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Αλέξανδρος Γ. Σφακιανάκης

Tuesday, August 17, 2021

Intraparotid Facial Nerve Schwannoma Mimicking Primary Parotid Neoplasm

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Ear Nose Throat J. 2021 Aug 17:1455613211040372. doi: 10.1177/01455613211040372. Online ahead of print.

ABSTRACT

The following report is of a 36-year-old male who presented with a growing mass in the region of the parotid gland. Initial fine needle aspiration biopsy suggested a primary neoplasm of the parotid gland, but subsequent frozen section analysis intraoperatively demonstrated a schwannoma of the facial nerve. An intracapsular enucleation of the schwannoma was perform ed in order to preserve the fibers of the motor nerve.

PMID:34402315 | DOI:10.1177/01455613211040372

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Digital Videokymography: Analysis of Glottal Closure in Adults

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High-speed videolaryngoscopy and quantitative analysis of laryngeal images are relevant in accurately diagnosing vocal fold closure patterns.
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Outcomes and prognostic factors of facial nerve repair: a retrospective comparative study of 31 patients and literature review

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Eur Arch Otorhinolaryngol. 2021 Aug 17. doi: 10.1007/s00405-021-07043-6. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate functional results of facial nerve repair by direct nerve suture or grafting, compare results between a traumatic and a tumoral group and identify prognostic factors.

METHODS: A retrospective monocentric cohort study was studied in a university ENT department. Thirty-one patients who benefited from facial nerve suture or grafting, with at least 12 months postoperative follow-up were included. Patients were divided into two groups according to the lesion type: traumatic (accident of the public road or iatrogenic) and tumoral. Preoperative data studied were sex, side, etiology documented by CT and/or MRI, facial palsy duration and grade according to House Brackmann grading system. Intraoperative data included: surgeon, age of patient, surgical technique, graft type, use of biological glue, facial nerve deriv ation, lesioned site. Postoperative data included: histological diagnosis, radiotherapy history, time to onset of the first signs of reinnervation, follow-up duration, and final facial function.

RESULTS: Success rate, including grade III and IV, was 68% in the whole cohort, 79% in the traumatic group and 59% in the tumoral group. Patients presenting with facial palsy evolving less than 6 months had better recovery results than those evolving longer than 6 months (p = 0.02). No other prognostic factors were identified.

CONCLUSIONS: The best outcome that can be achieved by suture or grafting of the facial nerve in traumatic or tumoral lesions is a grade III. Preoperative facial palsy duration is a prognostic factor and must be considered when establishing an operative indication.

PMID:34402952 | DOI:10.1007/s00405-021-07043-6

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Cochlear implantation among patients with otosclerosis: a systematic review of clinical characteristics and outcomes

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Eur Arch Otorhinolaryngol. 2021 Aug 17. doi: 10.1007/s00405-021-07036-5. Online ahead of print.

ABSTRACT

PURPOSE: There have been considerable advancements in cochlear implants in different clinical scenarios; however, their use in patients with otosclerosis remains challenging. This review aimed to investigate the surgical and clinical outcomes of cochlear implantation in patients with otosclerosis.

METHODS: An electronic literature search was performed using four main databases through February 2021 to identify original studies of cochlear implantation in patients with otosclerosis for inclusion in this systematic review. The study protocol was registered with the Prospectively Registered Systematic Reviews and Meta-analyses (reference number: CRD42021234753).

RESULTS: A total of 23 studies including 3162 patients were enrolled. Of these patients, only 392 had otosclerosis and underwent cochlear implantation. The duration of deafness was reported in only eight studies, extending up to 50 years. Far-advanced otosclerosis was observed in 153 patients. A total of 56 patients used hearing aids. Stapedectomy and stapedotomy were performed in 118 and 63 patients, respectively. In three studies, the temporary success of stapedectomy and stapedotomy was 6 (43%) and 5 (71%) patients, respectively. Computed tomography was used as a preoperative assessment tool in most studies (n = 14, 60.9%). Incomplete implant insertion occurred in 17 patients, while facial nerve stimulation occurred in 36 patients after implantation.

CONCLUSION: Cochlear implantation is a relatively safe modality that can provide promising audiological outcomes in patients with otosclerosis. However, several factors, including cochlear ossification, duration of deafness, and previous operations, can affect its outcomes. Further studies with a larger sample population are recommended.

PMID:34402951 | DOI:10.1007/s00405-021-07036-5

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Thrombose des sinus caverneux associée à une sinusite sphénoïdale chez un enfant

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CMAJ. 2021 Aug 16;193(32):E1281-E1282. doi: 10.1503/cmaj.201317-f.

NO ABSTRACT

PMID:34400491 | DOI:10.1503/cmaj.201317-f

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Effect of Wendler glottoplasty on voice and quality of life of transgender women

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Braz J Otorhinolaryngol. 2021 Aug 4:S1808-8694(21)00134-8. doi: 10.1016/j.bjorl.2021.06.010. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the effect of Wendler glottoplasty on voice feminization, voice quality and voice-related quality of life.

METHODS: Prospective interventional cohort of transgender women submitted to Wendler glottoplasty. Acoustic analysis of the voice included assessment of fundamental frequency, maximum phonation time formant frequencies (F1 and F2), frequency range, jitter and shimmer. Voice quality was blindly assessed through GRBAS scale. Voice-related quality of life was measured using the Trans Woman Voice Questionnaire and the self-perceived femininity of the voice.

RESULTS: A total of 7 patients were included. The mean age was 35.4 years, and the mean postoperative follow-up time was 13.7 months. There was a mean increase of 47.9 ± 46.6 Hz (p = 0.023) in sustained/e/F0 and a mean i ncrease of 24.6 ± 27.5 Hz (p = 0.029) in speaking F0 after glottoplasty. There was no statistical significance in the pre- and postoperative comparison of maximum phonation time, formant frequencies, frequency range, jitter, shimmer, and grade, roughness, breathiness, asthenia, and strain scale. Trans Woman Voice Questionnaire decreased following surgery from 98.3 ± 9.2 to 54.1 ± 25.0 (p = 0.007) and mean self-perceived femininity of the voice increased from 2.8 ± 1.8 to 7.7 ± 2.4 (p = 0.008). One patient (14%) presented a postoperative granuloma and there was 1 (14%) premature suture dehiscence.

CONCLUSION: Glottoplasty is safe and effective for feminizing the voice of transgender women. There was an increase in fundamental frequency, without aggravating other acoustic parameters or voice quality. Voice-related quality of life improved after surgery.

PMID:34400103 | DOI:10.1016/j.bjorl.2021.06.010

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