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.

Best practice recommendations: ENT consultations during the COVID-19 pandemic.

These best practice recommendations for ENT consultations during the COVID-19 pandemic have been drawn up because ENT examinations and treatments are at risk of contamination by the SARS-Cov-2 virus in certain instances. Thus, ENT specialists are among the professionals who are most exposed to this infection. During the pandemic, insofar as an asymptomatic patient may be infected and contagious, the same precautions must be employed whether the patient is ill with, suspected of having, or without any clinical evidence of COVID-19 infection. According to the scientific data available, the examinations and procedures potentially exposing to projections/aerosolizations of organic material of human origin are considered to be at risk of staff contamination. For ENT examinations and procedures without exposure to such projections/aerosolizations, the professional is advised to a long sleeve clean outfit, a surgical mask and gloves in case of contact with the patient's mucosa. ENT examinations and procedures with exposure to these projections/aerosolizations require the so-called "airborne", "contact", and "droplets" additional precautions: FFP2/N95 respiratory protection device, eye protection, disposable headwear and long sleeve overgown.

[Facial nerve monitoring during middle ear surgery: Results of a French survey]. / Surveillance électrophysiologique peropératoire du nerf facial en chirurgie otologique: résultats d'un sondage national français.

INTRODUCTION: Facial nerve injury is a rare complication of middle ear surgery. To date there is no widely accepted consensus on the use of intraoperative facial nerve monitoring during middle ear surgery, whereas its use has been proved as a valuable adjunct in neurotologic surgery. The purpose of our study was to identify introperative facial nerve monitoring practice patterns in France for middle ear surgery. METHODS: A 19-item survey has been made up by three experienced otologists under the auspices of the French Otology and Neurotology Association. With the support of the French Society of Otolaryngology--Head and Neck Surgery, the survey was electronically sent by email to 1249 practicing ENT with a valid email address. Answers were analyzed two months later. RESULTS: Among 1249 email sent, 299 were opened (24%) and 83 answers were collected (6,6%). Of the respondents, 66% had access to intraoperative facial nerve monitoring. Otolaryngologists involved in academic setting were influenced by their teaching duty in 27%. Intraoperative facial nerve monitoring should not be required for stapes surgery, ossiculoplasty, myringoplasty for, respectively, 92%, 93 % and 98% of the respondents. In cochlear implantation, 78% of ear surgeons used facial nerve monitoring. Answers were more controversial for chronic ear surgery, ear atresia and middle ear implant. Revision surgery and CT scan can influence answers. CONCLUSION: Despite a low response rate, results of this national survey revealed interesting findings. For most of the respondents, intraoperative facial nerve monitoring was not indicated in stapes surgery, myringoplasty and ossiculoplasty. The use of intraoperative facial nerve monitoring for cochlear implantation was supported by the majority of respondents. Variations in response rate were more significant for chronic ear surgery, including middle ear cholesteatoma, and for ear atresia surgery.

[The posterior pharyngeal wall in pharyngo-laryngeal cancer. Spontaneous healing after excision]. / La paroi pharyngée postérieure dans les cancers pharyngo-laryngés. Cicatrisation spontanée après exérèse.

Malignant lesions arising from the posterior pharyngeal wall, or spreading to involve it, present a therapeutic problem in cancer surgery as witnessed by the number of techniques proposed and used. In general, they require longer operating time, sometimes need a double team of surgeons and sometimes specialised training. There is an increased risk of complications. The experience with pharyngoplasty using mucosal or musculo-mucosal flaps, which leave the donor site bare, raised the possibility of partial repair in circular pharyngo-laryngectomy. A myocutaneous flap is sutured in "gutter" fashion anteriorly opposite the posterior pharyngeal wall which in fact consists of the prevertebral aponeurosis laid bare. Repair was not performed in certain partial posterior pharyngectomies. Seven patients underwent surgery using this technique. Four circular pharyngo-laryngectomies, including 2 as second stage procedures were performed. Healing occurred in all cases. No breakdown of sutures occurred. Oral feeding was possible from D12 on average and patients were discharged on D18. Three posterior pharyngectomies, including 1 as a second stage procedure, were performed. Feeding was possible in 2 patients on D15 and discharge on D18. These encouraging results suggest that this reliable, rapid single stage procedure technique should be adopted.

[Results and indications of curietherapy of the eustachian tube with iridium 192 in chronic otitis in the adult]. / Résultats et indications de la curiethérapie de la trompe d'eustache à l'iridium 192 dans l'otite chronique de l'adulte.

Between January 1985 and January 1988, 56 patients received radioactive implant therapy of the Eustachian tube with Iridium 192 in the context of tympanoplasty for chronic otitis with tubal dysfunction. After reviewing the method used, we present the results by category of chronic otitis and attempt to propose its indications. Tubal dysfunction was assessed on clinical and otoscopic data and tubal manometry in each patient. A randomised study would appear to be necessary to confirm the interesting results obtained in chronic mucous otitis, in the sequelae of chronic otitis, in evolving retraction pockets and finally for certain manifestly discharging cavities.

[Failure and complications of esthetic rhinoplasty. Apropos of 30 reoperations]. / Echecs et complications des rhinoplasties esthétiques. A propos de 30 rhinoplasties secondaires.

Out of 150 rhinoplasties carried out over 3 years in a Surgical Department. 20% of cases had previously undergone one or several surgical procedures. Based on these cases, the authors analysed the principal factors producing failure in cosmetic rhinoplasties and proposed a preventive strategy. The osteocartilaginous dorsum and point of the nose are considered separately in this paper.

[Curietherapy of the eustachian tube with Ir-192]. / Curiethérapie de la trompe d'Eustache par Ir 192.

