Impact of the Sars-COVID-19 Pandemic on the "Early Diagnosis" of Laryngeal Tumors: Data From Monocentric Tertiary Care Hospital of South Italy.

OBJECTIVE: The aim of this retrospective case-control study is to investigate how the Sars-COVID-19 pandemic has influenced the delay in the early diagnosis of laryngeal cancer in patients who visited the University Hospital "G. Martino" in the last 3 years of the pandemic. It is also proposed to compare the diagnosis, surgical staging, and therapeutic approach offered to patients affected by laryngeal cancer in the years affected by the COVID-19 pandemic compared to cases treated during the 3 years preceding the pandemic METHODOLOGY/PRINCIPAL: A single-center retrospective study was carried out to analyze the effects of the COVID-19 pandemic on the diagnosis and treatment of patients with squamous cell carcinoma of the larynx at our Otorhinolaryngology Division of the "Gaetano Martino" University hospital. The research period, 6 years, was divided into two sub-periods of equal months for which we divided the patients into two groups "Before COVID-19" and "During COVID-19", defined, respectively, from February 2017 to March 2020 and from April 2020 to May 2023. Patients aged 18 years and older with a diagnosis of squamous cell carcinoma, seen and surgically treated at the Otorhinolaryngology division of the "Gaetano Martino" University Hospital and patients referred from other hospitals were included in the study population. Patients affected by malignancies in other sites with secondary laryngeal involvement, patients not amenable to surgical therapy, treated only with radio-chemotherapy therapy, and patients not amenable to surgical therapy were excluded from the study. RESULTS: A total of 141 patients were recruited, divided into 76 patients in the "Before COVID-19" arm and 65 patients in the "During COVID-19" arm, with a male prevalence of 119 patients (84.4%). The mean age of our study population stands at a median of 69 years (percentile 25th 60.00 and percentile 75th 77.00). Smoking and alcohol are two predominant variables in our study population with a prevalence of 89.4% and 79.4%, respectively. A higher number of TNM stage IV cases was detected, 29.2% in the group "During COVID-19" compared to 5.3 detected in the group "Before COVID-19" (P = 0.005). In the "During COVID-19" group, we find an overall percentage of 61.5% for stages II-III-IV versus 36.9% present in the "Before COVID-19" group of patients. An adjuvant radiotherapy treatment was actuated in 30.26% of patients in the "Before COVID-19" versus 41.54% in "During COVID-19". CONCLUSIONS: The most important result of our research was the statistically significant difference in tumor staging at the time of diagnosis between the "Before COVID-19" and "During COVID-19" groups, with a higher mean value in the latter. The current data confirm the previously exposed hypothesis according to which the COVID-19 pandemic has led to a delay in early diagnosis, negatively influencing the staging at the time of the first ENT visit and the subsequent therapeutic approach to be offered to the patient.

Dupilumab in chronic rhinosinusitis with nasal polyps: Real life data in a multicentric Sicilian experience.

OBJECTIVE: This study aimed to evaluate the effectiveness and safety of dupilumab during the first year of treatment in a real-life setting, focusing on improvement in nasal polyp score (NPS) as well as specific symptoms, quality of life and olfactory function. METHODOLOGY/PRINCIPAL: A multicentric observational cohort study was carried out. A total of 170 patients were enrolled in the Otorhinolaryngology Unit of the three University Hospitals and considered for dupilumab therapy. All recorder characteristics were age (at the first dupilumab application visit), sex, smoke habits, previous local and systemic corticosteroid therapy, history of endoscopic sinus surgery, number of previous endoscopic sinus surgery, concomitant asthma, history of an allergic condition, immunoglobulin E (IgE), allergy to nonsteroidal anti-inflammatory drugs (NSAIDs), Aspirin Exacerbated Respiratory Disease (AERD), other comorbidities associated, blood eosinophils, nasal polyp score, sinonasal outcome test 22 (SNOT 22), sniffin' stick test, the start date of dupilumab therapy and number of doses of dupilumab and eventually, Dupilumab's adverse events related to administration. The Wilcoxon test for dependent samples was performed to compare variables. Statistical significance was assumed for p values < 0.05. RESULTS: A statistically significant reduction in SNOT-22 and NPS was shown at the 6th and 12th month compared to baseline values (p < 0.001 for both comparisons). A statistically significant increase value at the Sniffin' sticks test was shown in the 6th and 12th month compared to baseline values (p < 0.001 for both comparisons). At the 12-month follow-up, according to EUFOREA indications, all patients were considered to remain in treatment with dupilumab and continued the treatment because of a reduced NPS, improved quality of life and a reduced need for system corticosteroids. Dupilumab seemed to be well tolerated by all patients. Any adverse effect of the drug led to the quit of biological treatment. CONCLUSIONS: This multi-centric real-life study supported the effectiveness of dupilumab as an add-on therapy to intranasal corticosteroids in patients with severe uncontrolled CRSwNP in improvement of quality of life, severity of symptoms, polyp size reduction and smell function. Furthermore, our data support the safety profile of monoclonal therapy with dupilumab.

