Maria Rosaria Barillari, Andrea Nacci, Luca Bastiani, Giuseppina Mirra, Giuseppe Costa, Antonino Maniaci, Ludovico Docimo, Salvatore Tolone, Federica Giumello, Fabrizio Minichilli, Carlos M Chiesa Estomba, Jerome R Lechien, Thomas L Carroll
{"title":"Is there a role for voice therapy in the treatment of laryngopharyngeal reflux? A pilot study.","authors":"Maria Rosaria Barillari, Andrea Nacci, Luca Bastiani, Giuseppina Mirra, Giuseppe Costa, Antonino Maniaci, Ludovico Docimo, Salvatore Tolone, Federica Giumello, Fabrizio Minichilli, Carlos M Chiesa Estomba, Jerome R Lechien, Thomas L Carroll","doi":"10.14639/0392-100X-N2742","DOIUrl":"10.14639/0392-100X-N2742","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to compare the efficacy of voice therapy combined with standard anti-reflux therapy in reducing symptoms and signs of laryngopharyngeal reflux (LPR).</p><p><strong>Methods: </strong>A randomised clinical trial was conducted. Fifty-two patients with LPR diagnosed by 24 h multichannel intraluminal impedance-pH monitoring were randomly allocated in two groups: medical treatment (MT) and medical plus voice therapy (VT). Clinical symptoms and laryngeal signs were assessed at baseline and after 3 months of treatment with the Reflux Symptom Index (RSI), Reflux Finding Score (RFS), Voice Handicap Index (VHI) and GRBAS scales.</p><p><strong>Results: </strong>Groups had similar scores at baseline. At 3-month follow-up, a significant decrease in RSI and RFS total scores were found in both groups although it appeared to be more robust in the VT group. G and R scores of the GRBAS scale significantly improved after treatment in both groups, with better results in the VT group. The VHI total score at 3 months improved more in the VT group (VHI delta 9.54) than in the MT group (VHI delta 5.38) (p < 0.001).</p><p><strong>Conclusions: </strong>The addition of voice therapy to medications and diet appears to be more effective in improving treatment outcomes in subjects with LPR. Voice therapy warrants consideration in addition to medication and diet when treating patients with LPR.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"44 1","pages":"27-35"},"PeriodicalIF":2.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10914355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989034","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":"Extended cervical approach for retrosternal multinodular goiter.","authors":"Nir Tsur, Lirit Levi, Omry Frig, Noam Koch, Yossi Eshel, Gideon Bachar, Thomas Shpitzer, Moshe Yehuda, Yuri Pescovitz, Ory Wiesel, Dean Dudkiewicz, Aviram Mizrachi","doi":"10.14639/0392-100X-N2746","DOIUrl":"10.14639/0392-100X-N2746","url":null,"abstract":"<p><strong>Objective: </strong>Partial or total sternotomy is required for 10% of retrosternal goiter. This study reviewed our experience with an extended cervicotomic approach as an alternative surgical solution for retrosternal goiter.</p><p><strong>Methods: </strong>A retrospective study was performed on patients who underwent partial or total thyroidectomy for retrosternal goiter between 2014 and 2019 at a tertiary medical centre. Data on clinical, radiologic, and pathologic factors were analysed. Peri- and postoperative outcomes were compared between extended and standard cervical approaches to predict the need for an extended cervical approach.</p><p><strong>Results: </strong>The cohort included 265 patients, of whom 245 (92.4%) were treated by standard thyroidectomy. In 17 (6.4%), the standard approach proved insufficient, and the horizontal incision was extended to a T-shape to improve access. The remaining 3 patients required a sternotomy. Use of the extended cervical approach was significantly associated with clinical features such as male gender, diabetes, high body mass index and postoperative hypocalcaemia.</p><p><strong>Conclusions: </strong>The extended cervicotomic approach is an alternative surgical solution for retrosternal goiter, with no increased risk of significant post-operative complications.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"44 1","pages":"21-26"},"PeriodicalIF":2.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10914353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989033","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}
Luca Bruschini, Pietro Canzi, Andrea Canale, Edoardo Covelli, Andrea Laborai, Marta Monteforte, Michela Cinquini, Maurizio Barbara, Millo Achille Beltrame, Roberto Bovo, Bruno Castigliano, Cosimo De Filippis, Antonio Della Volpe, Francesco Dispenza, Pasquale Marsella, Anna Mainardi, Eva Orzan, Enrico Piccirillo, Giampietro Ricci, Nicola Quaranta, Domenico Cuda
