Inflammatory bowel disease: an increased risk factor for recurrent laryngeal nerve palsy in thyroid surgery

Transient or permanent recurrent laryngeal nerve palsy is a well known complication in thyroid surgery with reported incidences of 5-8% and 1-3%, respectively 1. Diplegia has an incidence of 0.4% 2. Inflammatory bowel disease (IBD) is an important cause of peripheral neurosensitivity, particularly autonomic neuropathy, which can lead to transient or permanent laryngeal nerve palsy when neural structures are involved during surgery. Several mechanisms have been implicated in the physiopathology of these neurological disorders, but the actual mechanism is still unknown. Herein we report on two patients with IBD presenting with transient bilateral recurrent laryngeal nerve palsy after total thyroidectomy without any evident mechanical or traumatic manoeuvres on apparently preserved nerves

Foreign bodies in the ears causing complications and requiring hospitalization in children 0-14 age: results from the ESFBI study

The occurrence of foreign bodies (FBs) in otorhinolaryngological practice is a common and serious problem among patients in paediatric age. The aim of this work is to characterize the risk of complications and prolonged hospitalization due to foreign bodies in ears in terms of the characteristics of the injured patients (age, gender), typology and features of the foreign bodies, the circumstances of the accident and the hospitalization's details

Local allergic rhinitis: considerations

the term "local allergic rhinitis" has gained popularity as a clinical entity in recent years. despite the apparent contradiction in the definitions of "nasal" and "local," we offer insights based on our extensive experience in the field. Local allergic rhinitis has been recognized and treated for many years, so it is not a new discovery. the nasal provocation test, which was introduced in the 1980s, was critical in identifying allergic rhinitis cases with suggestive symptoms but negative allergy tests. our reflections aim to contribute to a precise terminological decision that is consistent with various points of view

Predictive role of nasal functionality tests in the evaluation of patients before nocturnal polysomnographic recording

Obstructive sleep apnoea syndrome is a disease characterized by a collapse of the pharyngeal airway resulting in repeated episodes of airflow cessation, oxygen desaturation, and sleep disruption. It is a common disorder affecting at least 2-4% of the adult population. The role of nasal resistance in the pathogenesis of sleep disordered breathing and sleep apnoea has not been completely clarified. Aim of the present study was to establish whether nasal resistance and nasal volumes, measured by means of Active Anterior Rhinomanometry and Acoustic Rhinometry together with Muco-Ciliary Transport time play a positive predictive role in the evaluation of Obstructive sleep apnoea syndrome patients before running a nocturnal polysomnographic recording. A retrospective study was performed analysing 223 patients referred for suspected Obstructive sleep apnoea syndrome. All patients were submitted to complete otorhinolaryngological evaluation and underwent nocturnal polysomnography. On the basis of polysomnographic data analysis, the apnoea-hypopnoea index and snoring index, patients were classified into two groups: Group 1 (110/223 patients) with a diagnosis of mild-moderate Obstructive sleep apnoea syndrome (apnoea-hypopnoea index < 30) and Group 2 (113/223 patients) affected by snoring without associated hypoxaemia/hypercapnia. A control group of 76 subjects, not complaining of sleep disorders and free from nasal symptoms was also selected. The results showed, in all the snoring and Obstructive sleep apnoea syndrome patients, total nasal resistance and increased Muco-Ciliary Transport time compared to standard values. Furthermore, the apnoea-hypopnoea index was significantly higher in patients with higher nasal resistence and significantly different between the groups. These results allow us to propose the simultaneous evaluation of nasal functions by Active Anterior Rhinomanometry, Acoustic Rhinometry, and Muco-Ciliary Transport time in the selection of patients undergoing polysomnography

