Non­Hodgkin's lymphomas of the lacrimal sac: Current insights and future directions (Review).

Non-Hodgkin's lymphoma (NHL) of the lacrimal sac is a rare, yet clinically significant entity within the spectrum of ocular malignancies. While primary lacrimal sac lymphoma is uncommon, it poses unique diagnostic and therapeutic challenges due to its anatomical location and potential for aggressive behavior. Despite advancements being made in the current understanding and treatment of NHL, research that specifically addresses the involvement of the lacrimal sac is currently lacking. Thus, the present review aimed to provide insight into the epidemiology, clinical presentation, diagnostic modalities, histopathological features, treatment strategies and prognosis of lacrimal sac NHL. Through a methodical analysis of previous literature, the present review highlights the diverse spectrum of NHL subtypes that affect the lacrimal sac, including diffuse large B-cell lymphoma, extranodal marginal zone lymphoma, mantle cell lymphoma and follicular lymphoma. Moreover, the present review discusses the role of advanced imaging techniques in accurate staging and treatment planning, including computed tomography (CT), magnetic resonance imaging and positron emission tomography-CT. The present review also discusses evolving treatment approaches, such as surgical intervention, chemotherapy, radiotherapy, immunotherapy, combinations of the aforementioned treatments and targeted therapy. In addition, the present review highlights the significance of multidisciplinary collaboration in attaining optimal outcomes for individuals with lacrimal sac NHL. The present review aimed to provide a basis for 'further investigations into novel treatment modalities and prognostic markers that may aid in guiding personalized management strategies, ultimately improving outcomes for patients with NHL.

Can Multifrequency Tympanometry Be Used in the Diagnosis of Meniere's Disease? A Systematic Review and Meta-Analysis.

(1) Background: Ménière's disease (MD) is a disease of the inner ear, presenting with episodes of vertigo, hearing loss, and tinnitus.The aim of this study is to examine the role of multifrequency tympanometry (MFT) in the diagnosis of MD. (2) Methods: A systematic review of MEDLINE (via PubMed), Scopus, Google Scholar, and the Cochrane Library was performed, aligned with the PRISMA guidelines. Only studies that directly compare ears affected by Ménière's disease with unaffected or control ears were included. Random-effects model meta-analyses were performed. (3) Results: Seven prospective case-control studies reported a total of 899 ears, 282 of which were affected by Ménière's disease (affected ears-AE), 197 unaffected ears in patients with MD (UE), and 420 control ears (CE) in healthy controls. No statistically significant differences between the groups were observed regarding resonant frequency (RF). The pure tone audiometry average of the lower frequencies (PTA basic) was significantly greater in affected ears when compared with unaffected ears. The conductance tympanogram at 2 kHz revealed a statistically significantly greater G width of 2 kHz in the affected ears when compared to both unaffected and control ears, while control ears had a statistically significant lesser G width of 2 kHz compared to both the other two groups. (4) Conclusions: MFT, and specifically G width at 2 kHz, could be an important tool in the diagnosis of MD.

Deep Learning Techniques and Imaging in Otorhinolaryngology-A State-of-the-Art Review.

Over the last decades, the field of medicine has witnessed significant progress in artificial intelligence (AI), the Internet of Medical Things (IoMT), and deep learning (DL) systems. Otorhinolaryngology, and imaging in its various subspecialties, has not remained untouched by this transformative trend. As the medical landscape evolves, the integration of these technologies becomes imperative in augmenting patient care, fostering innovation, and actively participating in the ever-evolving synergy between computer vision techniques in otorhinolaryngology and AI. To that end, we conducted a thorough search on MEDLINE for papers published until June 2023, utilizing the keywords 'otorhinolaryngology', 'imaging', 'computer vision', 'artificial intelligence', and 'deep learning', and at the same time conducted manual searching in the references section of the articles included in our manuscript. Our search culminated in the retrieval of 121 related articles, which were subsequently subdivided into the following categories: imaging in head and neck, otology, and rhinology. Our objective is to provide a comprehensive introduction to this burgeoning field, tailored for both experienced specialists and aspiring residents in the domain of deep learning algorithms in imaging techniques in otorhinolaryngology.

Comparison of postoperative bleeding using harmonic scalpel and LigaSure in thyroid surgery: a 15-year single-centre retrospective study.

Aim Thyroidectomy is the most common operation in the field of endocrine surgery. The aim of this study was to compare the use of LigaSure vessel (LS) and harmonic scalpel (HS) in 1653 total thyroidectomies between January 2008 and March of 2023, with regards to analysis of surgical bleeding complications duration the hospital stay and operative surgical time. Methods It is a retrospective analysis of a prospectively maintained database. Patients have been categorized into two groups: Group A included 718 patients from January 2008 to May 2013 when LS was used, and the Group B included 935 patients from June 2013 to March 2023 when HS was used. Results From the total of 14 postoperative bleeding cases that occurred in patients of Group A, only in 4 of them it was necessary to have a reoperation. The other 10 cases involved minor haemorrhages, while from the total of 6 postoperative bleeding cases that happened to patients of Group B, there were 4 cases that needed a reoperation (p-value >0.05) and 2 patients with minor haemorrhages. The postoperative evaluation of minor bleedings revealed statistically significant differences between the two groups (p-value < 0.05). The average hospital stay was similar in the two groups. Conclusion Both devices exhibit identical safety profiles in thyroidectomies specifically regarding major bleeding complications that require reoperation. Additionally, HS was found to be more effective at achieving haemostasis, especially in the subgroup of patients with thyroid carcinoma. The results of the present study may be useful for high-volume centres performing numerous thyroidectomies every day.

