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Brenet E, Atallah S, Guerlain J, Moya-Plana A, Verillaud B, Kania R, Bakhos D, Philouze P, Righini CA, Bozorg A, Mérol JC, Labrousse M, Vergez S, Fakhry N, Gallet P, Cullié D, Malard O, Mauvais O, Fath L, Schultz P, Dufour X, Saroul N, Evrard D, Lesnik M, Even C, Costes V, Thariat J, Taillandier de Gabory LL, Makeieff M, Dubernard X, Baujat B. Carcinomas of the external auditory canal: Management and results: A multicenter REFCOR propensity score matching study. Eur J Cancer 2024; 201:113922. [PMID: 38364629 DOI: 10.1016/j.ejca.2024.113922] [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: 01/08/2024] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVES To analyse prognostic factors and survival outcomes of malignant tumors of the external auditory canal, to investigate the role of regional surgery, and adjuvant radiotherapy in early stages and to investigate the role of surgery in operable T4 stage. SETTING A retrospective analysis was conducted on all patients prospectively included in the national database of the French Expertize Network for Rare ENT Cancers (REFCOR) from January 2000 to December 2016. PARTICIPANTS 103 patients from 19 reference centers were included. A propensity score matching analysis was applied to enable comparisons between treatments. MAIN OUTCOMES AND MEASURES Event-free survival, overall survival and factors of poor prognosis of the cohort were described. The interest of local and regional surgery and postoperative radiotherapy were evaluated. RESULTS The factors of poor prognosis on event-free survival were immunosuppression (p = 0.002), Karnofsky status less than 90% (p = 0.02), body mass index less than 19 Kg / m2 (p = 0.0009), peripheric facial palsy (p = 0.0016), and positive margin (p = 0.0006). In early stages, locoregional surgery was associated with an increase in event-free survival (p = 0.003, HR = 0.21) versus local surgery alone, while postoperative radiotherapy was not associated with an increase in event-free survival (p = 0.86, HR = 0.91) or overall (p = 0.86, HR = 0.91). In locally advanced stages, locoregional surgery followed by radiotherapy was associated with an increase in event-free survival (p = 0.03, HR = 0.39) and overall (p = 0.02, HR = 0.34) versus chemoradiotherapy alone. CONCLUSION AND RELEVANCE Regional surgery is recommended for early stages of cancers of the external auditory canal. In operable cases, locoregional surgery followed by radiotherapy is recommended.
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Affiliation(s)
- Esteban Brenet
- Department of ENT-Head and Neck Surgery, Robert Debré University Hospital, 51100 Reims, France
| | - Sarah Atallah
- Department of ENT-Head and Neck Surgery, Tenon University Hospital, APHP, Sorbonne Universite, 75020 Paris, France; Doctoral School of Public Health, CESP, University of Paris Sud, 94807 Villejuif, France
| | - Joanne Guerlain
- Department of ENT-Head and Neck Surgery, Gustave Roussy Cancer Campus, 94800 Villejuif, France
| | - Antoine Moya-Plana
- Department of ENT-Head and Neck Surgery, Gustave Roussy Cancer Campus, 94800 Villejuif, France
| | - Benjamin Verillaud
- Department of ENT-Head and Neck Surgery, Lariboisière University Hospital, APHP, 75010 Paris, France
| | - Romain Kania
- Department of ENT-Head and Neck Surgery, Lariboisière University Hospital, APHP, 75010 Paris, France
| | - David Bakhos
- Department of ENT-Head and Neck Surgery, Bretonneau University Hospital, 37000 Tours, France
| | - Pierre Philouze
- Department of ENT-Head and Neck Surgery, La Croix Rousse University Hospital, HCL, 6900 Lyon, France
| | - Christian-Adrien Righini
- Department of ENT-Head and Neck Surgery, Grenoble Alpes University Hospital, 38043 Grenoble, France
| | - Alexis Bozorg
- Department of ENT-Head and Neck Surgery, François Mitterrand University Hospital, 21000 Dijon, France
| | - Jean-Claude Mérol
- Department of ENT-Head and Neck Surgery, Robert Debré University Hospital, 51100 Reims, France
| | - Marc Labrousse
- Department of ENT-Head and Neck Surgery, Robert Debré University Hospital, 51100 Reims, France
| | - Sébastien Vergez
- Department of ENT-Head and Neck Surgery, University Cancer Institute, 31100 Toulouse, France
| | - Nicolas Fakhry
- Department of ENT-Head and Neck Surgery, University Hospital of Marseille, APHM, 13915 Marseille, France
| | - Patrice Gallet
- Department of ENT-Head and Neck Surgery, University Hospital of Nancy, 54000 Nancy, France
| | - Dorian Cullié
- Department of ENT-Head and Neck Surgery, Lacassagne Cancer Institute, 06100 Nice, France
| | - Olivier Malard
- Department of ENT-Head and Neck Surgery, University Hospital of Nantes, 44093 Nantes, France
| | - Olivier Mauvais
- Department of ENT-Head and Neck Surgery, University Hospital of Besançon, 25000 Besançon, France
| | - Léa Fath
- Department of ENT-Head and Neck Surgery, University Hospital of Hautepierre, HUS, 67200 Strasbourg, France
| | - Philippe Schultz
- Department of ENT-Head and Neck Surgery, University Hospital of Hautepierre, HUS, 67200 Strasbourg, France
| | - Xavier Dufour
- Department of ENT-Head and Neck Surgery, University Hospital of Poitiers, 86021 Poitiers, France
| | - Nicolas Saroul
- Department of ENT-Head and Neck Surgery, University Hospital of Clermont-Ferrand, 63000, France
| | - Diane Evrard
- Department of ENT-Head and Neck Surgery, Bichat University Hospital, APHP, 75018 Paris, France
| | - Maria Lesnik
- Department of ENT-Head and Neck Surgery, Curie Cancer Institute, APHP, 75005 Paris, France
| | - Caroline Even
- Department of Oncology, Gustave Roussy Cancer Campus, 94800 Villejuif, France
| | - Valérie Costes
- Department of Pathologic Anatomy and onco-biology, University Hospital of Montpellier, France
| | - Juliette Thariat
- Department of Radiation Oncology, Cancer center Baclesse, 14076 Caen, France
| | | | - Marc Makeieff
- Department of ENT-Head and Neck Surgery, Robert Debré University Hospital, 51100 Reims, France
| | - Xavier Dubernard
- Department of ENT-Head and Neck Surgery, Robert Debré University Hospital, 51100 Reims, France
| | - Bertrand Baujat
- Department of ENT-Head and Neck Surgery, Tenon University Hospital, APHP, Sorbonne Universite, 75020 Paris, France.
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Thierry A, Barbe C, Labrousse M, Makeieff M, Merol JC, Carsin-Vu A, Truong F, Dubernard X, Brenet E. Intra-parotid facial nerve path by MRI tractography: radio-clinical comparison in parotid tumors. Eur Arch Otorhinolaryngol 2024; 281:925-934. [PMID: 37917163 DOI: 10.1007/s00405-023-08301-5] [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: 06/12/2023] [Accepted: 10/17/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE The objective of our study was to evaluate the ability of preoperative MRI tractography to visualize and predict the path of the facial nerve with respect to an intra-parotid mass. METHODS We performed an observational bicentric study from June 2019 to August 2020. All patients older than 18 years old, treated for a parotid mass with surgical indication, without MRI contraindication and who agreed to participate in the study were enrolled prospectively. All patients underwent a cervico-facial MRI with tractographic analysis. Postprocessed tractography images of the intra-parotid facial nerve were analyzed by two expert radiologists in head and neck imaging. The intraoperative anatomical description of the facial nerve path and its relationship to the mass was performed by the surgeon during the operation, with no visibility on MRI examination results. A statistical study allowed for the description of the data collected as well as the measurement of inter-observer agreement and agreement between tractography and surgery using kappa coefficients. RESULTS Fifty-two patients were included. The facial nerve trunk and its first two divisional branches were visualized via tractography in 93.5% of cases (n = 43). The upper distal branches were visualized in 51.1% of cases (n = 23), and the lower branches were visualized in 73.3% of cases (n = 33). Agreement with the location described per-operatively was on average 82.9% for the trunk, 74.15% for the temporal branch, and 75.21% for the cervico-facial branch. CONCLUSION Fiber tractography analysis by MRI of the intra-parotid facial nerve appears to be a good test for predicting the path of the nerve over the parotid mass and could be an additional tool to guide the surgeon in the operative procedure.
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Affiliation(s)
- Axelle Thierry
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France
- University of Reims-Champagne Ardennes, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - Coralie Barbe
- University Department of Health Research, University of Reims Champagne Ardennes, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - Marc Labrousse
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France
- University of Reims-Champagne Ardennes, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - Marc Makeieff
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France
- University of Reims-Champagne Ardennes, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - Jean-Claude Merol
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - Aline Carsin-Vu
- University Department of Health Research, University of Reims Champagne Ardennes, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - France Truong
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France
- University of Reims-Champagne Ardennes, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - Xavier Dubernard
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France
- University of Reims-Champagne Ardennes, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - Esteban Brenet
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France.
- University of Reims-Champagne Ardennes, Reims, France.
- Department of Radiology, University Hospital of Reims, Reims, France.
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Couloigner V, Schmerber S, Nicollas R, Coste A, Barry B, Makeieff M, Boudard P, Bequignon E, Morel N, Lescanne E. COVID-19 and ENT Surgery. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:161-166. [PMID: 32362564 PMCID: PMC7177055 DOI: 10.1016/j.anorl.2020.04.012] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In Otorhinolaryngology – Head and Neck Surgery, clinical examination and invasive procedures on the respiratory tract and on airway-connected cavities, such as paranasal sinuses and the middle ear, expose people to direct transmission of SARS-CoV-2 by inhalation or ocular projection of contaminated droplets, and to indirect transmission by contact with contaminated hands, objects or surfaces. Estimating an R0 of COVID-19 at around 3 justified postponing non-urgent face-to-face consultations and expanding the use of teleconsultation in order to limit the risks of SARS-CoV-2 infection of patients or health workers and comply with the lockdown. The health authority recommends cancellation of all medical or surgical activities, which are not urgent as long as this does not involve a loss of chance for the patient. The purpose of this cancellation is to significantly increase critical care capacity, prioritise the reception of patients with COVID-19, prioritise the allocation of staff and provision of the equipment necessary for their medical or surgical management, and contribute to the smooth running of downstream critical care within their establishment. Another goal is to reduce the risks of patient contamination within healthcare facilities. This document provides guidance on how to proceed with and adapt ENT surgery in the current pandemic context, as well as on the management of postponed operations. This best practice advice must of course be adapted in each region according to the development of the epidemic and pre-existing arrangements. Their local application can only be decided within the framework of collaboration between the ENT teams, the operational hygiene units and all the other specialties concerned.
