Acta Otorhinolaryngologica Italica最新文献

{"title":"Nasopharyngeal carcinoma. A \"different\" head and neck tumour. Part B: treatment, prognostic factors, and outcomes.","authors":"Giulio Cantù","doi":"10.14639/0392-100X-N2223","DOIUrl":"https://doi.org/10.14639/0392-100X-N2223","url":null,"abstract":"SUMMARY Nasopharyngeal carcinoma (NPC) is the most interesting and intriguing malignant tumour located in the nasopharynx, because it is a “peculiar” malignancy, “different” from almost all the other head and neck tumours according to several points of view. Given that radiotherapy (RT) is the treatment of choice for NPC, chemotherapy (CT) has been added to standard RT to improve outcome in high-risk patients, either as an adjuvant, neoadjuvant or concurrent treatment modality with radiation. Surgery plays an important role in rescuing recurrent or persistent disease after primary (CT)RT. This second part of the review provides a critical analysis of various treatment described in the literature, both for primary cancer and for regional and distant metastases. The prognostic factors and the final results of the various treatments will also be analysed.","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"43 3","pages":"155-169"},"PeriodicalIF":2.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5b/ef/aoi-2023-03-155.PMC10198365.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9915803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prognostic-nutritional index in HPV-negative head and neck squamous cell carcinoma treated with upfront surgery: a multi-institutional series.","authors":"Michele Tomasoni,&nbsp;Cesare Piazza,&nbsp;Alberto Deganello,&nbsp;Paolo Bossi,&nbsp;Giancarlo Tirelli,&nbsp;Piero Nicolai,&nbsp;Maria Cristina Da Mosto,&nbsp;Gabriele Molteni,&nbsp;Vittorio Giacomarra,&nbsp;Pietro Canzi,&nbsp;Stefano Pelucchi,&nbsp;Jerry Polesel,&nbsp;Daniele Borsetto,&nbsp;Paolo Boscolo-Rizzo","doi":"10.14639/0392-100X-N2358","DOIUrl":"https://doi.org/10.14639/0392-100X-N2358","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the prognostic value of pre-treatment prognostic-nutritional index (PNI) in patients with HPV-negative head and neck squamous cell carcinoma (HNSCC).</p><p><strong>Methods: </strong>A multi-institutional retrospective series of HPV-negative, Stages II-IVB, HNSCCs treated with upfront surgery was evaluated. Correlation of pre-operative blood markers and PNI with 5-year overall (OS) and relapse-free (RFS) survival was tested using linear and restricted cubic spline models, as appropriate. The independent prognostic effect of patient-related features was assessed with multivariable models.</p><p><strong>Results: </strong>The analysis was conducted on 542 patients. PNI ≥ 49.6 (HR = 0.52; 95% CI, 0.37-0.74) and Neutrophil-to-Lymphocyte Ratio (NLR) > 4.2 (HR = 1.58; 95% CI, 1.06-2.35) confirmed to be independent prognosticators of OS, whereas only PNI ≥ 49.6 (HR = 0.44; 95% CI, 0.29-0.66) was independently associated with RFS. Among pre-operative blood parameters, only higher values of albuninaemia and lymphocyte count (> 1.08 x 10³/microL), and undetectable basophile count (= 0 10³/microL) were independently associated with better OS and RFS.</p><p><strong>Conclusions: </strong>PNI represents a reliable prognostic tool providing an independent measure of pre-operative immuno-metabolic performance. Its validity is supported by the independent prognostic role of albuminaemia and lymphocyte count, from which it is derived.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"43 3","pages":"170-182"},"PeriodicalIF":2.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ee/43/aoi-2023-03-170.PMC10198367.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9915806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TSH level as a risk factor of thyroid malignancy for nodules in euthyroid patients.","authors":"Abdulaziz K Alaraifi,&nbsp;Mohammed Alessa,&nbsp;Leen O Hijazi,&nbsp;Areej M Alayed,&nbsp;Abdulaziz A Alsalem","doi":"10.14639/0392-100X-N2288","DOIUrl":"https://doi.org/10.14639/0392-100X-N2288","url":null,"abstract":"<p><strong>Objective: </strong>With the increased prevalence of incidental thyroid cancer, determining the predictors of thyroid malignancy has become a source of debate. This study aimed to determine the impact of thyroid stimulating hormone (TSH) levels on rates of thyroid cancer in euthyroid patients.</p><p><strong>Methods: </strong>A retrospective study included 421 patients who underwent thyroidectomy at a tertiary hospital between 2016 and 2020. Patients' demographics, history of cancer, pre-operative workup and final histology reports were obtained. The study sample was divided into two groups based on the final histopathology (benign <i>vs</i> malignant). The two groups were compared using the appropriate statistical tests to determine the predictors of thyroid cancer in euthyroid patients.