Complex rhinobronchial dystrophy and immunodeficiency: Chance association or exceptional congenital syndrome? Publication date: Available online 14 November 2019 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases Author(s): N. Migueres, F. de Blay, J.J. Braun Abstract Introduction We report a case of an exceptional syndromic association of apparently congenital rhinobronchial dystrophy associated with congenital anosmia and common variable immunodeficiency in a twelve-year-old girl. Case summary This young girl, born in 2000, consulted for the first time in 2012 for recurrent respiratory tract infections, refractory to all forms of treatment, starting in early childhood, associated with congenital anosmia and severe atrophic rhinitis as well as common variable immunodeficiency. The laboratory work-up essentially revealed IgG4 deficiency and imaging demonstrated bronchiectasis (lingula), multiple tracheobronchial diverticula, atrophic rhinitis and congenital anosmia with agenesis of the olfactory bulbs and sulci. Discussion After eliminating a number of differential diagnoses, we were left with the problem of the aetiology, the possible links between these various symptoms and the genetic basis for this apparently congenital complex rhinobronchial disease associated with common variable immunodeficiency. Do these various symptoms correspond to a chance association or an exceptional congenital syndrome that has not yet been identified in the literature? Conclusion A review of the clinical and genetic literature did not enable us to propose a single diagnosis for these symptoms or this complex syndrome.

Otosclerosis surgery: Assessment of patient comfort Publication date: Available online 14 November 2019 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases Author(s): C.-E. Rouf, D. Bakhos, J.-B. Riou, S. Morinière, E. Lescanne Abstract Objectives To evaluate operative comfort and stress in patients undergoing stapedotomy for otosclerosis under local versus general anesthesia. Material and methods Consecutive otosclerosis patients managed over a 9-month period responded to 3 validated questionnaires to assess peri- and post-operative comfort: Glasgow Benefit Inventory, Cohen's Perceived Stress Scale and the Posttraumatic Stress Disorder Checklist Scale. These results and audiometric data were compared between local and general anesthesia groups. Results Twenty-one patients were included in the local anesthesia group and 7 in the general anesthesia group, after exclusion of patients with history of otosclerosis surgery. There was no significant inter-group difference on Glasgow Benefit Inventory (P = 0.38) or Posttraumatic Stress Disorder Checklist Scale (P = 0.86). Perceived Stress Scale scores were higher in the general anesthesia group (P = 0.038). In total, 67% of patients reported no discomfort under local anesthesia, and 86% were ready to undergo the procedure under local anesthesia again. There were no significant differences in postoperative symptoms, or in air-bone gap ≤ 10 dB (local anesthesia 81%, general anesthesia 71%; P = 0.156). Conclusions Local anesthesia in otosclerosis surgery did not increase stress or postoperative symptoms compared to general anesthesia. Audiometric results were not affected by type of anesthesia.

French adaptation of the “Frenchay Dysarthria Assessment 2” speech intelligibility test Publication date: Available online 13 November 2019 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases Author(s): A. Ghio, L. Giusti, E. Blanc, S. Pinto Abstract Objectives Speech intelligibility can be defined as “the degree to which a speaker's intended message is recovered by a listener”. Loss of intelligibility is one of the most frequent complaints in patients suffering from speech disorder, impairing communication. Measurement of intelligibility is therefore an important parameter in follow-up. We developed a French version of the “Frenchay Dysarthria Assessment, 2nd edition” (FDA-2), an intelligibility test recognized internationally in its English version. The present study details the construction of the test and its preliminary validation. Materials and methods We first compiled a set of words and phrases in French, based on the criteria defined in FDA-2. In a second step, we validated the test in healthy subjects in normal and noisy conditions, to check sensitivity to speech signal degradation. Results The test proved valid and sensitive, as scores were significantly lower for noise-degraded stimuli. Conclusion This French-language intelligibility test can be used to evaluate speech disorder: for example, in dysarthria, head and neck cancer or after cochlear implantation.

