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

{"title":"Transcutaneous platelet-rich plasma injection under laryngeal electromyographic guidance","authors":"R. Haddad, A. Mattei, A. Giovanni","doi":"10.1016/j.anorl.2026.05.007","DOIUrl":"10.1016/j.anorl.2026.05.007","url":null,"abstract":"","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 5","pages":"Pages 437-438"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057691","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":"Limitations of the Apnea-Hypopnea Index in pediatric obstructive sleep apnea. A critical review: Toward a multiparametric approach","authors":"V. Couloigner,&nbsp;R. Luscan,&nbsp;B. Fauroux","doi":"10.1016/j.anorl.2026.08.005","DOIUrl":"10.1016/j.anorl.2026.08.005","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Materials and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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<!--> <!-->&lt;<!--> <!-->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 (<em>r</em>² <!-->≈<!--> <!-->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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 5","pages":"Pages 403-408"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent otorrhea and anterior auditory canal tumefaction: What is your diagnosis?","authors":"S. Gargula,&nbsp;R. Haddad,&nbsp;M. Daval,&nbsp;M.-P. Tuset","doi":"10.1016/j.anorl.2026.02.007","DOIUrl":"10.1016/j.anorl.2026.02.007","url":null,"abstract":"","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 5","pages":"Pages 429-430"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of myringoplasty before 6 years of age: A STROBE analysis","authors":"H. Khidichian,&nbsp;F. Simon,&nbsp;N. Leboulanger,&nbsp;V. Couloigner,&nbsp;F. Denoyelle,&nbsp;N. Loundon","doi":"10.1016/j.anorl.2026.05.003","DOIUrl":"10.1016/j.anorl.2026.05.003","url":null,"abstract":"<div><h3>Objective</h3><div>To report anatomical and functional results and predictive factors for failure of myringoplasty in children under 6 years of age.</div></div><div><h3>Material and methods</h3><div>Retrospective study of myringoplasty for tympanic membrane perforation in children under 6 years of age with at least 2 years’ follow-up. Anatomic and audiological results were evaluated before surgery, at 6 weeks (short-term), 12 months (medium-term) and 24 months (long-term). Predictive factors for failure were analyzed.</div></div><div><h3>Results</h3><div>Forty-seven myringoplasties were included, with a mean patient age of 4.7<!--> <!-->±<!--> <!-->0.4 years. Thirty-nine received underlay grafts and 8 received inlay grafts. The rate of success (tympanic closure, and no otitis media with effusion, myringitis of tympanic retraction) at 6 weeks was 77%, and 70% at 24 months: 79% for underlay and 25% for inlay techniques (<em>P</em> <!-->=<!--> <!-->0.005). Audiometric thresholds improved significantly, with 96% of patients with air-bone gap<!--> <!-->≤<!--> <!-->20<!--> <!-->dB at 12 months after surgery, compared to 57% before (<em>P</em> <!-->=<!--> <!-->0.002). No risk factors for failure were identified, except use of inlay.</div></div><div><h3>Conclusion</h3><div>Myringoplasty performed before the age of 6 yielded satisfactory anatomic and functional results, comparable to other pediatric series across all age groups. The underlay cartilage graft technique provided the best long-term outcomes.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 5","pages":"Pages 377-382"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260132","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":"Evaluating the interpretation of neck CT/MRI scans by ChatGPT-4V for detecting primary oropharyngeal squamous cell carcinoma: An exploratory study","authors":"B. Schmidl,&nbsp;R. Walter,&nbsp;C.C. Hoch,&nbsp;T. Huetten,&nbsp;S. Pigorsch,&nbsp;F. Stögbauer,&nbsp;T. Hussain,&nbsp;B. Wollenberg,&nbsp;M. Wirth","doi":"10.1016/j.anorl.2026.02.012","DOIUrl":"10.1016/j.anorl.2026.02.012","url":null,"abstract":"<div><h3>Objectives</h3><div>Early and accurate detection of head and neck squamous cell carcinoma and the subset of oropharyngeal squamous cell carcinoma (OPSCC) is essential for the therapy and the prognosis of patients. Computer tomography (CT) is the primary imaging modality and is currently evaluated manually by radiologists and head and neck oncologists. Since image recognition in the form of artificial intelligence (AI) was introduced recently with the large language model (LLM) ChatGPT-4V, this exploratory study for the first time evaluates the application of image recognition by ChatGPT in interpreting neck CT and MRI scans for OPSCC detection, and corresponding images without any oropharyngeal lesion.