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Gargula S, Daval M, Tuset MP, Darrouzet V, Ayache D. Burnout in ENT France: Update and risk factors; a STROBE analysis. Eur Ann Otorhinolaryngol Head Neck Dis 2024:S1879-7296(24)00057-7. [PMID: 38705822 DOI: 10.1016/j.anorl.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
BACKGROUND Burnout can significantly impact practitioners and their co-workers, and hence patients. There are no data for the prevalence of burnout in French ENT specialists, or for associated risk factors. MATERIAL AND METHODS A French national cross-sectional online survey was performed on the initiative of the ENT National Professional Council (CNPORL), contacting all ENT specialists whose e-mail address was known to the French Society of ENT, the National Professional Council or the National ENT Union. The 22-question Maslach Burnout Inventory (MBI) was sent out, along with 16 extra questions on possible risk factors. OBJECTIVES The study sought to assess the prevalence and severity of burnout, using the MBI, and to analyze risk factors. RESULTS Among the 1936 physicians, 406 contacted responded to the questionnaire (21%). Mean age was 47±14 years (range, 25-77 years); 53% male, 47% female. 196 (48%) reported burnout, including 20 (5%) severe burnout. Independent risk factors for burnout of whatever severity, comprised social interaction issues, history of identified burnout, and medicolegal pressures. Social interaction issues were independently associated with specifically severe burnout. CONCLUSIONS Burnout affected almost half of respondents. There are identifiable risk factors, for which improvements could be implemented.
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Affiliation(s)
- S Gargula
- Service d'Otorhinolaryngologie, Hôpital La Conception, 147, boulevard Baille, 13004 Marseille, France.
| | - M Daval
- Service d'Otorhinolaryngologie, Hôpital Fondation Adolphe-de-Rothschild, 29, rue Manin, 75019 Paris, France
| | - M-P Tuset
- Service d'Otorhinolaryngologie, Hôpital Fondation Adolphe-de-Rothschild, 29, rue Manin, 75019 Paris, France
| | - V Darrouzet
- Service d'Otorhinolaryngologie, CHU Bordeaux, Université de Bordeaux, 33000 Bordeaux, France; Conseil National Professionnel d'ORL, France
| | - D Ayache
- Service d'Otorhinolaryngologie, Hôpital Fondation Adolphe-de-Rothschild, 29, rue Manin, 75019 Paris, France; Conseil National Professionnel d'ORL, France
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Dahan LS, Giorgi R, Vergez S, Le Taillandier de Gabory L, Costes-Martineau V, Herman P, Poissonnet G, Mauvais O, Malard O, Garrel R, Uro-Coste E, Barry B, Bach C, Chevalier D, Mouawad F, Merol JC, Bastit V, Thariat J, Gilain L, Dufour X, Righini CA, Moya-Plana A, Even C, Radulesco T, Michel J, Baujat B, Fakhry N, Albert S, Andry G, Babin E, Bach C, Badet JM, Badoual C, Baglin A, Banal A, Barry B, Baudin E, Baujat B, Bensadoun R, Bertolus C, Bessède JP, Blanchard D, Borel C, Bozorg-Grayeli A, Breheret R, Breton P, Brugel L, Calais G, Casiraghi O, Cassagnau E, Castillo L, Ceruse P, Chabolle F, Chevalier D, Chobaut J, Choussy O, Cosmidis A, Coste A, Costes V, Crampette L, Darrouzet V, Demez P, Dessi P, Devauchelle B, Dolivet G, Dubrulle F, Duflo S, Dufour X, Faivre S, Fakhry N, Ferron C, Floret F, de Gabory L, Garrel R, Geoffrois L, Gilain L, Giovanni A, Girod A, Guerrier B, Hans S, Herman P, Hofman P, Housset M, Jankowski R, Jegoux F, Juliéron M, Kaminsky MC, Kolb F, St Guily JL, Laccoureye L, Lallemant B, Lang P, Lartigau E, Lavieille JP, Lefevre M, Leroy X, Malard O, Massip F, Mauvais O, Merol JC, Michel J, Mom T, Morinière S, de Monès E, Moulin G, Noel G, Poissonnet G, Prades JM, Radulesco T, de Raucourt D, Reyt E, Righini C, Robin YM, Rolland F, Ruhin B, Sarroul N, Schultz P, Serrano E, Sterkers O, Strunski V, Sudaka A, Tassart M, Testelin S, Thariat J, Timochenko A, Toussaint B, Coste EU, Valette G, Van den Abbeele T, Varoquaux A, Veillon F, Vergez S, Wassef M. Mucoepidermoid carcinoma of salivary glands: A French Network of Rare Head and Neck Tumors (REFCOR) prospective study of 292 cases. Eur J Surg Oncol 2021; 47:1376-1383. [DOI: 10.1016/j.ejso.2020.11.123] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/31/2020] [Accepted: 11/13/2020] [Indexed: 12/18/2022] Open
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Fieux M, Franco-Vidal V, Devic P, Bricaire F, Charpiot A, Darrouzet V, Denoix L, Gatignol P, Guevara N, Montava M, Roch JA, Tankéré F, Tronche S, Veillon F, Vergez S, Vincent C, Lamas G, Tringali S. French Society of ENT (SFORL) guidelines. Management of acute Bell's palsy. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:483-488. [PMID: 32636146 DOI: 10.1016/j.anorl.2020.06.004] [Citation(s) in RCA: 2] [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] [Indexed: 10/23/2022]
Abstract
AQFThe authors present the guidelines of the French Society of ENT and Head and Neck Surgery (SFORL) regarding the management of Bell's palsy 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 group to edit the final version. Guidelines were graded A, B, C or "expert opinion" according to decreasing level of evidence. Thorough ENT and neurological clinical examination is recommended in all patients presenting with peripheral facial palsy to confirm diagnosis of Bell's palsy. MRI with gadolinium enhancement should explore the entire course of the facial nerve, if possible within the first month. ENMG should be performed to assess prognosis for recovery. In confirmed Bell's palsy, corticosteroid therapy should be implemented as early as possible (ideally within 72h) at a dose of 1mg/kg/day for 7-10 days. Antiviral therapy should be associated to steroids in patients with severe and early-onset disease and in Ramsay-Hunt syndrome. Isolated antiviral therapy is not recommended. To date, there is no evidence that surgical facial nerve decompression provides benefit.
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Affiliation(s)
- M Fieux
- Service d'Otologie et d'Otoneurologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Chemin du Grand Revoyet, 69495 Pierre-Bénite, France
| | - V Franco-Vidal
- Service ORL et Chirurgie Cervico-Faciale, Hôpital Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux, France
| | - P Devic
- Service de Neurologie Clinique et Fonctionnelle, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Chemin du Grand Revoyet, 69495 Pierre-Bénite, France
| | - F Bricaire
- Service des Maladies Infectieuses, Hôpital Pitié-Salpêtrière, AP-HP, 47-83, Boulevard de l'Hôpital, 75013 Paris, France
| | - A Charpiot
- Service ORL et Chirurgie Cervico-Faciale, Hôpital de Hautepierre, 1, Avenue de Molière, 67200 Strasbourg, France
| | - V Darrouzet
- Service ORL et Chirurgie Cervico-Faciale, Hôpital Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux, France
| | - L Denoix
- Service d'Otologie et d'Otoneurologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Chemin du Grand Revoyet, 69495 Pierre-Bénite, France
| | - P Gatignol
- Service ORL et Chirurgie Cervico-Faciale, Hôpital Pitié-Salpêtrière, AP-HP, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - N Guevara
- Service ORL et Chirurgie Cervico-Faciale, Centre Hospitalier de Nice, IUFC, 31, Avenue de Valombrose, 01600 Nice, France
| | - M Montava
- Service ORL et Chirurgie Cervico-Faciale, Hôpital de la Conception, AP-HM, 147, Boulevard Baille, 13005 Marseille, France
| | - J A Roch
- Service de Radiologie, Hôpital Privé Jean Mermoz, 55, Avenue Jean Mermoz, 69008 Lyon, France
| | - F Tankéré
- Service ORL et Chirurgie Cervico-Faciale, Hôpital Pitié-Salpêtrière, AP-HP, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - S Tronche
- SFORL, 26, Rue Lalo, 75016 Paris, France
| | - F Veillon
- Service de Radiologie, Hôpital de Hautepierre, 1, Avenue de Molière, 67200 Strasbourg, France
| | - S Vergez
- Service ORL et Chirurgie Cervico-Faciale, Hôpital Larrey, 24, Chemin de Pouvourville, 31059 Toulouse, France
| | - C Vincent
- Service ORL et Chirurgie Cervico-Faciale, Hôpital Salengro, Rue Michel Polonowski, 59037 Lille, France
| | - G Lamas
- Service ORL et Chirurgie Cervico-Faciale, Hôpital Pitié-Salpêtrière, AP-HP, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - S Tringali
- Service d'Otologie et d'Otoneurologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Chemin du Grand Revoyet, 69495 Pierre-Bénite, France.