Malignant External Otitis: What the Diabetes Specialist Should Know-A Narrative Review.

AIMS: Malignant external otitis (MEO) is a special type of external otitis associated with extensive inflammation and osteomyelitis. It is believed to originate from the external auditory meatus and advance regionally to the soft tissues and the bone, eventually involving the skull base. Pseudomonas aeruginosa and diabetes mellitus are factors commonly involved in the pathogenesis of MEO. Although its treatment has changed considerably during the last decades, morbidity and mortality of the disease remain high. Our aim was to review basic aspects of MEO, a disease unknown until 1968, which attracts great interest among Ears, Nose and Throat (ENT), diabetes and infectious diseases specialists. METHODS AND RESULTS: In this narrative review we mainly include relevant papers written in English or with an English abstract. We searched PubMed and Google Scholar, using the keywords malignant external otitis, malignant otitis externa, necrotizing external otitis, skull base osteomyelitis, diabetes mellitus and surgery up to July 2022. Some of the most recent articles, with specific references to earlier articles and a book reference regarding the pathophysiology, diagnosis and treatment of MEO and its relationship to diabetes mellitus, were included. CONCLUSION: MEO is not an uncommon disease and is principally treated by ENT surgeons. Nevertheless, diabetes specialists should be aware of the disease presentation and management, since they will often encounter patients with undiagnosed MEO or will need to manage glucose levels in patients hospitalized with the disease.

Cancer rate of Bethesda category II thyroid nodules.

Aim Thyroid nodules are very common and may be found in more than 50% of the population. Fine-needle aspiration cytology (FNAC) of thyroid nodules is a very useful diagnostic tool with high sensitivity and predictive value for diagnosis. The Bethesda System for Reporting Thyroid Cytopathology (BSRTC) uses six categories for thyroid cytology reporting (I-nondiagnostic, IIbenign, III-atypia of undetermined significance (AUS)/ follicular lesion of undetermined significance (FLUS), IV-follicular neoplasm/suspicious for follicular neoplasm (SFN), V-suspicious for malignancy, and VI-malignant. Our objective was to determine the malignancy rate in Bethesda II nodules. Methods From June 2010 to May 2020 a retrospective analysis was performed among 1166 patients who underwent thyroid surgery for benign thyroid diseases in our institution. Thyroid cytopathological slides and Ultrasound (US) reports were reviewed and classified according to the BSRTC. Data collected included age, gender, cytological features, and histological type of thyroid cancer. Results During the study period, 44.77% (522/1166) of patients with an FNA categorized as Bethesda II underwent thyroid surgery. Incidental malignancy was found in 1.53% (8/522) cases of Bethesda II. The most common malignant tumour type was papillary thyroid carcinoma. Conclusion The current study demonstrates that incidental thyroid carcinoma can be diagnosed after thyroidectomy even in patients with an FNA categorized as Bethesda II.

Multiple symmetric lipomatosis (Madelung's disease) with symptoms and signs of hypertension, lipodystrophy, and dyspnea: A case report and literature review.

Madelung's disease generally refers to a benign symmetrical lipomatosis of the neck, but its presentation can vary. It is treated surgically and different approaches can be implemented. In cases of a threatened airway, a tracheostomy can be performed.

Analgesic effect of paracetamol monotherapy vs. the combination of paracetamol/parecoxib vs. the combination of pethidine/paracetamol in patients undergoing thyroidectomy.

INTRODUCTION: The purpose of this study was to investigate the analgesic effect of 3 different regimens of combination analgesics administered to patients undergoing thyroidectomy. MATERIAL AND METHODS: A total of 152 patients undergoing total or subtotal thyroidectomy were enrolled. Patients allocated to group A received a combination of intravenous (IV) paracetamol and intramuscular (IM) pethidine, patients in group B received a combination of IV paracetamol and IV parecoxib, while patients in group C received IV paracetamol monotherapy. RESULTS: The analgesic regimens of groups A and B were found to be of equivalent efficacy (p-value = 1.000). In contrast, patients in group C (paracetamol monotherapy) had higher numerical rating scale scores, compared to both patients in groups A (p-value < 0.001) and B (p-value < 0.001). CONCLUSIONS: The combinations of IV paracetamol with either IM pethidine or IV parecoxib are superior to IV paracetamol monotherapy in achieving pain control in patients undergoing thyroid surgery.