1,720,986 research outputs found
CO2 Laser Marsupialization for Internal and Combined Laryngocele
Full text linkIntroduction Laryngocele is an air -filled dilatation of the laryngeal saccule that can be classified according to its extent (internal, external, or combined) and contents (laryngocele or laryngopyocele). To date, there is no consensus on the best treatment for laryngocele.Objective The present study aims to demonstrate for the first time the effectiveness of CO(2 )laser marsupialization for internal and combined laryngoceles. Methods A retrospective study was accomplished in our ENT Clinic of the University Hospital, from 2010 to today, recruiting patients according to strict criteria. All patients had internal or combined laryngocele/laryngopyocele treated with CO2 laser marsupialization.Results A total of 15 patients were enrolled for a total of 17 laryngoceles; 66.67% of the patients were males and the mean age was 54.4 (114.12) years old. Internal laryngoceles accounted for 64.71% of the total, and only 7 cases were laryngopyoceles. At the 3-year follow-up, no signs of recurrence were found.Conclusion CO2 laser marsupialization is efficacious in the treatment of laryngocele or laryngopyocele, both internal and combined, in terms of efficiency, safety, and fast postoperative recovery, without need for tracheotomy or open surgery
Laryngeal disease and tumours and its related surgery
No full textThe larynx plays a role in breathing and phonation
and is involved in swallowing through its
sphincter function in order to protect the lower
airways. Therefore, laryngeal pathology, whether
benign or malignant, often manifests itself with
dysphonia, dyspnoea and/or dysphagia, as well
as with other less specific symptoms such as
cough, ear pain, pharyngeal globe and sore throat.
Furthermore, in most cases, laryngeal pathologies
require surgical treatment as anti-inflammatory
and/or antibiotic medical therapy
alone is seldom sufficient [1, 2]. In any case, for
a correct diagnostic and therapeutic classification
of the pathology, it is advisable, first of all, to
begin with the study of the larynx from an embryological,
anatomical and physiological point of
view and then to move on to the characteristics of
the various laryngeal pathologies and, therefore,
how these impair the structure and function of the
organ
Reanimation Techniques of Peripheral Facial Paralysis: A Comprehensive Review Focusing on Surgical and Bioengineering Approaches
Full text link: Peripheral facial paralysis represents a disabling condition with serious psychological and social impact. Patients with peripheral facial paralysis have a disfigurement of the face with loss of harmony and symmetry and difficulties in everyday facial functions such as speaking, drinking, laughing, and closing their eyes, with impairment of their quality of life. This paralysis leads to impairment of facial expression, which represents one of the first means of communication, an important aspect of human interaction. This review aims to explore the reanimation techniques for managing peripheral facial paralysis. An analysis of static and dynamic techniques for facial reanimation is provided, including muscle flaps, nerve grafting techniques, and bioengineering solutions. Each technique showed its benefits and drawbacks; despite several options for facial reanimation, no technique has been detected as the gold standard. Therefore, each patient must be evaluated on an individual basis, considering their medical history, age, expectations, and treatment goals, to find the best and most fitting treatment
Editorial: News and update in transoral robotic surgery in oropharyngeal, hypopharyngeal, and laryngeal cancers
Full text linkHyposmia in COVID-19: Temporal Recovery of Smell: A Preliminary Study
Full text linkBackground and Objectives: Hypo/anosmia is a characteristic symptom of COVID-19 infection. The aim of this study is to investigate the time of smell recovery and to identify a possible order of perception recovery of different odors in COVID-19 patients. Materials and Methods: A prospective observational study was conducted on not hospitalized COVID-19 patients, selected according to eligible criteria. The study was approved by the Ethical Committee. A questionnaire formulated by our team was submitted to patients in order to know the duration of the hypo/anosmia and hypo/ageusia and the order of odor recovery: vanillin (mixed olfactory/gustatory substances), phenyl ethyl alcohol (rosewater) (pure olfactory substances), eucalyptol (mixed olfactory/trigeminal substances), and eugenol (mixed olfactory/trigeminal/gustatory substances). Results: 181 patients were included. Hypo/ageusia and hypo/anosmia lasted on average 10.25 (& PLUSMN;8.26) and 12.8 (& PLUSMN;8.80) days, respectively. The most frequent odor recovery sequence was: (1) phenyl ethyl alcohol; (2) eucalyptol; (3) vanillin; and (4) eugenol. In COVID-19 patients, hypo/anosmia occurs more often in women and at a young age. Conclusions: This preliminary investigation highlighted novel data: there is a chronological order in perception recovery of different olfactory substances and, therefore, in the restoration of the various sensitive nerve pathways involved in the sense of smell
Voice prosthesis in total laryngectomized patients: From patient selection to complication management
No full textThe volume offers a comprehensive overview of voice rehabilitation after total laryngectomy through a multidisciplinary approach which is the result of the collaboration between otolaryngology specialists and speech therapists.
After a short introduction on total laryngectomy and voice recovery, the volume discusses patient selection for voice prosthesis. The following part describes the surgical steps for prosthesis implantation and replacement, the complications that may occur and their solutions. The fourth part focuses on voice rehabilitation. The closing part reviews the different types of voice prostheses and devices and their use and correct management for optimal respiratory, olfactory and speech rehabilitation.