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Nevoux J, Barbara M, Dornhoffer J, Gibson W, Kitahara T, Darrouzet V. Authors' response to the letter on the article: "International consensus (ICON) on treatment of Ménière's disease". Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:239. [PMID: 32057696 DOI: 10.1016/j.anorl.2020.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- J Nevoux
- Department of otology and neurotology, CHU de Bicetre, AP-HP, 94270 Le Kremlin-Bicêtre, France; Saclay university, Paris-Sud Medical School, 94270 Le Kremlin-Bicêtre, France.
| | - M Barbara
- Department of otology and neurotology, Sapienza university, Rome, Italy
| | - J Dornhoffer
- Department of otolaryngology, head and neck surgery, university of Arkansas for medical sciences and Arkansas Children's Hospital, Little Rock, AR, USA
| | - W Gibson
- Department of otolaryngology, head and neck surgery, university of Sydney, Australia
| | - T Kitahara
- Department of otolaryngology, Nara medical university, Japan
| | - V Darrouzet
- Department of otolaryngology, Skull Base Surgery, CHU de Bordeaux, université de Bordeaux, 33000 Bordeaux, France
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Fieux M, Darrouzet V, Tringali S. Peripheral facial nerve palsy and cholesteatoma. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:81-82. [DOI: 10.1016/j.anorl.2019.10.011] [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: 11/24/2022]
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Dumas AR, Schwalje AT, Franco-Vidal V, Bébéar JP, Darrouzet V, Bonnard D. Cochlear implantation in far-advanced otosclerosis: hearing results and complications. ACTA ACUST UNITED AC 2019; 38:445-452. [PMID: 30498273 PMCID: PMC6265674 DOI: 10.14639/0392-100x-1442] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 08/22/2017] [Indexed: 11/23/2022]
Abstract
Severe forms of otosclerosis known as far-advanced otosclerosis (FAO) can lead to severe to profound sensorineural hearing loss and can justify cochlear implantation. Because of the pathophysiology of otosclerosis, patients implanted for FAO may experience an increased rate of complications, such as facial nerve stimulation or electrode dislocation, and may have poorer hearing outcomes than expected. This retrospective study aimed to compare cochlear implantation hearing outcomes, surgical difficulties and complications in FAO patients versus non-FAO patients. Moreover, we evaluated whether high resolution computed tomography (CT scan) findings were predictive of perioperative problems, complications and hearing outcomes. FAO patients were diagnosed based on medical history, examination and CT scan. Thirty-five ears from FAO patients were compared to 38 control ears. Audiometric results were assessed at least 12 months after implantation by pure tone average, speech reception threshold, monosyllabic and disyllabic word recognition score (WRS) and Central Institute for the Deaf (CID) sentences test. Complications and surgical difficulties were compiled. CT scan findings were categorised within 3 grades of otosclerotic extension. No significant difference was found between FAO and non-FAO hearing outcomes, except that monosyllabic WRS were lower for FAO patients, especially those who underwent previous stapedotomy. Facial nerve symptomatology occurred in 8.6% of FAO patients; among these, one required explantation-reimplantation surgery. 86% of FAO implanted patients had retrofenestral extension on CT. These were associated with poorer disyllabic WRS (51% vs 68%, p < 0.05) than those with only fenestral involvement. Although not significant, high grade of severity on CT tended to be associated with surgical difficulties and complications. Cochlear implantation in FAO patients is an effective treatment technique. Though the overall complication rate is low, it tends to be higher in cases of severe extension on CT. Patient counselling should be adjusted accordingly.
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Affiliation(s)
- A Ribadeau Dumas
- Department of Otorhinolaryngology and Skull Base Surgery, Pellegrin University Hospital F-33000, University of Bordeaux, France
| | - A T Schwalje
- Department of Otolaryngology, Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, USA
| | - V Franco-Vidal
- Department of Otorhinolaryngology and Skull Base Surgery, Pellegrin University Hospital F-33000, University of Bordeaux, France
| | - J P Bébéar
- Department of Otorhinolaryngology and Skull Base Surgery, Pellegrin University Hospital F-33000, University of Bordeaux, France
| | - V Darrouzet
- Department of Otorhinolaryngology and Skull Base Surgery, Pellegrin University Hospital F-33000, University of Bordeaux, France
| | - D Bonnard
- Department of Otorhinolaryngology and Skull Base Surgery, Pellegrin University Hospital F-33000, University of Bordeaux, France
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Nevoux J, Barbara M, Dornhoffer J, Gibson W, Kitahara T, Darrouzet V. International consensus (ICON) on treatment of Ménière's disease. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:S29-S32. [PMID: 29338942 DOI: 10.1016/j.anorl.2017.12.006] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [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: 11/12/2017] [Revised: 12/07/2017] [Accepted: 12/12/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To present the international consensus for recommendations for Ménière's disease (MD) treatment. METHODS Based on a literature review and report of 4 experts from 4 continents, the recommendations have been presented during the 21st IFOS congress in Paris, in June 2017 and are presented in this work. RESULTS The recommendation is to change the lifestyle, to use the vestibular rehabilitation in the intercritic period and to propose psychotherapy. As a conservative medical treatment of first line, the authors recommend to use diuretics and Betahistine or local pressure therapy. When medical treatment fails, the recommendation is to use a second line treatment, which consists in the intratympanic injection of steroids. Then as a third line treatment, depending on the hearing function, could be either the endolymphatic sac surgery (when hearing is worth being preserved) or the intratympanic injection of gentamicin (with higher risks of hearing loss). The very last option is the destructive surgical treatment labyrinthectomy, associated or not to cochlear implantation or vestibular nerve section (when hearing is worth being preserved), which is the most frequent option.
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Affiliation(s)
- J Nevoux
- Department of otology and neurotology, CHU de Bicetre, AP-HP, 94270 Le Kremlin-Bicêtre, France; Saclay university, Paris-Sud Medical School, 94270 Le Kremlin-Bicêtre, France.
