F. Rubin

Comparison of Video Head Impulse Test and Caloric Reflex Test in advanced unilateral definite Menière's disease

AIMS There have been very few studies of the Video Head Impulse Test (VHIT) in patients with Menières Disease (MD). Some reported 100% normal VHIT results, others not. These discrepancies may be due to differences in severity. The present study compared VHIT and caloric reflex test results in advanced unilateral definite MD. MATERIAL AND METHOD A prospective study included 37 consecutive patients, with a mean age of 56±12 years. Mean hearing loss was 59±18dB HL; 12 patients were subject to Tumarkins otolithic crises. Abnormal caloric reflex was defined as ≥20% deficit, and abnormal VHIT as presence of saccades or <0.64 gain in vertical semicircular canals and <0.78 in horizontal canals. RESULTS All patients had normal VHIT results, and 3 had normal caloric reflex; mean caloric reflex deficit was 45%. CONCLUSION The present study is the only one to use the August 2015 updated definition of MD. The results showed that, outside of episodes of crisis, VHIT was normal during advanced unilateral definite MD, in contrast to abnormal caloric reflex. This feature could help distinguish MD from other inner ear diseases, and it would be interesting to try to confirm this hypothesis by studying MD patients.

Styloglossus muscle: a critical landmark in head and neck oncology

GOAL To document the role of the styloglossus muscle (SG) in head and neck oncology and at the time of surgical treatment and mandibular preservation surgery for squamous cell carcinoma of the lateral oropharynx (SCCLO). METHOD Based on a search conducted within the Pubmed, Embase, and Cochrane databases, using the key words SG muscle, parapharyngeal space and oropharynx, the authors discuss the embryology, physiology, anatomy and radiology of this muscle as well as its role in the oncologic staging surgery of SCCLO. RESULTS The most specific radiologic exam to evaluate the involvement of SG muscle in SCCLO is magnetic resonance imaging (MRI). According to the eigth international staging classification systems, radiologic invasion of the SG muscle, at the time of MRI, leads to reclassify as T4a many tumors considered as T1-3 at the time of clinical and/or on computerized tomography evaluation. This must lead to extreme care when comparing oncologic results from series published prior and after the MRI era. When transoral resection of the SG muscle is advocated for SCCLO, one must know that this maneuver brings numerous arterial and venous structures within the operative field. If difficulties to achieve safe margins of resection and/or to control bleeding are encountered, a simple trans cervical maneuver described herein is most useful. CONCLUSION The importance of the SG muscle should be emphasized as a touchstone for staging and surgeons guide to mandibular preservation surgery of SCCLO. The various approaches allowing the control of this muscle and its vascular environment must be taught at the time of initial training.

Otitis media with effusion in nasal polyposis and outcomes following surgery: A longitudinal observational study

In patients with nasal polyposis (NP), otitis media with effusion (OME) seems to be a marker of severity of the inflammatory process occurring in those patients. The aim was to assess whether OME could represent a marker of resistance to the surgical treatment of NP.

Writing otorhinolaryngology head & neck surgery operative reports

Only about ten articles devoted to operative reports have been published in the medical literature, but this document is essential, both medically and legally, to ensure optimal management of operated patients. In this technical note, based on published studies on this subject, the authors describe the key features of operating reports after otorhinolaryngology head & neck surgery and emphasize the need to write this document during the minutes after the end of the operation, the importance of standardization and its teaching role during surgical training.

Diagnostic approach to sudden onset of diffuse isolated oedema of the lips

In the light of a case of sudden onset of diffuse, isolated oedema of the lips, the authors describe the key points of the diagnostic approach and the main epidemiological and clinical data.

Transoral lateral oropharyngectomy

Based on a review of the indexed scientific medical literature, the authors document the key technical points, the errors to avoid, the limitations, indications and main oncologic and functional results when performing transoral lateral oropharyngectomy in cancer originating from the tonsillar region.