Perception of environmental issues in the head-and-neck surgery room: A preliminary study.

OBJECTIVES: To assess the perception of environmental issues in head-and-neck surgery rooms and to compare the perception of priority environmental issues according to health professionals' age-group, initial training and role in the operating room. METHODS: A multicenter descriptive observational study was conducted in January 2023, contacting health professionals working in the operating rooms of 5 French centers. An anonymous online questionnaire explored the perception of environmental issues according to age, initial training and role in the operating room. RESULTS: Sixty-nine percent of the 387 persons contacted (267/387) completed the entire questionnaire. Ninety-six percent of respondents (256/267) said that they felt concerned about climate change issues and 85% (226/267) felt well-informed. Ninety-three percent (251/267) were willing to make environmental efforts in the operating room. Priorities were to improve waste recycling and reduce the amount of waste for 95% (251/267) and 97% (259/267) of respondents respectively. Those under 40 years of age tended to feel better informed about climate issues (76% [75/99] versus 60% [100/168]; P=0.010). CONCLUSION: Our study showed that the vast majority of health professionals working in head-and-neck surgery rooms in France felt concerned about climate issues and were ready to make an effort. Nevertheless, it seems important to carry out information campaigns dedicated to these environmental issues.

Perception of endoscopic endonasal surgery training by French otolaryngology residents: A STROBE analysis of expectations.

OBJECTIVES: To analyze the perception of endoscopic endonasal surgery training by French otolaryngology residents. MATERIAL AND METHODS: A multicenter retrospective observational study was conducted from March to April 2023. Otolaryngology residents from 7 French regions filled out a 27-item questionnaire on their training in endoscopic endonasal surgery. RESULTS: Out of 283 residents contacted, 126 (45%) filled out the questionnaire. Seventy-four (59%) had already partially or completely performed the surgeries specified in their diploma course. The level of mastery of the main steps of endonasal surgery and the level of autonomy were higher in the consolidation stage group than in the basic and advanced stages. Seventy residents (56%) felt they had gaps in their level of training. To improve training, 94 (75%) wished for more dissection sessions, surgical skills assessments each semester and simulation sessions. Eighty-nine (71%) felt they needed to find their own teaching aids and other methods to complete their training. One hundred and thirteen (90%) felt that the lack of funding available for congresses and training courses was detrimental. CONCLUSION: This study highlighted the overall satisfaction of residents with their training in endoscopic endonasal surgery. They expressed a desire for more dissection, simulation and evaluation.

Chronic nasal dysfunction: A clinical case illustrating the concept in practice.

INTRODUCTION: We illustrate the diagnostic method for chronic nasal dysfunction by an observation in which the clinical history was compared to preoperative responses on the DyNaChron self-administered questionnaire, with ENT interpretation of the sinonasal CT scan preceding and guiding nasal endoscopy. CASE REPORT: The initial suspicion of rhinitis medicamentosa was transformed by the radiological and endoscopic findings of chronic respiratory rhinitis signs. Prick tests showing sensitivity to dust mites then suggested an allergic origin of the mucosal inflammation, which affected neither the olfactory nose nor the paranasal sinuses. A septal deviation hampering visualization of the right ethmoidal reliefs completed the clinical picture. Inferior turbinate hypertrophy secondary to allergic inflammation could have been aggravated by prolonged daily use of nasal vasoconstrictors. Failure of medical treatment combining nasal lavage, topical corticosteroids and an attempt at weaning led to effective medical and surgical management combining septoplasty, bilateral inferior turbinoplasty, continuation of topical corticosteroids and initiation of allergen immunotherapy. In addition to complete relief of nasal obstruction and abandonment of nasal vasoconstrictors, improved sense of smell completed the restoration of nasal comfort. DISCUSSION: It is helpful to conceive the nose as being anatomically and pathophysiologically a triple organ and to evaluate therapy in terms of improvement in each symptom.

Surgical and instrumental options for chronic rhinitis: A systematic review and PRISMA meta-analysis.