</p><p><strong>Results: </strong>TSH levels were significantly higher in patients with malignant nodules compared to those with benign nodules (1.94 <i>vs</i> 1.62, p = 0.002). It was 1.54 times more likely for thyroid nodules to be malignant when TSH levels were higher (p = 0.038). Meanwhile, larger nodules (> 4 cm) were significantly more prevalent in benign nodules (43.1%) than in malignant nodules (21.1%). Larger nodules decreased the possibility of thyroid cancer by 24% (OR = 0.760, p-value = 0.004).</p><p><strong>Conclusions: </strong>High TSH levels in euthyroid patients were significantly correlated with the risk of thyroid malignancy. In addition, as Bethesda category proceeded toward malignancy, TSH levels increased. High TSH levels and small nodule diameters can be used as additional parameters in predicting thyroid cancer in euthyroid patients.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"43 3","pages":"183-188"},"PeriodicalIF":2.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/df/50/aoi-2023-03-183.PMC10198371.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9915805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial analysis of transnasal olfactory cleft access: a computed tomography study.","authors":"Teffran Joey Chan, Melissa Lee, Andrew Vernu Thamboo","doi":"10.14639/0392-100X-N2118","DOIUrl":"10.14639/0392-100X-N2118","url":null,"abstract":"<p><strong>Objective: </strong>To our knowledge, the spatial access of naris to olfactory cleft has not been quantified. We aimed to study the relationship and space of middle turbinate, septum, anterior nasal spine and cribriform plate to improve topical medication delivery and drug applicators.</p><p><strong>Methods: </strong>One hundred CT scans of patients (50 males, 50 females) over the age of 18 were included. Subjects with radiographic sinonasal pathology, previous surgery, or specific variant nasal anatomy were excluded. Scans were independently reviewed and bilateral measurements on bony landmarks were taken by two blinded authors. Inter-rater reliability was analysed with intraclass correlation.</p><p><strong>Results: </strong>The average age was 46.26 years (σ = 14.0). Average distance from the anterior nasal spine to olfactory cleft was 52.3 mm (σ = 4.2 mm), and the average length of cribriform plate was 18.8 mm (σ = 3.8) with an angle relative to hard palate averaging -8.8 degrees below parallel (σ = 5.5 degree). The widths of the olfactory cleft at anterior and posterior edges of cribriform plate were 2.3 mm (σ = 0.7 mm) and 2.0 mm (σ = 0.7 mm).</p><p><strong>Conclusions: </strong>The findings suggest a 52.3 mm distance from the naris to the anterior border of cribriform plate. The average width along this path was 3.2 mm, suggesting devices narrower than this could potentiate direct drug delivery access.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"43 3","pages":"197-202"},"PeriodicalIF":2.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/08/33/aoi-2023-03-197.PMC10198370.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9613643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-neoplastic recurrences in otorhinolaryngological diseases Introduction.","authors":"Marco Benazzo","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"43 Suppl 1","pages":"S1-S2"},"PeriodicalIF":2.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7e/13/aoi-2023-02-S1.PMC10159637.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10596341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of recurrent cerebrospinal fluid leak, current practices and open challenges. A systematic literature review.","authors":"Paolo Castelnuovo,&nbsp;Marco Valentini,&nbsp;Giorgio Sileo,&nbsp;Paolo Battaglia,&nbsp;Maurizio Bignami,&nbsp;Mario Turri-Zanoni","doi":"10.14639/0392-100X-suppl.1-43-2023-02","DOIUrl":"https://doi.org/10.14639/0392-100X-suppl.1-43-2023-02","url":null,"abstract":"SUMMARY Cerebrospinal fluid leak (CSFL) is a rare pathological condition which requires prompt and adequate management due to the high rate of associated major complications. At present, CSFL can be successfully treated through endoscopic endonasal approaches with success rates higher than 90%. Despite this, CSFL recurrence may occur, and its management is critical and still represents a matter of debate. A systematic review of the literature on the management of recurrent CSFL was conducted. It included a cohort of 1,083 cases of CSFL treated with surgical or conservative approaches; 112 cases of recurrence were reported for