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OBJECTIVE: To describe the key points of cervical resection for prestyloid parapharyngeal pleomorphic adenoma and to discuss the role of modern imaging. OBSERVATION: Retrospective case series of 10 patients (4 women and 6 men, age 29-63 years) with prestyloid parapharyngeal pleomorphic adenoma with 2 to 8cm largest diameter on MRI, consecutively resected via a cervical approach between 2000 and 2020 in a French tertiary university referral care center. Seven patients had a minimum 10 years' follow-up, and one was lost to follow-up before the fifth postoperative year. Peri- and postoperative complications comprised great auricular nerve transection without subsequent symptomatic neuroma (2 patients), associated transoral approach to free the upper pole of the adenoma (2 patients), capsule effraction (3 patients), and hematoma (1 patient). There were no cases of facial paresis or palsy, other cranial nerve impairment, trismus, auriculotemporal or first-bite syndrome. One of the three patients with capsule effraction showed local recurrence at month 17. CONCLUSION: In agreement with previous reports, the present case series confirmed the role of the cervical approach to resect prestyloid parapharyngeal pleomorphic adenoma, and hence the need to continue teaching it.
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Free-flap reconstruction for recurrence of head-and-neck cancer with vessel depletion is a technical challenge, and the literature is sparse. The present technical note describes the key-points of an approach harvesting the internal mammary pedicle. Results are reported in 3 patients, and pros and cons are discussed.
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Surdez , Alemanha , Humanos , História do Século XX , Surdez/história , História do Século XIX , Pessoas FamosasRESUMO
OBJECTIVE: To describe, according to the CARE guidelines, an easily reproducible technique using two local muscle flaps to reduce the unsightly retromandibular hollow left by total parotidectomy for cancer. CASE DESCRIPTION: A 40-year-old Caucasian male with T3N1M0 temporal skin melanoma was managed by skin resection, conservative total parotidectomy and ipsilateral level II-IV selective lymph-node dissection. Two rotational muscle flaps were taken from the ipsilateral posterior belly of the digastric and sternocleidomastoid muscles. Postoperative course was uneventful, with 3 days' hospital stay, without facial or spinal palsy. At 3 days, 3 months and 9 months postoperatively, the appearance of the parotid region was similar to the non-operated contralateral region. CONCLUSION: Easy to perform and without associated scars, the approach described here should be included in the armamentarium available to the head and neck surgeon to avoid an unsightly hollow after total parotidectomy for cancer, in an effort to improve quality of life.
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Músculos do Pescoço , Glândula Parótida , Neoplasias Parotídeas , Retalhos Cirúrgicos , Humanos , Masculino , Adulto , Neoplasias Parotídeas/cirurgia , Músculos do Pescoço/cirurgia , Glândula Parótida/cirurgia , Melanoma/cirurgia , Neoplasias Cutâneas/cirurgiaRESUMO
OBJECTIVES: Review of the scientific medical literature dedicated to clinical data, diagnosis and treatment for laryngeal tuberculosis published since the turn of the 21st century. MATERIAL AND METHODS: Search of the Medline, Cochrane and Embase databases for the period 2000-2022. Selection of cohorts and case reports documenting clinical data, diagnosis and treatment for laryngeal tuberculosis. RESULTS: In total, 119 articles were analyzed. Immunodepression, HIV infection, history of lung tuberculosis, general symptoms suggesting tuberculosis, smoking and associated laryngeal cancer were noted in 18%, 3%, 20% and 41% of cases, respectively. No pathognomonic symptoms or signs emerged. Voice impairment, of various types and severity, isolated and/or associated with other signs, was the most frequent laryngeal symptom, in 86% of cases. All laryngeal sites were involved, with numerous and various associations. Impaired laryngeal motion and tracheotomy were noted in 6% and 1% of cases, respectively. Time to diagnosis varied from less than 1month to 36months, for a median 3months, in case reports. Laryngeal tuberculosis was diagnosed bacteriologically with certainty in 28% of cases while diagnosis was based on indirect criteria and/or involvement of another site in the other 72%, with lung involvement in 54%. Treatment duration ranged from 6 to 24months (median, 6months), using 3 to 5 (median: 4) antitubercular antibiotics, with 4 used in 80% of cohorts and 77% of case reports. Overall rates of cure, death, treatment resistance, adverse events, and laryngeal sequelae were 99%, 0.5%, 0.5%, 6% and 5%, respectively. CONCLUSION: The clinical presentation and diagnostic difficulty in laryngeal tuberculosis did not change since the end of the 20th century. Quadritherapy is highly effective, with a low resistance rate and few adverse effects or laryngeal sequelae.