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Affiliation(s)
- V Couloigner
- Paediatric ENT Department, Necker-Enfants Malades University Hospital, AP-HP, Paris, France
| | - S Schmerber
- Department of Otorhinolaryngology, Head and Neck Surgery, Grenoble University Hospital, Grenoble, France
| | - R Nicollas
- Paediatric ENT Department, Marseille University Hospital, AP-HM, Marseille, France
| | - A Coste
- Department of Otorhinolaryngology, Head and Neck Surgery, Henri-Mondor University Hospitals, AP-HP, Tassigny, France; Department of Otorhinolaryngology, Head and Neck Surgery, Créteil Intercommunal University Hospital, AP-HP, Créteil, France
| | - B Barry
- Department of Otorhinolaryngology, Head and Neck Surgery, Bichat University Hospital, AP-HP, Paris, France
| | - M Makeieff
- Department of Otorhinolaryngology, Head and Neck Surgery, Reims University Hospital, Reims, France
| | | | - E Bequignon
- Department of Otorhinolaryngology, Head and Neck Surgery, Henri-Mondor University Hospitals, AP-HP, Tassigny, France; Department of Otorhinolaryngology, Head and Neck Surgery, Créteil Intercommunal University Hospital, AP-HP, Créteil, France
| | - N Morel
- ENT clinic, Échirolles, France
| | - E Lescanne
- Department of Otorhinolaryngology, Head and Neck Surgery, Tours University Hospital, Tours, France.
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Laccourreye O, Lisan Q, Bonfils P, Garrel R, Jankowski R, Karkas A, Leboulanger N, Makeieff M, Righini C, Vincent C, Martin C. Use of P-values and the terms "significant", "non-significant" and "suggestive" in Abstracts in the European Annals of Otorhinolaryngology, Head & Neck Diseases. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:469-473. [PMID: 31699624 DOI: 10.1016/j.anorl.2019.10.008] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [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] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To evaluate the use of P-values and the terms "significant", "non-significant" and "suggestive" in Abstracts in the European Annals of Otorhinolaryngology, Head & Neck Diseases. MATERIALS AND METHODS Consecutive articles accepted for publication during the period January 2016 - February 2019 were systematically reviewed. Main goal: descriptive analysis of the citation of P-values and use of the terms "significant", "non-significant" and "suggestive" in Abstracts. Secondary goal: analytic study of: (i) correlations between citation of a P-value and the main characteristics of authors and topics; and (ii) misuse of the terms "significant", "non-significant" and "suggestive" with respect to cited P-values, and correlations with author and topic characteristics. RESULTS In all, 91 articles were included. P-values and the terms "significant", "non-significant" and "suggestive" were cited in 35.1%, 41.7%, 10.9% and 0% of Abstracts, respectively. Citing a P-value did not significantly correlate with author or topic characteristics. There were discrepancies between the terms "non-significant", "significant" and "suggestive" and P-values given in the body of the article in 57.1% of Abstracts, with 30.7% overestimation and 25.2% underestimation of results, without significant correlation with author or topic characteristics. CONCLUSION Authors, editors and reviewers must pay particular attention to the spin resulting from inappropriate use of the terms "significant", "non-significant" and "suggestive" in Abstracts of articles submitted to the European Annals of Otorhinolaryngology, Head & Neck Diseases, to improve the rigor, quality and value of the scientific message delivered to the reader.
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Affiliation(s)
- O Laccourreye
- Comité de rédaction, annales d'otorhinolaryngologie et de pathologie cervico-faciale, Elsevier ed., 92130 Issy-les-Moulineaux, France; Université Paris Descartes Sorbonne Paris Cité, 75006 Paris, France.
| | - Q Lisan
- Comité de rédaction, annales d'otorhinolaryngologie et de pathologie cervico-faciale, Elsevier ed., 92130 Issy-les-Moulineaux, France; Université Paris Descartes Sorbonne Paris Cité, 75006 Paris, France
| | - P Bonfils
- Comité de rédaction, annales d'otorhinolaryngologie et de pathologie cervico-faciale, Elsevier ed., 92130 Issy-les-Moulineaux, France; Université Paris Descartes Sorbonne Paris Cité, 75006 Paris, France
| | - R Garrel
- Comité de rédaction, annales d'otorhinolaryngologie et de pathologie cervico-faciale, Elsevier ed., 92130 Issy-les-Moulineaux, France; Université de Montpellier, 34090 Montpellier, France
| | - R Jankowski
- Comité de rédaction, annales d'otorhinolaryngologie et de pathologie cervico-faciale, Elsevier ed., 92130 Issy-les-Moulineaux, France; Université de Lorraine, 54505 Nancy, France
| | - A Karkas
- Comité de rédaction, annales d'otorhinolaryngologie et de pathologie cervico-faciale, Elsevier ed., 92130 Issy-les-Moulineaux, France; Université de Saint-Étienne, 42270 Saint-Étienne, France
| | - N Leboulanger
- Comité de rédaction, annales d'otorhinolaryngologie et de pathologie cervico-faciale, Elsevier ed., 92130 Issy-les-Moulineaux, France; Université Paris Descartes Sorbonne Paris Cité, 75006 Paris, France
| | - M Makeieff
- Comité de rédaction, annales d'otorhinolaryngologie et de pathologie cervico-faciale, Elsevier ed., 92130 Issy-les-Moulineaux, France; Université de Reims, 51100 Reims, France
| | - C Righini
- Comité de rédaction, annales d'otorhinolaryngologie et de pathologie cervico-faciale, Elsevier ed., 92130 Issy-les-Moulineaux, France; Université de Grenoble, 38700 Grenoble, France
| | - C Vincent
- Comité de rédaction, annales d'otorhinolaryngologie et de pathologie cervico-faciale, Elsevier ed., 92130 Issy-les-Moulineaux, France; Université de Lille, 59120 Lille, France
| | - C Martin
- Comité de rédaction, annales d'otorhinolaryngologie et de pathologie cervico-faciale, Elsevier ed., 92130 Issy-les-Moulineaux, France
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Dubernard X, Kleiber JC, Makeieff M, Bazin A, Chays A. Drilling and control of the internal auditory canal by fixed endoscope. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:37-39. [DOI: 10.1016/j.anorl.2018.09.005] [Citation(s) in RCA: 2] [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: 12/01/2022]
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Affiliation(s)
- E Drapier
- Service d'oto-rhino-laryngologie, CHU de Reims, rue du General-Koening, 51100 Reims, France
| | - M Makeieff
- Service d'oto-rhino-laryngologie, CHU de Reims, rue du General-Koening, 51100 Reims, France
| | - X Dubernard
- Service d'oto-rhino-laryngologie, CHU de Reims, rue du General-Koening, 51100 Reims, France.
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Dubernard X, Brenet E, Makeieff M. A falsely silent mass. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:371-372. [PMID: 29910100 DOI: 10.1016/j.anorl.2018.06.001] [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: 11/29/2022]
Affiliation(s)
- X Dubernard
- Service d'oto-rhino-laryngologie, CHU de Reims, rue du General-Koening, 51100 Reims, France.
| | - E Brenet
- Service d'oto-rhino-laryngologie, CHU de Reims, rue du General-Koening, 51100 Reims, France
| | - M Makeieff
- Service d'oto-rhino-laryngologie, CHU de Reims, rue du General-Koening, 51100 Reims, France
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Dubernard X, Kleiber JC, Brenet E, Louges MA, Veleine Y, Labrousse M, Makeieff M, Bazin A, Chays A. [The tumors of the ear]. Presse Med 2017; 46:1079-1088. [PMID: 29097033 DOI: 10.1016/j.lpm.2017.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 05/03/2017] [Revised: 09/25/2017] [Accepted: 09/25/2017] [Indexed: 11/26/2022] Open
Abstract
Any cutaneous lesion of the outer ear must be managed jointly by a dermatologist and an ENT, regardless of the age of the patient. The presence of a malignant cutaneous carcinoma (Squamous cell carcinoma or melanoma) of the pavilion requires a minimum extension assessment by a cervical ultrasound, CT-scan and MRI will be prescribed according to the degree of infiltration and the presence of clinics signs (lymphadenopathy, facial paralysis, cognitive impairment). A polyp of the external auditory meatus must be systematically biopsied in consultation and, if necessary, in the operating room with fresh anatomopathological analysis. Any "otitis externa", which does not progress favorably under local treatment, must lead to eliminate a tumoral pathology of the external acoustic meatus or of the middle ear. Any suspicion of cholesteatoma should lead to an ENT consultation to confirm the diagnosis and consider its treatment to limit the auditory dysfunction. Any unilateral neurosensorial hearing loss or unilateral vestibular involvement with normal otoscopy should lead to eliminate a inner ear tumor by an MRI of the inner ear and the ponto-cerebellar angle in millimeter sections.
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Affiliation(s)
- X Dubernard
- Hôpital Robert-Debré, departement d'oto-rhino-laryngologie, 51100 Reims, France; Université de Reims Champagne-Ardenne, faculté de médecine, 51100 Reims, France.
| | - J-C Kleiber
- Université de Reims Champagne-Ardenne, faculté de médecine, 51100 Reims, France; Hôpital Maison-Blanche, departement de neurochirurgie, 51100 Reims, France
| | - E Brenet
- Hôpital Robert-Debré, departement d'oto-rhino-laryngologie, 51100 Reims, France
| | - M-A Louges
- Hôpital Robert-Debré, departement d'oto-rhino-laryngologie, 51100 Reims, France
| | - Y Veleine
- Hôpital Robert-Debré, departement d'oto-rhino-laryngologie, 51100 Reims, France
| | - M Labrousse
- Hôpital Robert-Debré, departement d'oto-rhino-laryngologie, 51100 Reims, France; Université de Reims Champagne-Ardenne, faculté de médecine, 51100 Reims, France
| | - M Makeieff
- Hôpital Robert-Debré, departement d'oto-rhino-laryngologie, 51100 Reims, France; Université de Reims Champagne-Ardenne, faculté de médecine, 51100 Reims, France
| | - A Bazin
- Hôpital Maison-Blanche, departement de neurochirurgie, 51100 Reims, France
| | - A Chays
- Hôpital Robert-Debré, departement d'oto-rhino-laryngologie, 51100 Reims, France; Université de Reims Champagne-Ardenne, faculté de médecine, 51100 Reims, France
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Laccourreye O, Bonfils P, Garrel R, Jankowski R, Karkas A, Leboulanger N, Makeieff M, Righini C, Vincent C, Martin C. Data sharing to serve ethics, transparency and reproducibility of medical science. Eur Ann Otorhinolaryngol Head Neck Dis 2017; 134:297-298. [PMID: 28919279 DOI: 10.1016/j.anorl.2017.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Brenet E, Dubernard X, Mérol JC, Louges MA, Labrousse M, Makeieff M. Assessment and management of cervico-mediastinal goiter. Eur Ann Otorhinolaryngol Head Neck Dis 2017; 134:409-413. [PMID: 28668317 DOI: 10.1016/j.anorl.2017.06.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Cervico-mediastinal goiter is a particular entity from the point of view of thyroid surgery. Its volume, hardness and intrathoracic extension require the surgeon to adapt technique and perform a painstaking preoperative work-up, so as to draw up fully-fledged plan. CT is now indispensable, to anticipate risks and determine whether sternotomy is needed. Surgery seems to induce more postoperative complications than in conventional surgery, although they can be reduced by retrograde dissection of the inferior laryngeal nerve and downward dissection of the posterior side of the lobe to optimize control of adjacent structures. This surgery requires optimal teamwork between all of the specialties involved in patient management: medical, radiological, anesthesiological and surgical.
