References of "LEFEBVRE, Philippe"
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See detailEvaluation of Surgical Simulation in Temporal Bone Surgical Radio-Anatomy Learning
ROGISTER, Florence ULiege; SALMON, Caroline ULiege; GHUYSEN, Alexandre ULiege et al

Conference (2019, March 28)

Background Lack of data regarding efficiency of simulation-based teaching, in particular high-fidelity virtual reality, constitutes a major drawback for its implementation in the medical training. However ... [more ▼]

Background Lack of data regarding efficiency of simulation-based teaching, in particular high-fidelity virtual reality, constitutes a major drawback for its implementation in the medical training. However, it provides a structured, safe and supportive environment to familiarize with complex anatomy and practice surgical skills. We aimed to evaluate high-fidelity virtual reality simulation in learning of temporal bone radio-anatomy during ENT residency. Materials and Methods 15 Belgian otorhinolaryngology residents completed 5 sessions of simulation in antro-mastoidectomy using VOXEL-MAN Tempo® surgical simulator. Technical mistakes and surgical parameters were recorded. Before and after training period, residents completed a temporal bone radiological anatomy test available online (http://www.radioanatomie.com). Pre- and post-simulation scores were compared as primary endpoint by non-parametric Wilcoxon test using RCmdr (https://www.r-project.org). As secondary endpoint, residents’ surgical skills following simulation training were blindly assessed on cadaveric human temporal bones using a reproducible scale by seniors otologist surgeons of our department. Correlation between radiological testing and dissection scale were evaluated by Spearman regression. Finally, trainees completed a survey on the device itself. Results Performance on radiological testing significantly increased with a mean improvement of 28 ± 12.12 (Wilcoxon p = 0.0011). Surgical results on cadaveric specimens were not correlated to surgical simulation parameters. Higher results on radiological testing were associated with higher scores on dissection scale, suggesting that subjects who succeeded better at dissection were those who knew best anatomy. Among residents, 80% felt this tool suitable for early surgical education, and 84.6% queried further information on simulation techniques. 100% of trainees would integrate this tool within their learning of temporal bone's radiological and surgical anatomy. Conclusions High-fidelity virtual reality simulator improved temporal bone anatomy teaching and specifically increased knowledge of temporal bone radiological anatomy. Acknowledgement No conflict of interest. [less ▲]

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See detailSurgical Simulation in Temporal Bone Surgical Radio-Anatomy Learning
ROGISTER, Florence ULiege; SALMON, Caroline ULiege; GHUYSEN, Alexandre ULiege et al

in B-ENT (2019, February 23)

Introduction and Aim: We aimed to evaluate high-fidelity virtual reality simulation in learning of temporal bone radio-anatomy during ENT residency. Methods: Fifteen ENT residents completed a radiological ... [more ▼]

Introduction and Aim: We aimed to evaluate high-fidelity virtual reality simulation in learning of temporal bone radio-anatomy during ENT residency. Methods: Fifteen ENT residents completed a radiological temporal bone anatomical testing before and after five training sessions on the VOXEL-MAN Tempo® surgical simulator. Secondary investigation: residents also completed a personal subjective assessment after these training session and residents’ technical skills were assessed on cadaveric temporal bones. Results: Primary outcome: Residents significantly improved their performance on the temporal bone radiological anatomy test after completing virtual training on the simulator. Secondary outcomes: The personal assessment survey indicated that 100% of the residents would integrate this virtual tool within the learning methods. No significant correlation was found between virtual simulator performances and surgical performances on cadaveric model, but a significant correlation was shown between the anatomical testing result and the performances on cadaveric model. Conclusions: This study suggested that a high-fidelity virtual reality simulator, the VOXEL-MAN Tempo® device, improved teaching of temporal bone anatomy and specifically increased trainees’ practical knowledge regarding radiological anatomy of temporal bone. [less ▲]

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See detailImpact of a Shift in Treatment Funding on a Multidisciplinary Sleep Clinic: a Cohort Study
VERMEIRE, Pierre ULiege; FANIELLE, Julien ULiege; BRUWIER, Annick ULiege et al

in B-ENT (2019)

Introduction and Aim: A shift in Obstructive Sleep Apnea (OSA) funding was implemented in Belgium on January 1, 2017. Funding was allowed for moderate to severe OSA and the rules shifted for treatments ... [more ▼]