Music in noise recognition: An EEG study of listening effort in cochlear implant users and normal hearing controls.

Despite the plethora of studies investigating listening effort and the amount of research concerning music perception by cochlear implant (CI) users, the investigation of the influence of background noise on music processing has never been performed. Given the typical speech in noise recognition task for the listening effort assessment, the aim of the present study was to investigate the listening effort during an emotional categorization task on musical pieces with different levels of background noise. The listening effort was investigated, in addition to participants' ratings and performances, using EEG features known to be involved in such phenomenon, that is alpha activity in parietal areas and in the left inferior frontal gyrus (IFG), that includes the Broca's area. Results showed that CI users performed worse than normal hearing (NH) controls in the recognition of the emotional content of the stimuli. Furthermore, when considering the alpha activity corresponding to the listening to signal to noise ratio (SNR) 5 and SNR10 conditions subtracted of the activity while listening to the Quiet condition-ideally removing the emotional content of the music and isolating the difficulty level due to the SNRs- CI users reported higher levels of activity in the parietal alpha and in the homologous of the left IFG in the right hemisphere (F8 EEG channel), in comparison to NH. Finally, a novel suggestion of a particular sensitivity of F8 for SNR-related listening effort in music was provided.

Effectiveness and Safety Profile of Dupilumab in Chronic Rhinosinusitis with Nasal Polyps: Real-Life Data in Tertiary Care.

Chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by a type 2 pattern of inflammation resulting in the production of some cytokines. Dupilumab radically changes the treatment of CRSwNP, but, considering its recent approval, it may be useful to evaluate its safety profile in a real-world setting. This work aimed to prospectively highlight the effectiveness and safety profile of dupilumab in patients with CRSwNP enrolled in the Otorhinolaryngology Unit of the University Hospital of Messina. An observational cohort study was carried out considering all patients treated with dupilumab. A descriptive analysis was conducted reporting all demographic characteristics, endoscopic evaluations, and symptom conditions. A total of 66 patients were treated with dupilumab, but three patients were excluded due to a lack of adherence during the observational period. A statistically significant reduction in the Sino-Nasal Outcome Test 22 (SNOT-22) and nasal polyps score (NPS) was shown at the 6th and 12th months compared to baseline values (SNOT-22, -37 and -50, p < 0.001 for both comparisons; NPS, -3 and -4, p < 0.001 for both comparisons). During the follow-up, eight patients (12.7%) had a reaction at the site of injection, and seven (11.1%) had transient hypereosinophilia. Given the optimal treatment response and the minimal adverse effects observed, clinicians should consider dupilumab a safe and effective treatment. Further studies are necessary to better understand the long-term effects.

Prevention of Recurrent Benign Paroxysmal Positional Vertigo: The Role of Combined Supplementation with Vitamin D and Antioxidants.

