European Annals of Otorhinolaryngology-Head and Neck Diseases最新文献

{"title":"Limitations of the Apnea-Hypopnea Index in pediatric obstructive sleep apnea. A critical review: Toward a multiparametric approach.","authors":"V Couloigner, R Luscan, B Fauroux","doi":"10.1016/j.anorl.2026.08.005","DOIUrl":"https://doi.org/10.1016/j.anorl.2026.08.005","url":null,"abstract":"<p><strong>Objectives: </strong>The Apnea-Hypopnea Index (AHI) is considered the gold standard for diagnosis and severity classification of pediatric obstructive sleep apnea (OSA). This review critically analyzes the scientific foundations of this paradigm and its clinical implications.</p><p><strong>Materials and methods: </strong>A systematic literature review in the PubMed and Cochrane databases was conducted according to the SWiM methodology (Synthesis Without Meta-analysis) following EQUATOR network guidelines. Studies were grouped according to 5 themes: methodological foundations of the AHI, clinical correlations, alternative parameters (oximetry and respiratory effort), sleep study indications, natural history and therapeutic options. The narrative review focused on randomized studies (CHAT, PATS) and international guidelines.</p><p><strong>Results: </strong>The definition of OSA in terms of an AHI threshold of 1 event/hour is based on old statistical data (Marcus et al., 1992) without clinical validation. The PATS study found no significant clinical difference between primary snorers (AHI<1) and mild OSA (AHI 1-5). The correlations between AHI and sleep questionnaires (Pediatric Sleep Questionnaire-Sleep-Related Breathing Disorder Scale [PSQ-SRBD], Obstructive Sleep Apnea-18 [OSA-18]) are very weak (r²≈2%). Oximetric parameters (oxygen desaturation index (ODI), pulse oximetry SpO₂ nadir, hypoxic burden) correlate better with cardiovascular morbidity, although pediatric thresholds remain to be validated. Markers of respiratory effort (flow limitation, pulse transit time, mandibular movement) may identify airway resistance syndrome missed by AHI alone, but are without reference values. Sleep study, with AHI assessment, is not always contributive: in typical clinical presentations without comorbidity, adenotonsillectomy may be proposed upfront.</p><p><strong>Conclusion: </strong>AHI is useful but insufficient to guide therapeutic management. A personalized multiparametric approach integrating oximetric data, respiratory effort, symptoms and validated questionnaires seems more appropriate. Sleep study indications should be reserved for clinical discordance, comorbidity, young children and failure of adenotonsillectomy.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Canaloplasty for acquired external auditory canal stenosis: Technical note and educational video.","authors":"S Gargula, M Daval, D Ebode, M-P Tuset","doi":"10.1016/j.anorl.2026.08.002","DOIUrl":"https://doi.org/10.1016/j.anorl.2026.08.002","url":null,"abstract":"<p><p>Acquired external auditory canal stenosis is rare, but leads to chronic otorrhea and conductive hearing loss that can become disabling. Surgery relies on canaloplasty associated to skin coverage to limit the high risk of recurrence. We describe a standardized retroauricular canaloplasty technique associated to retroauricular thin skin graft. The accompanying video (Supplementary Material) shows the key steps in fundus dissection, reaming, grafting and immobilization. This reproducible approach aims to optimize healing, limit the risk of anterior angle blunting and improve long-term functional results.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On the relation between subglottal pressure and vocal intensity in singing voice disorders.","authors":"M Beaud, B Amy de la Bretèque, S Gerber, C Pillot-Loiseau, N Henrich Bernardoni","doi":"10.1016/j.anorl.2026.06.006","DOIUrl":"https://doi.org/10.1016/j.anorl.2026.06.006","url":null,"abstract":"<p><strong>Aims: </strong>This study, conducted on singers consulting at a phoniatric outpatient clinic, aims to investigate whether the relationship between subglottal pressure and vocal intensity varies depending on the type of vocal pathology.</p><p><strong>Material and methods: </strong>A retrospective study was conducted using the medical files, acoustic, and aerodynamic assessments of 134 singing patients at a University Hospital in France. The assessments included measurements of vocal intensity and estimated subglottal pressure during singing at different pitches and loudness.</p><p><strong>Results: </strong>A significant difference was observed in the relationship between intensity and estimated subglottal pressure between singers with organic voice disorders, functional voice disorders and without voice disorder. Vocal efficiency was reduced in singers with organic laryngeal lesions: for the same estimated subglottal pressure, they produced lower intensities regardless of the pitches sung. Using an ascending hierarchical clustering, we identified two groups of pathologies. The first group included Reinke's edema, laryngocele, and polyps. Consistent with existing data, we found that these singer patients produced sounds of lower intensity at higher subglottal pressure values compared to singers without a disorder. The second group included singers with nodules, their relationship between intensity and estimated subglottal pressure tended to differ from that of singers without a disorder.