European Archives of Oto Rhino Laryngology

European Archives of Oto Rhino Laryngology

Quantitative criteria for age-related hearing loss using audiometric configuration analysis

18-10-2019 –

Abstract Objectives To suggest the most adaptable criteria of age-related hearing loss (ARHL) using prevalence matching with population-based data. Methods We chose 30, 25, 20, and 15 d
B as gap ranges of cutoff values of the descending type of hearing loss, between an average of low (500 Hz, 1 k
Hz) and high (4 k
Hz, 6 k
Hz) frequencies. Interaural difference was defined as 10 or 15 d
B. Hearing loss was defined over 25 d
B. We compared the prevalence results of the cross-matching criteria. We used population-based data from the Korea National Health and Nutrition Examination Survey. We assumed that the prevalence of ARHL ranged from 25 to 35%, and this prevalence will increase gradually with age. Results Among the eight possible criteria, age ≥ 65 years, average of all frequencies > 25 d
B at the each sides, gap between low- and high frequencies ≥ 20 d
B, and interaural difference ≤ 10 d
B were the most suitable criteria to suggest a quantitative definition of ARHL audiometrically. Conclusion In the current study, we recommend the new, quantitative ARHL criteria. The suggested criteria for ARHL might be easily accessed by other researchers to demonstrate their own hypotheses.

Endoscopic stapedotomy: safety and audiological results in 150 patients

17-10-2019 –

Abstract Objective The most widely accepted treatment for otosclerosis is currently microscopic stapes surgery under either local or general anesthesia. The aim of the study is to describe the surgical steps in endoscopic stapes surgery and to evaluate the audiologic and surgical outcomes. Materials and methods All patients who underwent exclusive endoscopic stapes surgery or revision surgery for previous stapedotomy between November 2014 and September 2018 were enrolled in this study. Demographic data, surgical information, preoperative and postoperative pure tone averages and air bone gaps, intraoperative and postoperative complications and follow-up data were summarized and gathered in a database for further consideration and analysis. Results In the period examined, 181 stapes surgical procedures were performed and out of these 150 met the inclusion criteria. There were no cases of major intraoperative complications. Sensorineural hearing loss was observed in one case. In one patient a gusher effect occurred during surgery. The postoperative air–bone gap improved significantly compared to the preoperative gap (8 vs 29 d
B HL, respectively), and the mean air–bone gap closure was 20 d
B HL. In 78.7% of cases, the observed postoperative air–bone gap was less than 10 d
B HL and in 14% it was between 11 d
B HL and 20 d
B HL. An ABG closure lower than 20 d
B HL was achieved in a total of 92.7% of patients. Conclusions Endoscopic stapes surgery is a safe procedure with a low risk of peri- or postoperative complications and is a possible alternative to the traditional microscopic surgical procedure in the treatment of otosclerosis.

The most reliable time point for intact parathyroid hormone measurement to predict hypoparathyroidism after total thyroidectomy with central neck dissection to treat papillary thyroid carcinoma: a prospective cohort study

16-10-2019 – JW Chang,KW Park,SN Jung,L Liu,SM Kim,BS Koo

Journal Article

Abstract Purpose We assessed the optimal time for intact parathyroid hormone (i
PTH) measurement for early detection of post-total thyroidectomy (TT) hypocalcemia in patients with papillary thyroid carcinoma (PTC). Methods In this single-center prospective cohort study, 143 patients who underwent TT with central neck dissection with or without lateral neck dissection for PTC were included. Biochemical profiles including i
PTH, corrected total calcium, and ionized calcium within 24 h after surgery were analyzed. Results The 4-h postoperative i
PTH was the most reliable predictor of post-TT transient or permanent hypoparathyroidism (cutoff for hypocalcemia was 3.75 pg/m
L, AUC = 0.885, P < 0.001, sensitivity 81.6%, specificity 86.0%; cutoff for permanent hypocalcemia was 2.48 pg/m
L, AUC = 0.819, P < 0.001, sensitivity 100%, specificity 57.8% calculated using ROC curves). Conclusions The 4-h postoperative i
PTH can most accurately predict hypoparathyroidism after TT with central neck dissection to treat PTC and facilitate the early discharge of low-risk postoperative hypoparathyroidism patients and decrease unnecessary overnight observation and calcium supplementation.