Introduction and Aim: A shift in Obstructive Sleep Apnea (OSA) funding was implemented in Belgium on January 1, 2017. Funding was allowed for moderate to severe OSA and the rules shifted for treatments delivery and monitoring by authorised medical opinion. Multidisciplinary Sleep Clinics have long existed, bringing together sleep specialists, dentists, orthodontists and surgeons. We aimed to assess whether a shift in treatment funding was associated with a change in the multidisciplinary sleep practice. Material and Methods: Sample consisted of all patients discussed in the sleep multidisciplinary team meetings of the University Hospital of Liege from January 2016 to December 2018. Interrupted times series, Mann-Whitney U tests and descriptive statistics were produced. Results: There were no differences in patients age, male sex preponderance, body mass index, clinical presentation and level of obstruction. Baseline OSA severity was significantly lower (mean apnea-hypopnea index and mean oxygen desaturation index lowered respectively with p = 0.0189 and p = 0.0466) after the funding rules changed. Oral appliance and ENT surgery were more often offered after the shift in funding. Conclusion: Sleep multidisciplinary team meeting changed patient selection and management after the implementation of the new funding rules for OSA. The shift in funding often resulted in treatment options change, reaching more people and offering more options. [less ▲]

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See detailENT Surgical Training in 2018: National Cross-sectional Study
ROGISTER, Florence ULiege; CAMBY, Séverine ULiege; LEFEBVRE, Philippe ULiege et al

in B-ENT (2019)

Introduction and Aim: This study aimed to draw up an inventory of the current practical training from the surgical trainees’ point of view, identifying strengths and gaps of current training and potential ... [more ▼]

Introduction and Aim: This study aimed to draw up an inventory of the current practical training from the surgical trainees’ point of view, identifying strengths and gaps of current training and potential tools to be developed. Material and Methods: We conducted a broad national survey among Belgian population within the North-part and South-part universities of the country. The questions included self-assessment, training objectives, training quality and training tools. Results: 35.7% of trainees evaluated their level of overall surgical competence at 3/5 compared to an ideal mastery. More than a half (55%) of trainees did not know the training objectives and 73% did not know the basic surgical procedures that a qualified ENT surgeon should be able to perform. The main mode of learning (41%) was the observation of a senior and repetition under supervision (companionship). The results showed mainly logistical and economic drawbacks, on which it seems possible to act using learning methods based on the implementation of organized training sessions, associated with different learning tools such as surgical and procedural simulation. Some of these are already available in our country but remain difficult to access or to develop. Conclusion: This study revealed a real demand and motivation from trainees and could serve as a basis to sketch a teaching scheme improving skills and confidence of future surgeons. Additional studies are needed to identify the most effective ways for implementing this type of teaching within the constraints of the surgical curriculum and teaching hospitals resources. [less ▲]

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See detailRhinologic Emergencies: a Prospective Audit in a University Teaching Hospital
ROGISTER, Florence ULiege; ATTA, Lucas; Delrez, Sophie ULiege et al

Conference (2018, April)

Aims: Increasing pressure to reduce healthcare cost threatens the provision of acute ENT coverage round the clock. Our goal was to audit our emergency rhinologic activity over a one-month period. Methods ... [more ▼]

Aims: Increasing pressure to reduce healthcare cost threatens the provision of acute ENT coverage round the clock. Our goal was to audit our emergency rhinologic activity over a one-month period. Methods: A prospective audit for all emergency ENT referrals was carried out from May 1st to May 31th 2017. Descriptive statistics were produced for age, sex, origin, time of arrival, diagnosis and outcome. A specific subgroup analysis was performed for rhinologic emergencies. A basic cost analysis was ran. Results: Over the study period, 190 patients were referred to the ENT emergency service. Twenty percent patients presented with nose or sinus complaint (36.8% with otological or neuro-vestibular primary complaint, 43.2% with laryngeal or neck complaint). Nose and throat complaints were more likely to present at night or on weekends. Ear complaints were more likely to present during business hours. Rhinologic complaint was more likely to require technical or surgical management than ear or throat complaint. Patients with nose complaint required minor procedure in 43.2% cases (35.6% of the total minor procedures), and required surgical procedure in 13.5% cases. Among the total ENT emergency surgical procedures, 62.5% were rhinologic ones, involving the nose (50%) or the sinus (12.5%). Ear or throat initial complaint were more likely to require no treatment or ambulatory management. Conclusion: The emergency rhinologic activity is justified in our hospital. An initial rhinological complaint was more likely to require specific ENT management than other complaints. ENT cover is an efficient service provision, especially for rhinologic emergencies. [less ▲]