</div></div><div><h3>Materials and methods</h3><div>The most likely diagnosis based on the CT images for 100 CT cases (50 OPSCC, 50 without lesion) and the available corresponding 62 MRI cases (31 OPSCC, 31 without an oropharyngeal lesion) by ChatGPT-4V was rated by two independent reviewers and the overall performance was evaluated in terms of accuracy, sensitivity, and specificity.</div></div><div><h3>Results</h3><div>In this study, ChatGPT-4V reached a sensitivity of 72% and a specificity of 78% in identifying OPSCC from CT images. For MRI scans, sensitivity was 80.6% and specificity 83.9%. Human papillomavirus-positive and more advanced lesions were detected more reliably.</div></div><div><h3>Discussion</h3><div>In this exploratory study of CT and MRI neck scans of the oropharynx, ChatGPT-4V demonstrated a mediocre performance for detecting OPSCC. Continued research and advancements in AI are essential to improve the reliability and clinical utility of LLMs for the interpretation of neck scans.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 5","pages":"Pages 361-368"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic glabellar lesion in an elderly patient","authors":"A.D. Asimakopoulos,&nbsp;Y. Lelonge,&nbsp;A. Karkas","doi":"10.1016/j.anorl.2026.02.009","DOIUrl":"10.1016/j.anorl.2026.02.009","url":null,"abstract":"","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 5","pages":"Pages 431-434"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Jael syndrome, or the nasty arrow","authors":"L. Hassler,&nbsp;J.-B. Morvan,&nbsp;M. Fieux","doi":"10.1016/j.anorl.2026.05.001","DOIUrl":"10.1016/j.anorl.2026.05.001","url":null,"abstract":"<div><div>The term “Jael syndrome” is a symbolic analogy referring to penetrating craniofacial trauma caused, intentionally or accidentally, by blade or similar weapon in which the foreign body is kept in-situ during initial management. It is rare in clinical and medicolegal practice, but is potentially life-threatening or with neurologic and functional impact. Its name comes from an episode in the Book of Judges in the Hebrew Bible (Old Testament) in which Jael, a woman, kills the Canaanite general Sisera by hammering a tent peg through his temple while he is asleep, thus ensuring the liberation of the people of Israel. Over the centuries, the story had an enduring influence on the European artistic and cultural imagination, with numerous paintings, sculptures, musical and literary compositions memorializing the symbolic power of a unique act of violence. Artists such as Abraham Godyn and Artemisia Gentileschi, baroque sculptors, composers such as Georg Friedrich Haendel and French writers such as Victor Hugo gave the figure of Jael a lasting place in our cultural heritage. In medicine, the first description of a penetrating craniofacial injury with the foreign body in-situ was by Geoffrey Jefferson, a British neurosurgeon, in the mid-20th century, who reported a case of orbitocranial impalement. Subsequently, a few rare cases mainly involved isolated case reports or retrospective series, with consequently low levels of evidence for optimal management. Via a present-day case of penetrating facial trauma involving an arrow, this article reviews diagnostic and therapeutic issues in Jael syndrome. The case illustrates the importance of management in a well-equipped tertiary referral center with specialized medical-surgical multidisciplinary teamwork. Management is based on fundamental principles: systematized initial clinical assessment using the ABCDE (ATLS®) algorithm; not moving or removing the foreign body during the initial stage; early protection of the airway and vascular system; and adapted imaging, ideally by head-and-neck CT angiography. Current strategies favor personalized, selective management based on clinical examination, lesion topography and hemodynamic stability, rather than systematic surgical exploration. However, multicenter prospective studies are needed to refine guidelines, notably by integrating advanced imaging and minimally invasive techniques in order to improve functional prognosis in these rare but high-risk trauma.