Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2014
But de la presentation L’objectif principal de notre etude est d’evaluer les resultats du traitem... more But de la presentation L’objectif principal de notre etude est d’evaluer les resultats du traitement chirurgical des schwannomes vestibulaires (SV). L’objectif secondaire est de comparer les resultats des voies d’abord retrosigmoide (VRS) et translabyrinthique (VTL). Materiel et methodes Il s’agit d’une etude retrospective portant sur 177 patients operes d’un SV entre 2008 et 2012 avec une moyenne de suivi postoperatoire de 18 mois [2–52]. Les donnees etudiees sont la fonction faciale (classification de House et Brackmann) et les resultats auditifs en fonction de la taille du SV (classification de Koos), et de la voie d’abord. Les complications postoperatoires sont egalement rapportees ainsi que la duree d’intervention. Resultats Cent trente et un patients ont ete operes par VRS, 46 par voie translabyrinthique. 58 % des tumeurs operees sont de stades 3 et 4 (49 % des VRS et 78 % VTL). Aucun deces n’est constate dans notre serie. La duree moyenne d’intervention pour les SV de stade 3 et 4 est de 182 minutes [120–246] pour la VRS et de 285 minutes [190–423] pour la VTL ( p Conclusion L’utilisation de la VRS permet une exerese plus rapide des SV de stades 3 ou 4, sans risque supplementaire pour la fonction faciale. Elle permet de preserver une audition utile (7,8 %) ou appareillable (18 %) pour des SV de stade 3 ou 4 operes par VRS, pour lesquels une exerese par VTL est generalement pratiquee.
European annals of otorhinolaryngology, head and neck diseases, 2014
Ossifying fibroma (OF) is a rare benign fibro-osseous tumor, mainly located in the head and neck ... more Ossifying fibroma (OF) is a rare benign fibro-osseous tumor, mainly located in the head and neck region. Most often, it affects the mandible but rare involvement of paranasal sinuses has been reported, associated with more locally aggressive behavior. We report the case of an 8-year-old boy with OF of the middle turbinate, revealed by ethmoiditis. Total resection was performed on an endoscopic approach. The patient was free of clinical or radiological recurrence at 3 years' follow-up. This was the youngest patient with OF of the middle turbinate so far reported in the international literature. Presumptive diagnosis is established by clinical examination and CT scan (location, oval-shaped mass, heterogeneous tumor with a thin bony rim). Definitive diagnosis is founded on histological examination (psammomatous bodies, osteoblastic rim, trabecular bone). Treatment in paranasal sinus OF is surgical, preferentially on an endoscopic approach. Resection should be as complete as possibl...
Revue de laryngologie - otologie - rhinologie, 2008
This study aims to describe anatomical variations in the posterior tympanum. Different configurat... more This study aims to describe anatomical variations in the posterior tympanum. Different configurations which influence surgical decisions in middle ear surgery are described. Surgical access to the sinus tympani remains a challenge for otologic surgeons. Usually, the retrotympanum is approached through the middle ear in the anterior-posterior direction during chronic ear surgery. An endoscopic approach is necessary to detail all reliefs of the middle ear and control the total removal in a cholesteatoma surgery. Our study included 120 ears with otosclerosis that were operated on. We have performed an intra-operative endoscopic examination with different endoscopes from the Storz company (3.0 mm diameter 45 and 70 degrees). Its rigid endoscopes have been used to obtain a detailed inspection of the entire middle ear cavity. Three main anatomical configurations increase difficulty for the otologic surgeons. One hundred and twenty ears were included in this retrospective study. We describ...
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2014
/ Annales françaises d'oto-rhino-laryngologie et de pathologie cervico-faciale 131 (2014) A29-A68... more / Annales françaises d'oto-rhino-laryngologie et de pathologie cervico-faciale 131 (2014) A29-A68 * Auteur correspondant. But de la présentation Les tumeurs du nerf facial sont des lésions rares, dont la prise en charge reste controversée. Elles comprennent
Revue de laryngologie - otologie - rhinologie, 2012
Evaluation of tubomanometry contribution to diagnosis middle ear barotraumas in relation with rhi... more Evaluation of tubomanometry contribution to diagnosis middle ear barotraumas in relation with rhinopharyngeal scar tissue, and contribution to check postoperative effectiveness of scar tissue surgical resection. Clinical cases study of two stewardesses who have lost their flight fitness consecutively to barotraumatic otitis during landing, engendered by rhinopharyngeal scar tissue. Pre-operative tubomanometric parameters were abnormal in both cases: decrease of intratympanic pressure in one case, variability of tube opening latency index and lengthening of intratympanic pressure rising time in the other case. Surgical section during endonasal endoscopy results in initially abnormal tubomanometric parameters normalization, allowing resumption of flight fitness without any barotrauma. Some abnormal tubomanometric parameters help to establish causality link between middle ear barotrauma and rhinopharyngeal scar tissue for which surgical section is thus indicated. Post-operative tuboman...