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See detailBaseline SNOT-22 as Outcome Predictor: a Powerful Tool just at Hand
ROGISTER, Florence ULiege; DE DORLODOT, Clotilde; ANSARI, Edward et al

Conference (2018, April)

Aims: SNOT-22 was initially designed for rhinosinusitis, but was recenty validated in various nose conditions. Nose or sinus complaint is a common cause of consultation in primary care or ENT clinic ... [more ▼]

Aims: SNOT-22 was initially designed for rhinosinusitis, but was recenty validated in various nose conditions. Nose or sinus complaint is a common cause of consultation in primary care or ENT clinic. Therefore we sought to optimize the simple and versatile instrument SNOT-22. Our aim was to determine the outcome of patients and healthy volunteers solely based on the pattern of the baseline SNOT-22 in a multi-centre study. Methods: Sixty-six healthy volunteers and 383 patients presenting to the rhinology clinic of the ENT academic departments of Godinne, Liege and Brussels participated in this study. SNOT-22 from all participants were collected blindly prior to diagnosis. Participants were then categorized in 5 groups according to their outcome: control, medical rhinologic condition, sinus surgery, functional nose surgery. SNOT-22 items relevant to each group were determined by multinomial logistic regression. Results: Control subjects showed the lowest SNOT-22 scores for all items. Medical rhinologic patients had lower scores than surgical patients. Patients requiring sinus surgery and those listed for nose surgery exhibited a specific pattern of SNOT-22 score. Most relevant items were #1 need to blow nose, #5 post-nasal discharge, #6 thick nasal discharge, #10 facial pain and #21 sense of smell. Conclusions: Distinct SNOT-22 patterns were correlated to subjects outcome. SNOT-22 was able to differentiate patients from controls, to score severity, and could further provide an accurate description of pathology. Baseline SNOT-22 could localize pathology in the sinus or in the nose and predict the need for surgical treatment. [less ▲]

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See detailA Prospective Audit of Acute ENT Activity in a Teaching Hospital.
Goffinet, Maxime ULiege; ATTA, Lucas; Delrez, Sophie ULiege et al

in B-ENT (2018, March 03)

Introduction and aim: Acute ENT coverage is available out-of-hours in most hospitals. However, increasing pressure to reduce healthcare cost threatens this service provision round the clock. Our goal was ... [more ▼]

Introduction and aim: Acute ENT coverage is available out-of-hours in most hospitals. However, increasing pressure to reduce healthcare cost threatens this service provision round the clock. Our goal was to audit the emergency ENT activity in our institution over a one-month period Material and methods: a prospective audit for all ENT referrals from the emergency department was carried out from May 1st to May 31th 2017. Descriptive statistics were produced for age, sex, origin, time of arrival, diagnosis and patient outcome. Results: a total of 190 patients (109 men and 81 women) were referred to the ENT emergency service over the study period (mean 6.1 case per day). Mean age was 47.9 (±23.6)year (range 1-95). Most patients were ambulatory (75.8%) and came from the area. Most admissions occurred during normal working hours (76.4%) and 62.0% patients came by self reference. The mean complaint duration before admission was 7.6 (±13.7) days (range 0-92 days). One third (33.2% patients) required ambulatory treatment. A quarter (24.7% patients) underwent a minor ENT procedure. Eighteen (9.5%) patients required admission to the ward (mostly for intravenous antibiotic). Eight patients (4.2%) required surgical treatment. There was no difference in the severity of diagnosis or management between patients referred by a physician (GP of specialist) and patients presenting spontaneously. At 30 days, 3 (1.6%) patients died (one of ENT cancer, two of unrelated cause), 106 (55.8%) benefited from an ENT follow’up, 65 (34.2%) were referred to another physician (GP or specialist), 16 (8.4%) were lost to follow’up. Conclusions: The workload suggests that emergency ENT activity is justified in our hospital. Restricting emergency ENT cover to patients referred by a GP or another physician would not allow for a better patient selection. [less ▲]

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See detailPost-irradiated Carotid Blowout Syndrome in patients with Nasopharyngeal Tumor: about 3 cases
DETROUX, Valentine ULiege; GOFFART, Yves; COLLIGNON, Laurent et al

in B-ENT (2018, March)

Introduction Rupture of the internal carotid artery (Carotid blowout syndrome) is a rare complication of irradiated nasopharyngeal tumor. We report three cases nasopharyngeal tumors treated with ... [more ▼]

