ACTA Otorhinolaryngologica Italica

The prognostic role of salivary miRNAs in oral squamous cell carcinoma: technical challenges and clinical perspectives

Chiara Romani — 2024-10-18

In management of oral squamous cell carcinoma (OSCC), only a few biomarkers, ranging from clinical and histopathological features to molecular alterations, have been demonstrated to have clinical and prognostic utility. The intent of this narrative review is to present current findings on the use of salivary microRNAs (miRNAs) as prognostic oncologic biomarkers in patients with OSCC. The ability to predict survival or recurrence during follow-up by quantification of specific miRNAs in saliva has been shown in a number of studies, and serves as a possible feature to address in future well-designed clinical studies to confirm their prognostic value. The non-invasiveness of liquid biopsy techniques, the ease of saliva collection, and the abundance and stability of miRNAs in such a biologic fluid make it an attractive combination to improve management of OSCC. For salivary miRNAs to be used in routine practice, however, methodological and sampling standardisation are still needed to increase the power and accuracy of the results obtained.

Notiziario SIO 2024

Redazione . — 2024-10-31

CONSIGLIO DIRETTIVO SIO (2024-2025)

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https://www.actaitalica.it/article/view/773/510

Telemedicine for hearing-impaired patients in Italy

Sara Ghiselli — 2024-10-31

Long-term safety and subjective satisfaction of Bonebridge and Vibrant Soundbridge in congenital unilateral conductive hearing loss

Yujie Liu — 2024-10-31

Purpose. The objective of this study was to assess and compare the long-term safety and subjective satisfaction levels of Bonebridge (BB) and Vibrant Soundbridge (VSB) in patients with congenital unilateral conductive hearing loss (UCHL).
Methods. The hearing effectiveness was measured using sound field hearing threshold (SFHT) and word recognition score (WRS). Long-term safety and subjective satisfaction levels were measured by questionnaires, including Speech, Spatial, and Qualities of Hearing Scale-12 (SSQ-12) and Abbreviated Profile of Hearing Aid Benefit (APHAB).
Results. Both BB and VSB were effective in improving the hearing of patients with congenital UCHL. Four of the 20 patients discontinued wearing the device postoperatively, and no complications were reported by long-term users. Patients experienced an overall improvement in their hearing experience across most subscales of SSQ-12 and a lower hearing problem rate across most subscales of the APHAB after implantation. However, the ‘quality of hearing’ subscale in the SSQ-12 did not show any improvement, and the aversiveness subscale in the APHAB exhibited a relatively higher percentage of reported problems after BB or VSB implantation. No significant differences were observed in SFHT, WRS, SSQ-12, and APHAB between the two groups.
Conclusions. Both BB and VSB are effective in improving the hearing of UCHL patients, with high subjective satisfaction and low complication rates in the long-term postoperative period, with no significant difference between the two devices. Follow-up device fitting is essential, especially to address increased device sound or noise after surgery, reduce non-usage rates and achieve higher subjective satisfaction levels.

Up-regulation of HIF-1α in refractory sudden sensorineural hearing loss

Wandong She — 2024-10-31

Objectives. To investigate the expression of hypoxia-inducible factor-1α (HIF-1α) in patients with refractory sudden sensorineural hearing loss (SSNHL).
Material and methods. Thirty patients with refractory SSNHL were treated with intratympanic methylprednisolone perfusion (IMP) for 10 days. Expression of HIF-1α and histone deacetylase 2 (HDAC2) was evaluated in peripheral blood mononuclear cells (PBMCs) and in vitro.
Results. Significant hearing improvement (≥ 15 dB) was observed in 16 patients [IMP glucocorticoid sensitive (GCS) group], while 14 patients had no therapeautic hearing recovery [IMP GC resistance (GCR) group]. The expression of HDAC2 decreased and HIF-1a increased in all refractory SSNHL patients before IMP. The expression of HDAC2 and HIF-1α after IMP was significantly changed in the GCS group, but not in the GCR group. The same expression profile was also observed in House Ear Institute-organ of Corti-1 (HEI-OC1) cells exposed to oxidative stress (OS). The results of gene manipulation experiments indicate that HIF-1α up-regulation significantly reduced HDAC2 expression in HEI-OC1 cells, especially under conditions of OS.
Conclusions. This study suggests that HIF-1α activation inhibits HDAC2 expression, causing glucocorticoid resistance in refractory SSNHL. HIF-1α might serve as a potential biomarker to predict prognosis of refractory SSNHL.

Laryngopharyngeal reflux: knowledge, attitudes, and practices among primary healthcare physicians

Sultan Bin Obaid — 2024-10-31

Objective. The aim of this study was to estimate the level of knowledge, attitudes, and practices regarding laryngopharyngeal reflux (LPR) among primary healthcare (PHC) physicians in Saudi Arabia.
Methods. This quantitative cross-sectional study used an online-based questionnaire distributed to physicians in PHC facilities and hospitals in Saudi Arabia. The questionnaire consisted of four sections that provided data on demographics, knowledge, attitudes, and practices.
Results. Of the 473 physicians included in the study, one-third were unaware of LPR, and twothirds were unfamiliar with the reflux symptom index (RSI). The most common sources of LPR knowledge were textbooks and literature (49.8%). The most recognised risk factor, symptom, and complication were high body mass index (75.8%), voice problems (82.4%), and laryngeal cancer (70.6%), respectively. The most recognised diagnostic and treatment options were laryngoscopy (73.5%) and lifestyle modifications (87.3%), respectively, while only 60.4% of participants recognised proton pump inhibitors as a treatment option. Most PHC physicians believed that LPR is underdiagnosed and that primary prevention and awareness among the general population need to be improved.
Conclusions. One in three PHC physicians knew nothing about LPR, and two in three were unfamiliar with the RSI. More than half could not recognise all major symptoms of LPR, which might be a cause for concern, as recognising these symptoms is crucial for proper diagnosis. We recommend increasing the education of physicians about LPR, its signs and symptoms, and the RSI, all of which provide valuable clues for diagnosis.