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 5","pages":"Pages 425-428"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining the cutting edge: A multi-country European survey among academic head and neck surgeons on surgical margin practices in oral cavity cancer","authors":"B. Celik,&nbsp;F. Gul,&nbsp;S. Serifler,&nbsp;K.S. Bulut,&nbsp;L.G. Locatello,&nbsp;P. Gorphe,&nbsp;C. Kerawala,&nbsp;C.R. Leemans,&nbsp;M.A. Babademez","doi":"10.1016/j.anorl.2026.03.008","DOIUrl":"10.1016/j.anorl.2026.03.008","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate current surgical margin assessment strategies, intraoperative frozen section (FS) use, and the interpretation of dysplasia and carcinoma in situ (CIS) among European academic head and neck surgeons.</div></div><div><h3>Methods</h3><div>A cross-sectional, web-based survey was distributed to head and neck surgeons in 17 European countries between June 5 and July 10, 2025. The 20-item questionnaire, structured into four domains, examined FS use, margin definitions, pathology access, and intraoperative imaging. Descriptive analysis was applied.</div></div><div><h3>Results</h3><div>Most respondents (92.3%) routinely used FS during oral cavity resections. Tumor bed sampling was preferred over main specimen sampling (64.1% vs. 35.8%), mainly to reduce sampling error (40.1%) and based on clinical experience (36.7%). A ≥<!--> <!-->5<!--> <!-->mm cutoff was the most accepted threshold for negativity (77.7%). CIS was considered a positive margin by 88% of participants, while interpretation of dysplasia varied. Only 42.7% reported access to a dedicated head and neck pathologist. Despite this, 94.8% expressed willingness to adopt intraoperative imaging modalities if proven effective.</div></div><div><h3>Conclusion</h3><div>This multi-country European survey among predominantly academic head and neck surgeons highlights both consensus and variability in surgical margin assessment. While FS remains widely practiced, significant differences persist in interpreting dysplasia and FS-guided margin conversion. These findings stress the need for standardized guidelines. Future prospective studies should validate margin thresholds and investigate the value of emerging intraoperative imaging technologies to improve oncologic outcomes.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 5","pages":"Pages 369-376"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983855","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":"Pharyngo-laryngeal dysfunction and severe COPD","authors":"C. Marécaux,&nbsp;M. Poncelet,&nbsp;O. Bonhomme,&nbsp;A. Lagier","doi":"10.1016/j.anorl.2026.05.004","DOIUrl":"10.1016/j.anorl.2026.05.004","url":null,"abstract":"<div><h3>Objectives</h3><div>The course of chronic obstructive pulmonary disease (COPD) features episodic exacerbation, contributing to severity. The present study assessed associations between COPD, dysphonia and dysphagia. Laryngeal aspiration is a risk factor for repeated exacerbation of COPD. Certain risk factors are common to COPD and laryngeal pathology; dyspnea impairs phonation and swallowing.</div></div><div><h3>Material and methods</h3><div>This prospective study included 29 patients with group E COPD outside of exacerbation episodes, and free of neurodegenerative disease and history of head and neck cancer. Phonation and swallowing were assessed concomitantly.</div></div><div><h3>Endpoints</h3><div>The main study endpoint was the prevalence of phonation and swallowing disorders in severe COPD. The secondary objective was to determine whether vocal disorder is a marker of dysphagia in patients at risk of respiratory infection.</div></div><div><h3>Results</h3><div>Prevalence of dysphonia and dysphagia was high on objective assessment but underestimated in self-reports. More than 50% of patients showed deficits in at least 1 mechanism of swallowing, and notably delayed triggering of the pharyngeal reflex. Only the s/z ratio was significantly associated with dysphagia.</div></div><div><h3>Conclusion</h3><div>Dysphagia and dysphonia are frequent and underestimated in severe COPD. The present study argues for systematic objective screening of swallowing disorder, even in the absence of complaint or dysphonia.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 5","pages":"Pages 383-386"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007101","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,&nbsp;H. Gil,&nbsp;A. Spinelli","doi":"10.1016/j.anorl.2026.08.004","DOIUrl":"10.1016/j.anorl.2026.08.004","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Case report</h3><div>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.</div></div><div><h3>Discussion</h3><div>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.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 5","pages":"Pages 417-420"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","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}