Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale最新文献

{"title":"Five-year outcomes of transoral robotic surgery with or without neoadjuvant chemotherapy in laryngeal squamous cell carcinoma: a preliminary experience.","authors":"Armando De Virgilio, Piero Giuseppe Meliante, Luigi D'Avino, Se-Heon Kim","doi":"10.14639/0392-100X-suppl.1-46-2026-A2314","DOIUrl":"10.14639/0392-100X-suppl.1-46-2026-A2314","url":null,"abstract":"<p><strong>Objective: </strong>Organ preservation is a key goal in management of laryngeal cancer. The combination of neadjuvant chemotherapy (NACT) and transoral robotic surgery (TORS) may extend minimally invasive surgery indications, but long-term data remain limited. This study evaluated 5-year oncologic outcomes of TORS with or without NACT in laryngeal squamous cell carcinoma (LSCC).</p><p><strong>Methods: </strong>We retrospectively analysed 37 LSCC patients treated between 2012 and 2017 with TORS, with NACT administered in advanced-stage disease. Kaplan-Meier analysis was used to estimate overall (OS), disease-specific (DSS), and disease-free survival (DFS). Survival differences were assessed using the log-rank test.</p><p><strong>Results: </strong>Mean follow-up was 73 months. In patients treated by TORS alone, we observed one-, 3-, and 5-year OS and DSS of 100%, with one-year DFS of 88.9% decreasing to 77.8% at 3- and 5-year, and 100% of laryngeal preservation rate. In patients with locally advanced cT3-4N+ cancer who underwent NACT followed by TORS, 5-year OS, DSS, and DFS were 82.4%, 93.3%, and 61.1%, respectively, with a 84.4% 5-year laryngeal preservation rate.</p><p><strong>Conclusions: </strong>TORS provides excellent long-term oncologic control in early LSCC. The addition of NACT allows extension to advanced disease while maintaining high laryngeal preservation rates, supporting a multimodal organ-preserving strategy.</p>","PeriodicalId":520544,"journal":{"name":"Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale","volume":"46 Suppl. 1","pages":"S82-S89"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic therapy in the curative treatment of laryngeal cancer.","authors":"Cristiana Bergamini, Stefano Cavalieri, Lisa Licitra","doi":"10.14639/0392-100X-suppl.1-46-2026-A2030","DOIUrl":"10.14639/0392-100X-suppl.1-46-2026-A2030","url":null,"abstract":"","PeriodicalId":520544,"journal":{"name":"Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale","volume":"46 Suppl. 1","pages":"S109-S117"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-laryngectomy videofluoroscopic assessment in relation to olfactory rehabilitation through the physiological olfactory recovery technique.","authors":"Giuseppina Mirra, Giuseppe Tortoriello, Sabrina Spinosa, Mariangela Abagnale, Vincenzo Della Peruta, Jacopo Galli, Giulio Cesare Passali, Luigi D'Avino","doi":"10.14639/0392-100X-suppl.1-46-2026-A2324","DOIUrl":"10.14639/0392-100X-suppl.1-46-2026-A2324","url":null,"abstract":"<p><strong>Objective: </strong>To correlate the anatomo-physiological characteristics of post-laryngectomy changes, assessed by videofluoroscopy, with the outcome and modalities of olfactory rehabilitation using the physiological olfactory recovery technique (PORT).</p><p><strong>Materials and methods: </strong>From 2019 to 2021, a prospective observational study was conducted at the Department of Otolaryngology-Head and Neck Surgery of Ospedale del Mare, Naples, Italy, on 31 patients who had undergone total laryngectomy with primary placement of a tracheo-oesophageal voice prosthesis. All patients completed a proprioceptive training programme with a speech-language pathologist and learned the PORT method. At the end of the 10-session rehabilitation protocol, all participants demonstrated significant improvement in olfactory perception, which was maintained at long-term follow-up. During subsequent application of PORT in selected patients, notable inter-patient differences emerged in both the modality and timing of response to rehabilitation. This prompted an anatomo-physiological investigation of the post-laryngectomy changes to objectify these variable outcomes. As part of an ongoing collaborative project between the Otolaryngology and Radiology Units aimed at monitoring swallowing and phonatory function in laryngectomized patients, videofluoroscopic examinations were analysed. A total of 31 videofluoroscopic studies performed between February and October 2022 were reviewed.