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Affiliation(s)
- E Brenet
- Département d'otorhinolaryngologie et chirurgie cervico-faciale, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France.
| | - X Dubernard
- Département d'otorhinolaryngologie et chirurgie cervico-faciale, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France
| | - J C Mérol
- Département d'otorhinolaryngologie et chirurgie cervico-faciale, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France
| | - M A Louges
- Département d'otorhinolaryngologie et chirurgie cervico-faciale, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France
| | - M Labrousse
- Département d'otorhinolaryngologie et chirurgie cervico-faciale, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France
| | - M Makeieff
- Département d'otorhinolaryngologie et chirurgie cervico-faciale, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France
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Garrel R, Jouzdani E, Costes V, Makeieff M, Crampette L, Guerrier B. About the Existence of a Foraminal Laryngeal Cyst. Otolaryngol Head Neck Surg 2016; 133:641. [PMID: 16213950 DOI: 10.1016/j.otohns.2004.09.079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2004] [Accepted: 09/21/2004] [Indexed: 10/25/2022]
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Garrel R, Jouzdani E, Gardiner Q, Makeieff M, Mondain M, Hagen P, Crampette L, Guerrier B. Fourth Branchial Pouch Sinus: From Diagnosis to Treatment. Otolaryngol Head Neck Surg 2016; 134:157-63. [PMID: 16399198 DOI: 10.1016/j.otohns.2005.05.653] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [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: 12/01/2004] [Indexed: 11/26/2022]
Abstract
BACKGROUND: Fourth branchial pouch sinus (FBPS) is rare and frequently unknown to clinicians. Misdiagnosis is common and definitive surgery is often made difficult by previous episodes of infection and failed attempts at excision. The purpose of this paper is to clarify the diagnostic criteria and the methods used for the surgical management of FBPS. MATERIALS AND METHOD: From a series of 265 head and neck cysts and fistulae, 7 cases of FBPS were retrospectively reviewed. The surgical technique is detailed. RESULTS: Six cases were located on the left side and one on the right. CT scanning showed an air-filled structure on both sides of the lesser horn of the thyroid cartilage in 2 cases out of 4, and barium swallow found a FBPS in 1 case out of 3. Direct pharyngoscopy allowed confirmation of the diagnosis in all cases and permitted catheterization of the tract with the spring guidewire of a vascular catheter which helped surgical location and subsequent dissection. The recurrent laryngeal nerve was systematically dissected to avoid inadvertent damage. A hemi-thyroidectomy was performed in one case. A transient laryngeal paralysis (lasting 9 months) was noted in a 3-week-old newborn operated on. None of the 7 cases had a recurrence after complete resection of the FBPS (3.7 years average follow-up). CONCLUSION: Symptoms on the right side do not exclude the diagnosis of a FBPS. Endoscopy is the key investigation. It allows confirmation of the diagnosis and catheterization of the tract, which aids the surgical dissection. Total removal of the sinus tract tissue with dissection and preservation of the recurrent laryngeal nerve is recommended. EBM rating: A-1
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Affiliation(s)
- Renaud Garrel
- Department of Otolaryngology-Head and Neck Surgery "A", CHU Gui de Chauliac, 34295 Montpellier, France.
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Garrel R, Bartolomeo M, Makeieff M, Crampette L, Guerrier B, Cartier C. Interest of video-assisted minimally invasive surgery in primary hyperparathyroidism. Eur Ann Otorhinolaryngol Head Neck Dis 2016; 133:247-51. [PMID: 27133292 DOI: 10.1016/j.anorl.2016.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 11/25/2022]
Abstract
INTRODUCTION Surgery is the only radical and definitive treatment for primary hyperparathyroidism. Exploration of the four parathyroid sites is giving way to minimally invasive techniques. The present study sought to compare two minimally invasive parathyroidectomy techniques, by classical cervicotomy (MIP-C) and by video-assistance (MIP-VA), in terms of success rate, complications rate, operating time, and patient and community physician satisfaction. MATERIALS AND METHOD A non-randomized retrospective comparative study included 112 patients presenting with primary hyperparathyroidism with identified parathyroid adenoma, operated on between January 2005 and October 2010. The two groups were constituted according to the surgeons' habitual practice: 54 cases of MIP-VA and 58 of MIP-C. RESULTS Results for MIP-VA and MIP-C were respectively: success, 96.3% vs. 100% (P=0.09); mean scar size, 1.47 vs. 3.43cm (P<0.01); hypocalcemia, 2 vs. 3 cases (P=0.1); theater time, 94.25 vs. 76min (P=0.02); and postoperative stay, 1.08 vs. 1.37 days (P=0.07). Patient satisfaction was comparable between groups, while 93.3% of community physicians found MIP-VA preferable to MIP-C, although only 39.3% had known the MIP-VA technique. CONCLUSION With efficacy, morbidity and patient satisfaction comparable to classical surgery, MIP-VA significantly reduced cervicotomy size and hospital stay. Community physicians considered it to be preferable to MIP-C.
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Affiliation(s)
- R Garrel
- Département d'ORL et CCF, Hôpital Guide-Chauliac, Pôle Neuroscience Tête et Cou, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France.
| | - M Bartolomeo
- Département d'ORL et CCF, Hôpital Guide-Chauliac, Pôle Neuroscience Tête et Cou, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France
| | - M Makeieff
- Département d'ORL et CCF, Hôpital Guide-Chauliac, Pôle Neuroscience Tête et Cou, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France
| | - L Crampette
- Département d'ORL et CCF, Hôpital Guide-Chauliac, Pôle Neuroscience Tête et Cou, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France
| | - B Guerrier
- Département d'ORL et CCF, Hôpital Guide-Chauliac, Pôle Neuroscience Tête et Cou, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France
| | - C Cartier
- Département d'ORL et CCF, Hôpital Guide-Chauliac, Pôle Neuroscience Tête et Cou, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France
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Pelliccia P, Bartolomeo M, Iannetti G, Bonafé A, Makeieff M. Traumatic intra-sphenoidal pseudoaneurysm lodged inside the fractured sphenoidal sinus. Acta Otorhinolaryngol Ital 2016; 36:149-52. [PMID: 27196081 PMCID: PMC4907163 DOI: 10.14639/0392-100x-192913] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 09/23/2013] [Indexed: 11/23/2022]
Abstract
We describe a case of traumatic intra-sphenoidal right internal carotid artery pseudoaneurysm lodged inside the fractured sphenoidal sinus that developed in a patient with a previous history of frontal and skull base fractures involving the sphenoid sinus and walls of the carotid canal, but with normal intracranial findings at early CT angiography. The patient presented two episodes of massive life-threatening delayed epistaxis before successful endovascular treatment combining the use of coils and an uncovered stent was instituted. This case report highlights that patients with head trauma who present sphenoid sinus fractures with or without massive epistaxis should be evaluated for the development of traumatic internal carotid artery pseudoaneurysm as soon as possible. If the first angiographic evaluation reveals normal findings, repeated epistaxis should prompt a second angiographic evaluation because psudoaneurysm takes time to develop. Early treatment with uncovered stent of the aneurysm can be a life-saving therapeutic approach.
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Affiliation(s)
- P Pelliccia
- Department of Head and Neck Surgery, CHU, Montpellier, France;,Department of Maxillo-Facial Surgery, University of Rome La Sapienza, Rome, Italy
| | - M Bartolomeo
- Department of Head and Neck Surgery, CHU, Montpellier, France
| | - G Iannetti
- Department of Maxillo-Facial Surgery, University of Rome La Sapienza, Rome, Italy
| | - A Bonafé
- Department of Neuroradiology, CHU, Montpellier, France
| | - M Makeieff
- Department of Head and Neck Surgery, CHU, Montpellier, France
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Laccourreye O, Bonfils P, Denoyelle F, Garrel R, Jankowski R, Karkas A, Makeieff M, Righini C, Vincent C, Martin C. Analysis of case reports submitted to the European Annals of Otorhinolaryngology Head & Neck Diseases. Eur Ann Otorhinolaryngol Head Neck Dis 2016; 133:171-4. [PMID: 26879581 DOI: 10.1016/j.anorl.2016.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To assess flaws, rejection rate and reasons for rejection of case reports submitted for publication in the European Annals of Otorhinolaryngology Head & Neck Diseases. MATERIALS AND METHODS A prospective analysis of flaws noted in reviewing 118 case reports from 29 countries consecutively submitted to the European Annals of Otorhinolaryngology Head & Neck Diseases during the period Sept. 1, 2014 to Sept. 30, 2015. RESULTS The most frequent flaws, noted in 74.5% of cases, were: lack of originality (more than 15 such cases previously reported in the medical literature) and lack of new data contributing to the medical literature. Overall, 5% of the cases were accepted for publication, 7% were not resubmitted by the authors, and 88% were rejected. On univariate analysis, none of the variables under analysis correlated with acceptance or rejection of the submitted case. Editorial decision time varied from 1 to 7months (median, 1 month). In 16.3% of the 104 cases of rejection (17/104), the editors suggested resubmission in the section "Letter to the Editor" or "What is your diagnosis?"; 15 of the 17 reports were resubmitted, and 10 (66.6%) were ultimately accepted for publication. CONCLUSION The editorial committee of the European Annals of Otorhinolaryngology Head & Neck Diseases hope that the present data and review of the literature will provide authors with a framework to avoid major errors leading to rejection and will speed publication of the case reports they submit to our columns in the near future.
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Affiliation(s)
- O Laccourreye
- HEGP, service d'oto-rhinolaryngologie et de chirurgie cervico-faciale, AP-HP, université Paris-Descartes, Sorbonne Paris Cité, 20-40, rue Leblanc, 75015 Paris, France.