Is C-reactive protein to albumin ratio an indicator of poor prognosis in Bell’s palsy?

16-10-2019 – S Cayir,O Hizli,S Kayabasi

Journal Article

Abstract Purpose The aim of this study was to determine whether the C-reactive protein to albumin ratio was associated with the prognosis in patients with Bell’s palsy. Methods Reviewing records of 79 patients diagnosed with Bell’s palsy, 3 groups were constituted: recovered group (with a House Brackman grade of 1 or 2 after treatment, 56 patients), unrecovered group (23 patients) and control group (60 healthy individuals). Age, hemoglobin, C-reactive protein to albumin ratio, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, white blood cell and hemoglobin values were compared among the groups. Results Age, hemoglobin and platelet to lymphocyte ratio were not significantly different between the groups (p = 0.12, p = 0.31, p = 0.86 and p = 0.87, respectively). Median C-reactive protein to albumin ratio, neutrophil to lymphocyte ratio and white blood cell were significantly greater both in non-recovery group (p < 0.001) and recovery group (p = 0.001 and p < 0.001, respectively) compared to the control group. Additionally, median C-reactive protein to albumin ratio and neutrophil to lymphocyte ratio were significantly greater in the non-recovery group, compared to the recovery group (p = 0.002, and p < 0.001, respectively). However, median white blood cell did not significantly differ between the non-recovery and the recovery groups (p = 0.89). Conclusion Higher C-reactive protein to albumin ratio and neutrophil to lymphocyte ratio were associated with poor prognosis in patients with Bell’s palsy. C-reactive protein to albumin ratio might be the most significant indicator of poor prognosis in patients with Bell’s palsy.

Dynamic imaging in suspected Eagle syndrome

15-10-2019 – EN Siniscalchi

Letter

Changes in elastic properties of the nasal tip using Columellar strut graft versus tongue-in-groove method over one year after rhinoplasty

15-10-2019 – S Atighechi,M Dadgarnia,S Vaziribozorg,M Baradaranfar,V Zand,M Meybodian,M Mandegari,S Shirkhoda

Journal Article

Abstract Introduction In this study, we decided to investigate the changes in elasticity of the nasal tip using Columellar strut graft versus toung in groove method over a year after rhinoplasty. Materials and methods In this before-after randomized clinical trial study, 44 candidates for rhinoplasty were enrolled Columellar strut graft group (n = 22) and toung in groove group (n = 22). Also 22 patients who referred to ENT clinic without any previous rhinoplasty and without any decision for it during the next year, considered as control group. One group underwent columellar strut graft and the other one underwent tongue in groove rhinoplasty and in control group participants received no intervention. Nasolabial angle and elasticity of the nasal tip were recorded and compared before the surgery, immediately after the surgery, 3 months and one year after the surgery. Result There was no significant difference between the mean elasticity of the nose and the nasolabial angle before the surgery, immediately after the surgery and 3 months after the surgery between the groups. However, there was significant differences in the mean elasticity of the nose and the nasolabial angle between the groups one year after the surgery (P value < 0.05). Pearson correlation coefficient test showed a significant correlation between nasal tip elasticity 3 months and 1 year after rhinoplasty (P = 0.032, r = 0.459) and nasolabial angle 3 months and 1 year after rhinoplasty (P = 0.045, r = 0.431). Conclusion According to the results, it can be concluded that the both the Columellar strut graft and toung in groove methods improve elastic properties of the nasal tip and nasolabial angle after rhinoplasty compare to the control group.