{"title":"Implantable hearing devices in clinical practice. Systematic review and consensus statements.","authors":"Luca Bruschini, Pietro Canzi, Andrea Canale, Edoardo Covelli, Andrea Laborai, Marta Monteforte, Michela Cinquini, Maurizio Barbara, Millo Achille Beltrame, Roberto Bovo, Bruno Castigliano, Cosimo De Filippis, Antonio Della Volpe, Francesco Dispenza, Pasquale Marsella, Anna Mainardi, Eva Orzan, Enrico Piccirillo, Giampietro Ricci, Nicola Quaranta, Domenico Cuda","doi":"10.14639/0392-100X-N2651","DOIUrl":"10.14639/0392-100X-N2651","url":null,"abstract":"<p><strong>Objective: </strong>Implantable hearing devices represent a modern and innovative solution for hearing restoration. Over the years, these high-tech devices have increasingly evolved but their use in clinical practice is not universally agreed in the scientific literature. Congresses, meetings, conferences, and consensus statements to achieve international agreement have been made. This work follows this line and aims to answer unsolved questions regarding examinations, selection criteria and surgery for implantable hearing devices.</p><p><strong>Materials and methods: </strong>A Consensus Working Group was established by the Italian Society of Otorhinolaryngology. A method group performed a systematic review for each single question to identify the current best evidence on the topic and to guide a multidisciplinary panel in developing the statements.</p><p><strong>Results: </strong>Twenty-nine consensus statements were approved by the Italian Society of Otorhinolaryngology. These were associated with 4 key area subtopics regarding pre-operative tests, otological, audiological and surgical indications.</p><p><strong>Conclusions: </strong>This consensus can be considered a further step forward to establish realistic guidelines on the debated topic of implantable hearing devices.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":" ","pages":"52-67"},"PeriodicalIF":2.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10914359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073040","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}
Gian Luca Fadda, Anastasia Urbanelli, Alessio Petrelli, Marta Trossarello, Letizia Nitro, Alberto Maria Saibene, Eugenio De Corso, Dario Gned, Marco Panfili, Giovanni Cavallo
{"title":"Type IV optic nerve and Onodi cell: is there a risk of injury during sphenoid sinus surgery?","authors":"Gian Luca Fadda, Anastasia Urbanelli, Alessio Petrelli, Marta Trossarello, Letizia Nitro, Alberto Maria Saibene, Eugenio De Corso, Dario Gned, Marco Panfili, Giovanni Cavallo","doi":"10.14639/0392-100X-N2462","DOIUrl":"10.14639/0392-100X-N2462","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to determine the prevalence and types of Onodi cells through computed tomography and investigate the relationship between Onodi cell and the surrounding structures, paying particular attention to the risky proximity to the optic nerve canal.</p><p><strong>Methods: </strong>In this study, 430 computed tomography scans of paranasal sinuses were analysed to establish the prevalence and different types of Onodi cells. Furthermore, the relationship between Onodi cell and different patterns of sphenoid sinus pneumatisation and surrounding structures were investigated. Special attention was paid to the relationship between Onodi cell and the optic nerve canal, particularly in cases when the optic nerve canal was bulging by more than 50% into the Onodi cell (Type IV).</p><p><strong>Results: </strong>The Onodi cell was detected in 21.6% of cases, with the most common being Type I (48.5% right, 54.3% left). Type IV bulging of the optic nerve canal into the Onodi cell was observed in 47.1% of cases on the right side, 41.2% on the left side and bilateral in 11.7% of cases.</p><p><strong>Conclusions: </strong>In our series, we observed a high prevalence of Type IV optic nerve bulging into the Onodi cell. For this reason, we suggest that clinicians should always try to identify it in a pre-operative setting with computed tomography to avoid catastrophic consequences during endoscopic sinus surgery approaching the sphenoid area.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":" ","pages":"36-41"},"PeriodicalIF":2.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10914358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073042","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}
Francesco Bussu, Luca Tagliaferri, Michaele Francesco Corbisiero, Cecilia Lotto, Raul Pellini, Pierre Guarino, Giuseppe Mercante, Andrea Galuppi, Francesco Cariti, Giovanni Almadori, Francesco Longo, Luca Calabrese, Jacopo Galli, Livio Presutti, Piero Nicolai, Gabriele Molteni
