Vocal fold leukoplakia recurrence risk model.

The paper aims to define the variables that elevate the risk of VFL recurrence after adequate primary treatment, and to present the Recurrence Risk Model with practical conclusions to handle pVFL and rVFL. Out of 207 patients with primary vocal fold leukoplakia (pVFL), in 41 (19.8%) recurrent VFL (rVFL) was diagnosed. All patients were assessed by using a trans-nasal flexible video-endoscope using white light, and NBI. The primary measure of our study was to investigate whether morphological features of pVFL in WL, vascular pattern in NBI, and primary histological findings could predict VFL recurrence. To create a model of risk factors, two methods were used: logistic regression and a conditional inference decision tree. The study showed smoking was the factor that significantly and most strongly increased the likelihood of rVFL, as well as the older age groups have a greater odds of rVFL. Types IV, V and VI, according to Ni 2019 classification, were associated with a significantly higher risk of rVFL. The algorithm combining patients' dependent variables and the combination of two classifications improves the predictive value of the presented VFL Recurrence Risk Model.

Irreversible facial nerve palsy as a revelator ofparotid gland cancer.

<br><b>Introduction:</b> Bell's palsy is still the diagnosis of exclusion. In most patients it does not progress, it is unilateral, and selflimiting. Additionally, the majority of patients recover spontaneously within 3 weeks. It is well known that all patients with irreversible facial nerve paresis (FNP) need further examinations to exclude the organic, infectious, metabolic, and autoimmunological causes of the palsy. The goal of the study was to assess the frequency of malignancies hidden under the diagnosis of "Bell's palsy".</br> <br><b>Aim:</b> We aimed to create a diagnostic algorithm to avoid failures concerning patients whose only symptom of parotid gland cancer was irreversible FNP.</br> <br><b>Material and methods:</b> We analyzed 253 consecutive patients with FNP treated in our department in the last 5 years. The subject of the study was "Bell's palsy" cases. All patients with irreversible FNP were reassessed in 6-12 months. We underlined all shortcomings in the diagnostics of those in whom malignancies were found in MRI of the neck and presented the proposal for a diagnostic algorithm to avoid missing such an entity.</br> <br><b>Results:</b> Bell's palsy was observed in 157/253 patients (62.06%), in 36/157 (22.92%) it remained permanent. In 4/36 patients (11.11%) with irreversible FNP, which constituted 2.54% of all "Bell's palsy" cases, parotid gland deep lobe mass was found in MRI. In one patient, infiltration of the skull base was diagnosed. Adenoid cystic carcinoma was confirmed in final histopathology in all cases.</br> <br><b>Conclusions:</b> Our experience has shown that irreversible FNP can be a revelator of the malignant tumor located in the deep lobe of the parotid gland. Contrast-enhanced MRI covering intra- and extracranial segments of the facial nerve should be ordered in all cases of FNP without recovery after 4 months. Repeated imaging should be considered in undiagnosed cases. The main point of our study is to underline that the assessment of the deep lobe of the parotid gland with MRI should be included in the standard diagnostic protocol in all irreversible "Bell's palsy" cases.</br>.

Lymphepithelial carcinoma - a rare tumor of the larynx. Case Report.

Lymphoepithelioma was described in 1921 separately by Regaud and Schmincke as nests of non-keratinizing squamous cells embedded in a lymphoid stroma (Regaud) and isolated transitional cells scattered in lymphoid tissue resembling sarcoma (Schmincke). Lymphoepithelial tumors are the most common lesions of the nasopharynx, although they have also been reported in other localizations, such as the nasal cavity, maxillary sinus, the base of the tongue, parapharyngeal area, tonsils and thymus. Lymphoepithelioma of the larynx is extremely rare. We present a case of a 55-year-old patient treated due to this type of lesion to share our experience in the management of this type of malignancy and contribute to the field of rare laryngeal tumors diagnosis and treatment.

Endoluminal larynx anatomy model - towards facilitating deep learning and defining standards for medical images evaluation with artificial intelligence algorithms.

The pioneering nature of this work covers the answers to two questions: (1) Is an up-to-date anatomical model of the larynx needed for modern endoscopic diagnostics, and (2) can such a digital segmentation model be utilized for deep learning purposes. The idea presented in this article has never been proposed before, and this is a breakthrough in numerical approaches to aerodigestive videoendoscopy imaging. The approach described in this article assumes defining a process for data acquisition, integration, and segmentation (labeling), for the needs of a new branch of knowledge: digital medicine and digital diagnosis support expert systems. The first and crucial step of such a process is creating a digital model of the larynx, which has to be then validated utilizing multiple clinical, as well as technical metrics. The model will form the basis for further artificial intelligence (AI) requirements, and it may also contribute to the development of translational medicine.