Odontogenic tumours: a 25-year epidemiological study in the Marche region of Italy

14-10-2019 – M Mascitti,L Togni,G Troiano,VCA Caponio,A Sabatucci,A Balercia,C Rubini,L Lo Muzio,A Santarelli

Journal Article

Abstract Purpose Epidemiological data of odontogenic tumours (OT) are conflicting, with significant differences among the countries. This study aims to evaluate incidence and prevalence of OTs in the Marche population in a period of 25 years, according to 4th Edition of WHO Classification. Methods In this study, only patients of Marche region treated for OTs were considered. Data were retrieved from Institute of Pathology, Marche Polytechnic University, Italy. Because this is the only tertiary referral centre for Head and Neck pathology within Marche region, the patient sample could be considered well representative of this area. From each case, age, sex, site, diagnosis and relapses were recorded. Results Overall, 100 patients were treated for OTs from 1994 to 2018 in Marche region. The annual incidence rate ranged from 0.13 to 0.39 per 100,000, while life prevalence was 6.50 per 100,000. Mean age of onset for primary OTs was 49.7 ± 20.1 years. Twenty-seven patients developed recurrences, showing a mean age of 54 ± 19.7 years and a mean recurrence time of 51.2 ± 34 months. Conclusion This is the first epidemiological study on OTs in Italian population according to 4th Edition of WHO Classification. Although limited in their retrospective nature, these findings could accurately estimate epidemiology of OTs in Italy.

The use of structured reporting of head and neck ultrasound ensures time-efficiency and report quality during residency

14-10-2019 – BP Ernst,S Strieth,F Katzer,M Hodeib,J Eckrich,K Bahr,T Rader,J Künzel,MF Froelich,C Matthias,WH Sommer,S Becker

Journal Article

Abstract Purpose Free text reports (FTR) of head and neck ultrasound studies are currently deployed in most departments. Because of a lack of composition and language, these reports vary greatly in terms of quality and reliability. This may impair the learning process during residency. The purpose of the study was to analyze the longitudinal effects of using structured reports (SR) of head and neck ultrasound studies during residency. Methods Attending residents (n = 24) of a tripartite course on head and neck ultrasound, accredited by the German Society for Ultrasound in Medicine (DEGUM), were randomly allocated to pictures of common diseases. Both SRs and FTRs were compiled. All reports were analyzed concerning completeness, acquired time and legibility. Overall user contentment was evaluated by a questionnaire. Results SRs achieved significantly higher ratings regarding completeness (95.6% vs. 26.4%, p < 0.001), description of pathologies (72.2% vs. 58.9%, p < 0.001) and legibility (100% vs. 52.4%, p < 0.001) with a very high inter-rater reliability (Fleiss’ kappa 0.9). Reports were finalized significantly faster (99.1 s vs. 115.0 s, p < 0.001) and user contentment was significantly better when using SRs (8.3 vs. 6.3, p < 0.001). In particular, only SRs showed a longitudinally increasing time efficiency (− 20.1 s, p = 0.036) while maintaining consistent completeness ratings. Conclusions The use of SRs of head and neck ultrasound studies results in an increased longitudinal time-efficiency while upholding the report quality at the same time. This may indicate an additive learning effect of structured reporting. Superior outcomes in terms of comprehensiveness, legibility and time-efficiency can be observed immediately after implementation.

Transoral robotic tongue base reduction and supraglottoplasty combined with maxillomandibular advancement: a new option for selected sleep apnea patients? Preliminary report

12-10-2019 – I Dallan,L Cristofani-Mencacci,V Seccia,C Cambi,G Fiacchini,S Berrettini,B Brevi

