[Neighbourhood noise pollution in housing].

NEIGHBOURHOOD NOISE POLLUTION IN HOUSING. The discomfort caused by environmental noise in home living space is very frequently observed in our time, its consequences are underestimated. The genesis of this nuisance lies in the poor quality of buildings, which are subject to a series of regulations and obligations that are often not respected, as well as incivism and non-compliance with Public Health Code decrees governing noise emissions from various activities.

Transmucosal gas-loss rates in middle ears initially filled with O or CO.

This study investigates the role of different gases in clearance of gas in the middle ear cavity (ME) by its mucosal blood flow. A rat model was used to measure gas volume changes in the ME cavity at constant pressure without ventilation. We disturbed the normal gas composition of the ME by filling it with O or CO, measured the consequent changes in gas volume over time and compared these results with previously obtained ones for air and N.

Characterization of endolymphatic sac tumors and von Hippel-Lindau disease in the International Endolymphatic Sac Tumor Registry.

Background: Endolymphatic sac tumors (ELSTs) are, with a prevalence of up to 16%, a component of von Hippel-Lindau (VHL) disease. Data from international registries regarding heritable fraction and characteristics, germline VHL mutation frequency, and prevalence are lacking.

Methods: Systematic registration of ELSTs from international centers of otorhinolaryngology and from multidisciplinary VHL centers' registries was performed.

[Cervico-facial necrotizing fasciitis].

Cervical fasciitis is a life-threatening condition often due to a benign pharyngeal or dental infection, leading to extensive necrosis, spreading along the fascia of the neck and possibly to the mediastinum. It represents one of the most severe ENT emergencies which requires immediate treatment by a multidisciplinary team. Facing any banal infection of the head and neck, great attention should be paid to any functional or general symptoms and signs of severe sepsis.

Comparison of 3 procedures for hypoglossal-facial anastomosis.

Objective: We aimed to evaluate rehabilitation of complete facial palsy with 3 procedures for hypoglossal-facial anastomosis: end-to-end ("original"), partial end-to-end with interpositional jump grafting ("jump") and the new partial end to end without grafting ("modified").

Methods: A medical jury reviewed videos of 36 patients with complete facial palsy who underwent surgery from 1998 to 2008 by original (n = 13), jump (n = 13), and modified (n = 10) procedures. The jury of 5 ear, nose, and throat surgeons who were blinded to the procedure evaluated rehabilitation by 3 facial nerve grading systems-House and Brackman (HB), Sunnybrook, and Freyss scales-and 3 subjective scores for the face at rest and during voluntary and emotional motions.

Impact of extensive surgery in multidisciplinary approach of pterygopalatine/infratemporal fossa soft tissue sarcoma.

Background: To evaluate a strategy whereby extensive surgery ± external radiotherapy (RT) could improve local control in pterygopalatine/infratemporal fossa (PIF) sarcoma.

Procedure: Forty-one patients with a diagnosis of sarcoma involving the PIF and referred to our Institute from 1984 to 2009 were included in the analysis. Patients received multidrug chemotherapy and radiotherapy ± surgery, depending on the period of treatment.

[Cervico-facial fascitiis. A major ENT emergency].

Cervical fasciitis is one of the most severe ENT emergencies, requiring immediate management by a multidisciplinary team. Often due to a benign pharyngeal or dental infection, this life-threatening condition leads to extensive necrosis spreading along the fascia of the neck, possibly to the mediastinum. A retrospective analysis of 150 consecutive patients admitted to our institution between January 2001 and December 2006 showed:--a 7% mortality rate;--pulmonary involvement in one-third of cases and hemodynamic failure or mediastinitis in half the patients;--mechanical ventilation for an average of 10 days, intubation for 13 days, tracheostomy for 31 days, intensive care unit management for 17 days, and hospitalization for 26 days; and--functional and esthetic sequelae in about half the patients.

Auditory outcomes after implantation and electrical stimulation of the lateral ampullar nerve in guinea pig.

Objective: To determine in a guinea pig model the factors of invasiveness of a bipolar electrode implanted in the horizontal semicircular canal (HSC) and to evaluate the consequences on hearing of electrical stimulation of the ampullary nerve.

Design: Sixteen guinea pigs divided into four groups underwent surgical opening of the HSC of one ear as follows: control (group 1), cyanoacrylate glue application on the HSC opening (group 2), electrode implantation with cyanoacrylate glue on the HSC opening (group 3), and electrode implantation with electrical stimulation (1 hr/day) for 9 days (group 4). Auditory brainstem responses were recorded before and after surgery and after electrical stimulation.