Peripheral facial nerve palsy and cholesteatoma Publication date: Available online 12 November 2019 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases Author(s): M. Fieux, V. Darrouzet, S. Tringali

Absence of high-risk human papilloma virus in p16 positive inverted sinonasal papilloma Publication date: Available online 12 November 2019 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases Author(s): A. Holm, A. Allard, I. Eriksson, G. Laurell, K. Nylander, K. Olofsson Abstract Objectives Sinonasal inverted papilloma (SIP) is a relatively rare disease, and its etiology is not understood. It is characterized by locally aggressive growth and a strong tendency to recur despite its benign histology. Aims The aim of this study was to identify the presence of human papilloma virus (HPV) and its surrogate marker p16 in SIP tissue samples from a regional cohort. Material and methods Subjects were identified from our regional center cohort of 88 SIP patients treated between 1984–2014. From these subjects, 54 were included in this study. Of these, 53 biopsies were analyzed with PCR, and 54 samples were immunohistochemically stained for p16. DNA was extracted from histopathologically verified SIP. Genotype screening for 13 high risk-, 5 oncogenic and 6 low risk HPV types was performed using the PapilloCheck® HPV-screening test. Results HPV analysis was successful for 38 of 53 samples. Of the 38 successfully analyzed samples, only 2 samples were positive for HPV 11. Notably, p16 was present in the epithelia in all samples, and in the papilloma lesions in 37 samples. Conclusion Since only 2 out of 38 SIPs were positive for HPV (type 11), and at the same time p16 was positive in epithelia in all samples and in 37 of 38 papilloma lesions of the samples, it is concluded that p16 cannot be used as a surrogate marker for high-risk HPV-infection in SIP. We are currently planning a prospective, multicenter study in order to increase the study power and in order to be able to better evaluate the clinical implications of HPV-and p16 in SIP.

Endonasal endoscopic oncologic resection and reconstruction of the anterior skull base in the elderly: A single-center retrospective study Publication date: Available online 11 November 2019 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases Author(s): E. Chabrillac, G. De Bonnecaze, M. Rives, V. Lubrano, E. Serrano, S. Vergez Abstract Introduction In old and frail patients, oncologic anterior skull-base surgery through an endonasal endoscopic approach avoids the morbidity incurred by transfacial and transcranial approaches, sometimes considered unreasonable, although surgery remains the gold standard treatment for sinonasal cancer. Objectives To assess the functional and oncologic results of this surgery in over-70 year-olds. Material and methods A single-center retrospective study included all patients aged over 70 years at surgery, who underwent endonasal endoscopic oncologic resection and reconstruction of the anterior skull base, between October 2008 and October 2018. Results Fifteen procedures in 13 patients met the inclusion criteria. Mean hospital stay was 7 days. All resections were considered R0, apart from one case with positive dura-mater margins (6.7%). All patients had complete radio-surgical treatment, in accordance with the REFCOR recommendations. Two cases of meningitis were reported (13.3%). At a median follow-up of 27 months, 4 patients presented local recurrence, 1 of whom also had lung metastases. Two patients died of disease-related or treatment-related causes. Conclusion This technique is a feasible treatment in patients aged over 70 years, providing good functional results, and acceptable oncologic outcome.

A novel two-step surgical technique for bone-anchored hearing aid conversion surgery Publication date: Available online 11 November 2019 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases Author(s): A. Cakır Cetın, E.A. Gunerı

Evidence-based medicine, Archibald Cochrane and tonsillectomy Publication date: Available online 10 November 2019 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases Author(s): O. Laccourreye

Many and various prejudices… Publication date: Available online 9 November 2019 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases Author(s): O. Laccourreye

Author's response to the letter on the article: “Relation between adenoid size and otitis media with effusion” Publication date: Available online 8 November 2019 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases Author(s): L. Skoloudik, D. Kalfert, T. Valenta, V. Chrobok