</p><p><strong>Results: </strong>Differences in patient responses to PORT correlated with individual anatomo-physiological variations in the amount and distribution of air reaching the proximal oesophagus during phonation - defined as the phonatory air bubble (PAB) - as well as with differences in the elasticity of the anatomical district examined. Five distinct types of proximal oesophageal PABs were identified, classified according to post-surgical anatomical characteristics and functional alterations related to adjuvant therapy, particularly radiation-induced fibrosis.</p><p><strong>Conclusions: </strong>PORT is an effective olfactory rehabilitation technique for laryngectomised patients with a trachea-oesophageal voice prosthesis, including those with complex anatomo-physiological conditions. Accurate interpretation of post-laryngectomy changes is essential for evaluating treatment efficacy: 28 of the 31 patients evaluated physiologically recovered the daily olfactory sniffing manoeuvre, although with variable modalities and timing. Overall, PORT represents a widely applicable and effective method for olfactory rehabilitation in the vast majority of patients with a tracheo-oesophageal voice prosthesis after total laryngectomy.</p>","PeriodicalId":520544,"journal":{"name":"Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale","volume":"46 Suppl. 1","pages":"S118-S126"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update on laryngeal cancer: Introduction.","authors":"Giuseppe Tortoriello","doi":"10.14639/0392-100X-suppl.1-46-2026-A2353","DOIUrl":"10.14639/0392-100X-suppl.1-46-2026-A2353","url":null,"abstract":"","PeriodicalId":520544,"journal":{"name":"Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale","volume":"46 Suppl. 1","pages":"S1-S2"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The neck matters: optimising lymph node management in laryngeal cancer.","authors":"Pierre Guarino, Francesco Chiari, Gerardo Petruzzi, Francesco Mazzola, Milena Fior, Alessandro Borrelli, Raul Pellini, Giuseppe Spriano, Filippo Ricciardiello, Claudio Donadio Caporale","doi":"10.14639/0392-100X-suppl.1-46-2026-A1997","DOIUrl":"10.14639/0392-100X-suppl.1-46-2026-A1997","url":null,"abstract":"<p><strong>Objective: </strong>Laryngeal squamous cell carcinoma (LSCC) accounts for nearly one quarter of head and neck malignancies, with cervical nodal status representing the strongest prognostic factor. This review aims to summarise evidence on neck management across different clinical scenarios.</p><p><strong>Methods: </strong>A narrative review of PubMed, Scopus, and Web of Science was conducted up to July 2025. Original studies, systematic reviews, meta-analyses, and clinical guidelines were included. Data were analysed according to clinical setting: cN0, cN+, rcN+, and rcN0.</p><p><strong>Results: </strong>In primary cN0 LSCC, the risk of occult nodal disease is site-dependent. Supraglottic tumours show the highest incidence (20-50%, > 50% in T3-T4), supporting elective bilateral selective neck dissection (SND) of levels II-IV, with level VI in selected cases. Early glottic tumours rarely metastasise (< 10%) and may be observed, while advanced glottic and subglottic tumours show higher risk (15-30%), justifying elective treatment. In cN+ disease, SND is indicated for N1-N2 and modified radical neck dissection for N3. Regional recurrence occurs in 15-25% of cases. In rcN+ disease, salvage SND provides regional control comparable to comprehensive dissection with lower morbidity. The role of elective dissection in rcN0 remains controversial despite occult metastasis rates > 20% in high-risk tumours.