Role of the TAp63 Isoform in Recurrent Nasal Polyps.

The pathogenic molecular mechanisms underlying the insurgence of nasal polyps has not been completely defined. In some patients, these lesions can have a recurrence after surgery removal, and the difference between recurrent and not recurrent patients is still unclear. To molecularly characterize and distinguish between these two classes, a cohort of patients affected by nasal polyposis was analysed. In all patients we analysed the p63 isoform expression using fresh tissues taken after surgery. Moreover, confocal immunofluorescence analysis of fixed sections was performed. The results show high ΔNp63 expression in samples from the nasal polyps of patients compared to the normal epithelia. Analysis of the expression level of the TAp63 isoform shows differential expression between the patients with recurrence compared to those not recurring. The data, considered as the ΔN/TAp63 ratio, really discriminate the two groups. In fact, even though ΔNp63 is expressed in non-recurrent patients, the resulting ratio ΔN/TAp63 is significantly lower in these patients. This clearly indicates that the status of TAp63 expression, represented by the ΔN/TAp63 ratio, could be considered a prognostic marker of low recurrence probability. In these samples we also investigated the expression of OTX2 transcription factor, known to be a selective activator of TAp63, detecting a significant correlation. Database analysis of HNSCC patients showed increased survival for the patients presenting OTX2 amplification and/or overexpression. These results, together with the fact that TAp63 can be selectively upregulated by HDAC inhibitors, open the possibility to consider local treatment of recurrent nasal polyps with these molecules.

New frontiers and emerging applications of 3D printing in ENT surgery: a systematic review of the literature.

3D printing systems have revolutionised prototyping in the industrial field by lowering production time from days to hours and costs from thousands to just a few dollars. Today, 3D printers are no more confined to prototyping, but are increasingly employed in medical disciplines with fascinating results, even in many aspects of otorhinolaryngology. All publications on ENT surgery, sourced through updated electronic databases (PubMed, MEDLINE, EMBASE) and published up to March 2017, were examined according to PRISMA guidelines. Overall, 121 studies fulfilled specific inclusion criteria and were included in our systematic review. Studies were classified according to the specific field of application (otologic, rhinologic, head and neck) and area of interest (surgical and preclinical education, customised surgical planning, tissue engineering and implantable prosthesis). Technological aspects, clinical implications and limits of 3D printing processes are discussed focusing on current benefits and future perspectives.

Utility of Glidescope(®) videolaryngoscopy in surgical procedures involving the larynx.

GlideScope(®) is a recently developed videolaryngoscope that helps to achieve a good view of the laryngeal inlet and the vocal cords. Videolaryngoscopy has been proven effective in patients with unusual anatomical or pathological features, suggesting the possibility of a difficult endotracheal intubation. This device may also be useful for otorhinolaryngologists by facilitating access to the larynx and tongue base, especially in selected cases, where good visualisation of disease-altered structures is vital. According to the current literature, GlideScope(®) has been used for surgical procedures involving the tongue base, such as biopsies, foreign body removal and radiofrequency treatment of obstructive sleep apnoea. We believe that the use of this kind of videolaryngoscopy might be also indicated for laryngeal surgery as a valid alternative to the placement of a direct laryngoscope. This technique, especially in those cases with anatomical issues or important comorbidities, may be preferred to ambulatorial flexible or rigid laryngoscopy, and in planning surgical procedures in "difficult" patients due to the operating room setting comprising constant anaesthesiological support. In our experience, we performed five procedures involving the larynx with the GlideScope(®) in patients presenting unusual clinical characteristics that potentially compromised surgical outcome. No complications related to videolaryngoscopy were found. We recommend the use of GlideScope(®) for small surgical procedures involving the larynx in selected patients.