[Sinonasal polyposis associated with a deficiency subclass immunoglobulin G: Place of substitution immunoglobulins]. / Polypose nasosinusienne associée à un déficit en sous-classes d'Immunoglobuline G: place de la substitution en immunoglobulines polyvalentes.

PURPOSE: To study the effect of the introduction of a substitution by intravenous Immunoglobulins (Ig IV) at patients with immunoglobulins G (IgG) subclasses deficiency and nasal polyposis. MATERIAL AND METHODS: Prospective study concerning five patients with IgG subclasses deficiency and nasal polyposis treated by Ig IV. Rhinologic, otologic and pulmonary symptoms, exacerbations of nasal polyposis, chronic otitis and asthma as well as the number of antibiotics and corticoids treatments were counted during the Ig IV substitution. OBJECTIVES: To study the association between IgIV substitution and the number of exacerbations of nasal polyposis, chronic otitis, asthma and the number of antibiotics and corticoids treatments in patients with IgG subclasses deficiency and nasal polyposis. RESULTS: Five patients with a IgG subclass deficiency and nasal polyposis were substituted. The number of antibiotics and corticoids cures increased at one patient and remained stable at four others. The number of sinus, ear and lung infections as well as the global rhinologic score of symptoms and the endoscopic stage of the nasal polyposis remained stable. In the absence of efficiency of the treatment, this one was interrupted at the end of 6 months for patients n° 1 and n° 3, 24 months for patient n° 4 and 42 months for patient n° 5. CONCLUSION: The current study failed to highlight clinical improvement in patients wih IgG subclasses deficiency and nasal polyposis treated by Ig IV. A previous study had not allowed to find a link between IgG subclasses deficiency and severity of nasal polyposis, what seems to be confirmed by the absence of improvement brought during the substitution of this deficit in the current study.

Optimizing anterior laryngeal exposure during direct suspension laryngoscopy in adults.

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.

A "royal" total laryngectomy that never was.

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.

Increasing use of EQUATOR guidelines in the European Annals of Otorhinolaryngology, Head and Neck Diseases between 2020 and 2022: A SWiM review.

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.

Cervical approach for prestyloid parapharyngeal pleomorphic adenoma resection.

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.

Digastric and sternocleidomastoid muscle flaps after conservative total parotidectomy for cancer: A CARE case report.

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.

Laryngeal tuberculosis in the early 21st century. Literature review of clinical, diagnostic and therapeutic data, according to SWiM guidelines.

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.

Internal mammary pedicle for head-and-neck reconstruction.

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.

Writing in the European Annals of Otorhinolaryngology Head & Neck Diseases. Dos and Don'ts!

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.

150 years ago: First complete removal of the larynx by Theodor Billroth.

This historical vignette celebrates the first total removal of the larynx in humans, performed by Theodor Billroth 150 years ago and stresses the importance of the prior experimental study of laryngeal ablation performed in dogs by Vincent Czerny. A part of the original article, written by his assistant Carl Gussenbauer, is reproduced, to help readers immerse themselves in this operation which opened up new perspectives in the treatment of laryngeal cancer.

To tweet or not to tweet in otorhinolaryngology, that is the question.

OBJECTIVE: To describe the scientific medical literature devoted to the various interactions between otorhinolaryngology (ORL) and social networks. MATERIAL AND METHODS: A literature search, conducted on December 15, 2021, using the search engine of the United States National Library of Medicine (PubMed) and the key-words "otorhinolaryngology", "social network", and "Twitter", retrieved 321 articles for which Abstracts were read for selection of articles with qualitative and quantitative data regarding the various relationships between ORL and social media. RESULTS: Forty-four articles were selected and analyzed. Thirty-nine originated from the USA and none from France or French-speaking countries. Only 1 article was a prospective randomized study. Schematically, two main types of publication were identified. The first dealt with user interactions, topics discussed, teaching of the ORL specialty and publicizing research. The second dealt with the limits and dangers of this new means of publicizing scientific thinking in our specialty. Reading these articles highlighted the role of social media in publicizing ORL research, and suggested distinct options to improve interactions between otorhinolaryngologists, patients and society as a whole. CONCLUSION: At a time when society is demanding rapid access to medical research findings, just as it is mandatory to master and adhere to the rules for medical writing in research, it is also now necessary to learn how to communicate via social media and send a tweet if one wishes to publicize its research and/or exchange with patients.

Total laryngectomy for laryngeal cancer 150 years after its first description: A boon more than a calamity: A STROBE analysis.

