robotic surgery (TORS) for isolated previously untreated squamous cell carcinoma (SCC) of the tonsillar fossa classified as T1-2. METHOD Retrospective analysis of two cohorts of isolated untreated T1-2 tonsillar fossa SCC consecutively operated on by a transoral approach, with (R=21) and without (NR=24) robotic assistance, in the period 2006-2014. Three main (survival, local control, and operative morbidity) and three secondary (pathologic data, incidence and duration of tracheotomy and nasogastric intubation, and hospital stay) endpoints were compared between groups. The significance threshold was set at P< .005. RESULTS Three- and five-year actuarial survival estimates were 80.2% and 74.5% respectively in group R, and 91.5% and 82.5% respectively in group NR (NS: P=.34). Three- and five-year actuarial local control estimates were 90% and 90% respectively in group R, and 95.8% and 91% respectively in group NR (NS: P=.81). There were no significant differences in morbidity, tracheotomy/nasogastric intubation time, or hospital stay. Positive resection margins (R1) were noted in 38.1% and 16.7% in groups R and NR, respectively (NS: P=.05) without significant impact on 5-year actuarial local control (P=0.78). CONCLUSION Robotic assistance in transoral lateral oropharyngectomy for T1-2 tonsillar fossa SCC did not significantly impact oncologic or functional outcome.
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Unilateral oral, pharyngeal and laryngeal vesicles. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:141-142. [DOI: 10.1016/j.anorl.2018.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Otitis media with effusion in nasal polyposis and outcomes following surgery: A longitudinal observational study. Clin Otolaryngol 2018; 43:1522-1527. [PMID: 30058276 DOI: 10.1111/coa.13201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/02/2018] [Accepted: 07/25/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE In patients with nasal polyposis (NP), otitis media with effusion (OME) seems to be a marker of severity of the inflammatory process occurring in those patients. The aim was to assess whether OME could represent a marker of resistance to the surgical treatment of NP. DESIGN Longitudinal observational cohort study including patients between January 1991 and January 2017. Mean follow-up was 7.4 years. SETTING Tertiary-care hospital centre. PARTICIPANTS Patients with NP who underwent surgery (radical bilateral sphenoethmoidectomy). MAIN OUTCOME MEASURES Four outcomes reflecting resistance to the surgical treatment: a clinical score of rhinologic symptoms, the mean number of systemic corticosteroids treatment per year, the recurrence rate of polyps and the rate of reoperation. RESULTS A total of 266 patients were included (63.9% of men, mean age 48 years). In multivariate linear mixed-effects regression, when compared to patients without OME, patients with OME presented a similar clinical score of symptoms (coefficient 0.09, 95% confidence interval (CI) -0.25 to 0.06, P-value = 0.24) and a borderline higher mean number of systemic corticosteroids treatments per year (coefficient 0.11, 95% CI 0.003-0.23, P-value = 0.04). In multivariate Cox regression analyses, patients with OME had a similar reoperation rate than patients without OME (hazard ratio (HR) 0.29, 95% CI 0.06-1.50) and a similar recurrence rate of polyps (HR 0.59, 95% CI 0.23-1.53). CONCLUSION In patients with NP, OME is not a marker of surgical resistance. Those patients should be managed similarly than patients without, and similar outcomes following surgery should be expected.
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Comparison of Video Head Impulse Test and Caloric Reflex Test in advanced unilateral definite Menière's disease. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:167-169. [DOI: 10.1016/j.anorl.2017.08.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 08/16/2017] [Accepted: 08/18/2017] [Indexed: 11/17/2022]
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Epidemiological features of cancers of the oral cavity, oropharynx, hypopharynx and larynx cancer in Réunion Island. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:175-181. [DOI: 10.1016/j.anorl.2018.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Idiopathic unilateral vocal-fold paralysis in the adult. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:171-174. [DOI: 10.1016/j.anorl.2018.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
Balance disorders presenting with symptoms of dizziness and vertigo are due to various diseases. Clinical approach gives the opportunity to identify emergency situations and most common causes, among them the first one being the benign paroxysmal positional vertigo. Oculomotor assessment is pertinent as major clinical orientation, particularly between peripheral and central diseases. These clinical findings support the respective indication of modern imaging and/or vestibular tests, focused on the direction of presupposed diagnosis. On elderly the risk of falls and their complications needs a specific evaluation.
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ONDAM, T2A, PMSI, SROS, MIGAC, MERRI, SIGAPS & IF: Highly linked French financial medical acronyms…. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:1-2. [DOI: 10.1016/j.anorl.2017.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Abstract
In this report, the authors analyze the revolutions (journal indexing, structuring of medical writing and reviewing, impact of information technology and transformation of the medical press's business model) that, in a very short space of time, have profoundly affected the world of medical writing, which has now come under the fire of "predatory" journals.
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Diagnostic approach to sudden onset of diffuse isolated oedema of the lips. Eur Ann Otorhinolaryngol Head Neck Dis 2017; 134:357-359. [PMID: 28082136 DOI: 10.1016/j.anorl.2016.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In the light of a case of sudden onset of diffuse, isolated oedema of the lips, the authors describe the key points of the diagnostic approach and the main epidemiological and clinical data.
