C. Van Laer

Definition, Classification and Reporting of Meniere's Disease and its Symptoms

This review describes the practicalities of using both the inner Ear Profile to define hydrops labyrinthi, and the American Academy of Otolaryngology and Head and Neck Surgery (AAO-HNS) guidelines to define Menieres disease. The requirement for standardisation is stressed since either system alone may be inadequate. It is suggested that the Inner Ear Profile could be adapted to the AAO-HNS criteria to create a unified method of evaluation.

Endoscopic management of severe subglottic stenosis in Wegener's granulomatosis.

Abstract: The optimal treatment for severe subglottic stenosis secondary to Wegener’s granulomatosis remains controversial. We report the case of a symptomatic middle-aged woman who was successfully treated with intratracheal dilation and intralesional injection of corticosteroids. The literature related to this issue is being reviewed.

Allograft tympanoplasty: Predictive value of preoperative status

The functional and anatomical results of a series of 181 consecutive allograft tympanoplasties for ears with drum perforation and an intact ossicular chain were retrospectively reviewed and related to preoperative factors. Drum closure was realized in 92% (166 of 181 cases evaluated 1 year after surgery), and 96.6% of the reconstructed drums were still intact 3 years after surgery (118 cases evaluated). An air‐bone gap of less than 21 dB was reached in 79.6% (of a total of 162 cases) 1 year after surgery, and in 78% (of a total of 118 cases) 3 years after surgery. Age, contralateral pathology, the wet or dry status of the ear preoperatively, and the preoperative air‐bone gap had no influence on anatomical results. The preoperative air‐bone gap did not predict the postoperative air‐bone gap. The influence of age and existence of contralateral pathology on hearing gain was only visible in some of the strictly defined patient groups. The wet preoperative status of the ear generally predicted lower functional gain.

Benign fibrous histiocytoma of the larynx: presentation of a case and review of the literature

A case of a benign histiocytoma of the larynx in a 39-year-old man is presented. Laryngeal fibrous histiocytoma is extremely rare. Its pathology is described including arguments for benignity. The literature is reviewed and management is discussed.

Reply to the Letter to the Editor Concerning: ‘Changes in Swallowing-Related Quality of Life After Endoscopic Treatment for Zenker’s Diverticulum Using SWAL-QOL Questionnaire’

Siau et al. raise some interesting points regarding the results of the use of the SWAL-QOL questionnaire for the assessment of swallowing-related quality of life after endoscopic treatment for Zenker’s diverticulum (ZD) [1]. First, the notice of the fact that SWAL-QOL does not address the symptom of regurgitation should indeed be regarded as a limitation of its use for the evaluation of this particular symptom in ZD patients both at baseline as well as during follow-up after ZD treatment. Potentially, this shortcoming might lead to a validated modification of SWAL-QOL and/or other questionnaires towards a more ZD-oriented tool. In fact, this would envisage some modifications in terms of adding questions related to regurgitation. As this complaint, also in our study [1], is a common symptom in ZD patients (48% combining dysphagia and/or regurgitation as their main complaint) at presentation, this is indeed highly relevant. In addition, as clearly pointed out by Siau et al., relapse of this specific complaint might usually suggest ZD recurrence [2]. In our study, due to the short follow-up time, this was not an issue. Similarly, Skaug et al. added two questions specific to dysphagia (regurgitation and nightly mucus production) at the MD Anderson Dysphagia Inventory (MDADI) in order to make this dysphagia questionnaire more specific for patients with ZD [3]. Second, we believe that the high rates of participant’s non-engagement (37.5%) in our study is not mainly due to the relatively long time needed to fill out SWAL-QOL questionnaire, but rather due to the high age-related prevalence of ZD cohorts (mean age being 69 years in the present trial, and in other studies ranging from 68 up to 82 years [4, 5]), and the unwillingness and/or the potential difficulty to work with the computer. Another important aspect of our present trial is that the main goal of the authors was to assess and estimate mean SWAL-QOL baseline values in ZD patients seeking treatment. In addition, we were able to report on changes in SWAL-QOL values after endoscopic ZD treatment over a short postoperative follow-up period of 3 months on average. This follow-up in the present study is too short to draw conclusions on the role of SWAL-QOL in detecting ZD relapse, as previous studies have indicated that recurrence rate would occur over a median time of 7–43 months [5]. The role of the SWAL-QOL questionnaire in long-term follow-up of endoscopic treatment of ZD is currently the subject of ongoing and future clinical trials. In other words, the present study was neither aiming to evaluate the role of SWAL-QOL in the long-term follow-up nor planning to detect ZD recurrences because of the short-term assessment.