Otorhinolaryngology, Head and Neck Diseases

Paradoxes of the French health care system Publication date: June 2019 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 136, Issue 3 Author(s): E. Babin, G. Grandazzi

Ileal migration of a salivary bypass tube in a dysphagic patient with bipolar disorder Publication date: June 2019 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 136, Issue 3 Author(s): S.D. Le Bon, A. Rodriguez Ruiz

Endoscopic lateralization of the vocal fold Publication date: June 2019 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 136, Issue 3 Author(s): C. Fabre, C.A. Righini, P.F. Castellanos, I. Atallah Abstract Vocal fold paralysis in adduction can result in significant breathing difficulties. Techniques such as vocal fold lateralization and/or arytenoidopexy help to improve respiratory function in this setting. These techniques require open approach or specific instruments. The authors describe an original vocal fold lateralization technique performed exclusively via an endoscopic approach. This technique helps to enlarge the glottic aperture, while preserving laryngeal architecture, and permanently improves respiratory function in patients with vocal fold paralysis in adduction.

Persistent stapedial artery in PHACE syndrome Publication date: June 2019 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 136, Issue 3 Author(s): R. Quatre, P. Manipoud, S. Schmerber Abstract Introduction PHACE syndrome is characterized by posterior fossa malformations, haemangioma, arterial anomalies, coarctation of the aorta, and eye abnormalities. Case report We present the case of a 6-year-old girl followed since birth for PHACE syndrome and left hemifacial haemangioma, who presented with left hearing loss. Computed tomography scan showed left persistent stapedial artery (PSA). Discussion Two types of arterial anomalies may be observed in PHACE syndrome: persistence of embryonic arteries and anomalies of cerebral arteries. PSA can be observed in the context of PHACE syndrome. Children with PHACE syndrome require regular audiometric follow-up to detect hearing loss and avoid its consequences on speech and language development.

Schwannoma of the external auditory canal: An exceptional site Publication date: June 2019 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 136, Issue 3 Author(s): A. Sbai, A. Lachkar, F. Elayoubi, R. Ghailan Abstract Introduction Schwannomas are benign solitary neural tumours that are only exceptional located in the external auditory canal, as only a few cases have been reported in the literature. Case report We report a case of schwannoma of the external auditory canal in an 18-year-old man admitted for an isolated mass of the initial segment of the right external auditory canal visible to the naked eye, obstructing all of the external auditory meatus. Computed tomography of the temporal bone showed an isolated mass of the external auditory canal. Management of this patient consisted of biopsy-excision of the mass, histological examination of which confirmed a schwannoma of the external auditory canal. Discussion Although rare, the possibility of a nerve tumour of the external auditory canal should always be considered. These tumours may be isolated or may occur in the context of von Recklinghausen's disease. The clinical presentation in the external auditory canal may correspond to recurrent otitis externa secondary to obstruction of the canal by the tumour, as in the case reported here. The definitive diagnosis must be based on the results of histological and immunohistochemical examination.

Desmoid tumours of the head and neck: A case report Publication date: June 2019 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 136, Issue 3 Author(s): R. Bouatay, R. Jabnoun, N. Kolsi, J. Koubaa Abstract Introduction Desmoid tumours of the head and neck, also known as fibromatosis, are rare, locally invasive benign tumours with high recurrence rate, causing considerable morbidity. Complete surgical excision of desmoid tumours is considered to be the only effective treatment. Case report We present a case of fibromatosis of the right posterolateral region of the neck in a 56-year-old woman who presented with right neck mass. The patient underwent complete excision of the tumour with no adjuvant therapy. No recurrence or neurological deficit was observed 2 years after surgery. Conclusion Although desmoid tumour is a benign neoplasm with no metastatic potential, treatment is challenging due to its aggressive, infiltrative behaviour with a tendency to recur.