Benign paroxysmal positional vertigo (BPPV) usually has a favorable course, although it is possible to observe BPPV with a high recurrence rate. Previous studies suggested that vitamin D deficiency might affect BPPV recurrences, and oxidative stress might play a complementary role in BPPV pathogenesis. This multicentric trial aimed to evaluate the effectiveness of oral nutritional supplementation with a compound of alpha-lipoic acid, Carnosine, and Zinc (LICA® (Difass International, Coriano (RN), Italy)), vitamins of group B and vitamin D in preventing BPPV recurrences. A total of 128 patients with high recurrence-BPPV were randomized in three arms: Arm 1 consisted of subjects with "insufficient" or "deficient" vitamin D blood levels, treated with daily oral supplementation of LICA®, vitamins of group B and vitamin D3 (800 UI), Arm 2 included BPPV subjects with "sufficient" vitamin D who did not receive any nutritional support, and Arm 3 included subjects with a "sufficient" serum concentration of vitamin D who received supplementation with a compound of LICA® and Curcumin. After six months of follow-up, a significant reduction of BPPV relapses compared to the baseline was found only in Arm 1 (−2.32, 95% CI: 3.41−1.62, p-value < 0.0001). Study results suggested that oral nutritional supplementation with vitamin D3 plus antioxidants can prevent relapses in patients suffering from high recurrence-BPPV.

Extended wear hearing aids: a comparative, pilot study.

PURPOSE: The study evaluated if there were differences between three types of hearing aids, Lyric extended wear (EW), receiver-in-the-ear canal (RITE), completely-in-the-canal (CIC) hearing aids in terms of audiological and psychosocial outcomes. METHODS: Fifteen patients were selected. INCLUSION CRITERIA: Pure-Tone Average (PTA) air conduction range of hearing threshold at 500, 1000, and 2000 Hz from 15 dB HL to 75 dB HL. Patients were assigned in three groups according to the hearing aid used: Extended wear, RITE, and CIC. Pure-tone audiometry, speech audiometry, free-field pure-tone and speech audiometry with hearing aids, and Matrix sentence test were performed. The Satisfaction with Amplification in Daily Life (SADL) questionnaire and the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire were used to assess the psychosocial and audiological benefits provided by hearing aids. RESULTS: No differences were demonstrated in the Matrix sentence test between the groups. A statistically significant difference was present between the "Personal image" of patients with EW and RITE with a p value of 0.01 (better outcome using EW). For the APHAB questionnaire, a significant difference was present in the "Aversiveness" of the patients with EW in comparison to CIC and RITE with a p value of 0.01 (higher aversiveness of sound using EW). CONCLUSION: In terms of audiological advantage, extended ear hearing aids are similar to RITE and CIC as demonstrated from the Matrix speech reception threshold. The result was confirmed using the APHAB questionnaire. Extended wear devices are better than daily hearing aids concerning the "personal image".

Oncological Outcomes of Primary vs. Salvage OPHL Type II: A Systematic Review.

Background: Open partial horizontal laryngectomy type II (OPHL type II) has two main aims: oncological radicality and laryngeal preservation. The aim of this review is to define and emphasize the oncological efficacy of OPHL type II, both as primary and salvage surgery, by analyzing the latest literature. Methods: The research was carried out on Pubmed, Scopus and Web of Science databases, by using strict keywords. Oncological outcomes were evaluated by the following parameters: overall survival, disease-specific survival, disease-free survival, local control, laryngeal preservation, local recurrence. Results: The review included 19 articles divided into three groups: (1) primary OPHL type II, (2) salvage OPHL type II, (3) adjuvant radiotherapy after primary OPHL type II. The articles showed excellent results as far as oncological radicality and organ preservation. Conclusions: This review demonstrated that OPHL type II is useful to obtain oncological radicality both as primary surgery and salvage surgery. Nevertheless, the only criterion that determined the positive outcome and efficacy of this technique is the strict selection of patient and tumor.

Does cybersickness affect virtual reality training using the Computer Assisted Rehabilitation Environment (CAREN)? Preliminary results from a case-control study in Parkinson's disease.