| | - M Barbara
- Department of otology and neurotology, Sapienza university, Rome, Italy
| | - J Dornhoffer
- Department of otolaryngology, head and neck surgery, university of Arkansas for medical sciences and Arkansas Children's Hospital, Little Rock, Arkansas, USA
| | - W Gibson
- Department of otolaryngology, head and neck surgery, university of Sidney, Australia
| | - T Kitahara
- Department of otolaryngology, Nara medical university, Japan
| | - V Darrouzet
- Department of otolaryngology, Skull Base Surgery, CHU de Bordeaux, université de Bordeaux, 33000 Bordeaux, France
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Nevoux J, Franco-Vidal V, Bouccara D, Parietti-Winkler C, Uziel A, Chays A, Dubernard X, Couloigner V, Darrouzet V, Mom T. Diagnostic and therapeutic strategy in Menière's disease. Guidelines of the French Otorhinolaryngology-Head and Neck Surgery Society (SFORL). Eur Ann Otorhinolaryngol Head Neck Dis 2017; 134:441-444. [DOI: 10.1016/j.anorl.2016.12.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Linder T, Mulazimoglu S, El Hadi T, Darrouzet V, Ayache D, Somers T, Schmerber S, Vincent C, Mondain M, Lescanne E, Bonnard D. Iatrogenic facial nerve injuries during chronic otitis media surgery: a multicentre retrospective study. Clin Otolaryngol 2016; 42:521-527. [PMID: 27661064 DOI: 10.1111/coa.12755] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To give an insight into why, when and where iatrogenic facial nerve (FN) injuries may occur and to explain how to deal with them in an emergency setting. DESIGN AND SETTING Multicentre retrospective study in eight tertiary referral hospitals over 17 years. PARTICIPANTS Twenty patients with partial or total FN injury during surgery for chronic otitis media (COM) were revised. MAIN OUTCOME MEASURES Indication and type of surgery, experience of the surgeon, intra- and postoperative findings, value of CT scanning, patient management and final FN outcome were recorded. RESULTS In 12 cases, the nerve was completely transected, but the surgeon was unaware in 11 cases. A minority of cases occurred in academic teaching hospitals. Tympanic segment, second genu and proximal mastoid segments were the sites involved during injury. The FN was not deliberately identified in 18 patients at the time of injury, and nerve monitoring was only applied in one patient. Before revision surgery, CT scanning correctly identified the lesion site in 11 of 12 cases and depicted additional lesions such as damage to the lateral semicircular canal. A greater auricular nerve graft was interposed in 10 cases of total transection and in one partially lesioned nerve: seven of them resulted in an HB III functional outcome. In two of the transected nerves, rerouting and direct end-to-end anastomosis was applied. A simple FN decompression was used in four cases of superficially traumatised nerves. CONCLUSIONS We suggest checklists for preoperative, intraoperative and postoperative management to prevent and treat iatrogenic FN injury during COM surgery.
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Affiliation(s)
- T Linder
- Department of Otorhinolaryngology Head and Neck Surgery, Luzerner Kantonsspital, Luzern, Switzerland
| | - S Mulazimoglu
- Department of Otorhinolaryngology Head and Neck Surgery, Luzerner Kantonsspital, Luzern, Switzerland
| | - T El Hadi
- Hearing and Balance Center, Dr El Hadi ENT Private Practice, Fès, Morocco
| | - V Darrouzet
- Department of Otolaryngology and Skull Base Surgery, Pellegrin University Hospital, Bordeaux, France
| | - D Ayache
- Otology-Neurotology Unit, Fondation Adolphe De Rothschild, Paris, France
| | - T Somers
- Department of Otorhinolaryngology Head and Neck Surgery, University of Antwerp, Antwerp, Belgium
| | - S Schmerber
- Department of Otorhinolaryngology Head and Neck Surgery, University of Grenoble, Grenoble, France
| | - C Vincent
- Department of Otolaryngology, Lille University, Lille, France
| | - M Mondain
- Department of Otorhinolaryngology Head and Neck Surgery, University of Montpellier, Montpellier, France
| | - E Lescanne
- Department of Otolaryngology, Tours University, Tours, France
| | - D Bonnard
- Department of Otolaryngology and Skull Base Surgery, Pellegrin University Hospital, Bordeaux, France
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Bastier P, Leroyer C, Lashéras A, Rogues AM, Darrouzet V, Franco-Vidal V. Early and late surgical site infections in ear surgery. Acta Otorhinolaryngol Ital 2016; 36:127-34. [PMID: 27196077 PMCID: PMC4907159 DOI: 10.14639/0392-100x-666] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 07/25/2015] [Indexed: 11/23/2022]
Abstract
A retroauricular approach is routinely used for treating chronic otitis media. The incidence of surgical site infections after ear surgery is around 10% in contaminated or dirty procedures. This observational prospective study describes surgical site infections after chronic otitis media surgery with the retroauricular approach and investigated their potential predictive factors. This observational prospective study included patients suffering from chronic otitis media and eligible for therapeutic surgery with a retroauricular approach. During follow-up, surgical site infections were defined as "early" if occurring within 30 days after surgery or as "late" if occurring thereafter. The data of 102 patients were analysed. Concerning early surgical site infections, four cases were diagnosed (3.9%) and a significant association was found with preoperative antibiotic therapy, wet ear at pre-operative examination, class III (contaminated) in the surgical wound classification, NNIS (National Nosocomial Infection Surveillance) index > 1, and oral post-operative antibiotic use. Seven late surgical site infections were diagnosed (7.1%) between 90 and 160 days after surgery and were significantly correlated to otorrhoea during the 6 months before surgery, surgery duration ≤60 minutes, canal wall down technique and use of fibrin glue. Surgical site infections after chronic otitis media surgery seem to be associated with factors related to the inflammatory state of the middle ear at the time of surgery in early infections and with chronic inflammation in late infections.
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Affiliation(s)
- P.L. Bastier
- ENT and Head and neck surgery department, Bordeaux University Hospital, Bordeaux, France
| | - C. Leroyer
- Infection control unit, Bordeaux University Hospital, Bordeaux, France
| | - A. Lashéras
- Infection control unit, Bordeaux University Hospital, Bordeaux, France
| | - A.-M. Rogues
- Infection control unit, Bordeaux University Hospital, Bordeaux, France
| | - V. Darrouzet
- ENT and Head and neck surgery department, Bordeaux University Hospital, Bordeaux, France
| | - V. Franco-Vidal
- ENT and Head and neck surgery department, Bordeaux University Hospital, Bordeaux, France
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Sagardoy T, de Mones E, Bonnard D, Darrouzet V, Franco-Vidal V. Arachnoid cyst of the fallopian canal and geniculate ganglion area: our experience of 9 cases. Clin Otolaryngol 2016; 42:461-466. [PMID: 26860697 DOI: 10.1111/coa.12629] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2016] [Indexed: 11/30/2022]
Affiliation(s)
- T Sagardoy
- Department of Otolaryngology and Skull Base Surgery, Pellegrin University Hospital, Bordeaux, France
| | - E de Mones
- Department of Otolaryngology and Skull Base Surgery, Pellegrin University Hospital, Bordeaux, France
| | - D Bonnard
- Department of Otolaryngology and Skull Base Surgery, Pellegrin University Hospital, Bordeaux, France
| | - V Darrouzet
- Department of Otolaryngology and Skull Base Surgery, Pellegrin University Hospital, Bordeaux, France
| | - V Franco-Vidal
- Department of Otolaryngology and Skull Base Surgery, Pellegrin University Hospital, Bordeaux, France
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Darrouzet V, Soulie D, Siddiqui SA, Guerin J, Caille JM, Bebear JP. Contribution of 3D-MRI in the Management of Acoustic Neurinomas. Skull Base Surg 2015. [DOI: 10.1159/000429977] [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: 11/19/2022]
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Darrouzet V, Bebear JP, Stoll D, San-Galli F, Siddiqui SA, Pinsolle J. Recent Technical Evolutions in Transbasal Surgery of Ethmoid Tumors. Skull Base Surg 2015. [DOI: 10.1159/000429774] [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: 11/19/2022]
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Darrouzet V, Siddiqui SA, Guerin J, Bebear JP. The Widened Retrolabyrinthine Approach in Surgery of Tumors of the Cerebellopontine Angle. Skull Base Surg 2015. [DOI: 10.1159/000429969] [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: 11/19/2022]
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Thomeer H, Perez F, Darrouzet P, Darrouzet V, Franco-Vidal V. Evaluation Quality of Equilibrium after Vestibular Schwannoma Surgery: A Prospective Cohort Study. Skull Base Surg 2014. [DOI: 10.1055/s-0034-1384044] [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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Grayeli A, Ferrary E, Tubach F, Bernat I, Deguine O, Darrouzet V, Robier A, Zaouche S, Dubreuil C, Marx M, Kalamrides M, Fraysse B, Sterkers O. Effect of Corticosteroids on Facial Function after Cerebellopontine Angle Tumor Removal: A Double-Blind Study versus Placebo. Skull Base Surg 2014. [DOI: 10.1055/s-0034-1384146] [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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Thomeer H, Darrouzet P, Darrouzet V. Evolution of Symptoms and CVEMPs after Middle Fossa Plugging of the Superior Semicircular Canal in the Superior Semicircular Canal Dehiscence Syndrome. Skull Base Surg 2014. [DOI: 10.1055/s-0034-1383927] [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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Longueville E, Pinsard L, Boudard P, Colin J, Darrouzet V, Korobelnik JF. [Using the superficial temporal fascia flap in orbital surgery]. Rev Laryngol Otol Rhinol (Bord) 2013; 134:213-218. [PMID: 25252577] [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: 06/03/2023]
Abstract
The superficial temporal fascia flap gives a fine malleable well vascularized tissue and can be used as a pedicled or a free flap to cover large areas of loss of substance. Its dissection needs a period of training. Its use in orbital surgery is rare. However when it is about an anophthalmic socket following radiotherapy with orbital retraction syndrome, it provides tissue of good quality. This could allow later reconstruction by mucous grafts. When used on cavities of exenteration it allows fast re-epithelialisation even post-radiotherapy, while allowing the monitoring of the cavity and in particular the early detection of any tumor recurrence. Its use is advantageous in unfavorable conditions especially after radiotherapy.