Introduction Rupture of the internal carotid artery (Carotid blowout syndrome) is a rare complication of irradiated nasopharyngeal tumor. We report three cases nasopharyngeal tumors treated with radiotherapy complicated with bleeding of the internal carotid artery presenting as a massive epistaxis. Case Series The first case presented a few episodes of small nose bleeding before a massive one. Internal carotid embolisation was performed to stop the bleeding. Unfortunately, few month later, he presented a meningitis related to skull base osteoradionecrosis and died from sceptic shock. The second case was transferred to our hospital with severe repetitive epistaxis that had been occurring for hours. No endovascular treatment was possible in his case and he died in intensive care unitthe dayof his admission. The thrid case presented one massive epistaxis which stopped without any treatment or compression. A spontaneous occlusion of his internal carotid artery occured without any neurological defects. He recently benefited from a nasopharyngeal muscle flap for the coverage of the carotid artery. These three patients all presented with a history of nasopharyngeal tumor handled by radiotherapy. Pathogenesis, treatment, and outcome are discussed on the light of a comprehensive literature review. Conclusions Carotid blowout syndrome secondary to radiation therapy is rare but life-threatening. Re-irradiation and skull base osteoradionecrosis are strong predisposing factors. [less ▲]

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See detailDerivation of cochlear cells from human iPSCs for modeling hereditary hearing loss
Czajkowski, Amandine ULiege; Grobarczyk, Benjamin; Borgs, Laurence et al

Conference (2017, November 24)

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See detailDerivation of cochlear cells from human iPSCs for modeling hereditary hearing loss
Czajkowski, Amandine ULiege; Grobarczyk, Benjamin; Borgs, Laurence et al

Poster (2017, May)

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See detailTyrosine kinase inhibition is an important factor for gene expression of CRTH2 in human eosinophils and lymphocytes: A novel mechanism for explaining eosinophils recruitment by the neuro-immune axis in allergic rhinitis.
El-Shazly, A. E.; Roncarati, Patrick ULiege; Lejeune, Margaux ULiege et al

in International Immunopharmacology (2017), 45(45), 180-186

We recently shown a novel neuro-immune competition between vasoactive intestinal peptide (VIP) and PGD2 for CRTH2 receptor, and that genistein augmented VIP and PGD2-induced eosinophil chemotaxis. However ... [more ▼]

We recently shown a novel neuro-immune competition between vasoactive intestinal peptide (VIP) and PGD2 for CRTH2 receptor, and that genistein augmented VIP and PGD2-induced eosinophil chemotaxis. However, there are neither studies on the CRTH2 gene expression in allergic rhinitis (AR) nor in the effect of tyrosine kinase inhibitors in CRTH2 gene regulation. Our Objectives were to study the gene expression modulation of CRTH2 receptor in AR patients and the effect of tyrosine kinase inhibitors (TKIs) on CRTH2 gene modulation. Nasal provocation tests, ELISA, qRT-PCR, western blot, flow cytometry and chemotaxis assays in modified micro-Boyden chambers, were all used, to achieve our objectives. Herein we show that AR patients increased the amounts of VIP and PGD2 in their nasal secretions in the early phase reaction, however CRTH2 gene expression from leukocytes recovered in their nasal secretions was upregulated only during the late phase reaction. The TKIs; Genistein, Erbstatin and Herbimycin A, induced the gene expression of CRTH2 and increased the protein content of CRTH2 in both human lymphocytes and eosinophils. This was functional as PGD2/VIP-induced eosinophil chemotaxis was augmented by the TKIs and inhibited by pervanadate, the tyrosine phosphatase inhibitor. These results open channels for therapeutic modalities targeting CRTH2 molecules in AR. [less ▲]

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See detailPotential use of estetrol in sensorineural hearing loss protection
DELHEZ, Amandine ULiege; Manfroid, Isabelle ULiege; LEFEBVRE, Philippe ULiege et al

in B-ENT (2017)

Introduction and Aims: Estrogens have a positive impact on the auditory function. Indeed, estradiol (E2) treatment in animals protects against acoustic trauma and aminoglycoside toxicity and its depletion ... [more ▼]