{"title":"Management of nasal vestibule carcinomas: recommendations by the Oncological Committee of the Italian Society of Otorhinolaryngology - Head and Neck Surgery.","authors":"Francesco Bussu, Luca Tagliaferri, Michaele Francesco Corbisiero, Cecilia Lotto, Raul Pellini, Pierre Guarino, Giuseppe Mercante, Andrea Galuppi, Francesco Cariti, Giovanni Almadori, Francesco Longo, Luca Calabrese, Jacopo Galli, Livio Presutti, Piero Nicolai, Gabriele Molteni","doi":"10.14639/0392-100X-N2786","DOIUrl":"10.14639/0392-100X-N2786","url":null,"abstract":"<p><strong>Objective: </strong>Squamous cell carcinoma of the nasal vestibule (NV SCC) is a head and neck malignancy for which there is no established consensus on most aspects of clinical management. The purpose of this document is to give updated recommendations that incorporate recent evidence on its clinical characteristics and the high efficacy of brachytherapy as primary treatment modality.</p><p><strong>Methods: </strong>A working group consisting of the members of the Scientific Committee for Oncology and Reconstructive Surgery of the Italian Society of Otorhinolaryngology Head and Neck Surgery and radiation oncologists expert in brachytherapy was formed to achieve a consensus.</p><p><strong>Results: </strong>Consensus was reached on a set of recommendations, proposing a refined anatomical definition of the nasal vestibule, a novel T staging system of the NV SCC, and brachytherapy as standard of care, with a new method for catheter implantation.</p><p><strong>Conclusions: </strong>The Committee emphasises the critical role of an accurate classification in clinical practice and encourages further research to validate the novel staging system and further improve treatment strategies. Where appropriate, it is recommended that patients be referred to centres with specific experience in brachytherapy for NV SCC.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"44 1","pages":"13-20"},"PeriodicalIF":2.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10914357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989035","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}
Luigi Angelo Vaira, Giancarlo Tirelli, Davide Rizzo, Francesco Uderzo, Francesco Avanzini, Franco Trabalzini, Nicoletta Rivelli, Doris Burger, Luca Calabrese, Paolo Solla, Francesco Bussu, Miguel Mayo-Yáñez, Jerome R Lechien, Giacomo De Riu, Paolo Boscolo-Rizzo
{"title":"Validity and reliability of the Questionnaire of Olfactory Disorders for Italian-speaking patients with olfactory dysfunction.","authors":"Luigi Angelo Vaira, Giancarlo Tirelli, Davide Rizzo, Francesco Uderzo, Francesco Avanzini, Franco Trabalzini, Nicoletta Rivelli, Doris Burger, Luca Calabrese, Paolo Solla, Francesco Bussu, Miguel Mayo-Yáñez, Jerome R Lechien, Giacomo De Riu, Paolo Boscolo-Rizzo","doi":"10.14639/0392-100X-N2736","DOIUrl":"10.14639/0392-100X-N2736","url":null,"abstract":"<p><strong>Objective: </strong>To translate and validate an Italian version of the Questionnaire of Olfactory Disorders (IT-QOD).</p><p><strong>Materials and methods: </strong>This is a prospective, multicentre study that involved patients with olfactory dysfunction (OD). Both cases and controls underwent administration of the IT-QOD, Sino-Nasal Outcome Test-22 (SNOT-22) and psychophysical evaluation of orthonasal and retronasal olfactory function.</p><p><strong>Results: </strong>The IT-QOD was administered to 96 patients and 38 controls. The Cronbach's alpha exceeded 0.90, indicating satisfactory internal consistency. The test-retest reliability was found to be high for both parosmia (rs = 0.944) and life quality (rs = 0.969). Patients with OD had significantly higher IT-QOD scores compared to healthy individuals (p < 0.001), indicating strong internal validity. The external validity was also satisfactory, as shown by the significant correlation with SNOT-22 (rs = -0.54) and the threshold, discrimination, and identification score (rs = -0.63).</p><p><strong>Conclusions: </strong>The IT-QOD was demonstrated to be reliable and valid to assess the impact of OD on the quality of life of Italian-speaking patients.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"44 1","pages":"42-51"},"PeriodicalIF":2.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10914352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989037","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}
Ognjen Cukic, Dejan Radaljac, Nenad Arsovic, Milan Jovanovic, Zoran Milutinovic
{"title":"Indirect laryngeal surgery of vocal fold polyps: a dying or evolving art?","authors":"Ognjen Cukic, Dejan Radaljac, Nenad Arsovic, Milan Jovanovic, Zoran Milutinovic","doi":"10.14639/0392-100X-N2487","DOIUrl":"10.14639/0392-100X-N2487","url":null,"abstract":"<p><strong>Objective: </strong>Vocal fold polyps (VFPs) are the most common benign laryngeal lesions that require surgery and are routinely managed by microlaryngoscopy (MLS) under general anaesthesia. Prior to introduction of MLS, VFPs were removed using indirect laryngoscopic surgery (ILS) in local anaesthesia, a procedure that required substantial surgical skill to operate with an unmagnified mirror view of the larynx. With the adoption of wireless endoscopy equipment and personal computers, we tried to simplify this technique so that it can be easily performed in the office. This study aimed to assess the effectiveness of ILS by comparing voice outcomes with MLS.