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Resume Objectifs L’objectif principal etait d’evaluer la qualite de vie de patients souffrant de spasme hemifacial essentiel, avant et apres decompression neurovasculaire, par deux questionnaires de qualite de vie specifiques traduits en francais afin de les valider. Les resultats chirurgicaux et les complications lies a ce traitement etaient etudies. Materiel et methodes Une etude retrospective etait menee sur 23 patients traites chirurgicalement par decompression neurovasculaire. Les questionnaires HFS-8 et HFS-30 etaient traduits de l’anglais au francais selon la methode de « traduction/contre-traduction » et soumis aux patients au moins un an apres la chirurgie. Resultats Les medianes des questionnaires HFS-8 et HFS-30 etaient respectivement de 16 ± 12,5 (8–20,5) et 38 ± 38,5 (23–61,5) avant chirurgie et de 0,5 ± 4,5 (0–4,5) et 5 ± 17,5 (1–18,5) apres chirurgie, montrant une amelioration significative de la qualite de vie (p 0,9) et ils etaient significativement correles (Pearson = 0,95 IC95[0,91 ; 0,98] p Conclusions Ces resultats sont en faveur de la validite des traductions francaises des questionnaires HFS-8 et HFS-30 proposees. La decompression neurovasculaire est un traitement sur et efficace du spasme hemifacial, et ces questionnaires sont des outils fiables dans l’evaluation de la qualite de vie apres chirurgie.

International audience; Post-operative outcomes for hearing after resection surgery to remove cerebellopontine angle (CPA) tumors other than vestibular schwannomas (VS) are not well understood. This study presents a series of patients with significant postoperative hearing recovery, trying to define the incidence among all patients operated on for removal of non-VS CPA tumors. Methods: This is a retrospective observational case series of 8 patients among 69 operated on for removal of non-VS CPA tumors between 2012 and 2020. All patients had pre-and post-operative hearing measurement with pure-tone average (PTA) and speech discrimination score (SDS), according to the American Academy of Otolaryngology-Head and Neck Surgery recommendations, auditory brainstem response (ABR) measurements and imaging. Results: Six meningiomas and two lower cranial nerve schwannomas operated on with a retrosigmoid approach were included for analysis. The mean pre-operative PTA and SDS were 58±20.7 dB and 13±17.5%, respectively. All patients had pre-operative class D hearing and asynchronous ABRs. They all showed significant hearing recovery, with an improvement of 36±22.2 dB (p=0.0025) and 85±16.9% (p=0.0001) in PTA and SDS, respectively, with mean follow-up of 21±23.5 months. Seven patients recovered to a class A hearing level and one patient to class B. The ABRs became synchronous for three patients. The incidence of auditory recovery was 13% for patients operated on with a conservative approach (n=60). Conclusion: A significant post-operative improvement in hearing could be a reasonable expectation in non-VS tumors extending into the CPA and a retrosigmoid approach should always be considered regardless of pre-operative hearing status.

Objective To evaluate the surgical results and complications in a cohort of patients operated on to repair a tegmen bony defect using either transmastoid approach with obliteration using S53P4 bioactive glass granules (TMA-O), or the classic middle cranial fossa approach (MCFA). Study design A retrospective monocentric study. Methods Twenty-five cases (24 patients) were included. Data regarding patient demographics, etiology, intraoperative findings, complications, recurrences, audiometric data, and follow-up were analyzed. Results Seven patients were operated with MCFA and 17 patients with TMA-O. One patient was operated on using a combined approach (MCFA + TMA-O). In the preoperative HRCT scan, the size of the defect was estimated to be 6 ± 3.8 mm in the TMA-O group and 6 ± 3.5 mm in the MCFA group (P = .969). Intraoperatively, in the MCFA group, the location of the defect was mostly anterior (86%) with an intact ossicular chain (86%). A discontinuous chain was observed in 15 patients (88%) in the TMA-O group. The mean follow-up time was 22 ± 14 months in the TMA-O group and 24 ± 15 months in the MCFA group (P = .762). In both groups, there were no early postoperative complications or recurrences during follow-up. Conclusion Repair of a tegmen bony defect with S53P4 bioactive glass granules seems to be safe and effective, limiting the use of the middle cranial fossa approach to cases with epitympanic defects and with an intact ossicular chain, and it could be used whatever the size of the defect and/or the presence of meningoencephalocele. Level of evidence 4.

Resume But Analyse des caracteristiques des tumeurs de la thyroide revelees par une paralysie laryngee unilaterale (PLU). Materiel et methodes Etude retrospective d’une cohorte de 30 patients avec une PLU revelant une affection tumorale thyroidienne (groupe A) et comparaison avec une cohorte de 99 patients avec une PLU revelant une affection tumorale non thyroidienne (groupe B). Resultats Le groupe A se composait de 66,6 % de femmes avec un âge median de 69 ans. La comparaison entre les deux groupes notait que le sexe etait plus souvent feminin au sein du groupe A (66,6 % vs 17,1 %, p Conclusion Cette etude confirme que la PLU n’est pas un element clinique qui permet d’orienter de facon formelle vers le caractere benin ou malin d’une tumeur thyroidienne et souligne l’importance d’une surveillance au long cours en l’absence de recuperation de la mobilite laryngee chez les patients operes d’une tumeur thyroidienne benigne ipsilaterale.