</p><p><strong>Conclusion: </strong>Our exploratory study on singer patients demonstrates that laryngeal pathologies influence the relationship between estimated subglottal pressure and vocal intensity. These preliminary findings confirm the value of estimated subglottal pressure during singing voice assessment. Future research should focus on larger groups of singer patients with more homogeneous laryngeal lesions.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sliding windows technique for the approach to the orbit and lateral sphenoid recess.","authors":"V Favier, M Fieux, M Veyrat, F Carsuzaa","doi":"10.1016/j.anorl.2026.08.003","DOIUrl":"https://doi.org/10.1016/j.anorl.2026.08.003","url":null,"abstract":"<p><p>The endoscopic endonasal approach to the orbit or the lateral recess of the sphenoid may require passing instruments through a transfixing trans-septal corridor to obtain an adequate working angle. However, this maneuver incurs non-negligible morbidity, with septal perforation, synechia and olfactory disorder. The \"sliding windows\" technique aims to reconcile optimal exposure with mucosal preservation. It is a safe alternative to wide septectomy, while preserving septal trophicity and olfactory function. It is based on asymmetric mucoperichondrial flaps and a central osteocartilaginous window, providing trans-septal access, without direct mucosal incision. By reducing denuded areas and ensuring double mucosal coverage, it can decrease the incidence of perforation and of the functional sequelae reported after conventional transfixing approaches. Three variants are described, depending on the needs for reconstruction and the extent of the approach: (1) unilateral septal flap; (2) asymmetric bilateral septal flaps; (3) asymmetric bilateral flaps, using the ipsilateral flap for reconstruction of the operative site at the end of the procedure. The \"sliding windows\" technique thus meets the aims of endoscopic endonasal surgery, in which functional preservation is a priority.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nasal trigeminal sensitivity after total laryngectomy: A psychophysical study.","authors":"M Saro-Buendía, M Mata, A García-Piñero, L Milián, P Suárez-Urquiza, M Armengot-Carceller","doi":"10.1016/j.anorl.2026.06.007","DOIUrl":"https://doi.org/10.1016/j.anorl.2026.06.007","url":null,"abstract":"<p><strong>Objectives: </strong>Total laryngectomy permanently diverts respiratory airflow through a tracheostoma, abolishing nasal breathing. Although olfactory loss is well described, it remains unclear whether nasal trigeminal chemosensation is perceptually accessible under natural airflow-deprived conditions. We aimed to assess trigeminal performance after total laryngectomy under both airflow-assisted (menthol lateralization detection threshold [LDT]) and non-assisted conditions.</p><p><strong>Material and methods: </strong>A prospective cross-sectional study assessed trigeminal function in patients undergoing total laryngectomy (n=1 preoperative; n=3 postoperative) and matched healthy volunteers (n=10). Trigeminal sensitivity was evaluated using a menthol LDT protocol and the trigeminal subscale of the Barcelona Smell Test-24 (BAST-24), alongside several patient-reported outcome measures.</p><p><strong>Results: </strong>Controls and the preoperative reference showed preserved trigeminal function (mean LDT 16.1±1.9; BAST-24 trigeminal 92.5±8.0%). Postoperative patients exhibited markedly elevated menthol thresholds (mean LDT 3.3±1.1), and trigeminal identification on BAST-24 was 0% in all three cases. Gustatory scores were preserved (100%) in all participants.</p><p><strong>Conclusion: </strong>One month after total laryngectomy, nasal trigeminal chemosensation appears poorly accessible under naturalistic airflow-deprived conditions, with a pronounced elevation of menthol lateralization thresholds and abolition of sniffing-dependent trigeminal identification. Notably, this deficit persists even when airflow is mechanically assisted, suggesting a sensory down-regulation beyond mere physical transport failure. These preliminary findings support further longitudinal studies assessing whether airflow-inducing rehabilitation may restore trigeminal perceptual availability.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-induced sleep endoscopy in the identification of obstruction sites causing obstructive sleep apnea-hypopnea syndrome in children.","authors":"M Demoures-Patris de Breuil, F Chatelet, N Leboulanger, B Fauroux, F Simon, V Couloigner, B Thierry, R Luscan","doi":"10.1016/j.anorl.2026.08.001","DOIUrl":"https://doi.org/10.1016/j.anorl.2026.08.001","url":null,"abstract":"<p><strong>Background: </strong>Evidence for drug-induced sleep endoscopy (DISE) versus multilevel surgery guided by clinical examination is sparse in pediatrics.</p><p><strong>Methods: </strong>A retrospective cohort study included all children undergoing DISE for obstructive sleep apnea (OSA) between September 2021 and April 2025 in a tertiary pediatric center. Clinical examination of obstruction sites was performed in consultation, and treatment was proposed. The data were compared against the intraoperative anatomic data collected during DISE and associated procedures.</p><p><strong>Objective: </strong>To assess the surgical contribution of DISE compared to clinical examination in consultation.</p><p><strong>Results: </strong>Files were analyzed for 240 patients, with a mean age of 6.4±4.6 years. 