OBJECTIVE: To illustrate the boon rather than a calamity that total laryngectomy can be for a patient with laryngeal cancer in the 21st century. MATERIAL AND METHOD: An observational retrospective analysis using the STROBE guideline compared two cohorts of patients with previously untreated cancer, managed by total laryngectomy: the first consisting of 123 patients collected by Morell Mackenzie during the fifteen years (1873-1887) following the initial description, and the second consisting of 53 patients consecutively treated in a French university otorhinolaryngology department during the fifteen years (2006-2020) preceding the 150th anniversary of the first performance. The main endpoint was the comparison of survival and locoregional control estimates (Kaplan-Meier life table method). Secondary endpoints comprised mortality estimates and causes, adjuvant treatments, and phonation modalities. RESULTS: The 26.2%, 13.1%, and 13.1% 1-, 3-, and 5-year actuarial survival estimates in the Makenzie cohort increased to 88.6%, 68.4%, and 60.9% in the recent French cohort (P<0.0001). The 50.1%, 40.4%, and 34.7% 1-, 3-, and 5-year actuarial locoregional control estimates in the Mackenzie cohort increased to 83.7% (P<0.0001). The 77.7% overall mortality in the Mackenzie cohort decreased to 37.7% (P<.0001). In the Mackenzie cohort, 97.8% of deaths were related to postoperative complications and locoregional recurrence, compared to 50% in the recent French cohort. Distant metastasis, metachronous second primary tumor and intercurrent diseases, not mentioned in the Mackenzie cohort, generated 45% of deaths in the French cohort. Adjunctive treatment was not used in the Mackenzie cohort, whereas neck dissection and postoperative radiation therapy were associated in respectively 98.1% and 69.8% of cases in the French cohort. Phonation was not documented in the Mackenzie cohort; 50% of survivors in the French cohort used a phonatory implant. CONCLUSIONS: The 20th century witnessed an incredible turn-around. Total laryngectomy, with limited indications, has transformed the etiology of deaths and no longer leaves patients "in a state of abject misery" as Morell Mackenzie put it in 1888.

1885: First total laryngectomy and artificial larynx in France.

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.

Great auricular nerve conservation and parotidectomy for tumor.

OBJECTIVE: To describe the key technical points for preserving the great auricular nerve during parotidectomy for tumor, and to discuss the literature regarding the benefits, limitations and indications for nerve-sparing surgery. Data suggested that great auricular nerve preservation should be discussed in the preoperative consultation, attempted intraoperatively and mentioned in the operative report once parotidectomy completed.

Sex-related quality of life after total laryngectomy for cancer.

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.

Successful 10-year outcomes after supracricoid partial laryngectomy for selected glottic squamous cell carcinoma classified as T3N0M0: A STROBE analysis.

PURPOSE: To evaluate long-term oncological outcome for patients with selected glottic squamous cell carcinoma (SCC) classified as T3N0M0 treated by supracricoid partial laryngectomy (SCPL). MATERIALS AND METHODS: Analysis of an inception cohort of 46 patients with isolated untreated SCC classified as T3N0M0 and minimum 10-year follow-up, consecutively treated by SCPL between 1982 and 2012 in a French university teaching hospital. The main endpoint was 5- and 10-year actuarial survival and local control estimates. Accessory endpoints comprised cause of death, screening for variables decreasing survival and increasing risk of local recurrence, oncologic consequences of local recurrence, and laryngeal preservation rate. RESULTS: Five- and 10-year actuarial survival was 78.1%, and 53.3%, respectively. The main causes of death were intercurrent disease and metachronous second primary, each in 33.3% of cases. Postoperative mortality (aspiration pneumonia) was 2.1%. There were no significant correlations between survival and any study variables. Five- and 10-year local control was 90.5%. Overall local recurrence varied significantly (P=0.003), from 2.3% with negative margins (R0) to 100% with positive margins (R1) and/or dysplasia. Local recurrence was associated with a significantly (P<0.005) increased risk of nodal failure and distant metastasis, and reduced survival. Overall laryngeal preservation was 89.1%. CONCLUSION: The present results suggest that SCPL should continue to be taught and that this type of partial laryngeal surgery should be included in the various organ-sparing strategies considered in advanced laryngeal cancer.

Perception of survival/laryngeal preservation trade-off in advanced T-stage laryngeal cancer.

