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

{"title":"Optimization of the automated Sunnybrook Facial Grading System - Improving the reliability of a deep learning network with facial landmarks.","authors":"T C Ten Harkel, F Bielevelt, H A M Marres, K J A O Ingels, T J J Maal, C M Speksnijder","doi":"10.1016/j.anorl.2024.07.005","DOIUrl":"https://doi.org/10.1016/j.anorl.2024.07.005","url":null,"abstract":"<p><strong>Objective: </strong>The Sunnybrook Facial Grading System (SFGS) is a well-established grading system to assess the severity and progression of a unilateral facial palsy. The automation of the SFGS makes the SFGS more accessible for researchers, students, clinicians in training, or other untrained co-workers and could be implemented in an eHealth environment. This study investigated the impact on the reliability of the automated SFGS by adding a facial landmark layer in a previously developed convolutional neural network (CNN).</p><p><strong>Methods: </strong>An existing dataset of 116 patients with a unilateral peripheral facial palsy and 9 healthy subjects performing the SFGS poses was used to train a CNN with a newly added facial landmark layer. A separate model was trained for each of the 13 elements of the SFGS and then used to calculate the SFGS subscores and composite score. The intra-class coefficient of the automated grading system was calculated based on three clinicians experienced in the grading of facial palsy.</p><p><strong>Results: </strong>The inter-rater reliability of the CNN with the additional facial landmarks increased in performance for all composite scores compared to the previous model. The intra-class coefficient for the composite SFGS score increased from 0.87 to 0.91, the resting symmetry subscore increased from 0.45 to 0.62, the symmetry of voluntary movement subscore increased from 0.89 to 0.92, and the synkinesis subscore increased from 0.75 to 0.78.</p><p><strong>Conclusion: </strong>The integration of a facial landmark layer into the CNN significantly improved the reliability of the automated SFGS, reaching a performance level comparable to human observers. These results were attained without increasing the dataset underscoring the impact of incorporating facial landmarks into a CNN. These findings indicate that the automated SFGS with facial landmarks is a reliable tool for assessing patients with a unilateral peripheral facial palsy and is applicable in an eHealth environment.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908081","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":"Bilateral cochlear fibrosis complicating chronic myeloid leukemia: A CARE case report.","authors":"G Lahlou, H Daoudi, C Djian, I Mosnier","doi":"10.1016/j.anorl.2024.07.003","DOIUrl":"https://doi.org/10.1016/j.anorl.2024.07.003","url":null,"abstract":"<p><strong>Purpose: </strong>We report the second case of bilateral sudden sensorineural hearing loss with intracochlear fibrosis due to chronic myeloid leukemia.</p><p><strong>Case report: </strong>A 44-year-old man presented to the emergency department with rapidly progressive bilateral hearing loss, tinnitus and vertigo, associated with dyspnea. Chronic myeloid leukemia complicated by pulmonary and cochleovestibular leukostasis was diagnosed, and cytoreductive treatment was started. Despite this treatment, bilateral total hearing loss and complete vestibular deficit persisted. MRI showed bilateral labyrinthitis, and emergency cochlear implantation was indicated. During surgery, inflammatory intracochlear tissue made electrode array insertion possible only against resistance. One year after implantation, there was significant improvement in speech recognition and communication scores.</p><p><strong>Conclusion: </strong>In case of sudden sensorineural hearing loss induced by chronic myeloid leukemia, treatment should be as fast as possible, with prompt cochlear implantation in case of definitive profound hearing loss, because of the risk of cochlear fibrosis and ossification.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908080","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":"Lymph node surgery for salivary gland cancer: REFCOR recommendations by the formal consensus method","authors":"","doi":"10.1016/j.anorl.2023.11.001","DOIUrl":"10.1016/j.anorl.2023.11.001","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the indications for neck dissection in the management of parotid, submandibular or minor salivary gland cancers depending on the clinical situation: i.e., clinical lymph node involvement (cN+) or not (cN0); low or high risk of occult nodal metastasis; diagnosis of malignancy before, during or after surgery.