Anterolateral thigh free flap reconstruction of pharyngoesophageal defect caused by radiotherapy for laryngeal cancer: A case report.

Salvage total laryngectomy is a common treatment option for patients with recurrent or residual laryngeal cancer after primary radiotherapy. If the tumor is limited to the larynx at the time of surgery, there is usually sufficient mucosa for primary closure of the hypopharynx. We present an unusual case of pharyngoesophageal defect caused by radiotherapy. Since the remaining mucosa of the posterior wall was insufficient for primary closure, the defect was reconstructed with an anterolateral thigh (ALT) free flap.

The importance of the gut microbiota in the promotion, development, and treatment outcomes of cancer with special regard to the gut-respiratory axis.

The role of oral and pharyngeal microbiota is important in the promotion and development of head and neck cancers, as discussed in detail in this publication. The object of this work is to gather scientific information on the importance of the gut- respiratory axis in the promotion, development, and treatment outcome of head and neck cancer (HNSCC). Scientific knowledge about the interaction of head and neck cancer tumor cells and gut microbiota is residual, so examples of the relationship between the gut microbiota and the promotion of development in cases of other malignancies are also discussed. The subject of this work is also to present the importance of the gut-respiratory axis in promotion, development, and its impact on treatment outcomes of head and neck cancers.

Leukoplakia: An Invasive Cancer Hidden within the Vocal Folds. A Multivariate Analysis of Risk Factors.

INTRODUCTION: Discerning the preoperative nature of vocal fold leukoplakia (VFL) with a substantial degree of certainty is fundamental, seeing that the histological diagnosis of VFL includes a wide spectrum of pathology and there is no consensus on an appropriate treatment strategy or frequency of surveillance. The goal of our study was to establish a clear schedule of the diagnostics and decision-making in which the timing and necessity of surgical intervention are crucial to not miss this cancer hidden underneath the white plaque. MATERIAL AND METHODS: We define a schedule as a combination of procedures (white light and Narrow Band Imaging diagnostic tools), methods of evaluating the results (a combination of multiple image classifications in white light and Narrow Band Imaging), and taking into account patient-related risk factors, precise lesion location, and morphology. A total number of 259 patients with 296 vocal folds affected by leukoplakia were enrolled in the study. All patients were assessed for three classifications, in detail according to Ni 2019 and ELS 2015 for Narrow Band Imaging and according to Chen 2019 for white light. In 41 of the 296 folds (13.9%), the VFL specimens in the final histology revealed invasive cancer. We compared the results from the classifications to the final histology results. RESULTS: The results showed that the classifications and evaluations of the involvement of anterior commissure improve the clinical utility of these classifications and showed improved diagnostic performance. The AUC of this model was the highest (0.973) with the highest sensitivity, specificity, PPV, and NPV (90.2%, 89%, 56.9%, and 98.3%, respectively). CONCLUSION: The schedule that combines white light and Narrow Band Imaging, with a combination of the two classifications, improves the specificity and predictive value, especially of anterior commissure involvement.

Common sense and tumor treatment. A case of pilomatrical carcinoma in a 21-year-old patient with surprisingly rapid tumor progression.

Pilomatrical carcinoma is a rare tumor originating from skin appendages, usually occurring between the 5th and 7th decade of life. We present a case of an exceptionally young, 21-year-old patient with surprisingly rapid tumor progression and answer the question, what was the reason for such uncontrolled tumor growth. The main concern is the diagnostic challenge and a peculiar, one week race against time and tumor progression so that the least disfiguring surgery could be done.

Isolated endobronchial juvenile xanthogranuloma: a case report.

Juvenile xanthogranuloma (JXG) is a rare non-Langerhans cell tumour usually diagnosed during infancy. The lesion is typically located in the skin; however, extracutaneous lesions have been described. The symptoms vary depending on the location and size of the lesion. Presented here is a case of 13-year-old girl with this type of tumour located within the bronchus. She reported chest discomfort, difficulty breathing, and cough. A month prior to admission she had suffered from a respiratory tract infection. Prolonged surgical treatment was required due to the tumour's atypical location and recurrence of the tumour following initial resection. Isolated pulmonary JXG is an extremely rare finding, which requires accurate diagnosis and careful planning of therapeutic treatment. Severe pulmonary symptoms, inconclusive histopathological examination, malignancy risk, and large tumour size are indications for radical surgical resection of the tumour. Non-surgical treatment with chemotherapy is useful in cases of inoperable tumours.