INTRODUCTION AND OBJECTIVE: This pilot study aimed to evaluate whether and to what extent cybersickness (CS) may affect a rehabilitation program using the Computer-assisted Rehabilitation Environment (CAREN), a virtual reality (VR) computer-assisted device for clinical rehabilitation. METHODS: The study was carried out on 30 subjects, 15 patients with Parkinson's Disease (PD) and 15 healthy controls (HC), which underwent a set of four exergames programmed by our team for PD rehabilitation training. RESULTS: All participants completed the Motion Sickness Susceptibility Questionnaire Short-form (MSSQ) before the training and the Motion Symptoms Assessment Questionnaire (MSAQ) immediately after a single CAREN session. Overall, mean MSAQ scores remained low after the session, suggesting that the users did not experience severe discomfort. We found no significant difference in MSAQ scores between the two groups, while there was a statistically significant difference for the subsection of MSAQ regarding the peripheral symptoms (i.e. sweating, cold sweating, feeling warm), which were higher in HC. Moreover, the results highlighted some correlation between MSSQ and MSAQ. Gastrointestinal symptoms in PD, as well as MSSQ and sopite-related symptoms in HC, were also correlated with susceptibility to CS. CONCLUSIONS: As CS is rarely reported after CAREN, this and similar devices may be considered comfortable and safe for patients' rehabilitation involving VR training, including PD persons.

Universal newborn hearing screening in the Italian Region of Sicily in 2018.

OBJECTIVES: We have clarified the role of Universal Neonatal Hearing Screening (UNHS) for both early diagnosis and rapid treatment in order to improve the prognosis of the deaf child and reduce patient management costs. Although in Sicily UNHS has been progressively implemented, there is scarce data in the literature on this matter. Therefore, the main objective was to collect in the year 2018 the following data: number of newborns screened for hearing loss, number of infants "referred" to transiently evoked otoacoustic emissions (TEOAE), number of infants with pathologic auditory brainstem response (ABR) and number of infants affected by permanent hearing loss. METHODS: UNHS monitoring was conducted through the collection of data through a questionnaire, which was analysed evaluating the effectiveness and adherence to the screening program prepared by the Department for Health Activities and the Epidemiological Observatory (DASOE). RESULTS: In 2018, there were 40,243 newborns in Sicily. A total of 37,562 newborns were screened (93.3%). There were 1,328 "referred" infants with TEOAE (3.5%). On the 2nd level, "referred" newborns examined were 1,080 of 1,328 expected (missing 248 "refer" newborns, equal to 18.6%). The number of "referred" infants confirmed with TEOAE was 113 of 1,080, while "referred" infants confirmed with ABR were 71. On the 3rd level, 67 of 71 were infants examined: 28 infants were suffering from monolateral hearing loss (13 slight/mild, 13 moderate, 1 severe and 1 profound) and 39 from bilateral hearing loss (1slight/mild, 19 moderate, 13 severe and 7 profound). Excluding 7 infants from the NICU, 60 of 37,562 infants had hearing loss (1.5%). CONCLUSIONS: The monitoring of the UNHS in Sicily has allowed obtaining the data of individual centres, absent in the literature to date, to verify the effectiveness of the screening, according to JCIH criteria, to highlight some criticalities and, finally, to propose possible solutions.

Radiofrequency VS Cold Surgery to Treat Oral Papillomatous Lesions.

INTRODUCTION: The aim of this study is to analyse different surgery (radio frequency and cold instrumentation) of oral benign papillomatous lesions. MATERIALS AND METHODS: A retrospective study was carried out in our section of Otorhinolaryngology from 2014 to 2018. 112 patients with oral benign papillomatous lesions were enrolled and divided into 2 groups. Group A of 62 patients treated with excision of lesions using radio frequency using a bipolar coagulation electrode (CelonLabENT). Group B of 50 patients treated with excision of the lesion using traditional cold instruments (scalpel and surgical forceps). All patients were evaluated for intraoperative bleeding, discomfort and recurrence rate. RESULTS: 112 patients (of which 37 males and 75 females) with mean age 32.9 ranged from 10 to 61 years. The HPV types associated with oral benign papillomatous lesions were HPV 6 (17%), 11 (23,3%), 13 (10,7%), 32 (34%), 2 (10%) and 57 (5%). There are no statistically significant differents among patients operated with radio frequency (Group A) and cold instrumentation (Group B) regarding intraoperative bleeding (P= 0.08), recurrence rate after 1 year from surgery (P=1), intraoperative discomfort (P=0.7) and postoperative discomfort (P=0.6). CONCLUSION: Radiofrequencies and surgery with scalpel and surgical forceps are equal valid methods for the treatment of benign papillomatous.