| | - P Bonfils
- HEGP, service d'oto-rhinolaryngologie et de chirurgie cervico-faciale, AP-HP, université Paris-Descartes, Sorbonne Paris Cité, 20-40, rue Leblanc, 75015 Paris, France
| | - F Denoyelle
- HEGP, service d'oto-rhinolaryngologie et de chirurgie cervico-faciale, AP-HP, université Paris-Descartes, Sorbonne Paris Cité, 20-40, rue Leblanc, 75015 Paris, France
| | - R Garrel
- HEGP, service d'oto-rhinolaryngologie et de chirurgie cervico-faciale, AP-HP, université Paris-Descartes, Sorbonne Paris Cité, 20-40, rue Leblanc, 75015 Paris, France
| | - R Jankowski
- HEGP, service d'oto-rhinolaryngologie et de chirurgie cervico-faciale, AP-HP, université Paris-Descartes, Sorbonne Paris Cité, 20-40, rue Leblanc, 75015 Paris, France
| | - A Karkas
- HEGP, service d'oto-rhinolaryngologie et de chirurgie cervico-faciale, AP-HP, université Paris-Descartes, Sorbonne Paris Cité, 20-40, rue Leblanc, 75015 Paris, France
| | - M Makeieff
- HEGP, service d'oto-rhinolaryngologie et de chirurgie cervico-faciale, AP-HP, université Paris-Descartes, Sorbonne Paris Cité, 20-40, rue Leblanc, 75015 Paris, France
| | - C Righini
- HEGP, service d'oto-rhinolaryngologie et de chirurgie cervico-faciale, AP-HP, université Paris-Descartes, Sorbonne Paris Cité, 20-40, rue Leblanc, 75015 Paris, France
| | - C Vincent
- HEGP, service d'oto-rhinolaryngologie et de chirurgie cervico-faciale, AP-HP, université Paris-Descartes, Sorbonne Paris Cité, 20-40, rue Leblanc, 75015 Paris, France
| | - C Martin
- HEGP, service d'oto-rhinolaryngologie et de chirurgie cervico-faciale, AP-HP, université Paris-Descartes, Sorbonne Paris Cité, 20-40, rue Leblanc, 75015 Paris, France
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16
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Dubernard X, Dabakuyo S, Ouedraogo S, Amroun K, Kere D, Nasser T, Deguelte S, Pochart JM, Merol JC, Makeieff M, Chays A, Schvartz C. Prophylactic neck dissection for low-risk differentiated thyroid cancers: Risk-benefit analysis. Head Neck 2016; 38:1091-6. [PMID: 26873677 DOI: 10.1002/hed.24402] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2015] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The benefit of neck dissection is the subject of debate in differentiated thyroid cancer (DTC). We analyze the risk-benefit of neck dissection for low-risk DTC without detectable lymph nodes. METHODS We conducted a retrospective study from 1983 to 2003; which included 295 patients without detectable lymph nodes who were treated by thyroidectomy with (C+) or without (C-) neck dissection. All patients had iodine131 therapy. We compared the frequency of remission, disease progression, and permanent complications between groups. RESULTS Two hundred twelve patients comprised the C+ group, and 83 patients the C- group. Respectively for C+ versus C-, remission rates were 92% versus 89.2% (p = .40), and progressive disease observed was 3.3% versus 7.2% (p = .10). Permanent hypoparathyroidism occurred in 15.1% in C+ versus 3.6% in C- (p = .006). CONCLUSION The risk-benefit analysis of neck dissection in patients with low-risk DTC shows no benefit in terms of complete remission or occurrence of progression. However, risk of complications seems to be higher in patients with neck dissection. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1091-1096, 2016.
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Affiliation(s)
- Xavier Dubernard
- Thyroïde Marne-Ardennes Register, CLCC Institut Jean Godinot, Reims, France.,Otolaryngology Department, Centre Hospitalier Robert Debré, Reims, France
| | - Sandrine Dabakuyo
- Thyroïde Marne-Ardennes Register, CLCC Institut Jean Godinot, Reims, France
| | | | - Koceila Amroun
- General Surgery Department, CLCC Institut Jean Godinot, Reims, France
| | - David Kere
- General Surgery Department, CLCC Institut Jean Godinot, Reims, France
| | - Talal Nasser
- Otolaryngology Department, Polyclinique de Courlancy, Reims, France
| | - Sophie Deguelte
- General Surgery Department, Centre Hospitalier Robert Debré, Reims, France
| | - Jean-Marie Pochart
- Thyroïde Marne-Ardennes Register, CLCC Institut Jean Godinot, Reims, France
| | - Jean-Claude Merol
- Otolaryngology Department, Centre Hospitalier Robert Debré, Reims, France
| | - Marc Makeieff
- Otolaryngology Department, Centre Hospitalier Robert Debré, Reims, France
| | - André Chays
- Otolaryngology Department, Centre Hospitalier Robert Debré, Reims, France
| | - Claire Schvartz
- Thyroïde Marne-Ardennes Register, CLCC Institut Jean Godinot, Reims, France
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Abstract
INTRODUCTION Tracheal rhinoscleroma is an infectious granulomatosis of the tracheobronchial tract caused by a Gram-negative bacillus. Exclusively tracheal involvement has been rarely reported in the literature. The purpose of this study was to report a case of subglottic stenosis secondary to rhinoscleroma. SUMMARY A 46-year-old North African woman with no medical or surgical history presented with inspiratory dyspnoea that had been present for several years. Endoscopic examination under general anaesthesia revealed tracheal stenosis. Histological examination of mucosal biopsies demonstrated Mikulicz cells and culture of bacteriological samples taken during a second biopsy confirmed the diagnosis of rhinoscleroma. CO2 laser subglottic obstruction relief was performed and treatment with ofloxacin was initiated. No recurrence of tracheal stenosis was observed with a follow-up of 6 months. DISCUSSION The diagnosis of rhinoscleroma is based on histological and bacteriological examination. Cultures are positive in 60% of cases, but negative cultures do not exclude the diagnosis of rhinoscleroma. Specific treatment consists of long-term antibiotic therapy, while surgery may be indicated for symptomatic treatment.
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Affiliation(s)
- A Bigi
- Département de chirurgie cervico-faciale, centre hospitalo universitaire, hôpital Gui-de-Chauliac, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France.
| | - M Bartolomeo
- Département de chirurgie cervico-faciale, centre hospitalo universitaire, hôpital Gui-de-Chauliac, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France
| | - V Costes
- Département d'anatomopathologie, pôle neurosciences, centre hospitalo universitaire, hôpital Gui-de-Chauliac, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France
| | - M Makeieff
- Département de chirurgie cervico-faciale, centre hospitalo universitaire, hôpital Gui-de-Chauliac, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France
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18
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Laccourreye O, Bonfils P, Denoyelle F, Garrel R, Jankowski R, Karkas A, Makeieff M, Righini C, Vincent C, Martin C. Characteristics and analysis of scientific articles submitted to the European Annals of Otorhinolaryngology, Head and Neck Diseases. Eur Ann Otorhinolaryngol Head Neck Dis 2015. [PMID: 26206137 DOI: 10.1016/j.anorl.2015.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 11/30/2022]
Abstract
OBJECTIVES To evaluate characteristics, suggested modifications and reasons for rejection in scientific articles submitted for publication in the European Annals of Otorhinolaryngology, Head and Neck Diseases. MATERIALS AND METHODS A prospective study analyzed the flaws noted by reviewers in 52 scientific articles submitted to the European Annals of Otorhinolaryngology, Head and Neck Diseases between August 31, 2014 and February 28, 2015. RESULTS Fifteen flaws concerning content and 7 concerning form were identified. In more than 25% of submissions, major flaws were noted: purely descriptive paper; lack of contribution to existing state of knowledge; failure to define a clear study objective and/or analyze the impact of major variables; poorly structured Materials and methods section, lacking description of study population, objective and/or variables; lack of or inappropriate statistical analysis; Introduction verbose and/or misrepresenting the literature; excessively heterogeneous and/or poorly described study population; imprecise discussion, straying from the point, overstating the significance of results and/or introducing new results not mentioned in the Results section; description of the study population placed in the Results section instead of under Materials and methods; serious mistakes of syntax, spelling and/or tense; and failure to follow the Instructions to Authors. After review, 21.1% of articles were published, 65.3% rejected and 13.4% non-resubmitted within 3 months of review. On univariate analysis, the only variable increasing the percentage of articles accepted was the topic not being devoted to head and neck surgery (P=0.03). CONCLUSION These results document the excessive flaw rate still to be found in manuscripts and demonstrate the continuing need for authors to master and implement the rules of scientific medical writing.
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Affiliation(s)
- O Laccourreye
- Editorial Board of the European Annals of Otorhinolaryngology, Head and Neck Diseases, c/o Elsevier Masson, 92442 Issy-les-Moulineaux cedex, France.
| | - P Bonfils
- Editorial Board of the European Annals of Otorhinolaryngology, Head and Neck Diseases, c/o Elsevier Masson, 92442 Issy-les-Moulineaux cedex, France
| | - F Denoyelle
- Editorial Board of the European Annals of Otorhinolaryngology, Head and Neck Diseases, c/o Elsevier Masson, 92442 Issy-les-Moulineaux cedex, France
| | - R Garrel
- Editorial Board of the European Annals of Otorhinolaryngology, Head and Neck Diseases, c/o Elsevier Masson, 92442 Issy-les-Moulineaux cedex, France
| | - R Jankowski
- Editorial Board of the European Annals of Otorhinolaryngology, Head and Neck Diseases, c/o Elsevier Masson, 92442 Issy-les-Moulineaux cedex, France
| | - A Karkas
- Editorial Board of the European Annals of Otorhinolaryngology, Head and Neck Diseases, c/o Elsevier Masson, 92442 Issy-les-Moulineaux cedex, France
| | - M Makeieff
- Editorial Board of the European Annals of Otorhinolaryngology, Head and Neck Diseases, c/o Elsevier Masson, 92442 Issy-les-Moulineaux cedex, France
| | - C Righini
- Editorial Board of the European Annals of Otorhinolaryngology, Head and Neck Diseases, c/o Elsevier Masson, 92442 Issy-les-Moulineaux cedex, France
| | - C Vincent
- Editorial Board of the European Annals of Otorhinolaryngology, Head and Neck Diseases, c/o Elsevier Masson, 92442 Issy-les-Moulineaux cedex, France
| | - C Martin
- Editorial Board of the European Annals of Otorhinolaryngology, Head and Neck Diseases, c/o Elsevier Masson, 92442 Issy-les-Moulineaux cedex, France
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Cuny F, Babin E, Lacau-Saint-Guily J, Baujat B, Bensadoun R, Bozec A, Chevalier D, Choussy O, Deneuve S, Fakhry N, Guigay J, Makeieff M, Merol JC, Mouawad F, Pavillet J, Rebiere C, Righini C, Sostras MC, Tournaille M, Vergez S. French Society of ENT (SFORL) guidelines for care pathway organization in head and neck oncology (short version). Early management of head and neck cancer. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132:205-8. [PMID: 26183548 DOI: 10.1016/j.anorl.2015.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 10/23/2022]
Abstract
Early management in oncology is based on coordination and high-quality exchange between the various health-care partners. The present guidelines are based on a literature search with levels of evidence. Treatment waiting time can be optimized by performing assessment as early as possible (Expert opinion), to limit the interval (ideally, less than 4 weeks) between first consultation and data collection. In the first specialist consultation, diagnostic work-up should be scheduled and the data required for management should be determined (Grade B). Work-up may be conducted on a day-care basis or with conventional admission (Expert opinion). The patient's medico-social context should be taken into account from the outset, with social work involvement whenever necessary (Expert opinion). Pain and nutritional management should be planned for (Grade A) and realistic therapeutic education be provided (Expert opinion). Community-hospital teamwork for supportive care should be optimized (Expert opinion). Management should be early and multidisciplinary, to shorten delay between diagnosis and treatment initiation.