an overall recurrence rate of 10.3%. Most of the leaks were localised in the anterior skull base (68.3%) and identification of recurrent CSFL may be troublesome. Therefore, the entire skull base must be meticulously examined and long-term follow-up is mandatory. The risk for CSFL recurrence is higher in patients affected by idiopathic intracranial hypertension (IIH), but its role in CSFL recurrence is yet to be understood. Recurrent CSFL must be repaired as soon as possible in order to reduce the risk of intracranial complications. The use of early post-operative CSF diversion by lumbar drain (LD) is currently a matter of debate even in case of CSFL recurrences.","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"43 Suppl 1","pages":"S14-S27"},"PeriodicalIF":2.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/40/fd/aoi-2023-02-S14.PMC10159643.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10284627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of sleep disordered breathing relapse after surgery.","authors":"Claudio Vicini,&nbsp;Giovanni Cammaroto","doi":"10.14639/0392-100X-suppl.1-43-2023-13","DOIUrl":"https://doi.org/10.14639/0392-100X-suppl.1-43-2023-13","url":null,"abstract":"SUMMARY This narrative review provides a general overview of the management of relapses after surgery for the treatment of sleep disordered breathing. This clinical scenario represents a challenging field, but fortunately several therapeutic options are included in sleep surgeons’ armamentarium. Each therapeutic modality is described in detail in a dedicated section.","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"43 Suppl 1","pages":"S103-S110"},"PeriodicalIF":2.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/16/10/aoi-2023-02-S103.PMC10159645.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10578728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to manage recurrences after surgery in CRSwNP patients in the biologic era: a narrative review.","authors":"Eugenio De Corso, Stefano Settimi, Claudio Montuori, Alessandro Cantiani, Marco Corbò, Giuseppe Alberto Di Bella, Fabio Sovardi, Fabio Pagella, Mario Rigante, Giulio Cesare Passali, Gaetano Paludetti, Jacopo Galli","doi":"10.14639/0392-100X-suppl.1-43-2023-01","DOIUrl":"10.14639/0392-100X-suppl.1-43-2023-01","url":null,"abstract":"<p><strong>Objective: </strong>This narrative review analyses factors affecting recurrence of Chronic rhinosinusitis with nasal polyps (CRSwNP) after surgery, such as type, extension and completeness of endoscopic sinus surgery (ESS). We also described new implications in the management of recurrences after the advent of biologics.</p><p><strong>Methods: </strong>We identified four topics: definition of disease state; factors linked to recurrence of polyps; evaluation and management of recurrence in clinical practice.</p><p><strong>Results: </strong>We analysed the differences between exacerbation and recurrence, as well as the concept of \"controlled disease\". We focused on potential predictors of recurrence after ESS, such as type 2 inflammation, asthma, aspirin-exacerbated respiratory disease, incomplete initial surgery and lack of adherence to long-term post-operative local corticosteroids. We discussed the new aspects of diagnosis and treatment of recurrences after surgery, summarising our suggestions in a detailed algorithm for practical management of patients with recurrent disease.</p><p><strong>Conclusions: </strong>The results emphasised the importance of accurate evaluation of patients with CRSwNP recurrence, focusing on the reasons of failure and risk of disease progression, in order to guide personalised interventions. It is crucial to define the concept of appropriate surgery, which affects the choice between starting a biologic or repeating surgery.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"43 Suppl. 1","pages":"S3-S13"},"PeriodicalIF":2.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ba/b4/aoi-2023-02-S3.PMC10159635.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10284631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence of conductive hearing loss after stapes surgery: a narrative review.","authors":"Ignacio Javier Fernandez,&nbsp;Federico Rondini,&nbsp;Livio Presutti,&nbsp;Giulia Molinari","doi":"10.14639/0392-100X-suppl.1-43-2023-07","DOIUrl":"https://doi.org/10.14639/0392-100X-suppl.1-43-2023-07","url":null,"abstract":"SUMMARY Among the functional failures of stapes surgery is recurrent conductive hearing loss, which can occur after a variable period of hearing improvement, from days/months up to many years after surgery. The most common cause of recurrent conductive hearing loss is prosthesis displacement, while fibrous adhesions or stapedotomy hole/oval window re-obliteration due to otosclerosis, occur less frequently. High resolution computed tomography plays an important role in the identification of the cause of hearing loss recurrence. Parallel to this, intra-operative exploration of the middle ear is crucial to confirm the cause of failure and address its treatment, possibly restoring hearing. While generally worse than after primary surgery, hearing outcomes after revision stapes surgery have improved thanks to advancements in pre-operative assessment, intra-operative view and technical refinements.","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"43 Suppl 1","pages":"S56-S60"},"PeriodicalIF":2.