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

{"title":"Auditory neuropathy as the first sign of leptomeningeal metastasis","authors":"R. Santarelli,&nbsp;F. Di Paola","doi":"10.1016/j.anorl.2026.03.003","DOIUrl":"10.1016/j.anorl.2026.03.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Auditory neuropathy is a hearing disorder characterized by impaired temporal coding of acoustic signals in the auditory nerve fibers, resulting in abnormal auditory perceptions relying on temporal cues. We describe the case of a woman with a history of cancer who developed auditory neuropathy as the first manifestation of leptomeningeal metastasis.</div></div><div><h3>Case summary</h3><div>A woman in her sixties complained of severe difficulties in understanding speech despite preserved sensitivity to sounds, which had begun two months before audiological assessment. Her past medical history was remarkable for an occult cancer, possibly breast cancer, diagnosed seven years earlier. Pure-tone audiometry showed mild bilateral sensorineural hearing loss associated with markedly reduced speech intelligibility. Otoacoustic emissions were normal, indicating preserved outer hair cell function, whereas auditory brainstem responses (ABRs) were absent despite preserved hearing thresholds. Contrast-enhanced brain magnetic resonance imaging (MRI) only demonstrated bilateral enhancement of the eighth cranial nerve. However, a brain MRI performed one month later revealed diffuse leptomeningeal enhancement, while cerebrospinal fluid (CSF) cytology was positive for atypical malignant cells, both findings consistent with leptomeningeal metastasis.</div></div><div><h3>Discussion</h3><div>This case illustrates that the onset of auditory neuropathy in a patient with a clinical history of cancer may represent an early clinical sign of leptomeningeal metastasis, highlighting the importance of prompt neuroimaging and CSF analysis.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 4","pages":"Pages 334-336"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786415","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":"Otoendoscopy: Tricks and tips for dealing with bleeding","authors":"E. Chebib,&nbsp;G. Orofino,&nbsp;V. Couloigner,&nbsp;F. Simon","doi":"10.1016/j.anorl.2026.01.001","DOIUrl":"10.1016/j.anorl.2026.01.001","url":null,"abstract":"<div><div>For pediatric myringoplasty, otoendoscopy is less invasive than traditional microscopic surgery, enabling a wide-angle view and precise identification of anatomic and pathological structures. It has significant advantages, with high rates of tympanic closure, shorter operating time and simpler postoperative course. Bleeding, however, notably in children's narrow auditory canals, is a major problem, impairing visibility and complicating surgery. There are various techniques for dealing with it: cautious infiltration of the external auditory canal, and adrenaline-soaked cotton pledgets help reduce bleeding locally and absorb excess blood while keeping the tympanomeatal flap raised, increasing the workspace and protecting the flap against the instruments. Specific instruments such as suction elevators allow the surgeon to operate with a single hand while maintaining optimal visibility. Associated to controlled anesthesia with moderate hypotension and controlled hypocapnia, these techniques ensure effective management of bleeding, making the endoscopic approach more comfortable and reliable.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 4","pages":"Pages 337-339"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158709","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":"Dynamics of prognostic nutritional index before and after surgery in head and neck cancer","authors":"T. Miura,&nbsp;H. Kessoku,&nbsp;T. Kobayashi,&nbsp;M. Nagaoka,&nbsp;H. Kojima","doi":"10.1016/j.anorl.2026.03.002","DOIUrl":"10.1016/j.anorl.2026.03.002","url":null,"abstract":"<div><h3>Aims</h3><div>To evaluate the relationship between changes in the prognostic nutritional index (PNI), which is an indicator of nutritional status, and outcomes in patients with head and neck cancer who underwent surgery at our hospital.