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Affiliation(s)
- F Cuny
- Inserm U1086 cancers et prévention, service d'ORL et chirurgie cervico-faciale, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France.
| | - E Babin
- Inserm U1086 cancers et prévention, service d'ORL et chirurgie cervico-faciale, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France
| | | | - B Baujat
- Service d'ORL, hôpital Tenon, 4, rue de la Chine, 75018 Paris, France
| | - R Bensadoun
- Service de radiothérapie, centre Antoine-Lacassagne, 33, avenue Valombrose, 06100 Nice, France
| | - A Bozec
- Service d'ORL et chirurgie cervico-faciale, centre Antoine-Lacassagne, 33, avenue Valombrose, 06100 Nice, France
| | - D Chevalier
- Service d'ORL et chirurgie cervico-faciale, hôpital Claude-Huriez, CHRU, rue Michel Polonovski, 59037 Lille cedex, France
| | - O Choussy
- Service d'ORL et chirurgie cervico-faciale, hôpital Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France
| | - S Deneuve
- Service d'ORL et chirurgie cervico-faciale, CRLCC centre Léon-Bérard, 28, promenade Léa-et-Napoléon-Bullukian, 69008 Lyon, France
| | - N Fakhry
- Service d'ORL et de chirurgie cervico-faciale, hôpital de la Conception, CHU, 147, boulevard Baille, 13005 Marseille, France
| | - J Guigay
- Unité de cancérologie médicale en cancérologie cervico-faciale, centre Antoine-Lacassagne, 33, avenue Valombrose, 06100 Nice, France
| | - M Makeieff
- Service d'ORL et chirurgie cervico-faciale, hopital Robert-Debré, CHU, avenue du Général-Koenig, 51100 Reims, France
| | - J-C Merol
- Service d'ORL et chirurgie cervico-faciale, hopital Robert-Debré, CHU, avenue du Général-Koenig, 51100 Reims, France
| | - F Mouawad
- Service d'ORL et chirurgie cervico-faciale, hôpital Claude-Huriez, CHRU, rue Michel Polonovski, 59037 Lille cedex, France
| | - J Pavillet
- Service d'oncologie médicale, CHU de Grenoble, avenue Maquis-du-Grésivaudan, 38700 La Tronche, France
| | - C Rebiere
- Service social, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France
| | - C Righini
- Clinique universitaire d'ORL, pôle TCCR, CHU de Grenoble Site Nord, Pavillon Dauphiné, 38043 Grenoble cedex, France
| | - M-C Sostras
- Service social, hôpital Tenon, 4, rue de la Chine, 75018 Paris, France
| | - M Tournaille
- Service social, CLCC François-Baclesse, avenue du Général-Harris, 14000 Caen, France
| | - S Vergez
- Service d'ORL et chirurgie cervico-faciale, pôle voies respiratoires, hôpital Larrey, 24, chemin de Pouvourville, 31400 Toulouse, France
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20
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Deneuve S, Babin E, Lacau-St-Guily J, Baujat B, Bensadoun RJ, Bozec A, Chevalier D, Choussy O, Cuny F, Fakhry N, Guigay J, Makeieff M, Merol JC, Mouawad F, Pavillet J, Rebiere C, Righini CA, Sostras MC, Tournaille M, Vergez S. Guidelines (short version) of the French Otorhinolaryngology - Head and Neck Surgery Society (SFORL) on patient pathway organization in ENT: The therapeutic decision-making process. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132:213-5. [PMID: 26139415 DOI: 10.1016/j.anorl.2015.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The authors present the guidelines of the French Otorhinolaryngology - Head and Neck Surgery Society (SFORL) for patient pathway organization in head and neck cancer, and in particular for multidisciplinary team meetings. The present article concerns the therapeutic decision-making process. METHODS A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience. They were then read over by an editorial group independent of the work group. The final version was established in a coordination meeting. The guidelines were graded as A, B, C or expert opinion, by decreasing level of evidence. RESULTS It is recommended that: an organ specialist should contribute to all multidisciplinary meetings on head and neck cancer; all members of the multidisciplinary meeting should have specific knowledge in head and neck cancer; any referring physician who does not follow the multidisciplinary meeting's advice should justify that decision; there should be sufficient time to prepare, discuss and sum up the cases dealt with in the multidisciplinary team meeting.
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Affiliation(s)
- S Deneuve
- Département de chirurgie oncologique, centre de lutte contre le cancer Léon-Bérard, 28, rue Laennec, 69008 Lyon, France.
| | - E Babin
- Service d'ORL, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France
| | - J Lacau-St-Guily
- Service d'ORL, hôpital Tenon, 4, rue de la Chine, 75018 Paris, France
| | - B Baujat
- Service d'ORL, hôpital Tenon, 4, rue de la Chine, 75018 Paris, France
| | - R-J Bensadoun
- Service d'oncologie et de radiothérapie, centre de Haute Énergie, 10, boulevard Pasteur, 06000 Nice, France
| | - A Bozec
- Service d'ORL, institut universitaire de la face et du cou, 31, avenue Valombrose, 06100 Nice, France
| | - D Chevalier
- Service d'ORL, hôpital Claude-Huriez, rue Michel Polonovski, 59037 Lille cedex, France
| | - O Choussy
- Service d'ORL, hôpital Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France
| | - F Cuny
- Service d'ORL, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France
| | - N Fakhry
- Service d'ORL et de chirurgie cervico-faciale, hôpital de la Conception, CHU, 147, boulevard Baille, 13005 Marseille, France
| | - J Guigay
- Service d'oncologie médicale, institut universitaire de la face et du cou, 31, avenue Valombrose, 06100 Nice, France
| | - M Makeieff
- Service d'ORL, hopital Robert-Debré, avenue du Général-Koenig, 51100 Reims, France
| | - J-C Merol
- Service d'ORL, hopital Robert-Debré, avenue du Général-Koenig, 51100 Reims, France
| | - F Mouawad
- Service d'ORL, hôpital Claude-Huriez, rue Michel Polonovski, 59037 Lille cedex, France
| | - J Pavillet
- Service d'oncologue médicale, CHU, 38043 Grenoble, France
| | - C Rebiere
- Service social, CHU, 14000 Caen, France
| | - C-A Righini
- Service d'ORL, hôpital Nord Michalon, BP 217, 38043 Grenoble cedex, France
| | - M-C Sostras
- Service social, hôpital Tenon, 4, rue de la Chine, 75018 Paris, France
| | - M Tournaille
- Service social, CLCC François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France
| | - S Vergez
- Service d'ORL, hôpital Larrey, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse cedex 9, France
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Bartolomeo M, Bigi A, Pelliccia P, Makeieff M. Surgical treatment of a case of adult epiglottic laryngomalacia. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132:45-7. [DOI: 10.1016/j.anorl.2013.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 08/22/2013] [Accepted: 10/30/2013] [Indexed: 11/16/2022]
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Leroux-Kozal V, Lévêque N, Brodard V, Lesage C, Dudez O, Makeieff M, Kanagaratnam L, Diebold MD. Merkel cell carcinoma: histopathologic and prognostic features according to the immunohistochemical expression of Merkel cell polyomavirus large T antigen correlated with viral load. Hum Pathol 2014; 46:443-53. [PMID: 25623078 DOI: 10.1016/j.humpath.2014.12.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 11/29/2014] [Accepted: 12/03/2014] [Indexed: 12/19/2022]
Abstract
Merkel cell carcinoma (MCC) is a neuroendocrine skin malignancy frequently associated with Merkel cell polyomavirus (MCPyV), which is suspected to be oncogenic. In a series of MCC patients, we compared clinical, histopathologic, and prognostic features according to the expression of viral large T antigen (LTA) correlated with viral load. We evaluated the LTA expression by immunohistochemistry using CM2B4 antibody and quantified viral load by real-time polymerase chain reaction. We analyzed formalin-fixed, paraffin-embedded (FFPE) tissue samples (n = 36) and corresponding fresh-frozen biopsies when available (n = 12), of the primary tumor and/or metastasis from 24 patients. MCPyV was detected in 88% and 58% of MCC patients by real-time polymerase chain reaction and immunohistochemistry, respectively. The relevance of viral load measurements was demonstrated by the strong consistency of viral load level between FFPE and corresponding frozen tissues as well as between primary tumor and metastases. From FFPE samples, 2 MCC subgroups were distinguished based on a viral load threshold defined by the positivity of CM2B4 immunostaining. In the LTA-negative subgroup with no or low viral load (nonsignificant), tumor cells showed more anisokaryosis (P = .01), and a solar elastosis around the tumor was more frequently observed (P = .03). LTA-positive MCCs with significant viral load had a lower proliferation index (P = .03) and a longer survival of corresponding patients (P = .008). Depending on MCPyV involvement, 2 MCC subgroups can be distinguished on histopathologic criteria, and the CM2B4 antibody is able to differentiate them reliably. Furthermore, the presence of a significant viral load in tumors is predictive of better prognosis.
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Affiliation(s)
- Valérie Leroux-Kozal
- Department of Pathology, Faculty of Medicine, Robert Debré University Hospital, 51092 Reims, France.
| | - Nicolas Lévêque
- Clinical and Molecular Virology Unit, University Hospital, 51092 Reims, France; Faculty of Medicine, EA-4684 Cardiovir SFR-CAP Santé, 51092 Reims, France
| | - Véronique Brodard
- Clinical and Molecular Virology Unit, University Hospital, 51092 Reims, France
| | - Candice Lesage
- Department of Dermatology, Robert Debré University Hospital, 51092 Reims, France
| | - Oriane Dudez
- Department of Pathology, Faculty of Medicine, Robert Debré University Hospital, 51092 Reims, France
| | - Marc Makeieff
- Department of Otolaryngology-Head and Neck Surgery, Robert Debré University Hospital, 51092 Reims, France
| | - Lukshe Kanagaratnam
- Department of Research and Innovation, Robert Debré University Hospital, 51092 Reims, France
| | - Marie-Danièle Diebold
- Department of Pathology, Faculty of Medicine, Robert Debré University Hospital, 51092 Reims, France
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Akkari M, Schmitt D, Jeandel C, Raingeard I, Blanchet C, Cartier C, Garrel R, Guerrier B, Makeieff M, Mondain M. Nodular recurrence and hypothyroidism following partial thyroidectomy for benign nodular thyroid disease in children and adolescents. Int J Pediatr Otorhinolaryngol 2014; 78:1742-6. [PMID: 25156198 DOI: 10.1016/j.ijporl.2014.07.037] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 07/17/2014] [Accepted: 07/31/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Diagnostic and therapeutic processing of a thyroid nodule in children and adolescents may require lobectomy-isthmusectomy (LI) or nodule-resection (NR). Very few data in the literature report the long-term evolution of the remaining thyroid lobe in a defined pediatric population. In this study, we aimed to answer the following questions: Does a nodule recurrence occur in the remainder lobe? Is a post-operative thyroxine treatment necessary? MATERIAL AND METHODS This retrospective study describes 28 patients under 18 who underwent LI (22 cases) or NR (6 cases) from January 2004 to March 2012. Ten of them were lost to follow up, 18 could be assessed (4 NR (22%) and 14 LI (78%) - mean follow-up 45±31 months). All patients benefited of post-operative thyroid ultrasonography, and regular endocrinologic follow-up. The following data were analysed: emergence of new thyroid nodules, evolution of pre-existing nodules, occurrence of post-operative hypothyroidism and requirement for completion thyroidectomy. RESULTS The mean age at the time of surgery was 14.3±1.9 years. Two patients (11%) had pre-existing nodules in the remaining thyroid gland, none of which showed an increase in size after surgery. De novo nodules developed in five patients (27.8%). Three patients who underwent LI (21.4%) needed thyroxine treatment for post-operative hypothyroidism. One patient (5.5%) needed completion thyroidectomy. CONCLUSIONS In this children and adolescents population, after performing LI or NR, remaining thyroid tissue stays free of nodules in 72.2% of the cases. A post-operative thyroxin treatment is necessary in 21.4% of cases after LI.