Frequency-lowering processing to improve speech-in-noise intelligibility in patients with age-related hearing loss.

OBJECTIVE: Modern hearing aids use various signal-processing strategies to improve speech intelligibility. In this manuscript, we studied the linear frequency transposition (LFT), a frequency-lowering algorithm, in patients with age-related hearing loss. Frequency-lowering algorithms transpose high-frequency sounds to a lower-frequency band. The study aimed to assess whether LFT could be used as a tool to improve speech intelligibility in patients with a better high-frequency preservation. METHODS: The study population consisted of 77 patients (age average 74.8 ± 12.4) wearing hearing aids with an open or tulip coupling system with age-related hearing loss. The unaided air conduction pure tone average (PTA) at 500, 1000, 2000 Hz was 43.5 ± 14.3 dB; the unaided word recognition score (WRS) average was 53.7 ± 12.5%. We compared WRS in all patients with the hearing aid turned on, in "quiet" and using a "pink" and "babble" masking noise. Three hearing aid settings were tested in each acoustic conditions: no transposition (NT), high transposition (HT), and low transposition (LT). "High" and "low" refer to the "start frequency"; all sounds above the start frequency are transposed in a lower-frequency band. When the start frequency was suggested by the fitting software, we called the condition "high transposition"; when the start frequency was set at the lowest possible value provided by the fitting software, we called the condition "low transposition". The quality of the voice was also assessed asking the patient to give a score from 1 to 10, where 10 was the maximum listening comfort [quality of voice score (QVS)]. RESULTS: Collected data were compared for each condition (NT, HT, LT, in quiet, pink noise and babble noise) and no statistically significant differences were found in WRS and QVS (quiet WRS p = 0.07, pink noise WRS p = 0.18, babble noise WRS p = 0.11, QVS p = 0.91). We selected 33 patients with a better WRS in babble noise using transposition (high and low). In this group, the age was significantly lower than patients who did not use transposition (p = 0.01). CONCLUSION: Linear frequency transposition is not useful to improve speech-in-noise intelligibility in patients with age-related hearing loss. Despite that no statistically significant differences were found, younger people could get advantages from the LFT when babble noise disturbs the listening of speech. The use of FL algorithm as a way to improve speech intelligibility in noisy environments should be always considered.

Adenomatous Neuroendocrine Tumors of the Middle Ear in a Young Man With Conductive Hearing Loss.

ABSTRACT: Neuroendocrine neoplasms of the ear pose a diagnostic challenge because clinical symptoms are no specific. Definite diagnosis is made by histopathological analysis with immunohystochemical evalutation. Therapy consists in a complete surgical resection. Controversial terminology of the neoplasm arises from the differentiation of these tumors composed of both endocrine and exocrine glands. Middle ear localization is an extremely rare presentation but less aggressive than gastrointestinal tract or lung localizations which are the most frequent. Radio-diagnostic analyses are necessary follow-up for preventing or detecting recurrence or metastasis. The authors present a case of neuroendocrine tumor of the middle ear in a young male of 37 years old who presented unilateral right hearing loss and tinnitus. A transcanal tympanoplasty was performed. There were no intraoperative complications and the postoperative period was uneventful.

Vocal Tract Discomfort Scale (VTDS) and Voice Symptom Scale (VoiSS) in the Early Identification of Italian Teachers with Voice Disorders