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Tuberculose Laríngea , Humanos , Tuberculose Laríngea/diagnóstico , Tuberculose Laríngea/tratamento farmacológico , Guias de Prática Clínica como Assunto , Antituberculosos/uso terapêuticoRESUMO
With this historical vignette, ending the series dedicated to the pioneers of total laryngectomy, published in the EuropeanAnnals of Otorhinolaryngology Head & Neck Diseases to mark the 150th anniversary of the first description of this surgical procedure in humans, the authors recount what history called "The Crown Prince's illness", and wonder what might have happened if the total laryngectomy proposed for Crown Prince Friedrich had finally been performed.
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Neoplasias Laríngeas , Laringectomia , Humanos , Neoplasias Laríngeas/cirurgia , PescoçoRESUMO
An analysis of the literature on laryngeal exposure during direct suspension laryngoscopy in adults summarized the resources available to improve visualization, specifically at the anterior commissure.
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Laringoscopia , Laringe , Adulto , HumanosRESUMO
Too many articles are still rejected by scientific medical journals due to lack of preparation of the manuscript and of knowledge of the modern editorial rules that govern scientific medical writing. Therefore, the editorial board of the European Annals of Otorhinolaryngology Heads & Neck Diseases summarized studies published by its members since 2020 in the columns of the scientific journal of the French Society of Otorhinolaryngology and the International Francophone Society of Otorhinolaryngology and data from the PubMed indexed literature dedicated to scientific medical writing in otolaryngology in the 21st century. The authors hope that this review, in the form of a list of "Dos and Don'ts", will provide authors with a practical guide facilitating publication of rigorous, reproducible and transparent scientific studies, in accordance with the movement toward better science that society as a whole has been fighting for since the beginning of this century.
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Escrita Médica , Otolaringologia , Humanos , Editoração , RedaçãoRESUMO
OBJECTIVES: To evaluate the use of EQUATOR guidelines in scientific articles published in the European Annals of Otorhinolaryngology, Head and Neck Diseases between 2020 and 2022. The aim was also to translate the most widely used guidelines into French, in order to promote their dissemination and use in otorhinolaryngology and head and neck surgery. METHOD: The SWiM guidelines were used. Articles published in the European Annals of Otorhinolaryngology, Head and Neck Diseases between January 1, 2020 and December 31, 2022 were retrieved from the PubMed bibliographic database. Editorials, Letters to the Editor and "What is your diagnosis" articles that did not meet any EQUATOR guidelines were excluded from the analysis. RESULTS: Of the 149 eligible published articles, 21.5% (n=32/149) mentioned use of such a guideline. Guideline use by the European Annals of Otorhinolaryngology, Head and Neck Diseases author community progressed from 0% in 2020 to 8% in 2021 and 63% in 2022. CONCLUSION: The analysis carried out in this article and the availability of the French version of the seven EQUATOR guidelines most widely used in the European Annals of Otorhinolaryngology Head & Neck Diseases could stimulate application and compliance by authors who submit their work to the journal of the French and international French-speaking societies of otorhinolaryngology.