OBJECTIVES: To evaluate the perception of the survival/laryngeal preservation trade-off in advanced T-stage laryngeal cancer. MATERIAL AND METHODS: The Cochrane, PubMed, Embase, and Science Direct databases were searched using the keywords "cancer, neoplasms, trade-off. One hundred and eighty four articles were found; 176 of these, without data in the Abstract documenting the survival/laryngeal preservation trade-off for advanced T-stage laryngeal cancer, were excluded. Eight articles, totaling 1,052 interviewees, were read to document modalities of evaluation, trade-off thresholds, and variables influencing the perception of trade-off. RESULTS: Evaluation of trade-off was based on responses in group discussions, interviews and questionnaires and on patient file analysis. One study reported that 28.2% of respondents could not make a decision between options, and in 4 studies 22% to 80% of respondents would not consider jeopardizing survival. A mean 2-3 year gain (range, 6 months to 5 years) in survival was required before preferring total laryngectomy to chemoradiotherapy. The percentage loss of disease-free survival tolerated by respondents who would consider a trade-off to preserve the larynx ranged from 5% to 100%, for a median 30%. Variables influencing trade-off comprised respondent status (patient/healthcare provider/healthy subject) and characteristics (job, having children) and treatment data (amount and modalities of information delivered, survival estimates after radiation therapy, health status after treatment). A time for reflection after diagnosis and good quality information were important for respondents. CONCLUSION: Several consequences emerge from these data. The first is to consider induction chemotherapy, to give the patient time to make an informed choice. The second is to not to give up teaching total laryngectomy The third is to determine whether the team's own results match the information delivered to patients.

Harmful impact of treatment refusal in T3-4M0 endolaryngeal squamous cell carcinoma candidates for total laryngectomy: A STROBE analysis.

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.

Keys for successful publication in Eur Ann Otorhinolaryngol Head Neck Dis: A STROBE analysis of peer reviews of articles submitted in 2020-2021.

OBJECTIVE: To evaluate reviewing and editorial decision for articles submitted to the European Annals of Otorhinolaryngology Head & Neck Diseases. MATERIALS AND METHODS: A retrospective analysis was made of reviewers' comments on 1,133 scientific articles (700 original articles, 96 literature reviews, and 337 case reports), originating from 69 countries, consecutively submitted on-line between January 1st, 2020 and December 31st, 2021. The main objective was to document the acceptance rate and decision time. Accessory objectives were to synthesize the main comments and to screen for correlations between acceptance and the main characteristics of first authors, articles and reviewers' comments. RESULTS: In total, 4.1% of submitted articles were accepted. Median decision time differed significantly (P<0.0001), at 1 month in case of refusal and 4 months in case of acceptance. Reviewers mentioned failure to adhere to the journal's authors' guide, to use the appropriate EQUATOR guidelines and to adopt the recommended P<0.005 significance threshold in 94.8%, 54.2%, and 39.9% of cases, respectively. On multivariate analysis, 3 variables significantly impacted acceptance, which increased from 1.3% to 44.6% (P<0.0001) when an appropriate EQUATOR guideline was used and from 0.3% to 57.4% (P<0.0001) when the significance threshold was set at P<0.005, and decreased from 10.5% to 1.1% (P=0.0001) when the article did not originate from a French-speaking country (member of the Francophonie organization). CONCLUSION: Adhesion to modern scientific medical writing rules increased acceptance rates for articles in the European Annals of Otorhinolaryngology Head & Neck Diseases. Teaching modern scientific medical writing needs to be enhanced in otorhinolaryngology.

Montgomery® implant extrusion after type I thyroplasty. A CARE case report.

GOAL: To document the first case of Montgomery® implant extrusion after type I thyroplasty for unilateral laryngeal nerve paralysis in adults. CASE: Three years after onset of right idiopathic unilateral laryngeal nerve paralysis resulting in severe dysphonia not improved by speech therapy, a 45-year-old Caucasian woman consulted to improve her voice. Maximum phonation time (MPT) was 5seconds. Voice Handicap Index (VHI) was 64. Type I thyroplasty with n°10 Montgomery® implant was performed without difficulties. Immediate postoperative course was uneventful. One month after thyroplasty, the patient considered her voice normal, with 8sec MPT and VHI of 23. At 4 months, there was implant extrusion through the cervical skin, with 9sec MPT and VHI of 18. CONCLUSION: When performing type I thyroplasty with Montgomery® implant, the otorhinolaryngologist must not only take care to position the implant properly within the thyroid lamina but also ensure that the inner flanges of the implant are well deployed, to achieve proper retention.