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ff/ca/aoi-2023-02-S56.PMC10159633.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10578723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent laryngeal papillomatosis: multimodal therapeutic strategies. Literature review and multicentre retrospective study.","authors":"Giulia Bertino,&nbsp;Fabio Pedretti,&nbsp;Simone Mauramati,&nbsp;Marta Filauro,&nbsp;Alberto Vallin,&nbsp;Francesco Mora,&nbsp;Erika Crosetti,&nbsp;Giovanni Succo,&nbsp;Giorgio Peretti,&nbsp;Marco Benazzo","doi":"10.14639/0392-100X-suppl.1-43-2023-14","DOIUrl":"https://doi.org/10.14639/0392-100X-suppl.1-43-2023-14","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Recurrent respiratory papillomatosis (RRP) is a benign, rare disease caused by Human Papilloma Virus (HPV) that can be divided into juvenile and adult forms. The course of the disease is variable, but is usually more aggressive in the juvenile form. The standard surgical treatment is represented by CO&lt;sub&gt;2&lt;/sub&gt; laser resection, although photoangiolytic lasers represent a valid alternative. Adjuvant therapies have been proposed for disease control in case of frequent surgical resections or spreading into the lower airways. In recent years, the development of immunotherapy led to the use of bevacizumab either intratumorally or intravenously, but the most promising therapeutic development is represented by HPV vaccination. This paper aims to present a narrative review of the literature and the experience of three different University Centres in the treatment of RRP.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis of the clinical charts of all patients affected by laryngeal papillomatosis and treated in three different University Centres between 2002 and 2022 was performed. The following parameters were collected: sex, age at first evaluation, sites of larynx involved, HPV type, type of first surgical treatment, presence and number of recurrences, surgical treatment of recurrences, adjuvant therapies, side effects and status at last follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seventy-eight patients were available for evaluation. Of these, 88% had adult onset RRP (Ao-RRP) and 12% juvenile onset RRP (Jo-RRP). The glottis was the most frequently involved subsite; all patients were submitted to surgical resection with CO&lt;sub&gt;2&lt;/sub&gt; laser under general anaesthesia. Recurrences appeared in 79% of the patients, the patients who did not recur were all adults. The mean number of recurrences was 9 (range 1-110). Recurrences were more frequent in children (M = 20; range 2-110) than adults (M = 5; range 1-21). Thirty-two (52%) of the 62 patients who recurred were re-treated with CO&lt;sub&gt;2&lt;/sub&gt; laser under general anaesthesia, while office-based treatment with a photoangiolytic laser was preferred in the remaining 30 (48%) patients. Adjuvant treatments were applied in 26 patients. The analysis of the course of the disease showed that in the 9 patients with Jo-RRP, 6 (67%) were free of lesions at the last follow-up, while the other 3 (33%) had papillomas. Of the 69 patients with Ao-RRP, 53 (77%) were alive and free of disease at the last visit, 14 (21%) were alive with disease, 1 (1%) was lost at follow-up and 1 (1%) died for other disease. Severe side effects were not observed except for 2 patients, who developed posterior glottic stenosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our results confirmed the literature review. RRP is a potentially aggressive disease, especially in juvenile onset. Surgical resection is still first-line treatment, but in case of multiple recurrences the use of adjuvant therapies must be taken int","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"43 Suppl. 1","pages":"S111-S122"},"PeriodicalIF":2.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8f/68/aoi-2023-02-S111.PMC10159644.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10284634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}