Journal Article

Abstract Purpose Transoral robotic surgery (TORS) and maxillo-mandibular advancement (MMA) are effective options for obstructive sleep apnea patients. Identification of the correct candidate is by far the most important item in achieving a succesful outcome. As a consequence, not all patients can be managed successfully via one or the other procedure. To overcome the limits of any single procedure we have combined, in a very selected population of patients, TORS tongue base reduction and MMA. Preliminary data are encouraging, in terms of both AHI and ESS. Methods A retrospective cohort study was conducted on five patients treated with combined TORS-MMA surgery. Demographic and clinical data, pre-operative and post-operative PSG and ESS were collected. Results Three of five patients were recruited. All patients presented severe OSAHS. Mean AHI and ESS went respectively from 48 and 12 pre-operatively to 19 and 4 post-operatively. Minor bleeding occurred in two patients. No significant sequelae have been reported. Conclusions Combined TORS and MMA is feasible and safe. Our very preliminary data are encouraging, in terms of both AHI and ESS. Long-term follow-up and a larger amount of subjects are needed to confirm this surgical approach as a valuable option for selected OSAHS patient.

Clinical significance of cervical and ocular vestibular evoked myogenic potentials in benign paroxysmal positional vertigo: a meta-analysis

11-10-2019 – R Oya,T Imai,Y Takenaka,T Sato,K Oshima,Y Ohta,H Inohara

Journal Article, Review

Abstract Purpose As the pathological cause of benign paroxysmal positional vertigo (BPPV), the dislocation or degeneration of otoconia in the utricle and saccule is suggested. Vestibular evoked myogenic potential (VEMP) could reflect otolithic dysfunction due to these etiologies of BPPV. The aim of this study was to validate the clinical significance of cervical (c) and ocular (o) VEMP in BPPV by a meta-analysis of previous articles. Methods Articles related to BPPV with data on cVEMP and oVEMP were collected. The following keywords were used to search PubMed and Scopus for English language articles: benign paroxysmal positional vertigo or BPPV and vestibular evoked myogenic potential or VEMP. Results The p13 latency in cVEMP and n1 latency in oVEMP were slightly but significantly prolonged in BPPV patients compared to control patients. AR in oVEMP of BPPV patients also showed higher value than that of control patients. However, the n23 latency and AR in cVEMP and p1 latency in oVEMP showed no significant difference between BPPV and control patients. Furthermore, latencies in VEMPs also showed no significant difference between an affected and a non-affected ear in BPPV patients. Conclusions Our results indicated that otolith dysfunction of BPPVs was detected by latencies in VEMPs, and AR in oVEMP more sensitively reflects the difference between affected and non-affected ears in BPPV patients. The otolith dysfunction of BPPV might be induced by the systemic condition. However, the differences of latencies between BPPV patients and control patients were too small to use VEMPs as a prognostic predictor.

Demystifying autoimmune inner ear disease

11-10-2019 – S Das,SS Bakshi,R Seepana

Journal Article, Review

Abstract Introduction Autoimmune inner disease (AIED) is an uncommon cause of sensorineural hearing loss and poses a diagnostic challenge. The present study aims to review the existing knowledge on the clinicopathological aspects, the diagnostic challenges, and therapeutic interventions in AIED. Discussion The incidence of AIED is less than five cases per 100,000 population. There are no definite seromarkers which make diagnosis of AIED difficult. Even though various markers have been studied, their sensitivity and specificity have not been replicated in the clinical scenario. The treatment of the condition is also an enigma. Corticosteroids are the drug of choice and require long-term use to prevent relapse. Various other therapeutic agents have been studied in a small cohort of patients, but the efficacy of these drugs needs to be validated in a large multicentric trial. Conclusion Timely intervention can restore hearing loss in AIED patients, but the clinician has to find a delicate balance between the hearing outcome and the potential side effects resulting from long-term use of the drugs. Treatment of steroid resistant AIED is a challenge and there are no universal guidelines for the same. AIED being an uncommon diagnosis, multicentric trials and collaboration are required to formulate diagnostic criteria and therapeutic guidelines.