Introduction and Aims: Estrogens have a positive impact on the auditory function. Indeed, estradiol (E2) treatment in animals protects against acoustic trauma and aminoglycoside toxicity and its depletion can contribute to age-related hearing loss. However, estradiol is not suitable in clinical practice, given the increased risk of cancer and thromboembolic events. There is a need to find new treatments that present a higher benefit/risk ratio. In this work, we studied a new natural estrogen derivative, estetrol (E4), that was shown to act as a Selective Estrogen Receptor Modulator (SERM). Estetrol is thus able to display estrogen-like as well as antiestrogen activity depending on the target tissue. Interestingly, E4 allows the prevention of menopause symptoms such as osteoporosis or hot flushes through an agonistic action, whereas it exerts anti-estrogenic effects on the mammary gland. These preclinical data suggest that E4 presents a safer profile than E2. Material and Methods: To investigate whether this molecule presents otoprotective actions, we exposed P2 cultured organs of Corti to gentamicin, with or without estetrol (E4). After 48 hours of culture, hair cell survival was evaluated following anti-myosin VII Immunohistochemistry. We next moved on to in vivo studies using young zebrafish larvae (5dpf), since they constitute a highly effective model to determine the potential ototoxicity of drugs and to screen for candidates of hair cell protective agents. We monitored the survival of hair cells within neuromasts following chronic or acute exposure to gentamicin. Results: In cochlear culture, gentamicin-induced hair cell loss was significantly reduced by E4. Interestingly, the toxicity of aminoglycoside was also reduced in vivo upon treatment of zebrafish larvae with E4. Conclusion: The survival rate of hair cells was increased in the presence of estetrol both in vitro and in vivo indicating that estetrol constitutes an interesting protective drug against hearing loss. [less ▲]

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See detailDerivation of cochlear cells from human iPSCs for modeling hereditary hearing loss
Czajkowski, Amandine ULiege; Grobarczyk, Benjamin; Borgs, Laurence et al

Poster (2016, September 16)

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See detailDerivation of cochlear cells from pathological or isogenic human iPSCs for modeling hereditary hearing loss
Czajkowski, Amandine ULiege; Grobarczyk, Benjamin; Hanon, Kevin ULiege et al

Poster (2016, May)

Alström Syndrome (AS) is a human autosomal recessive genetic disorder characterized by numerous clinical symptoms including deafness. AS is caused by mutations in the ALMS1 gene encoding for ALMS1 protein ... [more ▼]

Alström Syndrome (AS) is a human autosomal recessive genetic disorder characterized by numerous clinical symptoms including deafness. AS is caused by mutations in the ALMS1 gene encoding for ALMS1 protein expressed at the basal body and implicated in ciliogenesis, cell cycle and proliferation (Jagger et al., 2011; Zulato et al., 2011 & Shenje et al., 2014). We are interesting in understanding the unknown mechanisms involving this protein in the genetic deafness of AS patients. To develop a model as closer as possible to the human pathology, we are using human induced pluripotent stem cells (hiPSCs) generated from fibroblasts of healthy and AS patients. Using a stepwise protocol, we demonstrated that healthy hiPSCs (waiting for isogenic hiPSCs) can generate a population of cells with gene and protein expression patterns consistent with the ones of otic progenitor cells (OSCs). At this differentiation stage, we observed some proliferation and apoptotic defects between healthy and AS cells. When human OSCs are co-cultured with mouse feeder cells, they are able to differentiate into hair cells (HCs). We successfully differentiated AS hiPSCs generated from AS patients into HCs. We are currently confirming gene expression pattern and testing HCs functionality.  To exclude patient linked epigenetics and differentiation defects, we are correcting the genomic mutation in the AS hiPSCs to generate isogenic hiPSCs using the CRIPSR/Cas9 system. Thanks to the isogenic hiPSCs we will be able to confirm that these defects are well due to the ALMS1 mutation. [less ▲]

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See detailA Retrospective Multicentre Cohort Review of Patient Characteristics and Surgical Aspects versus the Long-Term Outcomes for Recipients of a Fully Implantable Active Middle Ear Implant
LEFEBVRE, Philippe ULiege; Gisbert, Javier; Cuda, Domenico et al

in Audiology and Neuro-otology (2016), 21(5), 333-345

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See detailFunctional respiratory imagning-aided virtual preoperative planning in nasal surgery: towards a personalized approach.
Ansari, Edward; Vos, Wim; Van Holsbeke, Cedric et al

in B-ENT (2016)

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See detailFunctional respiratory imagning-aided virtual preoperative planning in nasal surgery: towards a personalized approach
Ansari, Edward; Vos, Wim; Van Holsbeke, Cedric et al

Conference (2016)

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