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Otolaringologia , HumanosRESUMO
PURPOSE: To evaluate the consequences of treatment refusal in total laryngectomy (TL) candidates with T3-4M0 endolaryngeal squamous cell carcinoma (SCC). MATERIALS AND METHODS: A retrospective observational study was conducted in an inception cohort of 576 isolated T3-4M0 endolaryngeal SCC candidates for TL consecutively managed between 1970 and 2019 in a French university teaching hospital. The main endpoint was survival time and cause of death in 2 groups. Group A, 4.5% of the cohort, consisted of 26 patients who declined any laryngeal treatment. Group B consisted of 550 patients who accepted TL. Accessory endpoints were causes of TL refusal and associated variables. The STROBE guideline was applied. The significance threshold was set at P<0.005. RESULTS: One-and 3-year actuarial survival estimates increased significantly (P<0.0001) from 39% and 15% in group A, to 83% and 63% in group B, respectively. In group A, 92% of causes of death implicated index SCC progression, whereas in group B intercurrent disease, metachronous second primary, locoregional and/or metastatic SCC progression and postoperative complications accounted for 37%, 31%, 29%, and 2%, respectively. The actuarial survival estimates within group A increased significantly (P=0.0003) from 0% at 1-year in patients managed with isolated supportive care to 56% in patients managed with chemotherapy (reaching 0% at 5years). Reasons for TL refusal were fear of surgery, refusal of tracheostoma, loss of physiologic phonation, and certain comorbidities. Age and chronologic period correlated significantly with TL refusal. Median age decreased (P<0.001) from 69years in group A to 58 years in group B. Percentage TL refusal increased (P<0.0001) from 2% to 11% before and after start 1990, respectively. CONCLUSION: The current study determined loss of survival with refusal of any laryngeal treatment including TL, noted benefit of chemotherapy associated to supportive care, and discussed the possible contribution of immunotherapy.
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Carcinoma de Células Escamosas , Neoplasias Laríngeas , Laringe , Idoso , Humanos , Carcinoma de Células Escamosas/cirurgia , Neoplasias Laríngeas/cirurgia , Laringectomia , Laringe/patologia , Estadiamento de Neoplasias , Estudos Retrospectivos , Resultado do Tratamento , Recusa do Paciente ao Tratamento , Pessoa de Meia-IdadeRESUMO
OBJECTIVES: Analysis of the quality of sexual life after total laryngectomy (TL) for cancer. MATERIAL AND METHODS: The Cochrane, PubMed, Embase, ClinicalKey and Science Direct databases were searched using the keywords: "total laryngectomy, sexual function, sexual behavior, sexual complications, sexual dysfunction, sexuality, intimacy". The abstracts of 69 articles were read by two of the authors and 24 articles were selected. The main endpoint was the impact of impairment of quality of sexual life after TL for cancer and the methods used to assess this. The secondary endpoints were the type of sexual impairment, associated variables and their treatment. RESULTS: The study population consisted of 1511 TL patients aged 21 to 90 years, with a male/female sex ratio of 7.49. One of the 7 validated Likert scales was used in 79% of the articles to evaluate impairment of sexual quality of life. Impaired quality of sexual life was reported by 47% of patients on average (range, 5-90%). Erectile and ejaculatory function and ejaculatory behavior of male patients decreased after TL. Other impairments comprised decreases in libido, frequency of sexual intercourse and satisfaction. Tracheostomy, advanced disease stage, young age and associated depression were factors for impairment. In all, 23% of patients reported lack of postoperative support in this area. CONCLUSION: The quality of sexual life is severely impacted by TL for cancer. The present data are a source of information and should be taken into account before carrying out TL. A common information tool needs to be developed. There is patient demand for improved management of sexuality.
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Coito , Neoplasias Laríngeas , Humanos , Masculino , Feminino , Qualidade de Vida , Laringectomia/métodos , Comportamento Sexual , Neoplasias Laríngeas/cirurgiaRESUMO
This year, 2023, is the 150th anniversary of the first total laryngectomy for cancer, by Theodor Billroth. The authors reconstruct the conditions under which, on March 12, 1885, this operation was then performed for the first time in France, by Leon Labbé, and present the man himself, and also M. Cadier, the inventive genius who designed the first artificial larynx used in this country.