Abstract Introduction The current Italian law does not include any guidance regarding voice education, prevention of voice disorders and screening in subjects with high vocal loading such as teachers. Objectives We aimed to check the correlation between the Vocal Tract Discomfort Scale (VTDS) with the Voice Symptom Scale (VoiSS) for the evaluation of Italian teachers. In addition, we aimed to investigate whether there are differences in the frequency and intensity of discomfort symptoms in teachers with disabilities comparing vocal tract discomfort symptoms in teachers with high risk (HRVD) and low risk (LRVD) of vocal disorders according to the VoiSS cutoff (> 15.5). Methods We analyzed 160 Italian teachers (111 women and 49 men) that completed the VTDS and VoiSS at vocal evaluation. The Spearman correlation test was applied to all variables. The Mann-Whitney U test was used to compare the average number of discomfort symptoms among HRVD and LRVD teachers. Results A moderate positive correlation was observed between the average number, frequency, and intensity of discomfort symptom and the total score, physical domain score, and limitation domain score of the VoiSS. Only the emotional domain score of the VoiSS showed a weak positive correlation (p< 0.001). Teachers considered in the HRVD group according to the VoiSS score had a higher number, frequency, and intensity of vocal tract discomfort symptoms. Conclusion There is correlation between the VTDS and VoiSS scales. Like the VoiSS, the VTDS is a questionnaire that detects HRVD teachers. Therefore, the results suggest that both questionnaires could be useful for a preventive voice program for Italian teachers

Vocal Tract Discomfort Scale (VTDS) and Voice Symptom Scale (VoiSS) in the Early Identification of Italian Teachers with Voice Disorders.

Introduction The current Italian law does not include any guidance regarding voice education, prevention of voice disorders and screening in subjects with high vocal loading such as teachers. Objectives We aimed to check the correlation between the Vocal Tract Discomfort Scale (VTDS) with the Voice Symptom Scale (VoiSS) for the evaluation of Italian teachers. In addition, we aimed to investigate whether there are differences in the frequency and intensity of discomfort symptoms in teachers with disabilities comparing vocal tract discomfort symptoms in teachers with high risk (HRVD) and low risk (LRVD) of vocal disorders according to the VoiSS cutoff (> 15.5). Methods We analyzed 160 Italian teachers (111 women and 49 men) that completed the VTDS and VoiSS at vocal evaluation. The Spearman correlation test was applied to all variables. The Mann-Whitney U test was used to compare the average number of discomfort symptoms among HRVD and LRVD teachers. Results A moderate positive correlation was observed between the average number, frequency, and intensity of discomfort symptom and the total score, physical domain score, and limitation domain score of the VoiSS. Only the emotional domain score of the VoiSS showed a weak positive correlation ( p < 0.001). Teachers considered in the HRVD group according to the VoiSS score had a higher number, frequency, and intensity of vocal tract discomfort symptoms. Conclusion There is correlation between the VTDS and VoiSS scales. Like the VoiSS, the VTDS is a questionnaire that detects HRVD teachers. Therefore, the results suggest that both questionnaires could be useful for a preventive voice program for Italian teachers.

Comparison of Electrocochleography and Video Head Impulse Test findings in Vestibular Migraine and Ménière Disease: A Preliminary Study.

OBJECTIVES: To evaluate electrophysiological findings among patients with vestibular migraine (VM) and to compare them with those of patients suffering from definite Ménière disease (MD) without migraine. MATERIALS AND METHODS: Twenty-one consecutive patients suffering from VM were enrolled; all subjects were selected according to the criteria proposed by the Bàràny Society for Neuro-otology. Each patient underwent a careful otological and neurotological examination. After completing a questionnaire regarding migraine and vertigo complaints, they were assessed by audiometric testing, video head impulse test (vHIT), and electrocochleography (EcochG). Data were compared with those of 21 patients who fulfilled the criteria for definite MD. RESULTS: 52.38% of the patients with VM suffered from at least two episodes of migraine per week, with 42.85% of the subjects complaining of migraines lasting ≥24 hours. 57.14% of the patients reported at least four episodes of vertigo per month, whereas 61.9% suffered from symptoms of chronic unsteadiness. No significant difference (p=0.76) resulted from the comparison of vHIT gain between patients with VM and MD. Eleven out of 21 patients (52.38%) with definite MD presented at least one ear with SP/AP >0.4, differently from patients with VM who exhibited SP/AP values suggestive of endolymphatic hydrops (EH) in only three cases (14.28%). CONCLUSION: The present study found a higher proportion of abnormal EcochG in MD than in VM (p=0.02) without any significant difference in the vHIT gain. On the basis of our findings, the identification of EH in some patients with VM cannot be definitely related to the same pathway that triggers MD symptoms. Future research may help in better understanding whether abnormal EcochG findings can predict the occurrence of MD among patients with VM.