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Galland S, Maire J, Darrouzet V, Maingon P, Demeaux H, De-Mones-del-Pujol E, Benech J, Vendrely V, Trouette R, Huchet A. Treatment of Cervical and Cranial Base Paragangliomas With Conformal Fractionated Radiation Therapy: A 25-year Experience in a Single Institution. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.2009] [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: 11/28/2022]
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Dournes G, Barreau X, Franco-Vidal V, Darrouzet V, Dousset V. Pre- and postoperative CT appearance of superior semicircular canal dehiscence syndrome. Diagn Interv Imaging 2012; 93:612-6. [DOI: 10.1016/j.diii.2012.04.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Bozorg Grayeli A, Ferrary E, Tubach F, Bernat I, Deguine O, Darrouzet V, Robier A, Zaouche S, Dubreuil C, Marx M, Kalamarides M, Fraysse B, Sterkers O. Corticosteroid Effect on Facial Function after Cerebellopontine Angle Tumor Resection: A Double-Blind Study versus Placebo. Skull Base Surg 2012. [DOI: 10.1055/s-0032-1314191] [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: 10/28/2022]
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Vidal V, Darrouzet P, Gimbert E, Darrouzet V. Interest of Audiovestibular Workup in Chiari Malformation. Skull Base Surg 2012. [DOI: 10.1055/s-0032-1314416] [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: 10/28/2022]
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Ayache D, Darrouzet V, Dubrulle F, Vincent C, Bobin S, Williams M, Martin C. Imaging of non-operated cholesteatoma: Clinical practice guidelines. Eur Ann Otorhinolaryngol Head Neck Dis 2012; 129:148-52. [DOI: 10.1016/j.anorl.2011.09.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Accepted: 09/30/2011] [Indexed: 11/26/2022]
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Milhe de Saint Victor S, Bonnard D, Darrouzet V, Bellec O, Franco-Vidal V. Stage II vestibular schwannoma: predictive factors for postoperative hearing loss and facial palsy. Eur Ann Otorhinolaryngol Head Neck Dis 2012; 129:87-92. [PMID: 22226671 DOI: 10.1016/j.anorl.2011.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Revised: 05/16/2011] [Accepted: 09/06/2011] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To assess predictive factors for deafness and facial palsy after vestibular schwannoma surgery on a translabyrinthine or retrolabyrinthine approach, and to compare sequela results to those for gamma knife radiosurgery. PATIENTS AND METHODS A retrospective study included 70 patients operated on for stage II vestibular schwannoma (Koos classification). Postoperative hearing was assessed on pure-tone average and speech discrimination score, and facial palsy on the House and Brackmann classification, preoperatively and at 1 year postoperatively. Various predictive factors were assessed for both. Statistical analysis used the Fischer exact test, with a significance threshold of P<0.05. RESULTS Hearing was conserved in 18.9% of patients operated on with a retrolabyrinthine approach, with 8.1% conserving useful hearing. Facial function was conserved in 91.4%. Predictive factors for hearing conservation did not achieve statistical significance, but showed trends for: preoperative pure-tone average threshold≤30dB and speech discrimination score≥ 70%, age less than 55 years, tinnitus, nearly normal auditory brainstem response (ABR) latency, and homogeneous tumor on MRI. Predictive factors for conserved facial function likewise did not achieve statistical significance, but showed trends for: age less than 55 years, deafness of progressive onset, absence of cardiovascular risk factors, nearly normal ABR latency and tumor size<13.5mm on MRI. CONCLUSION Facial nerve risk is largely the same with surgery or gamma knife radiosurgery. Concerning hearing, gamma knife radiosurgery seems to provide better hearing conservation, but only over the short term.
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Affiliation(s)
- S Milhe de Saint Victor
- Service d'otorhinolaryngologie et de chirurgie de la base du crâne, CHU Pellegrin, université Victor-Segalen Bordeaux-2, place Amélie-Raba-Léon, Bordeaux cedex, France
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Galland-Girodet S, Darrouzet V, Maire JP, de-Mones-del-Pujol E, Demeaux H, Digue L, Benech J, Protat B, Trouette R, Aymeri H. Place de la radiothérapie des paragangliomes de la tête et du cou : à propos d’une série de 30 patients traités au centre hospitalier universitaire de Bordeaux entre 1987 et 2010. Cancer Radiother 2011. [DOI: 10.1016/j.canrad.2011.07.071] [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: 10/17/2022]
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Guille J, De Mones Del Pujol E, Bonnard D, Darrouzet V, Franco-Vidal V. [Chondrocalcinosis of the temporomandibular joint revealed by a hearing loss: a case report]. Rev Laryngol Otol Rhinol (Bord) 2011; 132:167-172. [PMID: 22533072] [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: 05/31/2023]
Abstract
INTRODUCTION Chondrocalcinosis is a microcrystalline arthropathy that principally affects the knee. It is a rare disorder, usually asymptomatic, that occurs mainly in the elderly people. PURPOSE To report a case of a temporomandibular joint chondrocalcinosis with ossicular contact revealed by a conductive hearing loss. CASE REPORT We describe the case of a 57-year-old man with a right conductive sudden hearing loss of 15 dB. The CT scan revealed a lytic lesion in the right attic extended to the middle cerebral fossa in contact with the ossicles with a suspicion of lysis of the head of the malleus. MRI showed a lesion enhancing after gadolinium injection on T1 weighted images. A biopsy revealed a chondrocalcinosis of the temporomandibular joint. Due to the complexity of surgical excision and the benin character of the lesion, a medical treatment and a radiologic follow-up every six months were proposed. CONCLUSION Chondrocalcinosis of the temporo-mandibular joint is rare especially when it is revealed by a hearing loss. We present here a review of the literature.
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Affiliation(s)
- J Guille
- CHU Pellegrin, Service ORL et Chirurgie Cervico-Faciale, Pôle Tête et Cou FX Michelet, Place A. Raba Léon, 33076 Bordeaux cedex, France
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de Gabory L, Maunoury A, Maurice-Tison S, Merza Abdulkhaleq H, Darrouzet V, Bébéar JP, Stoll D. Long-Term Single-Center Results of Management of Ethmoid Adenocarcinoma: 95 Patients over 28 Years. Ann Surg Oncol 2010; 17:1127-34. [DOI: 10.1245/s10434-010-0933-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2009] [Indexed: 11/18/2022]
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Markou K, Goudakos J, Franco-Vidal V, Darrouzet V. Lipomas of the Cerebellopontine Angle: Report of Three Cases. Skull Base 2009. [DOI: 10.1055/s-2009-1224492] [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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Goudakos J, Markou K, Maunoury A, Franco-Vidal V, Darrouzet V. Interesting Case of Bilateral Simultaneous Superior Semicircular Canal Dehiscence and Otosclerosis. Skull Base 2009. [DOI: 10.1055/s-2009-1224414] [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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Kossowski M, Bordure P, Darrouzet V, Dubreuil C, Tran Ba Huy P. [Bell's palsy]. Ann Otolaryngol Chir Cervicofac 2008; 125:323-327. [PMID: 18842253 DOI: 10.1016/j.aorl.2008.06.002] [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: 06/06/2008] [Accepted: 06/24/2008] [Indexed: 05/26/2023]
Affiliation(s)
- M Kossowski
- Service d'ORL et de chirurgie cervicofaciale, hôpital d'Instruction des Armées-Percy, 101, avenue Henri-Barbusse, 92141 Clamart cedex, France.