Modular anatomic approach to oral tongue carcinoma: functional outcomes and quality of life

Luca Gazzini — 2024-10-31

Objectives. The purpose of this study is to present the long-term functional swallowing outcomes of various surgical approaches to oral tongue/floor of mouth squamous cell carcinoma (OTFOMSCC) according to a modular and compartment-based concept previously described elsewhere.
Methods. A retrospective study was conducted on patients undergoing surgery for OTFOMSCC from January 2017 to April 2023 in the Department of Otorhinolaryngology at the Hospital of Bolzano. Functional swallowing outcomes and quality of life (QoL) were assessed through the administration of a scale and questionnaires between 6 months and 1 year postoperatively or after the end of adjuvant therapy, stratifying the results according to the surgical technique used.
Results. A total of 92 patients with OTFOMSCC were enrolled: 44 patients underwent transoral anatomically guided surgery (TAGS) for early-stage tumours, and 48 underwent major surgery for advanced stages. Among the latter 48 patients: 35 underwent compartment tongue surgery (CTS), 3 underwent extended glossectomies (EG) Type A, 6 underwent EG Type B, and 4 underwent EG Type C. After TAGS, all patients resumed oral feeding for all consistencies. In the CTS group, only one patient faced challenges with pure liquids, yet all achieved the target of consuming a semisolid and semiliquid diet. EG exhibited a noticeable decline in performance from Type A to total glossectomy (Type C).
Conclusions. Following an anatomically-guided approach to the resection of OTFOMSCC allows the surgery to be modulated on the structures involved by the tumour, thus achieving optimal oncological results, while maintaining the possibility to predict functional outcomes and postoperative QoL.

Role of PET/CT in improving the cost effectiveness of nimotuzumab in nasopharyngeal carcinoma

Xiao-bin Fu — 2024-10-31

Objective. This study aims to use the maximum standardised uptake value (SUV_max) of 18F-fluorodeoxyglucose positron emission tomography to improve the cost effectiveness of nimotuzumab (NTZ) in locoregionally advanced nasopharyngeal carcinoma (LA-NPC).
Methods. Two hundred and forty-eigh patients with LA-NPC, who met the inclusion criteria, were recruited from January 2012 to June 2019. The survival differences and independent factors were assessed using the Kaplan-Meier method and by Cox proportional hazards regression analysis. A cost effectiveness analysis was performed.
Results. The optimal cut-off value for SUV_max was 12.92. Multivariable analysis indicated a prognostic significance of overall survival (OS) for the NTZ treatment (p = 0.023) and SUV_max (p = 0.014). The exploratory subgroup survival analysis revealed that LA-NPC patients with SUV_max > 12.92 treated with concurrent chemoradiotherapy (CCRT) and NTZ had a significantly improved 3-year OS compared to patients treated with CCRT alone (96.2 vs 73.2%, p = 0.047). Furthermore, the treatment cost for NTZ was $6,317.61. This incurred an additional cost of $274.68 for every 1% increase in OS. Conclusions. For patients with LA-NPC with SUV_max > 12.92, the addition of NTZ to CCRT can improve OS and is cost effective.

In memory of Carlo Bicciolo

Enrico de Campora — 2024-10-31

On July 19, 2024, Carlo Bicciolo returned to the House of the Lord; a good and righteous man who had the privilege of a long and rich life, which he honoured in every moment and at every stage. Carlo, with his 98 years splendidly carried until the end, was perhaps the Dean of Italian Otorhinolaryngology. However, longevity is certainly not the reason why I am here to share the grief for his loss; it is rather the memory of his incredible humanity, as well as his intellectual and professional ability.

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https://www.actaitalica.it/article/view/772/509

Utility of intraoperative scoring system in rhino-orbital mucormycosis as a prognostic tool

Neehal Zuturu — 2024-10-31

Objective. To assess the utility of an intraoperative scoring system for mucormycosis and to predict prognosis by comparing the score with postoperative outcomes.
Methods. This study was conducted among 80 patients with mucormycosis who underwent surgical management with mandatory pterygopalatine fossa and infratemporal fossa exploration. All cases were scored using our intraoperative scoring assessment tool. Postoperative outcomes in terms of favourable prognosis and mortality were evaluated and compared with demographics, clinical history and intraoperative findings.
Results. An intraoperative score of more than 25 was statistically significant in predicting mortality (p < 0.0001). In all, 86.7% of patients with a score above 25 succumbed to the disease. Statistical significance of mortality (p < 0.05) was observed in those with involvement of pterygopalatine fossa (78.9%), orbit (73.7%), infratemporal fossa (57.9%), cribriform plate (36.8%) and those with history of intake of antiviral drugs (47.4%), use of supplemental oxygen (31.6%) and renal failure (26.3%).
Conclusions. This study enabled better prediction of postoperative prognosis in mucormycosis and reiterated the importance of exploration of pterygopalatine fossa and infratemporal fossa in management and prognostication of invasive fungal sinusitis.