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2013
Patients et méthodes.-Une population de dix patients opérés et suivis dans le même centre est pré... more Patients et méthodes.-Une population de dix patients opérés et suivis dans le même centre est présentée et analysée (âge, étiologie, niveau socioculturel, durée de la surdité, port ou non d'un appareil conventionnel antérieur). Les patients ont été évalués comme lors de la première année :-par des tests en cabine : • audiométrie tonale, • intelligibilité de la parole ;-test VCV, mots et phrases de Fournier en listes ouvertes et fermées dans le silence et dans le bruit à différents rapports signal/bruit (+10 dB, 0 dB, −5 dB). Tous les tests sont présentés en voix enregistrée :-localisation spatiale ;-par auto-questionnaires identiques à celui de la première année (APHAB et auto-questionnaire du service). Résultats.-L'indice de satisfaction reste très élevé (90 %) tout comme le temps de port du dispositif. Les résultats restent stables au cours du temps puisque le gain moyen tonal initial retrouvé lors de la première année de +19,2 dB reste stable ; en revanche, il existe une amélioration notable de la discrimination en vocale avec le temps pour une partie des patients. Les réglages ont peu bougé au cours du temps passés les six premiers mois. Il n'y a à ce jour aucune panne de batterie interne. Un patient a été réopéré. Conclusion.-La discussion portera sur la place qu'il faut accorder à ce type d'implant au sein de l'offre de réhabilitation actuelle proposée aux patients atteints de surdité moyenne à sévère.
To present a prospective temporal bone fracture database, and study facial and cochleovestibular ... more To present a prospective temporal bone fracture database, and study facial and cochleovestibular sequelae and their impact on quality of life. Prospective study of consecutive cases of 39 patients with 45 temporal bone fractures over 11-month period in a university tertiary referral center. Based on epidemiological data, clinical and imaging findings, treatment modalities and outcome of patients with follow-up of one year, the present study focused on facial and cochleovestibular sequelae and their impact on quality of life after one-year period. After 12months, 44% of patients present with balance problems, 56% with hypoacusis, 56% with tinnitus, and 15% with facial paralysis. In 75%-80% of patients, the cochleovestibular sequelae are described as disabling. Post-trauma quality of life was significantly impaired compared with pre-trauma quality of life, even after 12months. Long-term cochleovestibular sequelae were significantly associated with poor long-term quality of life. The study demonstrates the need to focus on prevention of temporal bone fractures, notably by promoting the use of helmets and improvements in helmet design. The rapid diagnosis of temporal bone fracture is crucial as it enables effective initial management aimed at avoiding sequelae. The frequency of cochleovestibular sequelae after temporal bone fracture and their impact on quality of life demonstrate the importance of, and need for, ongoing follow-up by a local medical team who can diagnose and manage these long-term sequelae.
Revue de laryngologie - otologie - rhinologie, 2012
Evaluation of tubomanometry contribution to diagnosis middle ear barotraumas in relation with rhi... more Evaluation of tubomanometry contribution to diagnosis middle ear barotraumas in relation with rhinopharyngeal scar tissue, and contribution to check postoperative effectiveness of scar tissue surgical resection. Clinical cases study of two stewardesses who have lost their flight fitness consecutively to barotraumatic otitis during landing, engendered by rhinopharyngeal scar tissue. Pre-operative tubomanometric parameters were abnormal in both cases: decrease of intratympanic pressure in one case, variability of tube opening latency index and lengthening of intratympanic pressure rising time in the other case. Surgical section during endonasal endoscopy results in initially abnormal tubomanometric parameters normalization, allowing resumption of flight fitness without any barotrauma. Some abnormal tubomanometric parameters help to establish causality link between middle ear barotrauma and rhinopharyngeal scar tissue for which surgical section is thus indicated. Post-operative tuboman...
