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Objectives: Sinonasal inverted papillomas (SIP) present a potential for recurrence years after the surgery, but most studies report short-term follow-up, and risk factors for recurrence are still debated. Furthermore, several classifications are described, and no consensus exists regarding which one should be used. The aims of this study were to report our long-term results, investigate for potential risk factors for recurrence, and compare the existing 8 staging systems., Methods: Over a 28-year period, 110 patients with a diagnosis of SIP were enrolled. The median follow-up time was 55.6 months., Results: In multivariate Cox regression modeling, history of previous surgery was the only variable associated with recurrence (hazard ratio = 4.91, 95% CI, 1.80-13.39). Recurrences occurred up to 60 months after the surgery. Among the 8 staging systems, none proved to be associated with recurrence., Conclusion: The only factor associated with recurrence of SIP was prior surgery, probably corresponding to an incomplete initial resection. Due to late recurrences, an extended follow-up of at least 5 years is mandatory. In the absence of a classification predicting prognosis, Krouse's staging system should be used to homogenize studies' report since it is the most widely used.

Background: Indications for preservation of orbital contents in case of malignant sinonasal tumors invading the orbit remain controversial., Methods: A retrospective consecutive review was conducted of patients in a tertiary care center over a 15-year period., Results: Ninety-three patients were diagnosed with a malignant tumor invading the orbit. Eighty-three were treated with curative intent of which 58 underwent surgery. Mean follow-up was 45 months. Orbital preservation was feasible in 66% of cases, whereas orbital clearance was performed in cases of locally advanced disease (invasion of extraocular muscles, ocular globe, or orbital apex). Local control rate was 70% for patients treated with orbital clearance and 74% for those with orbital preservation, with no statistical difference. Five-year survival and 5-year relapse-free survival were similar in both groups., Conclusion: Using our strategy, the eye can be spared in more patients than what is currently proposed, without oncologic or survival disadvantages. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1708-1716, 2016., (© 2016 Wiley Periodicals, Inc.)

Introduction: We present a retrospective two-center study series and discussion of the current literature to assess the benefits of facial nerve monitoring during parotidectomy., Materials and Methods: From 2007 to 2012, 128 parotidectomies were performed in 125 patients. Of these, 47 procedures were performed without facial nerve monitoring (group 1) and 81 with facial nerve monitoring (group 2). The primary endpoint was the House-Brackmann classification at 1 month and 6 months. Facial palsy was determined when the House-Brackmann grade was 3 or higher., Results: In group 1, 15 facial palsies were noted; 8 were transient and 7 were definitive. In group 2, 19 facial palsies were noted; 12 were transient and 7 were definitive. At both one and six months after parotidectomy, the rate of facial palsy in reoperation cases was significantly higher in group 1 than in group 2., Conclusion: Facial nerve monitoring is a simple, effective adjunct method that is available to surgeons to assist with the functional preservation of the facial nerve during parotid surgery. Although it does not improve the facial prognosis in first-line surgery, it does improve the facial prognosis in reoperations.

Lymphatic malformations are benign malformations frequently occurring in the head and neck. Retropharyngeal location is rare, can be life threating and its management is particularly challenging. Over a three-year period, three patients presented with symptomatic (dyspnea and/or dysphagia) retropharyngeal lymphatic malformation. All were treated using a radiofrequency ablation of lymphatic malformation through a trans-oral approach. No major complications occurred following the surgery. During the follow-up, no recurrence was noted and all patients were asymptomatic. Radiofrequency ablation in the management of retropharyngeal lymphatic malformations is a simple technique with very good results and allows a fast recovery with minimum morbidity and a short hospital stay., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Objective: Chyle fistula is a known complication in cervical surgery. It can lead to a postoperative lymphorrhea. There is no consensus on its management. The aim of this work is to propose a management strategy for postoperative chyle leak., Materials and Methods: A literature review was conducted using PubMed database., Results: Six prospectives articles were included. The enteral diet allowed a success in 57% of cases, and in these cases a lymph flow less than 580 mL/day. Parenteral nutrition was effective when the flow was less than 1050 mL/day. Reoperation was performed in case of failure of the nutritional treatments., Conclusion: Several therapeutics are available. From this meta-analysis, we developed a management strategy. We initiate an enteral diet when lymph flow is less than 500 mL/ day. Parenteral nutrition is used if the flow rate is between 500 and 1000 mL/day or in case of inefficiency of enteral diet during 10 days. Finally, revision surgery is necessary when the flow is greater than 1000 mL/day or when parenteral nutrition was ineffective in 10 days.

Introduction: Hyposmia is a common cause of functional complaint in patients with nasal polyposis. The aim of the current study was to report the olfactory functional results after sinus surgery., Materials and Methods: A systematic review of the scientific literature was achieved in the Pubmed database., Results: Overall, 10 series published between 1989 and 2013, involving 959 patients, were selected. The surgery for nasal polyposis, adjuvant medical treatment, may allow olfactory improvement. The results are even better than surgery is as wide as possible and the evolutionary stage is low.