</div></div><div><h3>Material and methods</h3><div>We retrospectively reviewed the medical records of 148 patients (128 men and 20 women) who underwent surgery from 2015 to 2022. The median age was 68.5 (range: 40–88) years. Overall survival (OS) was calculated using the Kaplan-Meier method. The PNI was calculated preoperatively and postoperatively. Based on changes in pre- and post-treatment, patients were categorized as having high PNI both before and after surgery (high-to-high [HTH]), low PNI before and high PNI after surgery (low-to-high [LTH]), high PNI before and low PNI after surgery (high-to-low [HTL]), and low PNI both preoperatively and postoperatively (low-to-low [LTL]).</div></div><div><h3>Objectives</h3><div>The effects of pre- and post-treatment changes in the PNI on patient outcomes were determined using the Cox proportional hazards model.</div></div><div><h3>Results</h3><div>The median PNI was 49 and 48 before and after surgery, respectively. In the multivariate analysis, preoperative PNI was an independent poor prognostic factor for disease-free survival (DFS) and OS (<em>P</em> <!-->=<!--> <!-->0.037 and <em>P</em> <em>=</em> <!-->0.039). The postoperative PNI was an independent poor prognostic factor for DFS and OS (<em>P</em> <!-->&lt;<!--> <!-->0.01). In the univariate analysis, the HTL and LTL groups showed poorer patient outcomes when the HTH group was used as a reference.</div></div><div><h3>Conclusion</h3><div>Changes in PNI could be a useful indicator of postoperative outcomes in patients with head and neck cancer.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 4","pages":"Pages 267-273"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647280","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":"Temporal bone osteolytic lesion with skull base extension","authors":"A.D. Asimakopoulos,&nbsp;J.-M. Dumollard,&nbsp;A. Karkas","doi":"10.1016/j.anorl.2025.12.003","DOIUrl":"10.1016/j.anorl.2025.12.003","url":null,"abstract":"","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 4","pages":"Pages 340-342"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138048","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":"Efficacy of swallowing muscle training for the treatment of patients with post-stroke dysphagia: A systematic review and meta-analysis","authors":"B. Pastor-Benavente,&nbsp;P. Hernández-Lucas,&nbsp;A. González-Castro,&nbsp;R. Leirós-Rodríguez","doi":"10.1016/j.anorl.2026.03.005","DOIUrl":"10.1016/j.anorl.2026.03.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Strokes may cause some swallowing difficulty or associated dysphagia in 25–80% of patients, increasing morbidity and mortality associated with nutritional and respiratory disorders. Therefore, the aim of this research was to evaluate the efficacy of swallowing muscle training in patients with dysphagia in post-stroke patients.</div></div><div><h3>Methods</h3><div>A systematic search was carried out in PubMed, Scopus, Web of Science and MEDLINE.</div></div><div><h3>Results</h3><div>Of the 13 investigations analyzed, four evaluated the effects of Shaker exercise, tongue training and chin flexion against resistance; two investigations applied mandibular opening exercises against resistance; and only one, the effect of training with forced swallows was evaluated. Meta-analysis confirmed their significant effect on reducing the risk of penetration and aspiration.</div></div><div><h3>Conclusion</h3><div>Swallowing muscle training has beneficial effects on swallowing function in patients with post-stroke dysphagia and reduced the risk of penetration and aspiration.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 4","pages":"Pages 297-305"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786550","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":"The impact of surgical excision modalities of Merkel cell carcinoma of the head and neck on recurrence, survival, and quality of life: A systematic review","authors":"M. Geoffroy,&nbsp;F. Alibert,&nbsp;M. Fadel,&nbsp;M. Samimi,&nbsp;S. Boucher","doi":"10.1016/j.anorl.2026.01.012","DOIUrl":"10.1016/j.anorl.2026.01.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Standard treatment for locoregional (stages I–III) Merkel cell carcinoma (MCC) includes wide local excision (WLE) with lymph node management. However, the optimal surgical approach remains debated, especially in the head and neck, where extensive excision may impair function and aesthetics, affecting patients’ health-related quality of life (HR-QoL), and delay postoperative radiotherapy (RT).</div></div><div><h3>Objective</h3><div>This systematic review aimed to evaluate the impact of surgical excision modalities — including surgical margins, Mohs micrographic surgery (MMS), and histological resection status — on recurrence and survival outcomes in head and neck MCC (HN-MCC). Secondary objectives included assessing morbidity and HR-QoL.