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Ayache D, Darrouzet V, Somers T, Sichel JY, Bobin S. [Serous otitis media in adult]. ACTA ACUST UNITED AC 2008; 125:52-7. [PMID: 18281010 DOI: 10.1016/j.aorl.2007.09.003] [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] [Received: 09/05/2007] [Accepted: 09/06/2007] [Indexed: 11/30/2022]
Affiliation(s)
- D Ayache
- Service ORL, fondation Adolphe-de-Rothschild, 25, rue Manin, 75019 Paris, France.
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Bodenez C, Darrouzet V, Rouanet-Larriviere M, Barreau X, Liguoro D, Bebear JP, Franco-Vidal V. [Facial paralysis after temporal bone trauma]. Ann Otolaryngol Chir Cervicofac 2006; 123:9-16. [PMID: 16609664 DOI: 10.1016/s0003-438x(06)76633-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
OBJECTIVES To evaluate functional outcome in 64 cases of facial paralysis following temporal bone fracture and discuss decisive arguments leading either to medical treatment or surgical management. METHODS Sixty-four patients suffering from post-traumatic facial paralysis were managed between 1995 and 2003: 38 (59%) were given medical treatment and 26 (41%) underwent surgery. A combined middle fossa and transmastoid approach was mostly used (58%). Electrophysiological testing and CT scan results were the main points of the decision algorithm. RESULTS Electroneuromyography seems to be the most accurate exploration for guiding treatment. Good results (grades I to II on the House and Brackmann scale) were obtained in 63% of cases after medical management and in 39% of cases after surgical treatment. Grades III or IV were obtained in 13% of medically-treated patients and 42% of surgically-treated patients. CONCLUSION Management of facial paralysis following temporal bone fracture in accordance with electrophysiological testing (evoked EMG) together with CT scan findings enabled accurate indications for surgical treatment. A good grade I or II result can be expected after medical management. A grade III is at best reached after nerve anastomosis.
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Affiliation(s)
- C Bodenez
- Service d'ORL et de Chirurgie Cervico-faciale, Centre Hospitalier Universitaire, Place A. Reba Léon, 33076 Bordeaux.
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Franco-Vidal V, Blanchet H, Liguoro D, Darrouzet V. [Side-to-end hypoglossal-facial nerve anastomosis with intratemporal facial nerve translocation. Long-term results and indications in 15 cases over 10 years]. Rev Laryngol Otol Rhinol (Bord) 2006; 127:97-102. [PMID: 16886539] [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: 05/11/2023]
Abstract
OBJECTIVES To describe functional results concerning facial and lingual mobility after side-to end hypoglossal facial nerve anastomosis. MATERIAL AND METHODS 15 patients were operated on between 1993 and 2002 (11 cases of facial nerve injury during vestibular schwannoma surgery, and 4 cases of brainstem stroke). Were assessed at a minimum of 18 months postop tonus and facial voluntary movements recovery (modified House Brackmann (HB) grading), lingual mobility (amyotrophy and self-evaluation questionnaire), and patients' overall satisfaction (questionnaire). RESULTS The mean delay to evaluation was 57.5 months. The tonus recovery appeared within 6 to 8 months (mean 28.5 weeks, SD 4.6 weeks). All patients recovered a normal tonus. The facial function was evaluated HB grade III in II cases (73.3%), grade IV in 3 cases (20%) and grade V in one (6.6%). Eye occlusion was obtained within 13.6 months on average (SD 2.6 months) in all cases except one. The blepharorraphy was maintained in 2 patients. No facial spasm was noted. The lingual motricity troubles were absent in 93.3% of cases. Patients were satisfied in 93.3% of cases. The less satisfactory results were observed when patients were managed late (>2 years after nerve section) and in case of brainstem stroke. CONCLUSION This technique seems to be very efficient. It presents the advantage to preserve lingual motricity and to decrease postoperative problems of midface spasticity.
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Affiliation(s)
- V Franco-Vidal
- CHU de Bordeaux, Hôpital Pellegrin, Clinique ORL, Place A. Raba Léon, 33076 Bordeaux, France
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Diallo BK, Franco-Vidal V, Vasili D, Négrevergne M, Darrouzet P, Diouf R, Darrouzet V. [The neurotologic evaluation of vestibular schwannomas. Results of audiological and vestibular testing in 100 consecutive cases]. Rev Laryngol Otol Rhinol (Bord) 2006; 127:203-9. [PMID: 17315783] [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: 05/14/2023]
Abstract
OBJECTIVES To determine the results and sensitivity of a comprehensive audiological and vestibular work-up in patients presenting with vestibular schwannoma (VS). MATERIAL AND METHODS One hundred consecutive cases of VS diagnosed from January 2004 to May 2005 were prospectively studied. The tumour size was classified according to Koos classification and hearing was assessed according to the five-stage classification from the Tokyo consensus. A comprehensive work-up was conducted in all patients, including pure tone and speech audiometry, Brainstem Evoked Audiologic Potentials (BEAP) assessment, Vestibular Evoked Myogenic Potentials (VEMP) examination and bithermal caloric testing using videonystagmography, on both sides. BEAP responses were considered as normal or endocochlear when interwave intervals were normal, absent because of poor hearing or retrocochlear when wave 1 to 5 interval > 4.3 ms and/or when this interval was greater than > 0.25 ms between sides, or when no response was recorded when hearing was preserved. VEMP were considered as normal absent or diminished (amplitude < 50%, as compared with contralateral). Caloric responses were considered normal, reduced (reduced by > or = 30%) absent (reduced by > 80%). RESULTS Fifty-six women and 44 men were examined (mean age 57.8 years). Left and right side were equally affected. Vertigo, tinnitus and hearing loss were the main presenting symptom in 21%, 32% and 68% of the cases, respectively. Eighty-two per cent were operated, 17% simply monitored and 1% irradiated. The tumours were Stage 1, 2, 3 and 4 in 14%, 28%, 21% and 37%, respectively. Hearing was class A in 9%, Class B in 34%, Class C in 14% and Class E-D in 43% of the cases. Globally, BEAP showed a retrocochlear pattern in 64% of the cases and no response in 30%. Abnormal responses of VEMP were observed in 94% of the cases. Caloric testing was abnormal in 61% and normal in 11%. Responses could not be analyzed in 28% of patients. Only one patient showed normal responses to the whole work-up (99% sensitivity). This patient had a small intrameatal tumour and actually complained of contralateral symptoms. CONCLUSION The results suggest that a full audiovestibular assessment can help diagnose VS of all sizes. But false-negative results remain possible in small intrameatal tumours (1%). In addition it can give useful postoperative prognostic information.
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Affiliation(s)
- B K Diallo
- CHU de Dakar, Clinique Universtaire ORL, Dakar, Sénégal
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Le Garlantezec C, Vidal VF, Guerin J, Bébéar JP, Liguoro D, Darrouzet V. [Management of cerebellopontine angle meningiomas and the posterior part of the temporal bone. Report on 44 cases]. Rev Laryngol Otol Rhinol (Bord) 2005; 126:81-9. [PMID: 16180346] [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: 05/04/2023]
Abstract
OBJECTIVES To review and study the management of CPA meningiomas through the experience of an otoneurosurgical team. MATERIAL AND METHODS Fourty-two patients (44 meningiomas) were considered. Seventy-seven per cent of tumors (34 cases) were operated on; 6 tumors (14.6%) were exclusively irradiated using fractionated radiation therapy (FRT) and four only surveyed (9,8%). RESULTS transpetrosal approaches were exclusively used. These were translabyrinthine (TLA) in 47%, widened retrolabyrinthine (WRLA) in 41% of cases, transcochlear approach (TCA) in three cases and a middle fossa in one. A transtentorial approach was combined in 35% of cases (8 TLA, 4 WRLA). Surgical removal was incomplete in 11,8% of cases; in 3 cases growing tumor was treated by FRT included one case of anaplasic tumor Postoperative complications were: 1 meningitis, 1 wound abscess, 2 hydrocephalus (6%) and 4 CSF fistulas (12%). No complications have been observed during the last 7 years (21 cases). House and Brackmann Grade 1 or 2 facial function was obtained in 59% of cases (but 10 patients had a preoperative facial nerve paresis). A normal or subnormal AAO-HNS Class A-B Hearing could be preserved in 57% of WRLA. Radiation therapy allowed tumor shrinkage in all cases. In 3 cases this regression was of more than 50%. CONCLUSION Surgery is the gold standard in treating CPA meningiomas. Transpetrosal approaches and particularly WRLA pure or combined to a transtentorial approach are for us the best way to remove these tumors in preserving hearing and facial nerve function. When hearing is poor or when tumor extension to the clivus or the premeatal area is consistent a TLA is either planned preoperatively or obtained from a WRLA.