</p></div><div><h3>Material and methods</h3><p>The French Network of Rare Head and Neck Tumors (REFCOR) formed a steering group which drafted a narrative review of the literature published on Medline and proposed recommendations. The level of adherence to the recommendations was then assessed by a rating group according to the formal consensus method.</p></div><div><h3>Results</h3><p>In cN+ salivary gland cancer, ipsilateral neck dissection is recommended. In cN0 salivary gland cancer, ipsilateral neck dissection is recommended, except for tumors at low risk of occult nodal metastasis. If definitive pathology reveals a high risk of occult nodal involvement, additional neck treatment is recommended: ipsilateral neck dissection or elective nodal irradiation.</p></div><div><h3>Conclusion</h3><p>The rate of occult lymph node involvement, and therefore the indication for elective neck dissection, depends primarily on the pathologic grade of the salivary gland cancer.</p></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463795","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":"Analysis of endonasal sinus surgery in a private outpatient setting in a tropical environment: A STROBE analysis","authors":"","doi":"10.1016/j.anorl.2024.02.006","DOIUrl":"10.1016/j.anorl.2024.02.006","url":null,"abstract":"<div><h3>Objectives</h3><p>To evaluate results and failure factors in endonasal surgery in a private outpatient setting in a tropical environment.</p></div><div><h3>Material and method</h3><p>A single-center observational study included 337 patients consecutively undergoing endonasal surgery in a private hospital on Réunion Island, a French overseas administrative <em>Département</em> in the Indian Ocean between 2019 and 2021. The main objective was to assess the success rate of the outpatient pathway. Secondary objectives comprised analysis of complications and identification and management of factors for failure of outpatient management. The study was conducted according to the STROBE editorial guideline.</p></div><div><h3>Results</h3><p><span>The 337 surgeries notably comprised 112 septoplasties<span> (37.5%), 104 meatotomies (30.3%), 15 unilateral total ethmoidectomies (4.6%), 48 bilateral total ethmoidectomies with sphenoidotomy (14.3%), and 18 Draf procedures (5.5%). Seventy-five percent of patients (252/337) were operated on as outpatients, with a success rate of 90% (227/252 patients). The rate of severe </span></span>intraoperative complications<span> was 1.5% (5/337). On multivariate analysis<span>, 3 variables were identified as influencing risk of failure of the outpatient pathway: emergency analgesia in the operating room [odds ratio (OR): 91.61; 95% confidence interval (CI): 22.8–540.3], operating time (OR: 1.05; 95% CI: 1.01–1.09), and recovery room time (OR: 1.02; 95% CI: 1.01–1.03).</span></span></p></div><div><h3>Conclusion</h3><p>Our study in a tropical environment found eligibility and success rates for outpatient endonasal surgery similar to those in metropolitan France. This makes surgical and anesthesiological training a key factor in the success of outpatient care, while the location of the care structure and the climate seem to have little impact.</p></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139944568","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":"Dangers and therapeutic difficulties of intracranial hemangioma in infants: A CARE case report","authors":"","doi":"10.1016/j.anorl.2024.02.001","DOIUrl":"10.1016/j.anorl.2024.02.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Description of neurological complications<span> induced by intracranial hemangioma in infants and by the initiation of beta-blocker treatment (propranolol).</span></p></div><div><h3>Observation</h3><p><span><span><span>A 2-month-old infant was referred for grade 5 non-congenital unilateral peripheral facial palsy. Work-up revealed ipsilateral profound hearing loss and two intracranial hemangiomas: one in the ipsilateral </span>internal auditory canal (IAC), the other in the </span>cerebellum opposite the nodule of vermis. Initial treatment with a beta-blocker (propranolol 1</span> <!-->mg/kg/day for 1<!--> <!-->month, then 3<!--> <!-->mg/kg/day) resulted in disappearance of symptoms and regression of lesions within 8<!--> <!-->weeks. At 20<!--> <!-->months after introduction of maintenance therapy (propranolol 3<!--> <span>mg/kg/day), two asthma attacks occurred, leading to initiation of fluticasone and continuation of the beta-blocker. Thirty months after discontinuation of treatment, no further progression was noted.