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Affiliation(s)
- M Akkari
- Service d'ORL et Chirurgie Cervico Faciale, CHU de Montpellier, Université Montpellier 1, Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France.
| | - D Schmitt
- Service d'ORL et Chirurgie Cervico Faciale, CHU de Montpellier, Université Montpellier 1, Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France
| | - C Jeandel
- Service d'Endocrinologie Pédiatrique, CHU de Montpellier, Université Montpellier 1, Hôpital Arnaud de Villeneuve, 371 avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
| | - I Raingeard
- Service des maladies endocriniennes, CHU de Montpellier, Université Montpellier 1, Hôpital Lapeyronie, 371 avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
| | - C Blanchet
- Service d'ORL et Chirurgie Cervico Faciale, CHU de Montpellier, Université Montpellier 1, Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France
| | - C Cartier
- Service d'ORL et Chirurgie Cervico Faciale, CHU de Montpellier, Université Montpellier 1, Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France
| | - R Garrel
- Service d'ORL et Chirurgie Cervico Faciale, CHU de Montpellier, Université Montpellier 1, Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France
| | - B Guerrier
- Service d'ORL et Chirurgie Cervico Faciale, CHU de Montpellier, Université Montpellier 1, Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France
| | - M Makeieff
- Service d'ORL et Chirurgie Cervico Faciale, CHU de Montpellier, Université Montpellier 1, Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France
| | - M Mondain
- Service d'ORL et Chirurgie Cervico Faciale, CHU de Montpellier, Université Montpellier 1, Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France
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Chays A, Bazin A, Seidermann L, Makeieff M, Rousseaux P. Meniere Disease: Vestibular Neurotomy, Why, How, What Results? Skull Base Surg 2014. [DOI: 10.1055/s-0034-1383922] [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: 10/20/2022]
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André C, Bazin A, Makeieff M, Keiber J, Rousseaux P. Trigeminal Neuralgia: Surgical Decompression and Results about 70 Patients. Skull Base Surg 2014. [DOI: 10.1055/s-0034-1383923] [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: 10/20/2022]
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Chays A, Bazin A, Makeieff M, Littre F, Kleiber J, Rousseaux P. Endoscopy and Microscopy in the PCA: Two Complementary Procedures during Surgery of Hemifacial Spasm or Trigeminal Neuralgia. Skull Base Surg 2014. [DOI: 10.1055/s-0034-1383924] [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: 10/20/2022]
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Arnaud B, Chays A, Littre C, Makeieff M, Kleiber J, Rousseaux P. Management of Internal Auditory Canal for Acoustic Neuromas Surgery by Retro Sigmoid Approach. Skull Base Surg 2014. [DOI: 10.1055/s-0034-1383966] [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: 10/20/2022]
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Pelliccia P, Pero MMD, Mercier G, Iannetti G, Makeieff M. Transoral Endoscopic Resection of Low-Grade, Cricoid Chondrosarcoma. Ann Surg Oncol 2014; 21:2767-72. [DOI: 10.1245/s10434-014-3668-8] [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] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Indexed: 11/18/2022]
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Chays A, Labrousse M, Makeieff M. [Results and lessons after 10 years of universal neonatal hearing screening in the Champagne-Ardenne region of France]. Bull Acad Natl Med 2014; 198:781-799. [PMID: 26753409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In France, universal newborn hearing screening has been mandatory since April23rd, 2012, but it began in the Champagne-Ardenne region on January 15th 2004. More than 99 % of 160 196 newborns have since been systematically screened in this region. Bilateral hearing impairment was thus identified in 116 infants when they were around 3.5 months old. Earlier diagnosis improves the outcome of deafness, which is only diagnosed around age 20 months without screening. The authors report their experience and the lessons learnt.
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Jardel P, Fakhry N, Makeieff M, Ferrie JC, Milin S, Righini C, Lacout A, Costes V, Malard O, Marcy PY, Guevara N, Odin G, Bensadoun RJ, Thariat J. [Radiation therapy for pleomorphic adenoma of the parotid]. Cancer Radiother 2014; 18:68-76. [PMID: 24387927 DOI: 10.1016/j.canrad.2013.09.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [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: 04/09/2013] [Revised: 08/21/2013] [Accepted: 09/04/2013] [Indexed: 10/25/2022]
Abstract
Parotid pleomorphic adenoma is the most frequent tumor of salivary glands. The prognosis depends on the recurrences because they could lead to iatrogenic events (facial paralysis). Moreover the risk of malignant transformation increases with the number of local relapses. This article aims at reviewing histological and radiological criteria and the surgical techniques. To improve local control, adjuvant irradiation (in first intention or after recurrence) may be useful but is still controversial for benign tumors in young patients with a risk of radio-induced cancer. We listed studies in which adjuvant radiotherapy was used so as to define its place in the treatment strategy. Prognostic factors were found by some authors. Other studies have to be done before strong evidence-based recommendations are issued.
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Affiliation(s)
- P Jardel
- Service d'oncologie radiothérapie, PRC, CHU de Poitiers, 2, rue de la Milétrie, BP577, 86021 Poitiers, France
| | - N Fakhry
- Service d'ORL et chirurgie cervicofaciale, hôpital de La Timone Adultes, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - M Makeieff
- Département d'ORL et chirurgie cervicofaciale, hôpital Gui-de-Chauliac, CHRU de Montpellier, 34295 Montpellier cedex 5, France
| | - J-C Ferrie
- Service d'imagerie médicale, CHU de Poitiers, 2, rue de la Milétrie, BP577, 86021 Poitiers, France
| | - S Milin
- Service de cytologie et d'anatomie pathologiques, CHU de Poitiers, 2, rue de la Milétrie, BP577, 86021 Poitiers, France
| | - C Righini
- Clinique universitaire d'ORL, pôle tête et cou et chirurgie réparatrice, CHU de Grenoble, boulevard de la Chantourne, 38700 La Tronche, France
| | - A Lacout
- Service d'imagerie, clinique du Pont-Rouge, 15000 Aurillac, France
| | - V Costes
- Service d'anatomie et cytologie pathologiques, hôpital Gui-de-Chauliac, CHRU de Montpellier, 34295 Montpellier cedex 5, France
| | - O Malard
- Service d'ORL et chirurgie cervicofaciale, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France
| | - P-Y Marcy
- Service d'imagerie, centre François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France
| | - N Guevara
- Service d'ORL et chirurgie cervicofaciale, institut universitaire de la face et du cou, 33, avenue Valombrose, 06189 Nice, France
| | - G Odin
- Service d'oncologie radiothérapie, centre Antoine-Lacassagne, 33, avenue Valombrose, 06189 Nice, France; Institut universitaire de la face et du cou, 33, avenue Valombrose, 06189 Nice, France; Université Nice-Sophia-Antipolis, 33, avenue Valombrose, 06189 Nice, France
| | - R-J Bensadoun
- Service d'oncologie radiothérapie, PRC, CHU de Poitiers, 2, rue de la Milétrie, BP577, 86021 Poitiers, France
| | - J Thariat
- Service d'oncologie radiothérapie, centre Antoine-Lacassagne, 33, avenue Valombrose, 06189 Nice, France; Institut universitaire de la face et du cou, 33, avenue Valombrose, 06189 Nice, France; Université Nice-Sophia-Antipolis, 33, avenue Valombrose, 06189 Nice, France.
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Jardel P, Fakhry N, Makeieff M, Ferrie JC, Milin S, Righini C, Lacout A, Costes V, Malard O, Marcy PY, Guevara N, Odin G, Bensadoun RJ, Thariat J. Adénomes pléomorphes parotidiens récidivants : place de la radiothérapie. Cancer Radiother 2014. [DOI: 10.1016/j.canrad.2013.11.008] [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: 10/25/2022]
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Thariat J, Vedrine PO, Temam S, Ali AM, Orbach D, Odin G, Makeieff M, Nicollas R, Penicaud M, Toussaint B, Vergez S, Laprie A, Rives M, Montagne K, Teissier N, Castillo L. The role of radiation therapy in pediatric mucoepidermoid carcinomas of the salivary glands. J Pediatr 2013; 162:839-43. [PMID: 23140879 DOI: 10.1016/j.jpeds.2012.09.045] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [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: 12/14/2011] [Revised: 08/23/2012] [Accepted: 09/25/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the role of radiation therapy in rare salivary gland pediatric mucoepidermoid carcinoma (MEC). STUDY DESIGN A French multicenter retrospective study (level of evidence 4) of children/adolescents treated for MEC between 1980 and 2010 was conducted. RESULTS Median age of the 38 patients was 14 years. Parotid subsite, low-grade, and early primary stage tumors were encountered in 81%, 82%, and 68% of cases, respectively. All except 1 patient were treated by tumoral surgical excision, and 53% by neck dissection (80% of high grades). Postoperative radiation therapy and chemotherapy were performed in 29% and 11% of cases. With a median 62-month follow-up, overall survival and local control rates were 95% and 84%, respectively. There was 1 nodal relapse. Lower grade and early stage tumors had better survival. Postoperative radiation therapy and chemotherapy were associated with similar local rates. Patients with or without prior cancer had similar outcomes. CONCLUSIONS Pediatric salivary gland MEC carries a good prognosis. Low-intermediate grade, early-stage tumors should be treated with surgery alone. Neck dissection should be performed in high-grade tumors. Radiation therapy should be proposed for high grade and/or advanced primary stage MEC. For high-grade tumors without massive neck involvement, irradiation volumes may be limited to the primary area, given the risk of long-term side effects of radiation therapy in children. Pediatric MEC as second cancers retain a similar prognosis. Long-term follow-up is needed to assess late side effects and second cancers.
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Affiliation(s)
- Juliette Thariat
- Department of Radiation Oncology, Cancer Center Antoine-Lacassagne, Institut Universitaire de la Face et du Cou, University Nice Sophia-Antipolis, Nice, France.
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Makeieff M, Burcia V, Raingeard I, Eberlé M, Cartier C, Garrel R, Crampette L, Guerrier B. Positron emission tomography–computed tomography evaluation for recurrent differentiated thyroid carcinoma. Eur Ann Otorhinolaryngol Head Neck Dis 2012; 129:251-6. [DOI: 10.1016/j.anorl.2012.01.003] [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] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Revised: 01/10/2012] [Accepted: 01/12/2012] [Indexed: 11/16/2022]
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Makeieff M, Thariat J, Reyt E, Righini CA. Treatment of cervical paragangliomas. Eur Ann Otorhinolaryngol Head Neck Dis 2012; 129:308-14. [PMID: 23021979 DOI: 10.1016/j.anorl.2012.03.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 03/12/2012] [Accepted: 03/21/2012] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Review of the treatment of cervical paraganglioma. MATERIAL AND METHODS Review of the literature based on a Medline database. RESULTS The treatment of choice consists of a multidisciplinary approach based on a detailed clinical, laboratory and radiological work-up. Vascular reconstruction may be necessary when the tumour invades the artery wall. The main complication of surgery is damage to cranial nerves involved in speech and/or swallowing. Treatment of bilateral tumours must be conducted in two stages. The first side to be operated depends on the sites and size of the tumours, as the primary objective is to avoid bilateral vagus nerve palsy. Radiotherapy has been used to treat paragangliomas for several years and achieves tumour stabilization in the majority of cases. Potential indications reported in the literature are: inoperable tumours, recurrence after surgery, some bilateral tumours and malignant tumours. CONCLUSION Surgery is the standard treatment for cervical paraganglioma. Radiotherapy can be proposed when surgery is contraindicated.