</div></div><div><h3>Materials and methods</h3><div>A systematic search of Medline, Embase, and Web of Science identified studies on HN-MCC surgical treatments. Studies were categorized into a narrative review and an individual descriptive analysis of cases. Two independent reviewers performed study selection, data extraction, and risk-of-bias assessment.</div></div><div><h3>Results</h3><div>A total of 43 studies were included: 9 cohort studies, 10 case series, and 24 case reports. No randomized clinical trials were found. No superior technique was identified between MMS and WLE. No studies showed a statistical link between surgical margin categories or histological resection status and local control or survival outcomes. None of the cohort and case series studies reported data on HR-QoL in patients with HN-MCC.</div></div><div><h3>Conclusion</h3><div>Significant heterogeneity in available data limits definitive recommendations on surgical approaches for HN-MCC.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 4","pages":"Pages 306-318"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934752","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":"REFCOR guidelines on the management of olfactory neuroblastoma: A formalized expert consensus","authors":"V. Gorzkowski,&nbsp;C. Monnot,&nbsp;C. Castain,&nbsp;G. de Bonnecaze,&nbsp;B. Verillaud,&nbsp;J. Michel,&nbsp;A. Moya-Plana,&nbsp;V. Coste-Martineau,&nbsp;L. Digue,&nbsp;J. Thariat,&nbsp;C. Dupin,&nbsp;L. de Gabory,&nbsp;C. Rumeau","doi":"10.1016/j.anorl.2026.06.004","DOIUrl":"10.1016/j.anorl.2026.06.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Olfactory neuroblastoma (ONB) is a rare malignant tumor of the sinonasal tract. The objective of this study is to present an evidence-based synthesis of the recommendations of the French Expert Network of Rare ENT Cancers (REFCOR), published in 2022, concerning the diagnostic and therapeutic management of ONB.</div></div><div><h3>Method</h3><div>These recommendations result from a multidisciplinary consensus based on a critical analysis of the literature and feedback from expert centers within a structured process.</div></div><div><h3>Results</h3><div>ONB accounts for 6% of sinonasal cancers, with no identified risk factors. Diagnosis is based on CT and MRI of the paranasal sinuses and skull base, together with systemic disease staging. Histopathological analysis requires specialized expertise, with Hyams histological grade as the main prognostic factor. The standard of care consists in surgical resection followed by adjuvant radiotherapy. Chemotherapy may be considered in high-grade or unresectable forms. Because of the risk of late recurrence, at least 20<!--> <!-->years’ follow-up is recommended.</div></div><div><h3>Conclusion</h3><div>The REFCOR guidelines aim to standardize diagnosis and treatment for ONB, but require completion by discussion in a specialized multidisciplinary tumor board.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 4","pages":"Pages 325-329"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438679","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":"Definition of severity, management, and follow-up of isolated snoring in adults: An international consensus","authors":"H. Carrichon,&nbsp;V. Favier,&nbsp;G. Cammaroto,&nbsp;H. Dos Santos,&nbsp;A. de Vito,&nbsp;E. Zancanella,&nbsp;M.B. Cahali,&nbsp;A. Moniri,&nbsp;M. Carrasco-Llatas,&nbsp;M. Ravesloot,&nbsp;U. Alkan,&nbsp;R.C.T. Cheong,&nbsp;J.R. Lechien,&nbsp;A. Maniaci,&nbsp;C. O’Connor,&nbsp;F. Salamanca,&nbsp;O. Jacobowitz,&nbsp;D. Abedipour,&nbsp;A. Decotte,&nbsp;D. Schmitt,&nbsp;F. Carsuzaa","doi":"10.1016/j.anorl.2026.04.001","DOIUrl":"10.1016/j.anorl.2026.04.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Isolated snoring (IS), defined by nocturnal upper airway vibration without apneas, remains a prevalent yet underrecognized condition lacking standardized definitions for severity and management. Despite its significant impact on bed partners’ sleep quality and social life, no consensus exists on severity criteria or follow-up practices. This international Delphi consensus aimed to define IS severity, address the management of nasal comorbidity, and establish follow-up protocols to support personalized patient care.