</span></p></div><div><h3>Discussion</h3><p>Unilateral facial palsy in an infant suggests a number of diagnoses. MRI revealed IAC hemangioma. The choice of dosage and duration of treatment was based on a review of the literature and a strategy defined in multidisciplinary consultation.</p></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139941056","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":"Costs analysis of cochlear implantation in children","authors":"","doi":"10.1016/j.anorl.2024.02.012","DOIUrl":"10.1016/j.anorl.2024.02.012","url":null,"abstract":"<div><h3>Objectives</h3><p>The study assessed the direct medical costs of the cochlear implantation pathway from the healthcare payer's perspective, in children with bilateral severe to profound hearing loss, from diagnosis to 3 years’ follow-up after first implantation. We also compared costs between two populations: congenital and progressive deafness.</p></div><div><h3>Material and methods</h3><p>A retrospective costs analysis was performed for 56 children who received a cochlear implant in one French pediatric ENT center. The children had severe to profound hearing loss, and were implanted before the age of 10 years. We calculated direct medical costs in 3 phases: diagnosis to pre-implantation assessment, surgical and hospital management of implantation, and 3 years’ follow-up.</p></div><div><h3>Results</h3><p>Mean costs were €64,675 (range, €38,709–113,954) per child from diagnosis to 3 years after first implantation. Mean costs in congenital deafness detected on neonatal screening and on progressive deafness were respectively €65,420 and €63,930 (<em>P</em> <!-->=<!--> <!-->0.7).</p></div><div><h3>Conclusion</h3><p>The global cost was €64,675 per child from diagnosis to 3 years after first implantation. There was no difference in cost according to congenital versus progressive hearing loss.</p></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1879729624000292/pdfft?md5=34ef112d5741091e5e6b6eb5e2af1ba6&pid=1-s2.0-S1879729624000292-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050764","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":"Radiotherapy for salivary gland cancer: REFCOR recommendations by the formal consensus method","authors":"","doi":"10.1016/j.anorl.2023.11.006","DOIUrl":"10.1016/j.anorl.2023.11.006","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the indications for radiotherapy in salivary gland cancer and to specify the modalities and target radiation volumes.</p></div><div><h3>Material and methods</h3><p>The French Network of Rare Head and Neck Tumors (REFCOR) formed a steering group which drafted a narrative review of the literature published on Medline and proposed recommendations. The level of adherence to the recommendations was then assessed by a rating group, according to the formal consensus method.</p></div><div><h3>Results</h3><p>Postoperatively, radiotherapy to the primary tumor site<!--> <!-->±<!--> <!-->to the lymph nodes is indicated if one or more of the following adverse histoprognostic factors are present (risk<!--> <!-->&gt;<!--> <!-->10% of locoregional recurrence): T3–T4 category, lymph node invasion, extraglandular invasion, close or positive surgical margins, high tumor grade, perineural invasion, vascular emboli, and/or bone invasion. Intensity-modulated radiation therapy (IMRT) is the gold standard. For unresectable cancers or inoperable patients, carbon ion hadrontherapy may be considered.</p></div><div><h3>Conclusion</h3><p>Radiotherapy in salivary gland cancer is indicated in postoperative situations in case of adverse histoprognostic factors and for inoperable tumors.</p></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463797","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 unusual aural fullness","authors":"","doi":"10.1016/j.anorl.2024.02.004","DOIUrl":"10.1016/j.anorl.2024.02.004","url":null,"abstract":"","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013523","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":"The “right” track!","authors":"","doi":"10.1016/j.anorl.2023.11.010","DOIUrl":"10.1016/j.anorl.2023.11.010","url":null,"abstract":"","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139677785","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":"Ranula at the dawn of the French Republic","authors":"","doi":"10.1016/j.anorl.2024.04.004","DOIUrl":"10.1016/j.anorl.2024.04.004","url":null,"abstract":"","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1879729624000553/pdfft?md5=eabc607ef9f729b0c6aed631559cd17c&pid=1-s2.0-S1879729624000553-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873287","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}