137 (57%) had type 3 OSA, 7 (3%) type 2, and 96 (40%) type 1. DISE led to changes in surgical strategy in 75% of cases, with 803 procedures performed, compared to 597 planned in consultation (P<0.001). Agreement was satisfactory for partial tonsillectomy, but moderate to weak for surgery in other sites, and especially the tongue base and the laryngeal vestibule. Total anatomic score was significantly higher on DISE than in consultation. Median apnea-hypopnea index (AHI) improved significantly after surgery (P<0.001).</p><p><strong>Conclusion: </strong>DISE identified more obstruction sites than clinical examination in consultation, in children with OSA.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Destombes-Rosai-Dorfman (DRD) disease with nasal and lymph-node involvement.","authors":"C-A Righini, H Gil, A Spinelli","doi":"10.1016/j.anorl.2026.08.004","DOIUrl":"https://doi.org/10.1016/j.anorl.2026.08.004","url":null,"abstract":"<p><strong>Introduction: </strong>Destombes-Rosai-Dorfman (DRD) disease was first described in 1965 by the pathologist Paul Destombes. Almost 90% of patients show lymph-node involvement, which is usually cervical, although all organs can be affected.</p><p><strong>Case report: </strong>A 74-year-old woman consulted for left nasal obstruction and bilateral axillary lymphadenopathies. Clinical examination found a mass in the anterior left nasal cavity and several bilateral axillary lymphadenopathies, which were neither painful nor inflammatory. General health status was normal. Nasal and nodal samples showed large histiocytes with clear cytoplasm and emperipolesis. Within the histiocytes, immunohistochemistry found intense diffuse PS100 and CD68 expression and absence of CD1a marking. Progression was spontaneously favorable, without treatment.</p><p><strong>Discussion: </strong>DRD disease is a benign non-Langerhans histiocytosis, with many and varied clinical presentations. The pathophysiology is not known. Evolution is usually spontaneously favorable, but treatment is required in case of compression, obstruction or lysis, especially in bone, ENT or neurologic involvement.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Olfactory bulb hypoplasia and congenital anosmia in PTCH1-related Gorlin-Goltz syndrome: An emerging association.","authors":"S Costa, F Sousa, T Feliciano, J Lino","doi":"10.1016/j.anorl.2026.07.010","DOIUrl":"10.1016/j.anorl.2026.07.010","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital anosmia (CA) is a rare developmental condition that may occur in isolation or as part of a syndromic disorder. Gorlin-Goltz syndrome (GGS), an autosomal dominant condition most commonly caused by pathogenic variants in PTCH1, is classically characterized by cutaneous, odontogenic and skeletal abnormalities, while neurological manifestations remain incompletely defined.</p><p><strong>Case summary: </strong>We report the case of a 10-year-old girl with genetically confirmed PTCH1-related GGS who presented with lifelong anosmia. Otolaryngological evaluation confirmed absent olfactory function by psychophysical testing and electrophysiological assessment. Neuroimaging revealed bilateral olfactory bulb hypoplasia. Endocrinological evaluation excluded hypogonadotropic hypogonadism, distinguishing this phenotype from classical Kallmann syndrome.</p><p><strong>Discussion: </strong>This case adds to the limited, but growing evidence supporting an association between CA and PTCH1-related GGS, highlighting the role of disrupted Sonic Hedgehog signaling in olfactory system development. Recognition of olfactory dysfunction in these patients may contribute to a broader understanding of the neurodevelopmental spectrum associated with PTCH1 mutations.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of public health measures during the Covid-19 pandemic on the epidemiology of pharyngeal abscess.","authors":"F Bonnafous, M Thouin, A Alghamdi, K Aubry","doi":"10.1016/j.anorl.2026.07.009","DOIUrl":"https://doi.org/10.1016/j.anorl.2026.07.009","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic and the associated public health measures (shielding) altered the circulation of respiratory infections. However, their impact on pharyngeal abscess remains poorly documented.</p><p><strong>Objective: </strong>The primary objective was to assess the progression in the number of pharyngeal abscess cases between March 2018 and February 2024.</p><p><strong>Materials and methods: </strong>A retrospective single-center study compared the periods before, during and after the implementation of shielding measures. Demographic, clinical, therapeutic, and bacteriological data were analyzed.</p><p><strong>Results: </strong>Two hundred twenty patients with pharyngeal abscess were included. A significant increase in cases was observed after the lifting of shielding. We also identified a higher rate of surgical management and a predominance of Streptococcus pyogenes after the measures were lifted.</p><p><strong>Conclusion: </strong>Shielding measures implemented during the COVID-19 pandemic affected not only the number of pharyngeal abscess cases but also their management and bacteriological profile.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An outstanding ear.","authors":"M Ouazzani Touhami, M Bertrand, E Moreddu","doi":"10.1016/j.anorl.2026.07.005","DOIUrl":"https://doi.org/10.1016/j.anorl.2026.07.005","url":null,"abstract":"","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148690160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}