BACKGROUND: There is no consensus on the role of surgery in the treatment of chronic rhinitis (CR). Should it be considered when nasal symptoms are not controlled by medical treatment? Various targets (turbinates and secretory nerves) and techniques (surgical, laser, cryotherapy, radiofrequency and phototherapy) have been reported, but benefit varies between reports. The aim of this systematic review and meta-analysis was to evaluate results of surgical and instrumental procedures in CR care. METHODS: Two systematic reviews of the US National Library of Medicine, Cochrane Library, Web of Science and Embase databases were conducted in October 15, 2021 (registration numbers CRD42021284257 and CRD42021295227). A database watch was performed until submission of the manuscript. The review focuses on total nasal symptom score (TNSS) and quality of life (QoL) after treatment. All controlled studies reporting nasal surgery/instrumental procedures in adult patients with CR were included. RESULTS: The database search yielded a total of 5628 articles; after eligibility screening, 2091 patients were included from 21 studies. QoL results favored surgery/instrumental procedures over medical treatment (SMD -1.27; 95% CI [-2.38; -0.16]; I2=97%), as did TNSS (SMD -1.40; 95% CI [-2.30; -0.50]; I2=98%). The small number of studies and their heterogeneity did not allow meta-regression to be performed. CONCLUSION: This systematic review supports the use of surgical/instrumental procedures to improve nasal symptom score and QoL of adult patients with CR poorly controlled by medical treatment.

Recurrent laryngeal nerve monitoring in children using cricothyroid membrane needle electrodes.

AIMS: Thyroid pathology is rare in children and the rate of malignancy is higher than in adults. Thyroid surgery in children is therefore particularly at risk of causing recurrent laryngeal nerve (RLN) palsies. The classical technique for monitoring the RLN is not always adapted to children due to the large size of the dedicated endotracheal tubes. MATERIAL AND METHODS: Double-needle electrodes (NIM 3.0) were placed medially or paramedially through the cricothyroid membrane and carefully kept submucosal just below the level of the vocal folds. Before identification of the RLN, the vagal nerve was dissected on the side of the concerned lobe and stimulated. The thyroid surgery was then performed with the routine identification of the RLN. The response of the RLN is periodically checked using a stimulating probe. The main outcomes were the identification and stimulation of the RLN, quality of the voice in post-operative time. OBJECTIVE: The main objective of our study is to present a simple and efficient method, available for children of all ages, in order to perform monitoring of the recurrent laryngeal nerves during thyroid surgery. RESULTS: We present the results of our retrospective series, in a tertiary-care university pediatric hospital. We included nine children, corresponding to 15 nerves. In all cases, the RLN was identified, stimulated and a positive response was obtained via monitoring. CONCLUSIONS: This technique of monitoring is safe, feasible at any age, even in neonates, and, as the electrode stays in the operation field, its position is easily controlled.

Recurrent laryngeal nerve monitoring during thyroidectomy and parathyroidectomy in children.

OBJECTIVE: Injury of the recurrent laryngeal nerve (RLN) is the most frequent complication of thyroid and parathyroid (TP) surgery. Monitoring of the RLN in children is not widely studied as this is not a common disease in the pediatric population. The aim of our study was to evaluate the reliability, feasibility and benefits of RLN monitoring during TP surgery in children. METHODS: We analyzed all children who underwent TP surgery in our department between January 2009 and March 2018. Patients were classified into three groups: without monitoring (group 1), monitoring with an endotracheal tube (group 2) and monitoring with a double-needle electrode placed through the cricothyroid ligament (group 3). RESULTS: We performed 53 surgeries (77 RLNs at risk) on 47 patients aged between 6 months and 18 years. Fourteen RLNs were in group 1, 47 in group 2 and 16 in group 3. We found one transient lesion of the RLN in group 1, three in group 2 and two in group 3. Seven patients in group 3 could not undergo monitoring with the tube because they need an orotracheal tube smaller than the smallest monitoring tube size available. The sensitivity and specificity values of the monitoring methods were 33% and 97% in group 2 and 67% and 100% in group 3, respectively. The positive and negative predictive values were 50% and 95% in group 2 and 100% and 92% in group 3, respectively. No complications arose during insertion of the electrode through the cricothyroid ligament. CONCLUSION: Monitoring of the RLN with a double-needle electrode inserted through the cricothyroid ligament is a reliable method with no associated complication, which is achievable at any age.