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Affiliation(s)
- M Makeieff
- Service d'ORL et de chirurgie cervico-faciale, pôle neuroscience tête et cou, hôpital Gui de Chauliac, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex, France.
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Guerrier B, Berthet JP, Cartier C, Dehesdin D, Edet-Sanson A, Le Clech G, Garrel R, Kania R, Makeieff M, Page C, Poirée S, Potard G, Prades JM, Righini C, Roussel F, Toubert ME. French ENT Society (SFORL) practice guidelines for lymph-node management in adult differentiated thyroid carcinoma. Eur Ann Otorhinolaryngol Head Neck Dis 2012; 129:197-206. [PMID: 22883640 DOI: 10.1016/j.anorl.2012.07.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- B Guerrier
- ENT & Head Neck Surgery Department, University Hospital Center of Montpellier, 191 avenue du Doyen-Gaston-Giraud, Montpellier cedex, France
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Garrel R, Tripodi C, Cartier C, Makeieff M, Crampette L, Guerrier B. Cervical lymphadenopathies signaling thyroid microcarcinoma. Case study and review of the literature. Eur Ann Otorhinolaryngol Head Neck Dis 2011; 128:115-9. [PMID: 21333620 DOI: 10.1016/j.anorl.2010.11.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2010] [Accepted: 11/29/2010] [Indexed: 11/29/2022]
Abstract
BACKGROUND Some lateral cervical lymphadenopathies may lead to the discovery of papillary microcarcinomas (PMC) of the thyroid that are not radiologically apparent. This relatively rare clinical situation raises questions about the diagnostic approach to chronic cervical lymphadenopathy and the impact of lymph node metastasis on PMC prognosis. PURPOSE OF THE ARTICLE: To study the epidemiologic, clinical, and prognostic criteria of cases of lymphadenopathy that signaled PMC. PATIENTS AND METHODS A retrospective study of 167 consecutive cases of PMC compared with 13 cases where a cervical mass signaled other forms of PMC. RESULTS The mean age was 48.5 years, the ratio of men to women was 5:8, and the mean PMC size was 5.5mm. These data did not differently significantly from those of the other PMC cases. The preoperative imaging found fluid content in six cases, with microcalcifications in three cases. All cases were treated by modified radical neck dissection on the side with the lymphadenopathy and total thyroidectomy with central neck dissection. The lymphadenopathy included a ruptured capsule in five cases and was accompanied by central lymph node metastases in three cases. Thyroid capsule involvement was significantly more common in cases of PMC discovered due to lymphadenopathy than in other cases of PMC (69% versus 9.7%, respectively; p<0.001). The mean follow-up was 7.3 years. There were no deaths due to PMC signaled by lymphadenopathy. Two cases of lymph node recurrence after 8 and 10 years were controlled by another surgery and radioactive iodine treatment. CONCLUSION Any chronic cervical mass should suggest the possibility of thyroid origin, especially in cases with cystic content or microcalcifications in subjects with no particular risk factors. An ultrasound of the thyroid should be done, as well as a fine needle aspiration biopsy of the lymphadenopathy with a thyroglobulin assay. Treatment is the same as for any thyroid carcinoma, and results in a good oncological outcome, despite the possibility of lymph node recurrences.
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Affiliation(s)
- R Garrel
- Pôle Neuroscience Tête et Cou, Département ORL et Chirurgie Cervico Faciale, CHRU Gui-de-Chauliac, 34280 Montpellier, France.
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Benlyazid A, Thariat J, Temam S, Malard O, Florescu C, Choussy O, Makeieff M, Poissonnet G, Penel N, Righini C, Toussaint B, Lacau St Guily J, Vergez S, Filleron T. Postoperative Radiotherapy in Head and Neck Mucosal Melanoma. ACTA ACUST UNITED AC 2010; 136:1219-25. [DOI: 10.1001/archoto.2010.217] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Makeieff M, Pelliccia P, Letois F, Mercier G, Arnaud S, César C, Garrel R, Crampette L, Guerrier B. Recurrent Pleomorphic Adenoma: Results of Surgical Treatment. Ann Surg Oncol 2010; 17:3308-13. [DOI: 10.1245/s10434-010-1173-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Indexed: 11/18/2022]
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Jouzdani E, Yachouh J, Costes V, Faillie JL, Cartier C, Poizat F, Pierre G, Burcia V, Makeieff M, Crampette L, Guerrier B, Garrel R. Prognostic value of a three-grade classification in primary epithelial parotid carcinoma: result of a histological review from a 20-year experience of total parotidectomy with neck dissection in a single institution. Eur J Cancer 2010; 46:323-31. [PMID: 19931448 DOI: 10.1016/j.ejca.2009.10.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Accepted: 10/09/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND The tumour grading of primary parotid cancers (PPCs) remains controversial. METHODS A 20-year standardised single centre treatment has been assessed retrospectively. The histological review of 155 consecutively treated parotid malignancies identified 96 suitable cases for univariate and multivariate survival analyses. RESULTS Treatment involved total parotidectomy, neck dissection and post-operative radiotherapy in, respectively, 91.7%, 83.3% and 70.4% of cases. The 5-year overall survival, disease-specific and recurrence-free survival rates were 79.4%, 83.5% and 70.8%, respectively. Univariate analysis confirmed the classical prognostic factors, i.e. age>60 years, male gender, facial palsy, hardness of the tumour, clinical stage, tumour grade, facial nerve invasion and lymph node metastases. Multivariate analysis identified a three-grade classification just after the clinical stage as the most important prognostic factor. CONCLUSION This study identifies the prognostic significance of intermediate grade tumours.
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Affiliation(s)
- Elham Jouzdani
- Head and Neck Surgery Department, Gui de Chauliac Hospital, Montpellier University Hospital Center, France
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Choussy O, Ferron C, Védrine PO, Toussaint B, Liétin B, Marandas P, Babin E, De Raucourt D, Reyt E, Cosmidis A, Makeieff M, Dehesdin D. Role of Radiotherapy in the Treatment of Nasoethmoidal Adenocarcinoma. ACTA ACUST UNITED AC 2010; 136:143-6. [DOI: 10.1001/archoto.2009.212] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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41
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Mallet Y, Avalos N, Le Ridant AM, Gangloff P, Moriniere S, Rame JP, Poissonnet G, Makeieff M, Cosmidis A, Babin E, Barry B, Fournier C. Head and neck cancer in young people: a series of 52 SCCs of the oral tongue in patients aged 35 years or less. Acta Otolaryngol 2009; 129:1503-8. [PMID: 19922105 DOI: 10.3109/00016480902798343] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Prognosis was very poor as soon as a local failure developed. Up-front treatment should be optimized to control this rare disease. We propose producing and reporting recommendations via a concerted oncologic physician referral network. OBJECTIVES Squamous cell carcinoma (SCC) in young people is rare and the literature is confusing. This study was carried out to assess the demographics, clinical features, and treatment outcome in a cohort of patients aged 35 years or less with SCC of the oral tongue (SCCOT). PATIENTS AND METHODS This was a multicenter retrospective study. Fifty-two patients treated between 1990 and 2000 were identified. Descriptive statistics were analyzed to assess demographic and tumor variables. RESULTS The WHO performance status was excellent for all patients. Thirty-seven were classified as T1-T2 and 38 were N0. All of them except one were treated with curative intent. Treatment failures were observed in 25 patients (48%). Four patients could be successfully salvaged after SCCOT recurrence or progression. The disease-free survival (DFS) was 52% at 5 years. The 5-year overall survival (OS) rate was 64%. Factors that affected the OS were invasion of the floor (p=0.009), cross over of the midline (p=0.02), positive lymph nodes (p=0.02), and the lack of disease control (p=0.0001).
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Mallet Y, Avalos N, Ridant AML, Gangloff P, Moriniere S, Rame JP, Poissonnet G, Makeieff M, Cosmidis A, Babin E, Barry B, Fournier C. Head and neck cancer in young people: a series of 52 SCCs of the oral tongue in patients aged 35 years or less. Acta Otolaryngol 2009. [DOI: 10.1080/00016480902798343] [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: 10/21/2022]
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Cartier C, Jouzdani E, Garrel R, Makeieff M, Crampette L, Guerrier B. [Study of the platysma coli muscle vascularisation by the facial artery. Implication during the elevation of the musculo-cutaneous platysma coli muscle flap]. Rev Laryngol Otol Rhinol (Bord) 2009; 130:139-144. [PMID: 20345068] [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: 05/29/2023]
Abstract
AIM OF THE STUDY The purpose of this study was to assess the vascularity of the platysma muscle by the branches of the facial artery, in order to determine the best means of harvesting a musculo-cutaneous flap while ensuring maximum vascular security. PATIENTS AND METHODS Ten platysma muscles were dissected on 4 fresh specimens and one formaldehyde-preserved specimen. The dissection was performed after injection of the facial artery in 6 cases, while 4 muscles were dissected without any previous injection. RESULTS The vascular supply of the platysma muscle comes essentially from the branches of the submental artery and from branches descending straight from the facial artery. Other collateral branches contribute to this vascularization, but their importance is minor. All these arteries reach the muscle, entering its visceral aspect, then proceed to the sternal notch in a radial axis. CONCLUSION The size of the flap has to be defined within a quadrilateral figure with its base formed by the mandibular edge and its apex by the inferior limit of the flap. It is essential to preserve the maximum possible muscular thickness, especially on the medial side of the flap. If the facial artery needs to be ligated, this has to be done as it enters the submandibular space in order to protect most of the collateral branches destined to the muscle. The vascularization is then taken back by the homo- and contro-lateral facial vascularisation in an inverted flow in the remaining segment of the facial artery.
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Affiliation(s)
- C Cartier
- Hôpital Gui de Chauliac, Service O.R.L et Chirurgie Cervico-Faciale, Av Augustin Fliche, 34090 Montpellier, France.
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Makeieff M, Raingeard I, Alric P, Bonafe A, Guerrier B, Marty-Ane C. Surgical management of carotid body tumors. Ann Surg Oncol 2008; 15:2180-6. [PMID: 18512105 DOI: 10.1245/s10434-008-9977-z] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2007] [Revised: 04/21/2008] [Accepted: 04/21/2008] [Indexed: 11/18/2022]
Abstract
BACKGROUND Carotid body tumors (CBT) should be considered when evaluating every lateral neck mass. METHODS A retrospective study was conducted of 52 patients with 57 CBT. The surgical approach and complications were reviewed. All patients were operated on without preoperative embolization. RESULTS Multifocal paraganglioma (PG) were detected in six cases. A succinate dehydrogenase subunit D (SDHD) mutation was discovered in four patients. Vascular peroperative complication occurred in one case. Vascular reconstruction was decided peroperatively in five cases (8.8%). Vascular reconstruction was 0% for Shamblin 1 or 2 tumors, but 28.5% for Shamblin 3. A postoperative nerve paresis was reported in 24 patients (42.1%) and vagal nerve paralysis persisted in four cases (7.01%). The rate of serious complications, e.g., permanent nerve palsy, preoperative and postoperative complications, was 14.03%; it was 2.3% for Shamblin 1 or 2 tumors and 35.7% for Shamblin 3. One patient had malignant PG with node metastasis and was not referred for radiotherapy. No recurrence or metastasis was reported after 6-year follow-up. CONCLUSION Early surgical treatment is recommended in almost all patients after preoperative evaluation and detection of multifocal tumors. Surgical excision of small tumors was safe and without complication, but resection of Shamblin 3 tumors can be challenging. Routine preoperative embolization of carotid body paragangliomas is not required.