An essential success factor for tympanoplasties is effective aeration of middle ear, lack of tubular permeability being a factor for failure. The anti-inflammatory effect of curietherapy with Iridium 192 introduced into the tube during middle ear surgery was studied in 38 patients. Tubular dysfunction was evaluated by clinical and manometric examinations. During operation, a sealed plastic tube 1.6 mm in diameter was introduced into the Eustachian tube, an Iridium wire inserted on the following day, and a dose of 1.5 and 3 Gy applied to two groups respectively. Tubular function was assessed as normal or almost normal in 61% of cases. Results were compared with a group of 30 patients not receiving curietherapy.

[Update on exclusive radiotherapy of T1 and T2 of the faucial arch]. / Mise au point sur la radiothérapie exclusive des T1 et T2 de l'arche vélo-amygdalienne.

From April 1971 to October 1984, 71 patients with T1 or T2 tumors of the faucial arch were treated according to the following protocol: Telecobalt therapy to the primary site and to the neck nodes to a dose of 45 Gy. Brachytherapy to the primary site to a dose of 25 to 30 Gy using iridium 192. For node positive patients, boost dose to involved neck nodes with electrons, or radical neck dissection. Seven patients with T1N0 tumors were treated exclusively by 60 Gy iridium implantation. The crude disease free survival is 66% for the group of patients with tumors of the tonsillar region and 41% for those with tumors of the soft palate or uvula. Local control of tonsillar tumors was 98% while that of tumors of the soft palate was 85%. Regional control was 98% for the N0 group and 87% for the N1-3 group. Five cases of soft tissue ulceration were observed, all of which healed spontaneously within a few months. Less salivary impairment was seen than after treatment by external irradiation alone. While these promising results have encouraged the use of this protocol, the introduction of the plastic tube technique has expanded the indications to include almost all T1 and T2 tumors of the faucial arch without obvious extension to the base of tongue or retromolar trigone.

[Evaluation of low-dose cobalt teletherapy in the treatment of oropharyngeal cancers of moderate extension]. / Bilan de la télécobalthérapie à faible débit dans le traitement des cancers oro-pharyngés moyennement étendus.

Comparative efficacy of treatment with irradiation of 20 Gy, either conventionally fractionated (33 cases) or by semi-continuous low-dose irradiation (32 cases) was studied in 65 patients with oropharyngeal cancer with moderate extension (T2b and T3a). Survival rate was 44% in the low-dose group as against 24% in the conventionally treated group at 2-year follow up review. More particularly, however, there were 4 times fewer recurrences in the low-dose group (16% as against 61% in conventional group). This suggests the need for continuing study of the time factor in radiotherapy, although a few cases of necrosis (16%) were observed in the low-dose group.

[Critical study and role of partial vertical reconstructive laryngectomies with epiglottoplasty by the Tucker method. Apropos of 18 cases]. / Etude critique et place des laryngectomies partielles verticales reconstructives avec épiglottoplastie selon la méthode de Tucker. A propos de 18 cas.

Two groups could be distinguished in a series of 18 patients with glottic lesions: one with pure glottic tumors (12 cases) and the other with tumors extending beyond the glottic region (6 cases). All patients but one were operated upon by first intention for epidermoid carcinoma, but also for associated pronounced dysplasia. The so-called Tucker technique was used with slight modifications (less extensive resection of thyroid cartilage, conservation of the two arytenoid cartilages). The postoperative course was satisfactory with decanulation and ablation on the 13th day, and a mean hospital stay of 22 days. Two postoperative deaths due to vascular complications occurred and one patient developed a swinging epiglottis after 2 years. The remaining 16 patients are all alive, including 8 after less than 3 years. Analogous results were noted in an analysis of a total of 93 case-reports from 5 different series of patients. This method provides an elegant and satisfactory repair of pure cordal surgery, but adds nothing from the oncologic point of view since other better adapted and currently well defined operations have to be envisaged for lesions extending beyond this region.

[Severe nasosinus aspergillosis in immunosuppressed patients. Apropos of 3 cases]. / Aspergillose naso-sinusienne grave chez l'immunodéprimé. A propos de trois cas.

Nasosinusal lesions due to Aspergillus rarely occur during immunosuppressive chemotherapy, but are extremely grave, and often fatal due to the extensive necrotizing mucoperiostitis of facial bones provoked under these conditions. Three cases are reported, with recovery in one case only, after exenteration of orbit and denudation of dura mater in orbital roof.

[Myringoplasty in children]. / Myringoplastie chez l'enfant.

An anatomical success rate of 81% was obtained in 150 children 2 to 15 years of age operated upon by myringoplasty in the hospital Bretonneau, Paris between 1977 and 1984. Results were unrelated to age the season or the condition of the mucosa. Adverse factors were a previous history of a transtympanic aerator, a velar cleft or bilateral perforations. Mean functional gain after 1 year was 14 dB. It was not related to age or the technique used.

[Congenital glottic-subglottic stenoses]. / Sténoses glotto-sous-glottiques congénitales.

One particular form of congenital stenosis of larynx that should be considered as a separate entity is the combination of a glottic stenosis with subglottic retraction. The salient features of this malformation are analyzed in 15 cases: laryngeal dyspnea with dysphonia in 2 of 3 patients and the possible detection of a subglottic anomaly on lateral radiography of larynx. However, confirmation of diagnosis can only be by laryngotracheoscopy. It is important to establish a diagnosis of subglottic stenosis associated with a palmation, since treatment and prognosis are very different from those of an isolated glottic palmation: all attempts at endoscopic treatment resulted in failure that intubation or tracheotomy was necessary in 7 cases. One of the 3 fatal cases was directly related to lack of detection of the subglottic stenosis. A successful laryngoplasty was performed in 10 children.