Search

Resume Objectifs Le but de cette etude etait de traduire l’echelle MiRa en francais et de valider son utilisation par les chirurgiens francophones. Materiel et methodes L’echelle MiRa est une echelle d’analyse validee des dysmorphoses nasales. Peu d’outils d’evaluation esthetique sont disponibles en francais. Les recommandations de l’ISPOR et de l’OMS ont ete utilisees pour mener a bien le processus de traduction de l’anglais vers le francais de cette echelle, en cinq etapes. Pour evaluer la fiabilite de l’echelle MiRa dans sa version francaise, nous avons compare statistiquement la repetabilite intra-observateur (comparaison des scores obtenus lorsqu’un observateur evaluait chaque patient deux fois a un mois d’intervalle) et la repetabilite inter-observateur (comparaison des scores obtenus lorsque deux observateurs ont evalue le meme patient) en utilisant le test de Wilcoxon et le coefficient de correlation intraclasse (ICC) (α = 5 %). Objectifs Notre objectif etait d’obtenir une traduction du concept plutot qu’une traduction litterale pour permettre une bonne reproductibilite intra- et inter-observateurs. Resultats Chaque etape nous permettait de faire des changements progressifs vers une traduction conceptuelle equivalente a la version originale. Conclusion L’echelle MiRa est la seule echelle d’analyse esthetique validee dans la litterature pour les dysmorphoses nasales. L’utilisation combinee de deux recommandations internationales de traduction a permis d’obtenir une version francaise parfaitement conforme a l’original. Cette version est utilisable par les francophones.

Background Transpalpebral frontal septectomy (TFS) can be performed for unilateral frontal sinusitis drainage (into the contralateral healthy frontal sinus) or to provide access to the lateral extent of the contralateral frontal sinus. This procedure has demonstrated its usefulness in several problematic situations for the endoscopic surgeon. Objective The main objective of our study was to evaluate the feasibility of TFS. Secondary objectives were to define outcomes, early and late complications, contraindications, and failure rates of the TFS. Methods We reviewed patient demographics including age and gender, indication for frontal septectomy, prior surgeries, failure rates and necessity of revision surgery, early and late complications, and the side of the approach (ipsi- or contralateral to the frontal sinus pathology). Twenty patients who had undergone TFS were included. Patients were classified into 2 groups according to the surgical indication: group 1—TFS performed for unilateral frontal sinusitis to drain a frontal sinus in the contralateral frontal sinus; and group 2—TFS performed to provide access to the lateral extent of the contralateral frontal sinus. Scarring was assessed using the SCAR-Q questionnaire. Results TFS was performed on all patients in Groups 1 and 2 (success rate = 100%). No patients had recurrence of the pathology 6 months after surgery (0%). No patient needed revision surgery (0%). One complication (frontal hypoesthesia) was reported 6 months after surgery. Mean SCAR-Q score was 99.3 ± 2.5 (min = 91/100, max = 100/100). Conclusion TFS was feasible for all patients in this study. This procedure permits drainage of the frontal sinus and gives access to the lateral extent of the contralateral frontal sinus, without visible scarring, and with few lasting complications. Authorization to conduct this study was obtained from the Ethical Committee of our institution (APHM, n°2019_65).

Aims The aim of this study was to translate the MiRa scale into French and validate its use for French-speaking surgeons. Material and methods ISPOR and WHO recommendations were used to carry out the translation process from English to French in five steps. The MiRa scale is a validated analysis scale of nasal dysmorphoses. Few tools are available in French for French-speaking surgeons. ISPOR and WHO recommendations were used to complete the five-step translation process from English into French. To assess the reliability of the MiRa scale–French version, we statistically compared intra-observer repeatability (comparison of scores obtained when one observer assessed each patient twice at a one-month interval) and inter-observer repeatability (comparison of scores obtained when 2 observers assessed the same patient) using the Wilcoxon test and the intraclass correlation coefficient (ICC) (α = 5%). Objectives Our goal was to obtain a translation of the idea or concept rather than a literal translation to enable good intra- and inter-observer repeatability. Results Each step allowed us to make changes gradually working towards a conceptual translation equivalent to the original version. Conclusion The MiRa scale is the only aesthetic analysis scale validated in the literature for nasal dysmorphoses. The combined use of two sets of translation recommendations, with a five-step translation-back-translation process, made it possible to obtain a French version perfectly in line with the original. This version is usable by French-speakers.

The nasal septum presents inter-individual conformational variations. The objectives of this study were to establish a validated protocol for nasal septum analysis using geometric morphometrics (GM) to establish a classification of septal deviations (SD). This was a retrospective study including two groups of patients: patients operated on by septoplasty (SD group) and patients without nasal obstruction (control group). The 3D segmentation model was extracted from CT scans. Thirty landmarks were defined on the nasal septum and validated by MANOVA Procrustes. Using a clusterization process, the septum was classified to reflect its different conformations. Nasal resistances were compared between the two groups. Fifty scans of patients with SD were included. The percentage of variability due to measurement error was 7.9% across all landmarks. We identified two clusters for the SD group. Using GM, conformation of cluster 1 (S-shaped) and cluster 2 (C-shaped) was visualized and identified. There was a statistically significant difference regarding nasal resistance between each cluster in the SD group compared with the control group (p

But de la presentation Rapporter notre experience des dacryo-cysto-rhinostomie par voie endoscopique avec transillumination du sac lacrymal dans la prise en charge des epiphoras compliques ou non. Decrire la technique chirurgicale. Materiel et methodes Etude retrospective portant sur tous les patients operes, dans notre centre, par cette technique entre avril 2012 et avril 2013. L’analyse des resultats, a plus de 6 mois, portait sur la persistance de l’epiphora, la necessite d’une re-intervention chirurgicale et sur la recidive ou non des episodes de dacryocystite. Les echecs etaient analyses en vue d’en definir la cause. L’apport de la transillumination du sac lacrymale a l’aide d’une sonde de type optic light guide introduite par le canalicule lacrymal inferieur etait evaluee en termes de facilite d’utilisation et de duree operatoire par 2 chirurgiens seniors. Resultats Nous rapportons 40 DCR chez 34 patients (6 DCR bilaterales) operes sur une periode de 1 an. Vingt-deux patients (65 %) etaient operes d’un epiphora non complique et douze (35 %) etaient operes pour un ou plusieurs episodes de dacryocystite. Leur bilan comprenait toujours une imagerie de type dacryo-scanner ou scanner injecte du massif facial si dacryocystite. En post-operatoire une attelle de silicone etait placee dans la fosse nasale. Dans le groupe epiphora non-compliques seul un patient a necessite une reintervention et notre taux de succes etait donc de 96,5 %. Dans le groupe dacryocystite, aucun patient n’a recidive mais 25 % de ces cas presentaient un larmoiement post-operatoire. Notre taux de succes etait donc de 100 % en termes de controle infectieux et de 75 % en termes de reussite fonctionnelle. Le temps operatoire moyen etait de 32 minutes (min : 24 min et max : 41 minutes). L’apport de la transillumination, pour definir les contours du sac lacrymal, etait juge comme importante par les chirurgiens seniors. Elle permet de cibler le geste chirurgical, de limiter les temps de fraisage et de s’assurer de l’abouchement du canal d’union dans la fosse nasale. Conclusion Nous decrivons une technique chirurgicale fiable. La transillumination du sac lacrymal est une aide importante pour cette chirurgie.