Manipulation of Lateral Pharyngeal Wall Muscles in Sleep Surgery: A Review of the Literature.

BACKGROUND: Obstructive sleep apnea syndrome (OSAS) occurs due to upper airway obstruction resulting from anatomical and functional abnormalities. Upper airway collapsibility, particularly those involving the lateral pharyngeal wall (LPW), is known to be one of the main factors contributing to the pathogenesis of OSAS, leading the authors of the present study to propose different strategies in order to stiffen the pharyngeal walls to try to restore normal airflow. METHODS: An exhaustive review of the English literature on lateral pharyngeal wall surgery for the treatment of OSAS was performed using the PubMed electronic database. RESULTS: The research was performed in April 2020 and yielded approximately 2000 articles. However, considering the inclusion criteria, only 17 studies were included in the present study. CONCLUSIONS: The analyzed surgical techniques propose different parts of LPW on which to focus and a variable degree of invasivity. Despite the very promising results, no gold standard for the treatment of pharyngeal wall collapsibility has been proposed. However, thanks to progressive technological innovations and increasingly precise data analysis, the role of LPW surgery seems to be crucial in the treatment of OSAS patients.

Cochlear Implant Surgery: Endomeatal Approach versus Posterior Tympanotomy.

The aim of the present study was to compare the posterior tympanotomy (PT) technique to the endomeatal approach. The endomeatal approach (EMA) for Cochlear Implant (CI) surgery was performed on 98 patients with procident lateral sinus or a small mastoid cavity, on 103 ears (Group A). Conventional mastoidectomy and PT was performed on the other 104 patients, on 107 ears (Group B). Data on all patients were then collected for the following: intra- and post-operative complications, Tinnitus Handicap Inventory (THI), Vertigo Symptom Scale (VSS), duration of surgery, and postoperative discomfort. The difference in the total number of major and minor complications between the case group and the control group was not statistically significant. There was a statistically significant difference in discomfort between the two groups using the Visual Analogue Scale (VAS), both immediately postsurgery (p = 0.02) and after one month (p = 0.04). The mean duration of surgery was 102 ± 29 min for EMA and 118 ± 15 min for the PT technique (p = 0.008). EMA is a faster technique resulting in reduced postoperative patient discomfort in comparison to the PT method. The experience of the surgeon as well as the correct choice of surgical technique are fundamental to successful outcomes for cochlear implant surgery.

Symptomatology in head and neck district in coronavirus disease (COVID-19): A possible neuroinvasive action of SARS-CoV-2.

OBJECTIVE: The aim of this manuscript is to investigate transversally Ear Nose Throat (ENT) symptoms COVID-19 infection correlated and to study the neurotropism and neuroinvasiveness of the virus in the head-neck district through the investigation of the sense of smell, taste, tearing, salivation and hearing. METHODS: A total of 50 patients with laboratory-confirmed COVID-19 infection were included in our study. For each patient we evaluated the short version of the Questionnaire of Olfactory Disorders-Negative Statements (sQOD-NS), the Summated Xerostomia Inventory-Dutch Version (SXI-DV), The Standardized Patient Evaluation of Eye Dryness (SPEED), Schirmer test I, the Hearing Handicap Inventory For Adults (HHIA) and the Tinnitus Handicap Inventory (THI). All the tests we carried out were performed during the active phase of the symptomatology from COVID-19 (Condition A) and 15 after SARS-COV-2 RT-PCR test negative (Condition B). RESULTS: A total of 46 patients (92%) had olfactory dysfunction related to the infection. The 70% of patients reported gustatory disorders. Cough, fever, headache and asthenia were the most prevalent symptoms. There was a statistically significant difference (p < 0,001) in sQOD-NS, SXI-DV, SPEED, Schirmer test, HHIA and THI between Condition A and Condition B. CONCLUSIONS: In our population there was an alteration of the sense of taste, of the sense of smell, dry eyes and of the oral cavity and an auditory discomfort, symptoms probably linked to the neurotropism of the virus. Furthermore, anosmia, dysgeusia and xerostomia are early symptoms of COVID-19, which can be exploited for an early quarantine and a limitation of viral contagion.