Food-induced stimulation of the antisecretory factor to improve symptoms in Meniere’s disease: our results

11-10-2019 – A Scarpa,M Ralli,P Viola,C Cassandro,M Alicandri-Ciufelli,M Iengo,G Chiarella,M de Vincentiis,M Cavaliere,E Cassandro

Journal Article

Abstract Purpose Specially processed cereals (SPC) that increase endogenous antisecretory factor (AF) synthesis have been proposed to improve symptoms of Meniere’s disease (MD) with controversial results. The aim of this study was to evaluate the effects of SPC in patients with definite unilateral MD and compare the results to a treatment protocol with intravenous glycerol and dexamethasone. Methods Thirteen patients with unilateral MD were treated with SPC and 13 patients were treated with intravenous glycerol and dexamethasone for 12 months. Audio-vestibular evaluation was performed before (T0) and at the end of the treatments (T12). The number of vertigo spells were evaluated before and after therapy and the Efficacy Index (EI) was calculated. Questionnaires for hearing loss (HHIA), tinnitus (THI) and quality of life (TFL) were administered. Results EI decreased in the SPC group in the second semester compared to the first although not significantly (p = 0.6323). There was a significant reduction for THI score in the SPC group at T12 (p = 0.0325). No significant differences were found between the two groups at T0 (p = 0.4723), while a significant difference was found at T12 (p = 0.0041). Quality of life showed an improvement in daily activities in the SPC group compared to infusion therapy group. Conclusion Our study shows a reduced number of vertigo attacks and a positive effect on the discomfort generated by tinnitus and quality of life in patients with unilateral MD treated with SPC and when compared to patients treated with intravenous glycerol and dexamethasone. No effects on hearing thresholds were noted in both groups.

Ex-vivo surgical model for “Barbed Snore Surgery”: a feasibility study

10-10-2019 – V Rinaldi,A Costantino,A Moffa,M Casale

Journal Article

Abstract Introduction The “Barbed Snore Surgery” is one of the last technical innovations in palatal surgery for Obstructive Sleep Apnea. The availability of a low-cost surgical model able to replicate tissue consistency and main anatomical structures could be fundamental for the spreading of this surgery. The aim of this study was to assess the feasibility of an ex-vivo ovine model in the surgical training of BSS. Methods After adequate preparation of adult lamb heads, a post-graduate student with no surgical expertise was guided by a skilled surgeon in the execution of two BSS procedures: “Barbed Roman Blinds Technique” and “Barbed Anterior Pharyngoplasty”. Anatomical limitations and similarity with the human tissue were assessed and recorded during the simulation. Results All the procedures were successfully completed. Despite proportional differences, the palatal tissue was assessed as similar in consistency and thickness to the human tissue. The simulation was considered satisfactory and suitable for surgical training. Conclusion This ex-vivo ovine surgical model could represent the right tool for BSS training thanks to readily available and inexpensive specimens. Moreover, it appears to present the realistic anatomy and tissue consistence essential for an adequate surgical simulation.

Disease course after the first recurrence of head and neck squamous cell carcinoma following (chemo)radiation

10-10-2019 – M de Ridder,PD de Veij Mestdagh,JBW Elbers,A Navran,CL Zuur,LE Smeele,A Al-Mamgani

Journal Article

Abstract Purpose Recurrent head and neck squamous cell carcinoma (HNSCC) after chemoradiation is a challenging clinical problem. Salvage surgery (SS) is often extensive and mutilating. Oncological outcomes of SS are relatively well known, but little is published about the course of disease after the first recurrence, especially in patients without salvage possibilities. The aim of this study was to analyze the course of disease in patients with recurrent HNSCC after chemoradiation. Methods We retrospectively analyzed and descriptively reported the disease course in 198 patients with recurrent HNSCC after chemoradiation in the time period after the first recurrence. We scored any type of event, salvage treatment, systemic treatment and overall survival (OS). Results Of the 198 patients with recurrent HNSCC, salvage surgery was attempted in 104 (53%). SS was more frequently given in patients with recurrent laryngeal cancer, isolated regional failure (p < 0.001) and HPV-positive disease (p = 0.09). The 2-year OS of the whole group was 31% and was significantly different by tumor site, type of failure and SS. HPV-positive disease and salvaged recurrences were significantly predictive for better survival. One third of that salvaged patients was still alive without second recurrence. Median survival in patients that received any palliative systemic treatment without surgery, compared to those were no treatment was given, was 6 and 3 months, respectively (p = 0.006). Conclusions Main factors influencing the course of disease in recurrent HNSCC are the possibilities for SS and HPV-status. Therefore, SS should always be considered and discussed. In patients without possibilities for SS, overall survival is 3–6 months.