Laryngeal lesion associated with epidermolysis bullosa secondary to congenital plectin deficiency Publication date: June 2019 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 136, Issue 3 Author(s): T. Bourhis, S. Buche, S. Fraitag, P. Fayoux Abstract Introduction Epidermolysis bullosa (EB) is a congenital disease characterized by fragility of epithelial structures. The skin is the organ primarily affected, resulting in the formation of skin blisters. Some forms of EB may also present mucosal lesions. Case report We report the case of a girl with epidermolysis bullosa simplex (EBS) associated with muscular dystrophy secondary to congenital plectin deficiency. She presented severe respiratory tract lesions extending from the oral cavity to the larynx. In particular, we describe our medical and surgical management of the laryngeal lesions, responsible for several episodes of respiratory distress and feeding difficulties. Discussion Epidermolysis bullosa simplex associated with muscular dystrophy is a rare hereditary form of EB, as fewer than 50 cases have been reported in the literature. This form is characterized by mucosal lesions involving the upper aerodigestive tract, with consequences for feeding, phonation and breathing. Special care must be taken when performing diagnostic and therapeutic procedures to avoid worsening the lesions of this very fragile mucosa. Tracheotomy is a harmful procedure in these patients and should only be considered as a last resort.

Hypereosinophilic syndrome presenting with bilateral ear fullness Publication date: June 2019 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 136, Issue 3 Author(s): H.J. Jung, G.H. Yu, J.H. Park Abstract Introduction Hypereosinophilic syndrome is a rare disease with hypereosinophilia resulting in end-organ dysfunction. Patients present with organ-associated symptoms, and the targets frequently affected are heart, lung, skin, or the nervous system, and the middle ear involvement is rare. Case report A 30-year-old female with left ear fullness and hearing loss, which persisted for 6 months, was finally diagnosed with hypereosinophilic syndrome (HES). After high dose systemic steroids treatment, all symptoms improved. Conclusion Eosinophilic otitis media and HES involving the middle ear share many clinical manifestations. Prompt and accurate differential diagnosis is required for these diseases to ameliorate symptoms and promote recovery.

French Society of ENT (SFORL) guidelines. Indications for cochlear implantation in adults Publication date: June 2019 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 136, Issue 3 Author(s): R. Hermann, E. Lescanne, N. Loundon, P. Barone, J. Belmin, C. Blanchet, S. Borel, A. Charpiot, A. Coez, O. Deguine, A. Farinetti, B. Godey, D. Lazard, M. Marx, I. Mosnier, Y. Nguyen, N. Teissier, M.B. Virole, S. Roman, E. Truy Abstract The authors present the guidelines of the French Society of ENT and Head and Neck Surgery (SFORL) regarding indications for cochlear implantation in adults. After a literature review by a multidisciplinary workgroup, guidelines were drawn up based on retrieved articles and group-members' experience, then read over by an independent reading group to edit the final version. Guidelines were graded A, B, C or "expert opinion" according to decreasing level of evidence. There is no upper age limit to cochlear implantation in the absence of proven dementia and if autonomy is at least partial. Bilateral implantation may be proposed if unilateral implantation fails to provide sufficiently good spatial localization, speech perception in noise and quality of life, and should be preceded by binaural hearing assessment. Rehabilitation by acoustic and electrical stimulation may be proposed when low-frequency hearing persists. Quality of life should be assessed before and after implantation.

Head and neck carcinoma of unknown primary Publication date: June 2019 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 136, Issue 3 Author(s): T. Kennel, R. Garrel, V. Costes, P. Boisselier, L. Crampette, V. Favier Abstract In adult cervicofacial pathology, carcinoma of unknown primary is defined as lymph-node metastasis the anatomic origin of which is not known at the time of initial management. It constitutes up to 5% of head and neck cancers. Presentation may suggest benign pathology, delaying and confusing oncologic treatment. Diagnostic strategy in cervical lymph node with suspicion of neoplasia requires exhaustive work-up to diagnose malignancy and, in 45% to 80% of cases, depending on the series, to identify the primary site. Histologic types comprise squamous cell carcinoma, thyroid carcinoma, adenocarcinoma, neuroendocrine carcinoma and undifferentiated carcinoma. Association is sometimes found with human papilloma virus or Epstein Barr virus, guiding treatment. The objective of the present study was to provide clinicians with the necessary diagnostic tools, based on the current state of clinical, imaging and pathologic knowledge, and to detail treatment options.