Robotic-Assisted Neck Dissection: Our Experience

Abstract Introduction Robotic neck dissection surgery allows less invasiveness to significantly improve the aesthetic impact even though it does not compromise the principles of radical cancer procedure. Objective The aim of our work is to describe our personal experience with robotic neck dissection surgery. Methods A retrospective study was conducted by analyzing 10 patients subjected to a robotic neck dissection surgery. In the period from August 2012 to December 2018, these patients have been treated exclusively with robotic lateral-cervical dissection. Five of them were subjected to robotic-assisted transaxillary neck dissection (RATAND) and the other 5 treated with robotic-assisted retroauricular neck dissection (RARAND), then the surgical results have been compared with 5 similar dissections performed by open neck dissection (OND). Results The average surgical time of RATAND was estimated in 166 minutes, the average surgical time of RARAND was estimated in 153 minutes and the average surgical time of OND was estimated in 48 minutes. Both robotic techniques are valid from the oncological and aesthetic point of view, but in terms of surgical time, they are much longer than the open technique. Conclusions In terms of the post-operative decree, in our opinion, the retroauricular technique is more rapid for the purposes of recovery.

Robotic-Assisted Neck Dissection: Our Experience.

Introduction Robotic neck dissection surgery allows less invasiveness to significantly improve the aesthetic impact even though it does not compromise the principles of radical cancer procedure. Objective The aim of our work is to describe our personal experience with robotic neck dissection surgery. Methods A retrospective study was conducted by analyzing 10 patients subjected to a robotic neck dissection surgery. In the period from August 2012 to December 2018, these patients have been treated exclusively with robotic lateral-cervical dissection. Five of them were subjected to robotic-assisted transaxillary neck dissection (RATAND) and the other 5 treated with robotic-assisted retroauricular neck dissection (RARAND), then the surgical results have been compared with 5 similar dissections performed by open neck dissection (OND). Results The average surgical time of RATAND was estimated in 166 minutes, the average surgical time of RARAND was estimated in 153 minutes and the average surgical time of OND was estimated in 48 minutes. Both robotic techniques are valid from the oncological and aesthetic point of view, but in terms of surgical time, they are much longer than the open technique. Conclusions In terms of the post-operative decree, in our opinion, the retroauricular technique is more rapid for the purposes of recovery.

The Role of Probiotics in Chronic Rhinosinusitis Treatment: An Update of the Current Literature.

Chronic rhinosinusitis (CRS) is a significant health problem. It affects 5-12% of the general population. The causes that underlie the onset of CRS are not yet well known. However, many factors may contribute to its onset, such as environmental factors and the host's general condition. Medical treatment mainly uses local corticosteroids, nasal irrigation, and antibiotics. In recent years, a new therapeutic approach that employs the use of probiotics emerged. Probiotics have been extensively studied as a therapy for dysbiosis and inflammatory pathologies of various parts of the body. We aimed to examine the studies in vivo and in vitro and clinicals reports in the existing literature to update probiotics' role in rhinosinusitis chronic medical treatment.

Skull Base Csf- Leak Closure with Autologous Fibrin Sealant.

INTRODUCTION: There are many fibrin-derived sealants used as topical haemostatic agents in many surgical procedures. Fibrin sealants are usually non-autologous derivatives or animal derivatives, with the exception of Vivostat®, an autologous fibrin sealant derived from patients own blood. MATERIALS AND METHODS: We present our experience on the use of Vivostat® in skull base closures in 20 patients operated at the Otorhinolaryngology Unit of the Hospital Ospedali Riuniti Villa Sofia - Cervello of Palermo. All postoperative patients were placed in an anti-trendeleburg position for 48 hours. After removal of the nasal swabs we did not find any rhinorrhea and we checked the tightness of the skull base defect with computed tomography. RESULTS: On a total of the 20 patients (10 post-traumatic and 10 with iatrogenic leaks), 9 out of 10 post-traumatic cases had a leak in the border area between the anterior and posterior portion of the ethmoid, while 1 patient out of 10 post-traumatic cases had a leak at the level of the sella. In all 20 patients, we repaired skull base defects by fixing grafting materials with Vivostat®. We have not had any complications. Vivostat® is a useful product in skull base repair and safe for the patients. CONCLUSION: Vivostat® has been used as a sealant on body tissues with greater elasticity and more resistant allowing better and safer wound repair, especially in skull base surgery. In particular, its immediate polymerisation is very useful for an evaluation of the mechanical sealants in the closure of the skull base cerebrospinal fluid leak.

Alteration of Smell and Taste in Asymptomatic and Symptomatic COVID-19 Patients in Sicily, Italy.

OBJECTIVES: Alteration of smell and taste has been reported in patients with coronavirus disease 2019 (COVID-19). The incidence and clinical-symptomatic manifestation of COVID-19 is different between northern and southern Italy. This study aims to evaluate the onset of alteration of smell and taste in asymptomatic and symptomatic patients in Sicily (extreme south of Italy). METHODS: This prospective cross-sectional study was performed on asymptomatic and symptomatic COVID-19 patients tested for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) from May 1 to May 15, 2020. A questionnaire was used for evaluating the prevalence of smell and taste disorders in COVID-19 patients before performing nasopharyngeal swab. RESULTS: Of the total 292 patients, 242 (83.2%) were negative for SARS-CoV-2 and 50 were positive (16.8%). Twenty-six of the 50 (52%) SARS-CoV-2 positive patients reported smell/taste disorders. Twenty-eight of the 50 (57.1%) SARS-CoV-2 positive patients were hospitalized (group A), and 22 (42.9%) were nonhospitalized (group B). The mean age in group A and group B was 45.4 ± 13.7 years and 57.0 ± 15.0, respectively (P = .007). The symptoms reported by hospitalized patients were fever (71.4%), cough (64.2%), fatigue (82.1%), and dyspnea (100%), while in nonhospitalized patients, the most reported symptoms were sore throat (72.7%), rhinorrhea (77.2%), and altered smell (81.8%). Anosmia/hyposmia reported in group A and group B was 28.5% and 81.8%, respectively (P = .001). CONCLUSION: These preliminary results indicate that the majority of SARS-Cov-2 positive patients in southern Italy did not require hospitalization and presented with milder symptoms or no symptoms and the alterations in smell and taste occurred.