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2014
But de la presentation L’objectif principal de notre etude est d’evaluer les resultats du traitem... more But de la presentation L’objectif principal de notre etude est d’evaluer les resultats du traitement chirurgical des schwannomes vestibulaires (SV). L’objectif secondaire est de comparer les resultats des voies d’abord retrosigmoide (VRS) et translabyrinthique (VTL). Materiel et methodes Il s’agit d’une etude retrospective portant sur 177 patients operes d’un SV entre 2008 et 2012 avec une moyenne de suivi postoperatoire de 18 mois [2–52]. Les donnees etudiees sont la fonction faciale (classification de House et Brackmann) et les resultats auditifs en fonction de la taille du SV (classification de Koos), et de la voie d’abord. Les complications postoperatoires sont egalement rapportees ainsi que la duree d’intervention. Resultats Cent trente et un patients ont ete operes par VRS, 46 par voie translabyrinthique. 58 % des tumeurs operees sont de stades 3 et 4 (49 % des VRS et 78 % VTL). Aucun deces n’est constate dans notre serie. La duree moyenne d’intervention pour les SV de stade 3 et 4 est de 182 minutes [120–246] pour la VRS et de 285 minutes [190–423] pour la VTL ( p Conclusion L’utilisation de la VRS permet une exerese plus rapide des SV de stades 3 ou 4, sans risque supplementaire pour la fonction faciale. Elle permet de preserver une audition utile (7,8 %) ou appareillable (18 %) pour des SV de stade 3 ou 4 operes par VRS, pour lesquels une exerese par VTL est generalement pratiquee.
European annals of otorhinolaryngology, head and neck diseases, 2014
Ossifying fibroma (OF) is a rare benign fibro-osseous tumor, mainly located in the head and neck ... more Ossifying fibroma (OF) is a rare benign fibro-osseous tumor, mainly located in the head and neck region. Most often, it affects the mandible but rare involvement of paranasal sinuses has been reported, associated with more locally aggressive behavior. We report the case of an 8-year-old boy with OF of the middle turbinate, revealed by ethmoiditis. Total resection was performed on an endoscopic approach. The patient was free of clinical or radiological recurrence at 3 years' follow-up. This was the youngest patient with OF of the middle turbinate so far reported in the international literature. Presumptive diagnosis is established by clinical examination and CT scan (location, oval-shaped mass, heterogeneous tumor with a thin bony rim). Definitive diagnosis is founded on histological examination (psammomatous bodies, osteoblastic rim, trabecular bone). Treatment in paranasal sinus OF is surgical, preferentially on an endoscopic approach. Resection should be as complete as possibl...
Revue de laryngologie - otologie - rhinologie, 2008
This study aims to describe anatomical variations in the posterior tympanum. Different configurat... more This study aims to describe anatomical variations in the posterior tympanum. Different configurations which influence surgical decisions in middle ear surgery are described. Surgical access to the sinus tympani remains a challenge for otologic surgeons. Usually, the retrotympanum is approached through the middle ear in the anterior-posterior direction during chronic ear surgery. An endoscopic approach is necessary to detail all reliefs of the middle ear and control the total removal in a cholesteatoma surgery. Our study included 120 ears with otosclerosis that were operated on. We have performed an intra-operative endoscopic examination with different endoscopes from the Storz company (3.0 mm diameter 45 and 70 degrees). Its rigid endoscopes have been used to obtain a detailed inspection of the entire middle ear cavity. Three main anatomical configurations increase difficulty for the otologic surgeons. One hundred and twenty ears were included in this retrospective study. We describ...
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2014
/ Annales françaises d'oto-rhino-laryngologie et de pathologie cervico-faciale 131 (2014) A29-A68... more / Annales françaises d'oto-rhino-laryngologie et de pathologie cervico-faciale 131 (2014) A29-A68 * Auteur correspondant. But de la présentation Les tumeurs du nerf facial sont des lésions rares, dont la prise en charge reste controversée. Elles comprennent
Revue de laryngologie - otologie - rhinologie, 2012
Evaluation of tubomanometry contribution to diagnosis middle ear barotraumas in relation with rhi... more Evaluation of tubomanometry contribution to diagnosis middle ear barotraumas in relation with rhinopharyngeal scar tissue, and contribution to check postoperative effectiveness of scar tissue surgical resection. Clinical cases study of two stewardesses who have lost their flight fitness consecutively to barotraumatic otitis during landing, engendered by rhinopharyngeal scar tissue. Pre-operative tubomanometric parameters were abnormal in both cases: decrease of intratympanic pressure in one case, variability of tube opening latency index and lengthening of intratympanic pressure rising time in the other case. Surgical section during endonasal endoscopy results in initially abnormal tubomanometric parameters normalization, allowing resumption of flight fitness without any barotrauma. Some abnormal tubomanometric parameters help to establish causality link between middle ear barotrauma and rhinopharyngeal scar tissue for which surgical section is thus indicated. Post-operative tuboman...