Decoding supraglottic stenosis

10-10-2019 – A Colliard,A Ishii,C De Sandre,F Gorostidi,K Sandu

Journal Article

Abstract Objective Supraglottic stenosis (SPGS) is a rare condition and little is known about its optimal management. Its etiologies are varied and depend on the age group. Here, we review our institution’s series of patients and propose treatment strategies for SPGS. Methods SPGS patients between 2013 and 2019 were retrospectively reviewed. We recorded their demography, clinical data and endoscopy. The patients were treated with either an endoscopic, open or a combined approach. Subsequently, we reviewed photo and video documents, medical sheets and long-term follow-up charts. Results The report includes 14 children having a mean age of 5.7 years (range 2 months–13 years). Seven children had undergone prior supraglottoplasty for laryngomalacia, three children had blunt neck trauma and four had iatrogenic plus post-intubation etiology. Five children received endoscopic treatment and are currently symptom free. Four patients received a combined repair with satisfactory results. Five children received an open repair, four of which are decannulated and feed orally without aspiration. Most children in this group required additional endoscopic interventions. Conclusion Post supraglottoplasty stenosis can be treated optimally by an endoscopic approach. More severe supraglottic cicatrical sequelae with posterior glottic involvement may require a combined endoscopic and open approach. Transglottic stenoses with severe grades of multi-level stenoses require an extended cricotracheal resection.

Regenerating gene 1A single-nucleotide polymorphisms and nasopharyngeal carcinoma susceptibility

08-10-2019 – S Yasri,V Wiwanitkit

Letter

Bacterial cellulose tubes as a nerve conduit for repairing complete facial nerve transection in a rat model

08-10-2019 – A Binnetoglu,B Demir,D Akakin,E Kervancioglu Demirci,C Batman

Journal Article

Abstract Purpose Functionality of the facial nerve is cosmetically important. While many techniques have been investigated, early and effective treatment for traumatic facial nerve paralysis remains challenging. Here, we aim to examine bacterial cellulose (BC) as a new tubularization material for improving facial nerve regeneration. Methods Our study was performed on 40 female Sprague Dawley rats. Rats were randomly divided into four groups, with 10 rats per group. In all rats, the main trunk of the facial nerve was completely cut 8 mm before the branching point. For repairing the facial nerve, in group 1, the nerve was left to recover spontaneously (control group); in group 2, it was repaired by primary suturing (8.0 Ethilon sutures, Ethicon); in group 3, BC tubes alone were used to aid nerve repair; and in group 4, both BC tubes and primary sutures (8.0 Ethilon sutures) were used. After 10 weeks, the facial nerve regeneration was evaluated by the whisker movement test and electrophysiologically (nerve stimulation threshold and compound muscle action potential). Nerve regeneration was assessed by calculating the number of myelinated nerve fibers, and by microscopically evaluating the amount of regeneration and fibrosis. Results No significant difference was observed among the groups in terms of whisker movement and electrophysiological parameters (P > 0.05). We found that the numbers of regenerating myelinated fibers were significantly increased (P < 0.05) when BC tubes were used as a nerve conduit. Conclusions BC can be easily shaped into a hollow tube that guides nerve axons, resulting in better nerve regeneration after transection.