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Affiliation(s)
- M Makeieff
- Head and Neck Surgery Department, Hôpital Gui de Chauliac, CHU Montpellier, Montpellier, France.
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Barry B, Chevalier D, Lacau St-Guily J, Makeieff M, Reyt E. [Zenker diverticulum]. Ann Otolaryngol Chir Cervicofac 2008; 125:98-104. [PMID: 18436187 DOI: 10.1016/j.aorl.2007.04.008] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2007] [Accepted: 04/17/2007] [Indexed: 05/26/2023]
Affiliation(s)
- B Barry
- Service ORL et CCF, hôpital Bichat-Claude-Bernard, 75877 Paris cedex 18, France
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Serre A, Idri K, Fenoglietto P, Ailleres N, Santoro L, Lemanski C, Garrel R, Makeieff M, Allaw A, Dubois JB, Azria D. Dosimetric comparison between coplanar and non coplanar field radiotherapy for ethmoid sinus cancer. Radiat Oncol 2007; 2:35. [PMID: 17877793 PMCID: PMC2072954 DOI: 10.1186/1748-717x-2-35] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2007] [Accepted: 09/18/2007] [Indexed: 12/25/2022] Open
Abstract
Background To compare non coplanar field (NCF) with coplanar field (CF) -intensity-modulated radiotherapy (IMRT) planning for ethmoid cancer. Methods Seven patients treated with NCF IMRT for ethmoid cancer were studied. A CF IMRT optimization was prepared with the same constraints as for the NCF treatment. The maximum point doses (D max) obtained for the different optic pathway structures (OPS) should differ no more than 3% from those achieved with the NCF IMRT plan. The distribution of the dose in the target volume and in the critical structures was compared between the two techniques, as well as the Conformity (CI) and the Homogeneity Indexes (HI) in the target volume. Results We noted no difference between the two techniques in the OPS for the D1, D2, and D5%, in the inner ear and controlateral lens for the average Dmax, in the temporo-mandibular joints for the average mean dose, in the cord and brainstem for the average D1%. The dose-volume histograms were slightly better with the NCF treatment plan for the planning target volume (PTV) with a marginally better HI but no impact on CI. We found a great improvement in the PTV coverage with the CF treatment plan for two patients with T4 tumors. Conclusion IMRT is one of the treatment options for ethmoid cancer. The PTV coverage is optimal without compromising the protection of the OPS. The impact of non coplanar versus coplanar set up is very slight.
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Affiliation(s)
- Antoine Serre
- Department of Radiation Oncology, Val d'Aurelle Cancer Institute, Montpellier, France
| | - Katia Idri
- Radiophysics Unit, Val d'Aurelle Cancer Institute, Montpellier, France
| | | | - Norbert Ailleres
- Radiophysics Unit, Val d'Aurelle Cancer Institute, Montpellier, France
| | - Lore Santoro
- Radiophysics Unit, Val d'Aurelle Cancer Institute, Montpellier, France
| | - Claire Lemanski
- Department of Radiation Oncology, Val d'Aurelle Cancer Institute, Montpellier, France
| | - Renaud Garrel
- Department of Head and Neck Surgery, University Hospital Gui De Chauliac, Montpellier, France
| | - Marc Makeieff
- Department of Head and Neck Surgery, University Hospital Gui De Chauliac, Montpellier, France
| | - Ali Allaw
- Department of Radiation Oncology, Val d'Aurelle Cancer Institute, Montpellier, France
| | - Jean-Bernard Dubois
- Department of Radiation Oncology, Val d'Aurelle Cancer Institute, Montpellier, France
| | - David Azria
- Department of Radiation Oncology, Val d'Aurelle Cancer Institute, Montpellier, France
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Abstract
BACKGROUND Supracricoid partial laryngectomy (SCPL) results in laryngeal preservation in more than 95% of patients with T2 glottic carcinoma. Postsurgical glottic function is characterized by an absence of vocal cords, and phonation quality is a key post-SCPL quality-of-life factor. OBJECTIVE This investigation was designed to enhance post-SCPL vocal function, study anatomic function of the post-SCPL larynx, and correlate anatomic findings with perceptual and instrumented measurements of voice. METHOD Twenty-five patients were included. All had undergone SCPL with cricoepiglottopexy for T2 glottic carcinoma. All patients were evaluated by laryngostroboscopic examination, voice sample recording, and instrumented voice analysis with the aim of gaining further insight into postoperative larynx function. Laryngostroboscopic parameters such as laryngeal occlusion, epiglottic length, arytenoid movement, and vibratory area were assessed. The perceptual evaluation was based on the GRBAS scale. Acoustic and aerodynamic parameters were recorded, including fundamental frequency (F0), intensity, jitter, shimmer, signal-to-noise ratio (SNR), oral airflow (OAF), maximum phonation time (MPT), and estimated subglottic pressure (ESGP). Nonparametric tests were used to compare laryngostroboscopic parameters with instrumented measurements and perceptual evaluations of voice quality. RESULTS Correlations were established among occlusion, epiglottic length, and general grade of dysphonia. Oral air flow (P = 0.006) was found to be correlated with occlusion. Voice roughness was correlated with the presence of a clearly identifiable vibratory area (P = 0.003), whereas these vibratory areas were correlated with shimmer (P = 0.041), OAF (P = 0.001), and SNR (P = 0.001). The number of preserved arytenoids was not identified as a voice quality factor (P = 0.423). CONCLUSION This study highlighted correlations between the laryngostroboscopic examination results and the perceptive and instrumented measurements of voice. Glottis occlusion and epiglottis length were found to be key factors for postoperative voice quality. These results should help to advance technical development on surgical techniques to enhance voice results.
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Affiliation(s)
- Marc Makeieff
- Service ORL Chirurgie Cervico-Faciale, Hôpital Gui de Chauliac, Université de Médecine, Montpellier, France.
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Garrel R, Costes V, Drommard M, Barbotte E, Cartier C, Makeieff M, Crampette L, Guerrier B, Maudelonde T, Boulle N. Evaluation of the diagnostic accuracy of RT-PCR quantification of cytokeratin mrna in the detection of sentinel lymph node invasion in oral and oropharyngeal squamous cell carcinoma: A comparison with immunohistochemistry. Radiother Oncol 2007. [DOI: 10.1016/s0167-8140(07)80074-0] [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: 11/26/2022]
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Garrel R, Dromard M, Costes V, Barbotte E, Comte F, Gardiner Q, Cartier C, Makeieff M, Crampette L, Guerrier B, Boulle N. The Diagnostic Accuracy of Reverse Transcription-PCR Quantification of Cytokeratin mRNA in the Detection of Sentinel Lymph Node Invasion in Oral and Oropharyngeal Squamous Cell Carcinoma: A Comparison with Immunohistochemistry. Clin Cancer Res 2006; 12:2498-505. [PMID: 16638858 DOI: 10.1158/1078-0432.ccr-05-2136] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The main goal of sentinel lymph node (SLN) detection in head and neck squamous cell carcinomas is to limit neck dissections to pN+ cases only. However, intraoperative + diagnosis cannot be routinely done using the current gold standard, serial step sectioning with immunohistochemistry. Real-time quantitative reverse transcription-PCR (RT-PCR) is potentially compatible with intraoperative use, proving highly sensitive in detecting molecular markers. This study postoperatively assessed the accuracy of quantitative RT-PCR in staging patients from their SLN. EXPERIMENTAL DESIGN A combined analysis on the same SLN by serial step sectioning with immunohistochemistry and quantitative RT-PCR targeting cytokeratins 5, 14, and 17 was done in 18 consecutive patients with oral or oropharyngeal squamous cell carcinoma and 10 control subjects. RESULTS From 71 lymph nodes examined, mRNA levels (KRT) were linked to metastasis size for the three cytokeratins studied (Pearson correlation coefficient, r = 0.89, 0.73, and 0.77 for KRT 5, 14, and 17 respectively; P < 0.05). Histopathology-positive SLNs (macro- and micrometastases) showed higher mRNA values than negative SLNs for KRT 17 (P < 10(-4)) and KRT 14 (P < 10(-2)). KRT 5 showed nonsignificant results. KRT 17 seemed to be the most accurate marker for the diagnosis of micrometastases of a size >450 mum. Smaller micrometastases and isolated tumor cells did not provide results above the background level. Receiver operating characteristic curve analysis for KRT 17 identified a cutoff value where patient staging reached 100% specificity and sensitivity for macro- and micrometastases. CONCLUSION Quantitative RT-PCR for SLN staging in cN(0) patients with oral and oropharyngeal squamous cell carcinoma seems to be a promising approach.
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Affiliation(s)
- Renaud Garrel
- Departments of Head and Neck Surgery, Montpellier Teaching Hospital, Montpellier, France.
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Abstract
OBJECTIVES Surgery of recurrent pleomorphic adenoma (RPA) is known to lead to a high facial nerve complication rate. The efficacy of the continuous facial nerve monitoring (CFNM) technique remains to be proven in RPA surgery. The goal was thus to evaluate facial nerve palsy rates and the recovery period after parotidectomy for RPA using CFNM by way of continuous electromyography and to compare these rates and the operation time with those of patients who had undergone surgery without facial nerve monitoring. DESIGN Cohort study. PATIENTS Forty-seven patients were referred for RPA (1981-2003). Among them, 32 (18 unmonitored and 14 monitored) patients displayed no preoperative facial palsy, and histologic analyses revealed evidence of recurrence. The operation time and the extent and duration of postoperative facial nerve palsy were examined in both groups (monitored vs. unmonitored). Both groups had a similar clinical appearance distribution. RESULTS Facial nerve paralysis was estimated using the House-Brackmann grading scale. CFNM reduced the intensity of facial nerve paralysis independently of the kind of surgery performed. The complete deficit rates were 0% for the monitored group and 5.6% for the unmonitored group. Postoperative facial nerve paralysis was significantly lower (P = .01) in the monitored group than in the unmonitored group. CFNM improved the duration of facial paralysis (P = .001) in the monitored group. The operation time was significantly lower in the monitored group than in the unmonitored group (P = .001). CONCLUSIONS Routine use of CFNM during RPA surgery improves the surgical outcome. The facial nerve deficit can be reduced, and the recovery of facial nerve function is faster.
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Affiliation(s)
- Marc Makeieff
- Service ORL Chirurgie Cervico-Faciale, CHU Montpellier, Montpellier, France.
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