</p><p><strong>Conclusions: </strong>Neck management in LSCC should be adapted to risk: elective treatment is essential in high-risk cN0 disease, therapeutic dissection remains standard in cN+, and salvage SND is effective in rcN+, while elective treatment in rcN0 should be reserved for selected cases.</p>","PeriodicalId":520544,"journal":{"name":"Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale","volume":"46 Suppl. 1","pages":"S90-S99"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiomics in laryngeal squamous cell carcinoma: state of the art.","authors":"Sonia Lucchese, Francesca Laganaro, Gerardo Petruzzi, Antonello Vidiri","doi":"10.14639/0392-100X-suppl.1-46-2026-A2025","DOIUrl":"10.14639/0392-100X-suppl.1-46-2026-A2025","url":null,"abstract":"","PeriodicalId":520544,"journal":{"name":"Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale","volume":"46 Suppl. 1","pages":"S34-S44"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The histopathological spectrum of laryngeal epithelial neoplasia.","authors":"Elena Bellan, Angelo Paolo Dei Tos, Marta Sbaraglia","doi":"10.14639/0392-100X-suppl.1-46-2026-A2102","DOIUrl":"10.14639/0392-100X-suppl.1-46-2026-A2102","url":null,"abstract":"","PeriodicalId":520544,"journal":{"name":"Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale","volume":"46 Suppl. 1","pages":"S3-S18"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Margin burden and postoperative management after transoral laser microsurgery for laryngeal glottic squamous cell carcinoma: a multicentre retrospective study on 1216 patients.","authors":"Francesco Chu, Filippo Marchi, Claudio Sampieri, Stefano Filippo Zorzi, Marta Tagliabue, Elisa Bellini, Marta Filauro, Cristiana Moro, Guardmond Ajasllari, Francesc Xavier-Aviles-Jurado, Rosa Delia Ramírez-Ruiz, Jose Miguel Costa, Joan Lop Gros, Giovanni Motta, Vincenzo Della Peruta, Giuseppe Tortoriello, Isabel Vilaseca, Giorgio Peretti, Mohssen Ansarin","doi":"10.14639/0392-100X-suppl.1-46-2026-A2018","DOIUrl":"10.14639/0392-100X-suppl.1-46-2026-A2018","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the prognostic impact of surgical margin burden and postoperative management after transoral laser microsurgery (TOLMS) for glottic laryngeal squamous cell carcinoma (LSCC) in a large multicentre cohort.</p><p><strong>Methods: </strong>A retrospective multicentre study included 1216 patients with pT1-pT3 LSCC treated with TOLMS. Surgical margins were classified as free, single superficial positive, multiple superficial positive, or deep positive. Disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS) were analysed using Kaplan-Meier estimates and multivariable Cox models, accounting for pathological stage and postoperative management.</p><p><strong>Results: </strong>Pathological T category was independently associated with DFS and DSS. A single superficial positive margin showed DFS comparable to free margins. Multiple superficial positive margins were associated with increased recurrence risk, while deep margin involvement was strongly associated with both recurrence (hazard ratio [HR] 3.96) and disease-specific mortality (HR 6.82). Among patients with positive margins, second-look surgery achieved better DFS than postoperative radiotherapy or surveillance. Residual carcinoma at revision surgery was a major predictor of poor DFS and DSS.</p><p><strong>Conclusions: </strong>After TOLMS, oncologic risk is driven by margin type and burden rather than margin positivity alone. Deep margin involvement and residual disease identify patients requiring intensified management, supporting a risk-adapted postoperative strategy.</p>","PeriodicalId":520544,"journal":{"name":"Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale","volume":"46 Suppl. 1","pages":"S45-S55"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of surgical outcomes and postoperative complications based on free flap selection for reconstructing primary or recurrent locally advanced laryngeal-hypopharyngeal tumours.","authors":"Pietro De Luca, Arianna Di Stadio, Monir Abousiam, Luca de Campora, Matteo Simone, Sofia Pangallo, Marco Radici, Luca Calabrese, Marco Benazzo, Angelo Camaioni, Luca Gazzini","doi":"10.14639/0392-100X-suppl.1-46-2026-A2206","DOIUrl":"10.14639/0392-100X-suppl.1-46-2026-A2206","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate surgical outcomes and postoperative complications according to free flap selection in patients undergoing reconstruction after total or extended pharyngolaryngectomy for locally advanced (cT3-T4a) laryngeal-hypopharyngeal squamous cell carcinoma (SCC).