In response to the ‘Letter to the Editor’ on the paper ‘Aging effect on sleepiness and apneas severity in patients with obstructive sleep apnea syndrome: a meta-analysis study’

04-10-2019 – G Iannella,G Magliulo,A De Vito,C Vicini

Letter

The evaluation of canal wall up cholesteatoma surgery with the Glasgow Benefit Inventory

04-10-2019 – J Westerberg,E Mäki-Torkko,H Harder

Journal Article

Abstract Purpose The aim of the study was to investigate the change in health-related quality of life (HRQoL) after canal wall up cholesteatoma surgery, using the Glasgow Benefit Inventory (GBI). Methods Data from a consecutive group of 47 adults scheduled for primary cholesteatoma surgery using canal wall up (CWU) with obliteration, from January 2005 to December 2009, were analysed. Information was extracted from a medical database, and complementary data from patient files and audiograms were collected and recorded retrospectively. The GBI questionnaire was used for the assessment of HRQoL after surgery. Results There was no finding of residual or recurrent cholesteatomas in the study group. Hearing was improved at 1 and 3 years postoperatively. No patient suffered a total hearing loss. The overall GBI scores showed an improved HRQoL after surgery. Twenty-nine (85%) patients benefitted from surgery, 1 (3%) had no change, and 4 (12%) expressed deterioration. Conclusions Cholesteatoma surgery using CWU with obliteration gives an improved HRQoL for the majority of patients. The GBI questionnaire provides complementary information to hearing and healing results after cholesteatoma surgery.

How a personalised transportable folding device for seating impacts dysphagia

04-10-2019 – V Woisard,M Costes,H Colineaux,B Lepage

Journal Article

Abstract Purpose A personalised transportable folding device for seating (DATP) on a standard seat was developed by an occupational therapist at the Toulouse University Hospital Centre (patent no. WO 2011121249 A1) based on the hypothesis that the use of a seat to assist with better positioning on any chair during meals modifies the sitting posture and has an impact on cervical statics which increases the amplitude of movements of the axial skeleton (larynx and hyoid bone) and benefits swallowing. The aim of this work is to demonstrate that an improvement in sitting posture with the help of the DATP, through Hyoid bone motion, has an impact on the quality of swallowing in a dysphagic population which benefits from the device in comparison to a dysphagic population which does not benefit from the device after 1 month of care. The secondary endpoints concern the evaluation of the impact on other characteristics of swallowing, posture, the acceptability of the device and the quality of life. Methodology This is a randomised comparative clinical trial. The blind was not possible for the patients but the examiner who evaluated the outcome criterion was blinded to the group to which the patient belonged. The outcome criterion was the measurement of the hyoid bone movement during swallowing. The other criteria were collected during the videofluoroscopic examination of swallowing and by use of a questionnaire. Fifty-six (56) patients were included: 30 in the group without device (D−) and 26 in the group with the device (D+). All the patients benefited from a training course on seating. Only the D+ patients participated in this course where the use of the device was explained and the device was then kept for use at home for 1 month. Results A significant improvement was noted in the postural criteria before and after use, in favour of a better posture for the two groups (p < 0.001) and more hyoid bone motion in the D+ group. The difference was significant in the bivariate analysis for horizontal movement (p = 0.04). After adjustment of potential factors of confusion, we noted a significant mean difference for the three distances in the D+ group in comparison to the D− group, of + 0.33 (95% CI + 0.17; + 0.48) for horizontal movement, + 0.22 (95% CI + 0.03; + 0.40) for vertical movement and + 0.37 (95% CI = + 0.20; + 0.53) for horizontal movement. However, the other parameters, and notably the other swallowing markers were not significantly modified by the use of the device. Conclusion The personalised transportable folding device for seating developed to reduce dysphagia has an action on hyoid bone motion during swallowing. However, this positive effect on an intermediate outcome criterion of the quality of swallowing was not associated with an improvement in swallowing efficiency in the study population. The diversity of diseases with which the patients in this study were afflicted is a factor to be controlled in future studies with this device.