</div></div><div><h3>Methods</h3><div>A two-round Delphi process was conducted from December 2024 to April 2025, involving 35 otolaryngology experts from 16 countries. Thirty-nine initial statements were developed by a steering committee and evaluated using a 9-point Likert scale. Consensus was defined as<!--> <!-->≥<!--> <!-->75% agreement.</div></div><div><h3>Results</h3><div>Of 58 evaluated statements, 44 reached consensus. IS severity was associated with frequency of snoring, bed partner's complaints, and impact on the couple's quality of life, while objective acoustic parameters alone were not deemed reliable indicators. Nasal obstruction was recognized as a treatable comorbidity that may be assessed before snoring management. Personalized management using validated subjective tools was strongly recommended. For follow-up, expert consensus supported a 3- to 6-month reassessment using smartphone apps or quality-of-life metrics, with distinctions made between clinical and research goals.</div></div><div><h3>Conclusion</h3><div>This consensus supports a patient- and partner-centered approach to IS. It discourages reliance on isolated acoustic data for severity grading, promotes proactive management of nasal factors, and highlights the need for individualized treatment strategies. Future research should aim to validate objective and subjective tools to further standardize care pathways for IS.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 4","pages":"Pages 281-290"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786453","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":"Quality of life questionnaires in ENT: New tools, and update of the inventory","authors":"A. Coudert,&nbsp;S. Gargula","doi":"10.1016/j.anorl.2026.01.006","DOIUrl":"10.1016/j.anorl.2026.01.006","url":null,"abstract":"","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 4","pages":"Page 348"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138061","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":"Patient perception and awareness of psychophysical olfactory tests: A cross-sectional observational survey","authors":"J.R. Lechien,&nbsp;A. Maniaci,&nbsp;G. Salzano,&nbsp;C.M. Chiesa-Estomba,&nbsp;M. Mayo-Yanez,&nbsp;A. Saibene,&nbsp;G. Iannella,&nbsp;S. Saussez,&nbsp;L.A. Vaira","doi":"10.1016/j.anorl.2025.09.009","DOIUrl":"10.1016/j.anorl.2025.09.009","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the patient perception and awareness of psychophysical olfactory testing (PT).</div></div><div><h3>Methods</h3><div>A survey was distributed to 119 consecutive patients consulting in the Dour Medical Center for olfactory dysfunction (OD) lasting for more than 6<!--> <!-->months. The survey assessed the patient opinion regarding the usefulness, advantages, and impact of PT on the olfactory check-up and follow-up. Smell sense was evaluated with threshold, discrimination and identification (TDI) test, and the Olfactory Disorder Questionnaire (ODQ).</div></div><div><h3>Results</h3><div>Survey was completed by 118 patients (99%). There were 72 females (61%). The mean age was 55.1<!--> <!-->±<!--> <!-->15.1<!--> <!-->years. There were 53 (45.0%) patients with complete smell loss, 43 (36.4%) with partial smell loss, and 22 (18.6%) with disturbed smell (parosmia). The mean TDI was 18.0<!--> <!-->±<!--> <!-->10.9. The mean ODQ was 35.8<!--> <!-->±<!--> <!-->13.9. PT are considered a supportive test for the evaluation of the OD by 66% of patients. The primary PT limitations were considered as the presence of uncommon (65.3%) or unknown odors (42.7%), and the lack of consistency with their OD (55.9%), which was associated with the wish to improve PT with daily life odors (64.4%; r_s <!-->=<!--> <!-->−0.386; <em>P</em> <!-->=<!--> <!-->0.001). In 53.4% of cases, patients realized that they were able to smell some odors thanks to PT. Patients with parosmia reported less positive opinion of PT compared to those with anosmia/hyposmia.</div></div><div><h3>Conclusion</h3><div>Two thirds of patients with OD have good opinion of PT. Patients with anosmia or hyposmia reported better opinion than those with parosmia, strengthening the importance to consider specific PT dedicated to parosmia for this population. The inclusion of patients’ daily life odors in PT is a potential point of improvement for future studies.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 4","pages":"Pages 256-261"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370159","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}