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Sudden bilateral hearing loss revealing polyarteritis nodosa. Eur Ann Otorhinolaryngol Head Neck Dis 2014; 131:265-6. [DOI: 10.1016/j.anorl.2014.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 02/27/2014] [Accepted: 03/23/2014] [Indexed: 10/25/2022]
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Drainage of subperiosteal orbital abscesses complicating pediatric ethmoiditis: comparison between external and transnasal approaches. Int J Pediatr Otorhinolaryngol 2013; 77:796-802. [PMID: 23523197 DOI: 10.1016/j.ijporl.2013.02.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 02/08/2013] [Accepted: 02/12/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The aim of the present study was to compare the external (EA), transnasal endoscopic (TEA), and combined (CA) external and transnasal approaches to drain orbital subperiosteal abscesses complicating pediatric ethmoiditis. METHODS This retrospective study included 38 children consecutively operated in our center for an orbital subperiosteal abscess complicating an acute ethmoiditis. The distribution of surgical approaches used for our patients was the following: 12 TEA (32%), 21 EA (55%) and 5 CA (13%). All data were retrieved from patients' clinical charts. RESULTS No surgical complication was observed in the present study regardless of the approach. The percentage of surgical failures requiring additional drainage was almost twice as high after TEA (failure rate: 25%) than after EA (failure rate 14.3%), but this difference was not significant. Parameters which significantly influenced the risk of failure of TEA were the length and width of the abscess. The duration of postoperative hospitalization was significantly lower in the TEA group (3.1 days) than in the EA one (5.4 days). There were no failures in the CA group. CONCLUSIONS Failures of surgical drainage of orbital subperiosteal abscess complicating pediatric ethmoiditis are not rare and did not differ between external and transnasal endoscopic approaches in our study. The transnasal route is associated with a shorter postoperative duration of postoperative hospitalization. CA seems to be a viable surgical option combining the advantages of both endoscopic and external approaches.
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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] [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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Abstract
This report discusses the following issues related to typing of group A streptococci (GAS): The development and use of the 5' emm variable region sequencing (emm typing) in relation to the existing serologic typing system; the designation of emm types in relation to M types; a system for validation of new emm types; criteria for validation of provisional M types to new M-types; a list of reference type cultures for each of the M-type or emm-type strains of GAS; the results of the first culture exchange program for a quality control testing system among the national and World Health Organization collaborating centers for streptococci; and dissemination of new approaches to typing of GAS to the international streptococcal community.
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Correlation of histologic subtypes of primary basal cell carcinoma and number of Mohs stages required to achieve a tumor-free plane. J Am Acad Dermatol 1997; 37:395-7. [PMID: 9308552 DOI: 10.1016/s0190-9622(97)70138-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Certain histologic subtypes of basal cell carcinoma (BCC) behave more aggressively and require more aggressive treatment. OBJECTIVE The aim of this study was to see whether certain subtypes of BCC require more Mohs stages to achieve tumor-free margins. METHODS A retrospective study of 342 primary BCCs treated with Mohs micrographic surgery (MMS) was performed identifying the histologic subtype of BCC present and the number of stages required to clear the tumor. RESULTS The aggressive subtypes (infiltrative, morpheaform, micronodular, and mixed) were most frequently found when high numbers of Mohs stages were required for cure. CONCLUSION The more aggressive subtypes of BCC require more MMS stages to achieve tumor-free margins, which is consistent with the concept that these subtypes usually require more aggressive treatment from the start.
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[Fear of responsibility in training--a diploma paper. Anxiety before the first evening shift]. KRANKENPFLEGE. SOINS INFIRMIERS 1993; 86:12-6. [PMID: 8377457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Hospitals plan for the aging of America. HEALTH CARE STRATEGIC MANAGEMENT 1990; 8:13-5. [PMID: 10106881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
In planning for the senior market, hospitals face several key issues: determining position in a competitive marketplace, maintaining cost-effectiveness in times of financial challenge, and providing quality treatment in often complex cases. The authors review the trends for the next decade.
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Abstract
Melanophores were studied in tadpoles of the South African clawed toad, Xenopus laevis, during the first week after hatching (stages 46-49) at 25 degrees C. The tadpoles had melanophores with dispersed melanosomes in the light and punctate melanophores in the dark in LD 12:12. The melanophores remained punctate in constant dark and the melanosomes remained dispersed in constant light. Lights-out (in the light-time of LD 12:12) caused the melanophores to become punctate, which occurred more quickly than the dispersion of melanosomes, which commenced when the lights were turned on (in the dark-time of LD 12:12). Melanophores with dispersed melanosomes in tadpoles (in constant light) became punctate in response to a series of melatonin concentrations (0.2-5 ng/ml) in their bathing water irrespective of the time of day melatonin was administered. An image-analysis technique for assessing melanophore responses was tested.
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[Factors influencing the frequency, duration and cessation of breast feeding: a study of 1 100 neonates in Paris (author's transl)]. NEUROPSYCHIATRIE DE L'ENFANCE ET DE L'ADOLESCENCE 1980; 28:565-72. [PMID: 7231648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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The seminar process--an aid to learning. Nurs Outlook 1971; 19:37-9. [PMID: 5203619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Synthesis of DNA after partial hepatectomy without changes in the lipid and glycogen contents of the liver. Biochem Biophys Res Commun 1968; 30:571-5. [PMID: 5645444 DOI: 10.1016/0006-291x(68)90091-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Methocarbamol in management of tetanus. Tex Med 1966; 62:55-9. [PMID: 5931232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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