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Affiliation(s)
- C Le Garlantezec
- CHU Pellegrin, Service ORL, Place Amélie Raba-Léon, F-33076 Bordeaux cedex, France
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Babin E, Borsik M, Braccard S, Crampette L, Darrouzet V, Faure F, Fontanel JP, Houdart E, Jankowski R, Le Clech G, Malvezzi L, Morinière S, Perie S, Perret J, Pignat JC, Portier F, Serrano E, Plauchu H. [Treatments of hereditary hemorrhagic telangiectasia of the nasal mucosa]. Rev Laryngol Otol Rhinol (Bord) 2005; 126:43-8. [PMID: 16080648] [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: 05/03/2023]
Abstract
UNLABELLED Hereditary Hemorrhagic Telangiectasia is a systemic autosomal dominant disorder involving blood vessels. The most common symptom is recurrent epistaxis. The treatments of these epistaxis are numerous but such treatments are often symptomatic and their effects are often not sustained. Some of these treatments may be complicated by visceral vascular malformations. The aim of this study is to propose a treatment plan for these patients with hierarchical organisation of therapeutic options taking into account of their previous therapy. METHOD H. Plauchu organized in Paris, december 2002 a meeting with any medical specialists of this disease. They have analysed variety of therapies that have been proposed for epistaxis control in Hereditary Haemorrhagic Télangiectasia. RESULTS Most common use packing of nasal fossa and then hyperselective embolization of the internal maxillary and facial arteries for severe epistaxis. For chronic epistaxis, best treatment use sclerotics products (Ethibloc) and laser. After discussion, primary embolization could be useful to reduce vascularization of nasal fossa. CONCLUSION Treatment of epistaxis in Hereditary Haemorrhagic Telangiectasia could increase in few years. Use of an index card of for epistaxis in the disease of Rendu-Osler could help to find treatment of choice.
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Affiliation(s)
- E Babin
- CHU, Service ORL et de Chirurgie Cervico-Faciale, Avenue de la Côte de Nacre, F-14033 Caen Cedex 1, France.
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Franco-Vidal V, Négrevergne M, Darrouzet V. [Vertigo and pathology of the cerebello-pontine angle]. Rev Laryngol Otol Rhinol (Bord) 2005; 126:223-6. [PMID: 16496548] [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: 05/06/2023]
Abstract
Many pathologies of the cerebello-pontine angle can induce vertigo or dizziness. Usually they are due to benign or malignant tumors. Pathophysiology of this vertigo involve lesion of the labyrinth with erosion, of the endolymphatic sac by invasion or compression, or directly by lesion of the vestibular nerve like in vestibular schwannomas. The vestibular nerve can also be injured by extrinsic compression like in meningiomas. Finally very big tumors can be compressive on the cerebellum or on the brainstem inducing also dizziness. Vertigo is often an important symptom of cerebello-pontine angle tumors. In association with others it will guide the diagnosis. Nevertheless, auditory evoked potentials, video-nystagmography, and otolithic evoked potentials are very important to determine exactly if the vestibular nerve is injured and if there are signs of central compression before surgery.
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Affiliation(s)
- V Franco-Vidal
- CHU Pellegrin, Clinique ORL, 33076 Bordeaux cedex, France
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Nguyen DQ, Franco-Vidal V, Guérin J, Darrouzet V. [Delayed facial palsy after vestibular schwannoma resection: the role of viral reactivation. Our experience in 8 cases]. Rev Laryngol Otol Rhinol (Bord) 2004; 125:23-9. [PMID: 15244025] [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: 04/30/2023]
Abstract
OBJECTIVE To study the role of herpes virus reactivation in the onset of more than three days-delayed facial paralysis (FP) following vestibular schwannoma (VS) surgery and advocate a specific medical management. MATERIAL AND METHODS Retrospective study on 8 cases from a series of 348 patients operated on of a VS between 1996 and 2002. Seven of the eight patients were given intravenously acyclovir (30 mg x kg(-1) x d(-1) for 5 days) and methyl-prednisolone (2 mg x kg(-1) x d(-1) for 7 days). A serologic testing looking for specific anti-herpes simplex viruses type 1 and 2 (HSV-2) and varicella-zoster virus (VZV) antibodies at the onset of the FP and 2 weeks later could be done in only 3 cases. RESULTS Mean delay of FP onset was 8.75 days. Mean time for recovery with intravenous treatment was 90 days. All treated patients had a House and Brackmann grade 1 recovery. The last one had only a grade 3 after 400 days of evolution: he could not be treated because of postoperative transient psychiatric problems. Serologic testing revealed in those patients in whom it could be done either a high level of anti-HSV or -VZV antibodies at the time of onset or a dramatic increase in anti-HSV or anti-VZV antibodies between the two samples, strongly suggesting a HSV or VZV reactivation. CONCLUSION HSV or VZV reactivation can be evocated in most cases of delayed FPs arising in the postoperative course of VSs, suggesting usefulness of emergency-given steroid and acyclovir intravenous regimen to block virus replication and fight secondary oedema and inflammation causative of nerve lesions. Evoked reactivation mechanism is comparable to that already suspected in delayed FP arising with the same delay in middle ear surgical procedures.
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Affiliation(s)
- D Q Nguyen
- CHU de Grenoble, Hôpital La Tronche, Service ORL, F-38000 Grenoble, France
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Enée V, Guérin J, Bébéar JP, Darrouzet V. [Acoustic neuroma surgery. Results and complications in 348 cases]. Rev Laryngol Otol Rhinol (Bord) 2003; 124:45-52. [PMID: 12934442] [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: 03/04/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate post-operative complications after acoustic neuroma surgery. METHODS This was a retrospective study of 348 patients, who had acoustic neuroma surgery between 1984 and 1999. Symptoms, pre-operative evaluation, surgery and post-operative complications were analysed. RESULTS 174 men and 174 women had an operation. Mean age was 51.8 years (11-78). 31 patients had a grade I tumour, 106 a grade II, 71 a grade III and 140 had a grade IV tumour. 195 patients have been operated through the translabyrinthine approach, 110 through the retrolabyrinthine approach, 42 through the sub-occipital approach, and one through the transcochlear approach. Mortality was 0.85%, 59.2% patients had a post-operative facial paralysis. Most of patients had post-operative dizziness, and 30% still had vestibular disturbances after one year. 9 patients (2.6%) had a cerebrospinal rhinorrhea and 24 patients had a cerebrospinal wound leak (6.9%). 22 patients had post-operative meningitis (6.3%). 2 patients had a cerebello pontine angle haemorrhage, and 3 patients had a brain stem infarct. CONCLUSION Transpetrous approaches are safe for acoustic neuroma removal and the post-operative complication rate is low. The retrolabyrinthine approach seems to be a good hearing preservative approach, regardless of tumour volume.