Each topic addressed is supported by a wealth of detailed images and step-by-step videos. Given its features, the volume will be an invaluable tool for ENT specialists and speech therapists as well as residents in these fields
NBI and Laryngeal Papillomatosis: A Diagnostic Challenge: A Systematic Review
Full text linkNarrow-band imaging (NBI) represents a valid aid in laryngeal squamous cell carcinoma (LSCC) diagnosis for detecting vascular changes. However, LSCC and laryngeal papillomatosis (LP) show similar vascular patterns that may lead to misdiagnosis and improper treatment. This review aims to deepen this NBI limit in order to stress a careful preoperative evaluation of laryngeal lesions. The research was carried out on PubMed, Web of Science and Scopus databases using specific keywords. The topic of research was assessed by these parameters: accuracy, sensitivity, specificity, and positive and negative predictive values. This review included only five articles: they demonstrated that NBI is better than white-light endoscopy in detecting LSCC and LP. They also reported that LP is frequently mistaken for LSCC, resulting in high rates of false positives using NBI. This is the first review that emphasized this NBI limitation in distinguishing between LP and LSCC in cases of a type V pattern of intraepithelial papillary capillary loop. Although NBI application increased the rate of early cancer detection, LP reduces NBI accuracy. This drawback may lead to misdiagnosis and improper treatment. Our advice is to be careful in cases of type V pattern on NBI and to research LP epithelial and clinical features because it could be a pitfall
Thunderbeat®: a new step forward in transoral surgery—systematic review of literature and our experience
Full text linkIntroduction
Minimally invasive surgery is today the main challenge of ENT surgeons who aim to achieve oncological radicality with less aesthetic and functional impact. This is the basis for the widespread transoral surgical techniques, as the Thunderbeat®.
Objective
To date, the use of Thunderbeat® in transoral surgery is still little known and widespread. So, this study analyzes, with a systematic review, current literature about the transoral use of Thunderbeat® and shows our case studies.
Methods
The research was carried out on Pubmed, Scopus, Web of Science and Cochrane databases using specific keywords. Then, a retrospective study was carried out on 10 patients who underwent transoral surgery by Thunderbeat® in our ENT Clinic. Both in our cases and in the systematic review the following parameters have been evaluated: treated anatomical site and subsite, histological diagnosis, type of surgery, duration of nasogastric tube and hospitalization, post-operative complications, tracheostomy, resection margin status.
Results
The review included 3 articles that described transoral use of Thunderbeat® for a total of 31 patients suffering from oropharyngeal, hypopharyngeal and/or laryngeal carcinoma. Nasogastric tube was removed after 21.5 days on average, temporary tracheostomy was performed in 6 patients. The main complications were: bleeding (12.90%) and pharyngocutaneous fistula (29.03%). Thunderbeat® shaft was 35 cm long and 5 mm large. Our case studies included 5 males and 5 females, mean age 64.4 ± 10.28, with oropharyngeal or supraglottic carcinoma, parapharyngeal pleomorphic adenoma and cavernous hemangioma of the tongue base. Temporary tracheostomy was performed in 8 patients. Free resection margins were achieved in all cases (100%). No peri-operative complications occurred. Nasogastric tube was removed after 5.3 ± 2 days on average. All patients were discharged without tracheal tube and NGT after 18.2 ± 4.72 days on average.
Conclusion
This study demonstrated that Thunderbeat® has several advantages over other transoral surgical approaches, such as CO2 laser and robotic surgery, in terms of best combination of oncological and functional success, less post-operative complications and costs. So, it could represent a step forward in transoral surger
Laryngeal manifestations of Crohn’s disease
No full textCrohn’s disease is a chronic inflammatory bowel disease. It should be considered a multisystemic disease due to its extra-intestinal manifestations found in 25-40% of patients with inflammatory bowel disease. Laryngeal involvement is very uncommon and the lesions in hypopharynx and larynx are edema, ulcerations and granulation tissue. Symptoms are dysphonia, dysphagia, odynophagia and airway restriction. Laryngeal manifestations of Crohn’s disease are usually successfully treated with oral steroids. We describe a 54-year-old woman who presented with dysphagia and odynophagia for 20 days. She had a history of Crohn’s disease for 6 years. Laryngoscopy revealed a cobblestone appearance of epiglottis and laryngeal vestibule. A biopsy of the lesion of the epiglottis was taken and histologic analysis revealed a nonspecific chronic inflammation suggestive of Crohn’s disease. Therefore the patient was treated with oral steroids and laryngeal lesions resolved in a week. To date, the correlation between intestinal symptoms and head and neck manifestations is unknown. Though our case report suggests that head and neck manifestations are not related to bowel inflammatory activity. However more studies are required to deepen this matter
laryngeal amyloidosis
No full textLaryngeal amyloidosis is a rare and idiopathic disease that represents about 1% of all benign laryngeal lesions. It is characterized by the extracellular deposition of an abnormal amount of non-soluble fibrillar proteins in larynx. This disease presents unspecific symptoms and laringoscopic findings that make difficult to diagnose it. Management of these lesions consists of endoscopic resection of the mass through microdirect laryngoscopy. Recurrence is possible and it can occur up to 10 years after treatment; therefore a close and long-term follow-up is requested. A 60-year-old man presented with hoarseness and dysphonia. Laryngoscopy revealed a smooth, translucent and yellowish formation involving the middle-third of the left true vocal cord. The patient was first managed conservatively with speech therapy and after 6 months the lesion was removed by endoscopic CO2 laser surgery without evidence of recurrence in 2 years of follow-up. Laryngeal amyloidosis is a rare disorder that can be mistaken for a benign vocal cord polyp, nodule, retention cyst or laringocele. CO2 laser technique represents the highly effective approach to treat these lesions. Clinicians should know this rare amyloidosis site in order to avoid a delayed diagnosis and to treat it
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