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2013
Patients et méthodes.-Une population de dix patients opérés et suivis dans le même centre est pré... more Patients et méthodes.-Une population de dix patients opérés et suivis dans le même centre est présentée et analysée (âge, étiologie, niveau socioculturel, durée de la surdité, port ou non d'un appareil conventionnel antérieur). Les patients ont été évalués comme lors de la première année :-par des tests en cabine : • audiométrie tonale, • intelligibilité de la parole ;-test VCV, mots et phrases de Fournier en listes ouvertes et fermées dans le silence et dans le bruit à différents rapports signal/bruit (+10 dB, 0 dB, −5 dB). Tous les tests sont présentés en voix enregistrée :-localisation spatiale ;-par auto-questionnaires identiques à celui de la première année (APHAB et auto-questionnaire du service). Résultats.-L'indice de satisfaction reste très élevé (90 %) tout comme le temps de port du dispositif. Les résultats restent stables au cours du temps puisque le gain moyen tonal initial retrouvé lors de la première année de +19,2 dB reste stable ; en revanche, il existe une amélioration notable de la discrimination en vocale avec le temps pour une partie des patients. Les réglages ont peu bougé au cours du temps passés les six premiers mois. Il n'y a à ce jour aucune panne de batterie interne. Un patient a été réopéré. Conclusion.-La discussion portera sur la place qu'il faut accorder à ce type d'implant au sein de l'offre de réhabilitation actuelle proposée aux patients atteints de surdité moyenne à sévère.
To present a prospective temporal bone fracture database, and study facial and cochleovestibular ... more To present a prospective temporal bone fracture database, and study facial and cochleovestibular sequelae and their impact on quality of life. Prospective study of consecutive cases of 39 patients with 45 temporal bone fractures over 11-month period in a university tertiary referral center. Based on epidemiological data, clinical and imaging findings, treatment modalities and outcome of patients with follow-up of one year, the present study focused on facial and cochleovestibular sequelae and their impact on quality of life after one-year period. After 12months, 44% of patients present with balance problems, 56% with hypoacusis, 56% with tinnitus, and 15% with facial paralysis. In 75%-80% of patients, the cochleovestibular sequelae are described as disabling. Post-trauma quality of life was significantly impaired compared with pre-trauma quality of life, even after 12months. Long-term cochleovestibular sequelae were significantly associated with poor long-term quality of life. The study demonstrates the need to focus on prevention of temporal bone fractures, notably by promoting the use of helmets and improvements in helmet design. The rapid diagnosis of temporal bone fracture is crucial as it enables effective initial management aimed at avoiding sequelae. The frequency of cochleovestibular sequelae after temporal bone fracture and their impact on quality of life demonstrate the importance of, and need for, ongoing follow-up by a local medical team who can diagnose and manage these long-term sequelae.
Revue de laryngologie - otologie - rhinologie, 2012
Evaluation of tubomanometry contribution to diagnosis middle ear barotraumas in relation with rhi... more Evaluation of tubomanometry contribution to diagnosis middle ear barotraumas in relation with rhinopharyngeal scar tissue, and contribution to check postoperative effectiveness of scar tissue surgical resection. Clinical cases study of two stewardesses who have lost their flight fitness consecutively to barotraumatic otitis during landing, engendered by rhinopharyngeal scar tissue. Pre-operative tubomanometric parameters were abnormal in both cases: decrease of intratympanic pressure in one case, variability of tube opening latency index and lengthening of intratympanic pressure rising time in the other case. Surgical section during endonasal endoscopy results in initially abnormal tubomanometric parameters normalization, allowing resumption of flight fitness without any barotrauma. Some abnormal tubomanometric parameters help to establish causality link between middle ear barotrauma and rhinopharyngeal scar tissue for which surgical section is thus indicated. Post-operative tuboman...
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