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Affiliation(s)
- V Enée
- CHU de Strasbourg Ancienne Interne des Hêpitaux de Bordeaux, clinique en ORL Audiophonologie, 1 Avenue Molière, F-67098 Strasbourg, France
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Raux-Rakotomalala F, Houliat T, Martel J, Stoll D, Bébéar JP, Darrouzet V. [Adenoid cystic carcinoma of the head and neck: a review of 30 cases]. Rev Laryngol Otol Rhinol (Bord) 2003; 124:235-41. [PMID: 15038566] [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: 04/29/2023]
Abstract
OBJECTIVES To evaluate treatment results and identify prognostics factors which determine local and regional treatment failure and crude survival in adenoid cystic tumours (ACT) in the head and neck. METHODS A retrospective study (1984 to 2001) of 30 cases of adenoid cystic tumour. The mean age was 56.9 years, with a sex ratio female to male of 2:1. Tumours of all sites were encountered, most (26.7%) being in the nose and sinuses and major salivary glands (26.6%). Tumours at the T4 stage were found in 14 cases, mainly situated in the nose and sinuses (50%). No patient had cervical lymphadenopathy, while two patients (6.7%) had bony metastases at the time of diagnosis. Two patients (6.7%) were treated by surgery alone, for T1 and T2 tumours; four patients (13%) had radiotherapy alone, and 24 patients (80%) had surgery with post-operative radiotherapy with a mean dose of 60.3 Grays (56-65 Grays). RESULTS Local recurrence occurred in 30.8% (nine cases) after a mean interval of 43 months (1 to 10 years). Treatment of these recurrences was by revision surgery in six cases, leading to local control in one case, but in a patient with pulmonary metastases. No cases of lymph node recurrence were observed. 30% of patients developed metastases; these were pulmonary in 44% and bony in 33.3%. Mean follow-up was five years. Crude survival at 3 years was 91%, at 5 years 86%, and at 10 years 50%. The percentage tumour-free survival was 70% at 3 years, and 57% at 5 years. 22 patients (73.3%) are still alive, 17 of them recurrence-free. Analysis of the prognostic factors has shown tumour to be more aggressive in the nose and sinuses when they presented at an advanced stage (T4); recurrence was more common when excision was incomplete, or if there was peri-neural spread. Tumours of "massive" histological type carried a poorer prognosis than those of cribrigorm type (60% death compared with 10%). The development of metastases is independent of local recurrence. Metastases to bone appear to be more rapidly aggressive than pulmonary metastases, which may remain asymptomatic for some time. CONCLUSION Combined radiotherapy and surgery have allowed improved local control of ACT, but the therapeutic challenge remains the multiply recurrent ACT, or those with symptomatic metastases, and this despite new research techniques (neutral therapy, immuno-histochemistry, molecular biology). ACT are rare tumours, whose prognosis remains poor.
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Affiliation(s)
- F Raux-Rakotomalala
- CHU Pellegrin, Service d'ORL, Place Amélie Raba-Léon, F-33076 Bordeaux, France.
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Négrevergne M, Ribeiro S, Moraes CL, Maunsell R, Morata GC, Darrouzet V. [Video-nystagmography and vibration test in the diagnosis of vestibular schwannoma. Review of 100 cases]. Rev Laryngol Otol Rhinol (Bord) 2003; 124:91-7. [PMID: 14564823] [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: 04/27/2023]
Abstract
OBJECTIVE To evaluate informations given by the combination of videonystagmography (VNG) including vibratory tests and auditory brainstem responses (ABR) in patients suffering vestibular schwannoma (VS) and try to find the most conclusive test(s). Combination of different functional tests is supposed to improve diagnosis and preoperative evaluation and precise indication for magnetic resonance imaging (MRI) facing audiological and vestibular symptoms. MATERIAL AND METHOD A prospective study of 100 patients with VS. All patients underwent a preoperative work-up including complete audiometry, auditory brainstem response (ABR) and videonystagmography (VNG). VNG protocol included caloric testing, rotatory tests, oculometry tests (saccade testing, optokinetic testing) and spontaneous and gaze-evoked nystagmus. From these six tests a score of positivity could be set, from 0 to 6. RESULTS The vibratory test is non invasive and easy to realize. Were observed: 1/ a good sensitivity in vibratory test to elicit nystagmus in this context. 2/ a good correlation between subliminal rotatory chair tests and vibratory tests 3/ a better control of caloric testing using vibratory test. 4/ a good but deficient sensitivity of ABR alone with regard to VS (95%) 5/ an increase of sensitivity of VNG when coupling it with ABR and using as a criterion the score of positivity: no patient had all tests negative. CONCLUSION The vibratory test is a non-invasive, fast examination with an easy execution. It reinforces VNG-ABR association screening power to diagnose VS. It constitutes, combined to caloric testing a good tool to diagnose and evaluate unilateral vestibular weakness.
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Affiliation(s)
- M Négrevergne
- Institut G. Portmann, 114 Avenue d'Arès, F-33074 Bordeaux, France
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Darrouzet V, Fraysse B, Magnan J, Lamas G. [Questions to the experts]. Ann Otolaryngol Chir Cervicofac 2002; 119:301-10. [PMID: 12464857] [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] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Affiliation(s)
- V Darrouzet
- Service ORL, Hôpital Pellegrin, 33076 Bordeaux Cedex, France
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Truilhe Y, Richaud P, Houliat T, Lagarde P, Demeaux H, Stoll D, Darrouzet V. [Surgical methods of removal of T4 nasopharyngeal malignancies. A preliminary report on 18 cases]. Ann Otolaryngol Chir Cervicofac 2002; 119:138-45. [PMID: 12218867] [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: 02/26/2023]
Abstract
OBJECTIVES To describe the technique and evaluate postoperative sequelae and results of transfacial surgical removal of T4N0 nasopharyngeal malignant neoplasms. MATERIAL AND METHODS Eighteen cases of surgically-treated nasopharyngeal cancers, managed between january 1993 and october 2000, were retrospectively studied. Three patients were non-responders to neoadjuvant chemotherapy, 6 suffered local recurrence following standard treatment and 7 were operated first either because of a huge and osteolytic tumor or because of an uncommon histolopathology. RESULTS Preoperative Vth nerve neuralgia (8 cases) was alleviated (4 cases) or cured (3 cases). At the time of diagnosis, ophthalmoplegia was observed in 3 cases. It disappeared postoperatively in 2 cases and after following radiation therapy in one. Median follow-up of the series was of 31.8 mths. Four patients were died of disease; one of them from distant metastases 4 years post-surgery. One patient is alive with distant metastases. The 13 last (72.2%) are alive without disease with a 35.6 mths median follow-up (6-77 mths). DISCUSSION This short and heterogeneous series cannot lead to any evidence-based conclusion. But mid-term free-of-disease survival of 4 of the 5 patients suffering local recurrence and of patients presenting with so-called non-radiation-sensitive tumors is to be considered. In comparison with the high risk of neurological sequels following reirradiation, absence of specific toxicity of surgery observed in this series is to be underlined. CONCLUSION In selected cases surgical treatment does not demonstrate any toxicity and is able to offer mid-term local control of the disease. Its role is to be evaluated further before inclusion in the therapeutic algorithm of these very bad prognosis-associated tumors.
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Affiliation(s)
- Y Truilhe
- Service d'ORL, Hôpital Pellegrin, C.H.U. Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux cedex, France
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Darrouzet V, Bouccara D, Bozorg Grayeli A, Couloigner V, Negrevergne M, Sterkers O. [Menière's disease. Current status]. Rev Laryngol Otol Rhinol (Bord) 2002; 122:209-15. [PMID: 11799866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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Duclos JY, Duffas O, Deminière C, Darrouzet V, Stoll D. [Glomangioma or "glomus tumor" of the nasal cavity: apropos of a new case and review of the literature]. Rev Laryngol Otol Rhinol (Bord) 2002; 122:119-23. [PMID: 11715261] [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: 02/22/2023]
Abstract
Glomangioma, or "glomic tumour" is a benign soft tissue tumour appearing most commonly at the distal extremities, in the nailbed and subcutaneous tissue. This is a vascular tumour, rare for the dermatologist, and exceptional in an ENT site. We describe here what is, as far as we can tell from the literature, the eighteenth case. The problem is the diagnosis of a vascular tumour, arising usually from the septal mucosa, which has to be distinguished histopathologically from a haemangiopericytoma. Radiological investigation will define the extent of the tumour and guide the treatment plan, which is purely surgical and consists of wide excision to avoid the possibility of a local recurrence.
