R. Kania

Intracordal Injection of Autologous Fat in Patients With Unilateral Laryngeal Nerve Paralysis: Long‐Term Results From the Patient's Perspective

Objective Based on 80 patients with a previously nonsurgically treated unilateral laryngeal nerve paralysis (ULNP) and according to the patients self‐assessment, the authors document the long‐term results achieved with the intracordal injection of autologous fat.

Vertebrobasilar Occlusive Disorders Presenting as Sudden Sensorineural Hearing Loss

Background: Isolated sudden sensorineural hearing loss (SSHL) has been rarely related to vertebrobasilar occlusive disorders (VBOD). This is an important issue for both neurologists and otolaryngologists, since the management and prognosis of this type of hearing loss widely differs from that of hearing loss from other causes.

Auditory rehabilitation with cochlear implantation in patients with neurofibromatosis type 2.

Conclusions: New technological developments will most probably improve the efficiency of auditory brainstem implantation (ABI). Meanwhile, cochlear implantation in patients who have undergone prior reductive surgery, and who have maintained a positive electric stimulation, is an excellent alternative for rehabilitating complete and bilateral hearing loss in patients with neurofibromatosis type 2 (NF2). Auditory results are far better than those reported after ABI. Long-term follow-up will be necessary to demonstrate the validity of this strategy. Objectives: ABIs restore some degree of auditory perception in NF2 patients with bilateral and complete hearing loss, but results are often inadequate for maintaining social and professional activities. The aim of this study was to report the results of auditory rehabilitation by cochlear implantation in three cases of NF2. Patients and methods: This was a retrospective study undertaken in a tertiary referral center. The first patient had undergone previous surgery for a left grade III vestibular schwannoma (VS) and then underwent irradiation for a right grade I VS. Two years after irradiation, he suddenly lost his remaining hearing. Electric promontory stimulation was positive and cochlear implantation was performed. The second patient had undergone surgery for a left grade III VS and followed for a right grade II VS. She suddenly lost her remaining hearing. A cytoreductive surgery was performed and the cochlear nerve was preserved. Postoperative electric stimulation was positive. She was then implanted with a cochlear implant. The third patient presented with a right stage III and a left stage I VS. She first underwent a subtotal removal of the left VS with immediate cochlear implantation. She then underwent removal of the right VS stage III with no possible preservation of the cochlear nerve. Results: All three patients had excellent postoperative speech performance and were back to work 3 months after implantation. Imaging follow-ups at 4, 2, and 1 year, respectively, do not show any evolution of the tumor.

Transnasal endoscopic odontoidectomy after occipito-cervical fusion during the same operative setting—technical note

Recently, a purely transnasal endoscopic approach (TNEA) for decompression of the anterior cranio-cervical junction has been described. At present, there is only a limited number of patients having been operated on in a few specialized centers. The possibilities, safety, and limits of this approach are still under investigation. The relationship between TNEA and occipito-cervical fusion, especially, which may typically be considered in this kind of pathologies, should be further elucidated. So far, the feasibility of TNEA after previous occipito-cervical fusion has only been reported for a single case. In that case, there was a posterior atlanto-axial subluxation and basilar invagination. In the present paper, another example of a surgical procedure of TNEA after previous posterior fusion during the same operative setting is given. It differs from the other case concerning the pathophysiology. In fact, here, there was anterior atlanto-axial subluxation and no basilar invagination. The possibilities and limits of this novel approach are thoroughly discussed. Special interest is given to the problem of CCJ instability and previous occipito-cervical fusion. Technical hints and pitfalls are described in detail.

Enhanced sodium absorption in middle ear epithelial cells cultured at air–liquid interface

Conclusion As we demonstrated previously that transcription of α-ENaC was correlated with oxygen tension in the culture medium, this study suggests that the increase in α-ENaC expression observed under ALI conditions may result from greater oxygenation of ME cells. Objective The physiology of the middle ear (ME) is primarily concerned with keeping the cavities fluid-free, to allow transmission of sound vibrations from the eardrum to the inner ear. ME epithelial cells are thought to play a key role in this process as they actively absorb sodium and water in order to clear any excess fluid present in the cavities. Material and methods As an air–liquid interface (ALI) model has been shown to improve differentiation and enhance sodium absorption in other respiratory epithelia, we established an ALI model for ME cells. Results ME cells cultured under ALI conditions exhibited a fourfold increase in sodium absorption, which was not related to either a metabolic effect or to enhanced morphological differentiation, but instead to an increase in expression of the α-subunit of the epithelial sodium channel (α-ENaC).

Transcribriform and transplanum endoscopic approach for skull-base tumors

European Annals of Otorhinolaryngology, Head and Neck Diseases - Vol. 130 - N° 4 - p. 233-236

Exposure techniques in endoscopic skull base surgery: Posterior septectomy, medial maxillectomy, transmaxillary and transpterygoid approach

European Annals of Otorhinolaryngology, Head and Neck Diseases - Vol. 129 - N° 5 - p. 284-288

Dossier thématiqueLa chirurgie thyroïdienne endoscopique par techniques vidéo-assistées et totalement endoscopiquesEndoscopic thyroid surgery using video-assisted and totally endoscopic techniques

R.E. Kania *, M. Parodi , A. Coste , P. Herman , P. Tran Ba Huy , J.-F. Papon b,c,d,e a CNRS, LNRS 7060, service d’ORL & CCF, pôle neurosensoriel tête et cou, hôpital Lariboisière, AP–HP, université Paris-Diderot Paris-7, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France b Service ORL & CCF, hôpital Intercommunal, 94010 Créteil, France c Service ORL & CCF, groupe hospitalier Henri-Mondor – Albert-Chenevier, AP–HP, 94010 Créteil, France d Inserm, U955, 94010 Créteil, France e UMR_S841, faculté de médecine, université Paris-12, 94010 Créteil, France

Unilateral vs bilateral sphenopalatine artery ligation in adult unilateral epistaxis: A comparative retrospective study of 83 cases

Though most authors agree that TESPAL (transnasal endoscopic sphenopalatine artery ligation) should be considered in case of epistaxis resistant to nasal packing, there is no consensus on the indication for a unilateral/bilateral procedure. In this retrospective study of 83 patients with spontaneous intractable unilateral spontaneous epistaxis, we compared the outcomes of unilateral (n=36) vs bilateral (n=47) TESPAL. The main outcome was failure, defined as bleeding recurrence requiring another therapeutic procedure under general anaesthesia. The success rate was higher with bilateral TESPAL (91.5%) than with unilateral TESPAL (75%), without any major complication (p=0.041). This retrospective study supports the rationale for bilateral rather than unilateral TESPAL, and paves the way for further prospective studies. This article is protected by copyright. All rights reserved.

Minimally invasive surgery for superior semicircular canal dehiscence: Results of a four fenestration technique in twenty-one adults

Superior canal semicircular dehiscence (SCCD) may cause vestibular and audiological symptoms that are sometimes debilitating. Computed tomography (CT) and the vestibular evoked myogenic potential (VEMP) test are essential for the diagnosis of SCCD. Various surgical techniques have been developed to manage SCCD but have many associated complications. Our technique uses an approach that otologists and surgeons are highly familiar with and that has other advantages, such as minimizing surgical trauma and preventing recurrences. Plugging the superior canal with bone wax and fascia after performing four fenestrations is safe and effective for the surgical treatment of SCCD syndrome This article is protected by copyright. All rights reserved.