Two-party secret key distribution via a modified quantum secret sharing protocol.

We present and demonstrate a novel protocol for distributing secret keys between two and only two parties based on N-party single-qubit Quantum Secret Sharing (QSS). We demonstrate our new protocol with N = 3 parties using phase-encoded photons. We show that any two out of N parties can build a secret key based on partial information from each other and with collaboration from the remaining N - 2 parties. Our implementation allows for an accessible transition between N-party QSS and arbitrary two party QKD without modification of hardware. In addition, our approach significantly reduces the number of resources such as single photon detectors, lasers and dark fiber connections needed to implement QKD.

Field test of quantum key distribution in the Tokyo QKD Network.

A secure communication network with quantum key distribution in a metropolitan area is reported. Six different QKD systems are integrated into a mesh-type network. GHz-clocked QKD links enable us to demonstrate the world-first secure TV conferencing over a distance of 45km. The network includes a commercial QKD product for long-term stable operation, and application interface to secure mobile phones. Detection of an eavesdropper, rerouting into a secure path, and key relay via trusted nodes are demonstrated in this network.

SiPM for fast Photon-Counting and Multiphoton Detection.

We demonstrate fast counting and multiphoton detection abilities of a Silicon Photo Multiplier (SiPM). In fast counting mode we are able to detect two consecutive photons separated by only 2.3 ns corresponding to 430 MHz. The counting efficiency for small optical intensities at lambda= 532 nm was found to be around 16% with a dark count rate of 52 kHz at T= -5 masculine C. Using the SiPM in multiphoton detection mode, we find a good signal discrimination for different numbers of simultaneously detected photons.

Distribution of time-bin entangled qubits over 50 km of optical fiber.

We report experimental distribution of time-bin entangled qubits over 50 km of optical fibers. Using actively stabilized preparation and measurement devices we demonstrate violation of the Clauser-Horne-Shimony-Holt Bell inequality by more than 15 standard deviations without removing the detector noise. In addition we report a proof-of principle experiment of quantum key distribution over 50 km of optical fibers using entangled photon.

Experimental study of polarization properties of highly birefringent photonic crystal fibers.

We analyze experimentally the polarization properties of highly nonlinear small-core photonic crystal fibers (PCFs) with no intentional birefringence. The properties of recently emerged polarization maintaining PANDA PCFs are also investigated. The wavelength and temperature dependence of phase and group delay of these fibers are examined in the telecommunications wavelength range. Compared to a standard PANDA fiber, the polarization characteristics and temperature dependence are found to be qualitatively different for both types of fibers.

Quantum measurement of the degree of polarization of a light beam.

We demonstrate a coherent quantum measurement for the determination of the degree of polarization (DOP). This method allows us to measure the DOP in the presence of fast polarization state fluctuations, difficult to achieve with the typically used polarimetric technique. A good precision of the DOP measurements is obtained using eight type II nonlinear crystals assembled for spatial walk-off compensation.

[An evaluation study of the behavior of gastroenterologists faced with the symptom of rectal hemorrhage (486 cases)]. / Essai d'évaluation du comportement des gastro-entérologues face au symptôme "rectorragies" (486 observations).

An investigation concerning "attitudes" was conducted during the second term 1986 on behalf of the National French Association of training in H.G. It enabled to study with 486 patients suffering from recto-haemorrhage the means and costs of the different examinations performed by the participating gastroenterologists. The profit of each behaviour was taken into account, including the total number of acts and hospitalization (N:120, DMS:4.15 days) the advantage lies in total colonoscopy for finding out polyps. It is not so clear in the diagnosis of malignant tumors. Direct relationship is established between invested sums of money (acts + hospitalization) and the number of discovered polyps and to as lesser extent the number of cancers. This calculated study entrances the value of colonoscopy as the examination to be carried out in front of any recto-haemorrhage; it puts forward the different attitudes of specialists, individual as well as in the various means used; it gives a rather precise idea of the cost of finding out polyps. Eventually this attempt of evaluation allowed to appreciate the limits and difficulties of the method in use: those who accepted to say what they do must be thanked.