</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA guidelines. PubMed/MEDLINE, EMBASE, Cochrane and OVID databases were searched for studies published between 2000 and 2025. Adult patients undergoing partial or circumferential pharyngeal reconstruction with free flap reconstruction were included. Outcomes of interest were flap failure, pharyngocutaneous fistula (PCF), stricture and functional results. Odds ratios (OR) were calculated when feasible.</p><p><strong>Results: </strong>Twenty-three retrospective studies including 1,849 patients were analysed. The jejunal free flap (JFF) was the most commonly used reconstruction (78%), followed by the anterolateral thigh (ALT) flap (5%). Overall flap survival was high, with total flap necrosis occurring in 2.7% of cases. JFF reconstruction was associated with lower rates of stricture (3.8%) and PCF (3.3%) compared with ALT (9.2% and 5.5%, respectively). ALT reconstruction showed a significantly increased risk of stricture compared to JFF (OR 2.51, p = 0.0002).</p><p><strong>Conclusions: </strong>Free flap reconstruction after pharyngolaryngectomy is reliable, with high flap survival rates. The JFF remains associated with lower rates of luminal complications, particularly in circumferential defects, while the ALT flap represents a valid alternative. Flap selection should be individualised, and further prospective studies with standardised outcomes are warranted.</p>","PeriodicalId":520544,"journal":{"name":"Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale","volume":"46 Suppl. 1","pages":"S64-S72"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic transnasal craniectomy: impact on staging and prognosis of sinonasal adenocarcinoma.","authors":"Joackim Mahdjoub, Laurent Tavernier, Olivier Mauvais","doi":"10.14639/0392-100X-A924","DOIUrl":"10.14639/0392-100X-A924","url":null,"abstract":"<p><strong>Objectives: </strong>Postoperative prognosis of sinonasal adenocarcinoma (SNAC) is closely related to local recurrence. Our objective was to identify subclinical anterior skull base (ASB) invasion, and to evaluate the impact of endoscopic transnasal craniectomy on SNAC staging and prognosis.</p><p><strong>Methods: </strong>Retrospective study conducted from 2010 to 2023, including 33 patients, comparing 2 groups: conservative endoscopic sinus surgery (ESS) and complementary endoscopic resection with transnasal anterior skull base craniectomy (ERTC). Histopathology, overall survival (OS), recurrence-free survival (RFS), complication rates, surgery time and hospital stay were analysed.</p><p><strong>Results: </strong>Histopathology revealed malignant invasion in 36.8% of ASB surgical specimens, despite the absence of pre- or intraoperative evidence of skull base invasion. All were low-grade tumours, with 57.1% previously classified as cT2. ERTC was associated with an improvement in RFS, although not statistically significant, with a greater incidence of complications, but no impact on OS.</p><p><strong>Conclusions: </strong>This study provides the first significant evidence of frequent subclinical invasion of the ASB in cT2 cases. These findings raise important questions regarding the management of cT2 lesions. Should systematic biopsies of the anterior skull base be taken? Should a skull base resection be discussed in selected patients? Further studies with larger samples are necessary to better define the risk-benefit ratio of ERTC in low-stage SNAC prognosis.</p>","PeriodicalId":520544,"journal":{"name":"Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale","volume":"46 2","pages":"139-146"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13113273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}