Online script concordance test for clinical reasoning assessment in otorhinolaryngology: the association between performance and clinical experience.

Objective: To report on the creation and administration of an online Script Concordance Test (SCT) for ear, nose, and throat (ENT), the ENT-SCT.

Design: Prospective study.

Setting: Two tertiary care university centers.

[Practitioners facing balance disorders in older subjects].

As life expectancy keeps increasing, balance disorders in older patients represent a major medical and public health issue, mostly because they are the most important risk factor for repeated falls. The inevitable deterioration of the physiological mechanisms which control balance explains their important prevalence and their often multifactor nature. A multidisciplinary approach should thus be adopted.

The use of dabigatran in elderly patients.

Recent approval by the US Food and Drug Administration (FDA) of dabigatran etexilate, an oral direct thrombin inhibitor, for the prevention of stroke in patients with atrial fibrillation will likely extend its administration in elderly patients. The risk of major overdosage of dabigatran etexilate in this population is, however, much increased owing to frequent renal function impairment, low body weight, drug interactions that cannot be detected with a routine coagulation test, and no antagonist available. We report herein 2 clinical cases, including 1 fatal case, illustrating our concern regarding the risk of bleeding events in elderly patients.

Our experience in the management of petrous bone cholesteatoma.

We present the management of a series of petrous bone cholesteatomas. We performed a retrospective analysis on 28 patients with petrous bone cholesteatoma who underwent surgery between 1991 and 2008 at Lariboisiere Hospital, Paris, France. Main outcome measures included age of patients, surgical approaches, complications, and recurrence.

Endoscopic transsphenoidal approach to petrous apex cholesteatoma.

The purpose of this report is to present indications and risks of endoscopic transsphenoidal approach to treat petrous apex cholesteatoma. This is a retrospective analysis of two cases of petrous apex cholesteatoma presenting with double vision who underwent an endoscopic transsphenoidal approach at Lariboisiere Hospital, Paris, France. Control of the lesion was satisfactory in both cases.

Reversible cerebral vasoconstriction syndrome in two patients with a carotid glomus tumour.

We report two patients with reversible cerebral vasoconstriction syndrome (RCVS) and carotid glomus tumour. The first patient presented with multiple thunderclap headaches. Cervical and cerebral magnetic resonance imaging showed diffuse cerebral vasoconstriction on magnetic resonance angiogram (MRA) and a carotid glomus tumour.

Detection of bacterial biofilm on cochlear implants removed because of device failure, without evidence of infection.

Objective: To investigate the formation of bacterial biofilms on the surface of the electrode array of cochlear implants (CI) explanted because of device failure, without evidence of infection, by use of scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM).

Study Design: Prospective study.

Setting: Patients from 2 tertiary-care referral centers.

Unilateral rhinorrhea after translabyrinthine surgery due to parasympathetic hypersensitive syndrome: differentiation from cerebrospinal fluid leakage.

Introduction: Unilateral rhinorrhea after translabyrinthine surgery for vestibular or facial schwannoma usually suggests cerebrospinal fluid (CSF) leakage and requires specific measures, including revision surgery.

Objective: To draw attention to the possibility of postoperative unilateral rhinorrhea with concomitant hyperlacrimation and hypersialorrhea without a CSF origin and reflecting more a neuroplastic phenomenon.

Study Design: Retrospective study in a tertiary care center university clinic.

Biofilms on tracheoesophageal voice prostheses: a confocal laser scanning microscopy demonstration of mixed bacterial and yeast biofilms.

The aim of this study was to demonstrate the presence of yeast and bacterial biofilms on the surface of tracheoesophageal voice prostheses (TVPs) by a double-staining technique with confocal laser scanning microscopy (CLSM). Biofilms of 12 removed TVPs were visualized by scanning electron microscopy, then stained with ConA-FITC and propidium iodide for CLSM. Microbial identification was by partial 16S rRNA gene analysis and ITS-2 sequence analysis.

Endolymphatic sac tumors in von Hippel-Lindau disease: report of three cases.

Objectives: To illustrate the diagnostic and pathophysiologic issues of endolymphatic sac tumors (ELSTs) and its clinical association with von Hippel-Lindau (VHL) disease and to demonstrate the interest of genetic testing in such cases.

Study Design: Retrospective analysis of 3 cases of ELST with VHL in 3 different clinical and prognostic situations.

Main Outcomes: The first case was diagnosed on the concomitant finding of a central nervous system lesion.