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Affiliation(s)
- J Y Duclos
- C.H.U. Pellegrin, Clinique Universitaire O.R.L., Place Amélie Raba Léon, 33076 Bordeaux, France
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Stoll D, Bébéar JP, Truilhé Y, Darrouzet V, David N. [Ethmoid adenocarcinomas: retrospective study of 76 patients]. Rev Laryngol Otol Rhinol (Bord) 2001; 122:21-9. [PMID: 11499229] [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: 02/21/2023]
Abstract
From the retrospective study of 76 adenocarcinomas of the ethmoid sinuses, results were expressed in two terms: the morbidity related to surgery and the oncologic outcome. This case study extends between 1975 and 2000. It includes 71 men and 5 women, with an average of 61 years. 81% of them works in wood dust, with a mean duration of exposure of 26 years. The diagnosis of adenocarcinoma is realized in the three months after the first signs, essentially rhinologicals, next neurologicals and ophthalmologicals. The majority of tumors were classified as T3N0M0, i.e. 57.89%. The treatment of this tumors is surgical: 34.2% surgical only and 59.2% with radiotherapy. The transfacial approach (paralateronasal and degloving) and the combined surgery are respectively performed in 36 patients and 35 patients. 23.2% patients had a local recurrence, and 10% developed cervical nodes and systemic metastasis. Survival rate based on the Kaplan-Meier actuarial method is 82% at 3 years, 80% at 5 years, 72% at 10 years. The prognosis of ethmoidal cancer is strictly correlated to local control. Local recurrence is statistically more likely in patients with involvement of the dura, brain and sphenoid sinus. With the analysis of the carcinologics results, we discuss the therapeutics indications of the adenocarcinomas and a new classification. Taking in account the involvement of the dura, sphenoid and orbit. We did not find any statistical differences between T3 patients treated by combined approach (n = 13) or by transfacial approach (n = 15).
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Affiliation(s)
- D Stoll
- C.H.U. Pellegrin, Clinique Universitaire O.R.L., Place Amélie Raba Léon, 33076 Bordeaux, France
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Darrouzet V, Duclos JY, Liguoro D, Truilhe Y, De Bonfils C, Bebear JP. Management of facial paralysis resulting from temporal bone fractures: Our experience in 115 cases. Otolaryngol Head Neck Surg 2001; 125:77-84. [PMID: 11458219 DOI: 10.1067/mhn.2001.116182] [Citation(s) in RCA: 102] [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] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The goal of this study was to review decision factors and overall results regarding surgical and nonsurgical management of post-traumatic facial nerve paralysis (FP). STUDY DESIGN A retrospective study and literature review were performed. METHODS Between 1984 and 1990, 115 cases of post-traumatic FP were handled. Patients were evaluated through clinical, audiologic, radiologic, and electromyogram assessment. Depending on examination results, patients were treated either medically or surgically through total facial nerve decompression. RESULTS Forty-nine of the 50 medically treated patients experienced a normal or subnormal facial function recovery (grade I-II). Of the 65 (56.5%) surgically treated patients, 52 (80%) had immediate, 2 had delayed, and 11 (17%) had unknown delay-associated FP. The approaches chosen were middle fossa and transmastoid (75.3%), translabyrinthine (10.7%), or pure transmastoid according to facial nerve nonmotor branch evaluation, hearing, location of the fracture line, and the patient's general condition. Lesions were predominantly found in the geniculate ganglion area (66.2%). A nerve gap was found in only 13.8% of the cases. At 2 years after surgery, 93.8% had a grade I to III recovery. None had grade V or VI. CONCLUSION The rarity of severe nerve lesions encountered in surgically treated patients raises the question of better selection of candidates for surgery. Surgery is clearly indicated when FP is total, is of immediate onset, and is associated with a bad prognosis electromyogram pattern. In other settings, decisions are to be made based on high-resolution CT data and electromyogram results, thanks to a clinical survey and second electromyogram evaluation.
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Affiliation(s)
- V Darrouzet
- Department of Otorhinolaryngology, University Hospital of Bordeaux, France.
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Martel J, Darrouzet V, Duclos JY, Bébéar JP, Stoll D. [Olfactory esthesioneuromas]. Rev Laryngol Otol Rhinol (Bord) 2001; 121:227-36. [PMID: 11233705] [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: 02/19/2023]
Abstract
Olfactory neuroblastomas are rare malignant tumours of the nose arising from the olfactory epithelium. In a retrospective series of 18 cases and a review of the literature, the authors establish the main features of this tumour. They emphasise the difficulties of histological examination, often requiring immuno-cyt-chemistery and electron microscopy. They point out the value of a new classification, and confirm treatments being radio-surgical, with use of the combined rhino-neurosurgical approach when there is extension to the cribriform plate. They report a 5-year survival of 91.5%, with 87.5% at 10 years. The high incidence of lymph gland metastases (16.6%) is greater than that of local recurrence (11%) especially in the more advanced cases. The question of prophylactic treatment of the neck nodes is one to be considered.
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Affiliation(s)
- J Martel
- C.H.U. Pellegrin, Clinique Universitaire O.R.L., Place Amélie Raba Léon, 33076 Bordeaux, France
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Enée V, Houliat T, Truilhé Y, Darrouzet V, Stoll D. [Malignant melanoma of the nasosinal mucosa. Retrospective study apropos of 20 cases]. Rev Laryngol Otol Rhinol (Bord) 2001; 121:243-50. [PMID: 11233707] [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: 02/19/2023]
Abstract
Twenty patients were treated for malignant melanoma (MM) of the mucosal surfaces of the nose and sinuses between 1987 and 1999 in our department. The mean age of these patients was 64 years, and there were 11 females and 9 males (sex ratio 1.2). Two patients had a past history of cutaneous or choroidal malignant melanoma, and were considered as having secondary melanoma. All patients presented with nasal obstruction and/or recurrent epistaxis. None of the patients with primary MM had either lymphadenopathy or distant metastases. 17 patients were treated surgically by the transfacial approach, aiming to obtain a cure. Radiotherapy and chemiotherapy were given only to the patients with secondary MM. Six patients have since presented with single or multiple local recurrence, and nine had distant metastases. The 3-year survival rate was 60%. This retrospective study has allowed us to compare the results of our series with these in the literature, and to review the treatment of this rare condition.
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Affiliation(s)
- V Enée
- C.H.U. Pellegrin, Clinique ORL et CCF, Tripode, Place Amélie Raba Léon, F-33076 Bordeaux, France
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Darrouzet V, Lacher-Fougère S, Duclos JY, Chambrin A, Bébéar JP. [Facial paralysis: treatment with an acyclovir-methylprednisolone combination, preliminary results]. Rev Laryngol Otol Rhinol (Bord) 2001; 121:199-202. [PMID: 11109888] [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: 02/18/2023]
Abstract
RATIONALE Many actual data suspect a viral etiology to Bell's palsy. Herpes viridae are more and more incriminated. On these basis, we have studied the efficacity of parenteral association of 30 mg/Kg/j of Aciclovir and 1 mg/Kg/j of Methylprednisolone in the treatment of Bell's palsy with less than 12 days of evolution. METHOD The evaluation concern 53 patients. We also evaluated the functional motor result (using House and Brackmann staging) and search prognostic factors in clinic and paraclinic data. A viral investigation have been made in most of the cases. RESULTS Only one of our patients treated with Aciclovir keeps some sequeles (stage III of House and Brackmann classification). We didn't found any deleterious effect. Statistically, the electromyography is the only one test with a prognostic value. But we feel that delay between the starting and the treatment of the palsy is important. Viral tests show sometime abnormal Ig against the Herpes viridae group. CONCLUSIONS These promising results are lightened with a review of the literature. A multicentric investigation is already in place for a stronger statistic effect.
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Affiliation(s)
- V Darrouzet
- C.H.U. Pellegrin, Clinique Universitaire O.R.L., Bordeaux, France
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