International audience; Middle ear adenomatous neuroendocrine tumours are extremely rare causes of middle ear masses. Differential diagnosis is of primary importance to decide on the correct management since they require surgery whereas other lesions can be actively watched.CT and MRI show a non‐hypervascular lesion, differentiating it from paraganglioma. It is a mesotympanic lesion that usually encases the ossicles without bone erosion and it can invade the retrotympanum and Eustachian tube.Radical surgery is the treatment of choice. Since middle ear adenomatous neuroendocrine tumours adhere to adjacent structures and lack a tumour capsule, gross total resection is challenging.Late recurrences may be observed and complicated by the development of middle ear cholesteatoma, emphasising the importance of a long follow‐up.Recurrence can be associated with neural and intracranial invasion, lymph node or distant metastasis, highlighting the malignant potential of middle ear adenomatous neuroendocrine tumours.

International audience; Objectives. The aim of the present study was to assess quality of life before and after surgery for hemifacial spasm, in order to validate two specific quality of life scales translated in French. Surgical results and complications were reported. Material and methods. Twenty-three patients with hemifacial spasm treated by microvascular decompression were retrospectively included. The HFS-8 and HFS-30 quality of life scales were translated from English into French using a forwardbackward method and implemented on patients at least 1 year after surgery. Results. Median HFS-8 and HFS-30 values were respectively 16 ± 12.5 (range, 8-20.5) and 38 ± 38.5 (range, 23-61.5) before surgery and 0.5 ± 4.5 (range, 0-4.5) and 5 ± 17.5 (range, 1-18.5) after surgery, showing significant improvement in quality of life (p < 0.001). The internal consistency of both scales was excellent (Cronbach's alpha > 0.9), and they were significantly correlated (Pearson coefficient = 0.95; 95% CI [0.91; 0.98]; p < 0.0001). Success rates were respectively 83% and 91% after primary and revision surgeries. Complications were transient with minor consequences in 80% of cases, but could impact quality of life when lasting. Conclusions. These results support the validity of the French versions of HFS-8 and HFS-30. Microvascular decompression is a safe and effective treatment for hemifacial spasm, and these scales are reliable tools to assess postoperative quality of life.

Post-operative outcomes for hearing after resection surgery to remove cerebellopontine angle (CPA) tumors other than vestibular schwannomas (VS) are not well understood. This study presents a series of patients with significant post-operative hearing recovery, trying to define the incidence among all patients operated on for removal of non-VS CPA tumors.This is a retrospective observational case series of 8 patients among 69 operated on for removal of non-VS CPA tumors between 2012 and 2020. All patients had pre- and post-operative hearing measurement with pure-tone average (PTA) and speech discrimination score (SDS), according to the American Academy of Otolaryngology-Head and Neck Surgery recommendations, auditory brainstem response (ABR) measurements and imaging.Six meningiomas and two lower cranial nerve schwannomas operated on with a retrosigmoid approach were included for analysis. The mean pre-operative PTA and SDS were 58 ± 20.7 dB and 13 ± 17.5%, respectively. All patients had pre-operative class D hearing and asynchronous ABRs. They all showed significant hearing recovery, with an improvement of 36 ± 22.2 dB (p = 0.0025) and 85 ± 16.9% (p = 0.0001) in PTA and SDS, respectively, with mean follow-up of 21 ± 23.5 months. Seven patients recovered to a class A hearing level and one patient to class B. The ABRs became synchronous for three patients. The incidence of auditory recovery was 13% for patients operated on with a conservative approach (n = 60).A significant post-operative improvement in hearing could be a reasonable expectation in non-VS tumors extending into the CPA and a retrosigmoid approach should always be considered regardless of pre-operative hearing status.

To analyze the characteristic of thyroid tumor associated with ipsilateral unilateral laryngeal paralysis (ULP) in the adult patient.Retrospective analysis of a cohort of 30 patients with ULP related to an ipsilateral thyroid tumor (group A) and comparison with a cohort of 99 patients in whom ULP revealed a non-thyroid tumor (group B).Group A consisted of 66.6% of women with a mean age of 69 years. Comparison between both groups noted that female gender was more frequent in group A (66.6% vs. 17.1%, P0.0001), and the underlying tumor was more frequently malignant in group B (89.9% vs. 43.4%, P0.0001). Within group A, the incidence for recovery of laryngeal motion varied form 0% for malignant tumor to 50% for benign tumor. In patients with a benign thyroid tumor in whom recovery of laryngeal motion did not occur, the watch policy initiated allowed to detect a pathology (malignant tumor or neurological) explaining persistent ULP in 57% of cases.The present series confirm that ULP in the face of thyroid tumor does not allow to distinguish formally between benign and malignant tumors and highlight the value of a long term watch policy in patients with benign thyroid tumor pathology in whom recovery of laryngeal mobility does not occur.