</p><p><strong>Materials and methods: </strong>ILS and MLS were performed in six patients each. Treatment outcomes were measured using a voice self-assessment and objective acoustic analysis. The total cost of both procedures was calculated.</p><p><strong>Results: </strong>Both techniques allowed successful removal of VFPs in all patients, without significant intergroup differences in voice outcomes. The cost of ILS was significantly lower.</p><p><strong>Conclusions: </strong>Despite the pilot nature of the study and the small sample size, our data indicate the potential value of this technique which, considering its simplicity and economic value could be used as an alternative to MLS in carefully selected patients.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":" ","pages":"424-429"},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10773547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10274169","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 and outcomes of minor salivary gland cancers of the larynx and trachea: a systematic review.","authors":"Claudia Montenegro, Davide Mattavelli, Davide Lancini, Alberto Paderno, Elisa Marazzi, Vittorio Rampinelli, Michele Tomasoni, Cesare Piazza","doi":"10.14639/0392-100X-N2635","DOIUrl":"10.14639/0392-100X-N2635","url":null,"abstract":"<p><strong>Objectives: </strong>Malignant minor salivary glands carcinomas (MiSGC) of the larynx and trachea are rare tumours and published evidence is sparse. We conducted a systematic review to describe shareable treatment strategies and oncological outcomes of these neoplastic entities.</p><p><strong>Methods: </strong>Full text English manuscripts published from January 1<sup>st</sup> 2000 to December 14<sup>th</sup> 2022 were included. Data on demographics, treatments and outcomes were collected. A pooled analysis of 5-year overall survival (OS) was performed.</p><p><strong>Results: </strong>Seventeen articles and 365 patients met the inclusion criteria. The most common subsites involved were subglottic and distal trachea. Adenoid cystic carcinoma was, by far, the most frequent histotype. The first-choice treatment strategy was surgery (86.8%), while adjuvant treatments were delivered in 57.4% of patients. Only 12.9% were treated with definitive radiotherapy with/without chemotherapy. The mean follow-up was 68.3 months. One hundred nine (34.9%) deaths were recorded and 62.4% were cancer-related. Five-year OS ranged from 20% to 100% and, at pooled analysis, it was 83% (range, 78-87%).</p><p><strong>Conclusions: </strong>In case of MiSGC of the larynx and trachea, surgery remains the mainstay of treatment. Adjuvant treatments are frequently delivered. Survival estimates are good overall, but highly heterogeneous.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":" ","pages":"365-374"},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10773543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41181737","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":"Assessment of middle ear function after conventional or endoscopic microdebrider assisted adenoidectomy.","authors":"Oj Giri, S Vijendra Shenoy, Navya Parvathareddy, Praneetha Puvvula, Deeksha Shetty, Nayanika Reddy","doi":"10.14639/0392-100X-N2593","DOIUrl":"10.14639/0392-100X-N2593","url":null,"abstract":"<p><strong>Objectives: </strong>To compare pre- and post-operative pure tone audiometric and impedance audiometric analysis following conventional and endoscopic microdebrider assisted adenoidectomy and compare the outcomes.</p><p><strong>Methods: </strong>Patients diagnosed with chronic adenoiditis were divided in groups of 25 each. Patients in the first group underwent conventional curettage adenoidectomy, while those in second group underwent endoscopic microdebrider assisted adenoidectomy. Pre- and post-operative pure tone and impedance audiometry were performed for all patients and outcomes were compared.</p><p><strong>Results: </strong>The endoscopic microdebrider assisted method resulted in significantly better outcomes compared to conventional curettage. Criteria such as hearing threshold (p value 0.004 at second follow-up), peak pressure (p value 0.045 at first follow-up) and tympanogram (p value 0.016) showed that the endoscopic method was better, while peak compliance (p value 0.340 at first follow-up) did not show any significant difference between groups.</p><p><strong>Conclusions: </strong>The endoscopic microdebrider assisted method for adenoidectomy has a definite advantage of better visualisation resulting in better clearance of tissue, leading to enhanced middle ear function compared to conventional curettage.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":" ","pages":"417-423"},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10773544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41181731","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}