Rhinosinusitis: clinical-based phenotyping

rhinosinusitis (RS) is a common disease and is currently classified into two main types: acute RS (ARS) and chronic RS (CRS), which in turn includes CRS with or without nasal polyps. different guidelines consider this classification. however, in clinical practice, other phenotypes exist. the current article would propose new clinical-based phenotyping of RS, including the following clinical phenotypes: simple catarrhal RS, acute RS, acute bacterial RS, severe (complicated) acute RS, chronic RS, and recurrent chronic RS. atreatment strategy should be tailored considering the clinical phenotype and could include phytomedicines, intranasal non-pharmacological remedies, and local bacteriotherapy. In conclusion, RS requires thorough diagnostic work-up, and the therapeutic approach should be mainly based on appropriate management

Editorial – Obstructive sleep apnea syndrome and recurrent upper airway disease in children

Obstructive Sleep Apnea Syndrome (OSAS) and snoring are important health issues in the pediatric popu- lation, with a respective prevalence of 0.1% to 13% and 6% to 12% and a strict correlation with recurrent upper airway disease. Awareness of OSAS and snoring as health issues in children and adolescents is inadequate; there is a significant gap between the estimated number of children with OSAS and clinically diagnosed cases. Missed or delayed treatment may put young patients at risk of growth lag, hyperactivity, attention deficit, learning disabilities, and low levels of education and literacy; there is a significant increase in the use of health services by children with OSAS. Studies have demonstrated that the severity of OSAS correlates directly with total annual costs and is age-independent; other studies have shown that annual healthcare costs are reduced by one-third for children with OSAS undergoing adenotonsillectomy

An overview on upper respiratory tract infections and bacteriotherapy as innovative therapeutic strategy

OBJECTIVE: The aim of this review is to describe the most common recurring and chronic upper respiratory tract infections (URTI) in children and discuss the role of bacterial interference and bacteriotherapy in their prevention and treatment. MATERIALS AND METHODS: A literature review has been performed on the following topics: acute otitis media, adenoiditis, tonsillitis, rhinosinusitis, microbiotics and the role of bacterial interference, and bacteriotherapy in the prevention and treatment of URTI. RESULTS: Research studies into the characteristics of the microbiological flora and its role in the pathogenesis of URTI have focused on a single pathogen, on resistance to and ineffectiveness of antibiotic therapies, or on the persistence of bacterial biofilm. Recent evidence supports a central role of the existing microbial ecosystem in the pathogenesis of respiratory disease. In light of this, new therapeutic approaches include the implantation and persistence within the normal microflora of relatively innocuous “effector” bacteria that can competitively exclude or prevent the outgrowth of potentially disease-causing bacteria. Recently, a retrospective and observational study demonstrated that S. salivarius 24SMB and S. oralis 89a nasal spray could be effective in the prevention of recurrent otitis media in a real-life setting. Other studies have focused on the role of bacteriotherapy in children with beneficial effects in the prevention of URTI. CONCLUSIONS: The results of previous studies on the role of bacteriotherapy in paediatric URTI suggest that the use of bacterial interference phenomena through bacteriotherapy is a feasible, safe approach and deserves proper consideration as a promising therapeutic strategy against URTI

Correlation between female sex and allergy was significant in patients presenting with dysphonia

Aim of the present study was to investigate the prevalence of allergy in patients affected by both organic and/or functional vocal fold disorders. The secondary aim was to assess the correlation between sex and allergy in dysphonic patients. A retrospective chart review was performed on dysphonic patients. A total of 76 patients underwent fiberoptic endoscopy to assess the objective picture. Logistic regression analyses have been conducted to assess the association between sex and the outcome variables. The laryngoscopic examination revealed the presence of poor glottic closure in 32.9%, hyperkinesias in 11.8%, redness in 11.84%, polyps in 5.3%, oedema in 3.95%, vocal fold hypertrophy in 5.3%, nodules in 42.1%, cordectomy in 2.6%. Allergic rhinitis was present in 56.6%, milk intolerance in 13.2%, asthma in 9.2%, atopic dermatitis in 3.9%, drugs intolerance in 11.8%. A total of 76.32% patients presenting with dysphonia were allergic. A statistically significant association was found between female sex and presence of allergy. In conclusion, allergy testing should be performed routinely on female professional voice users. Mild respiratory disorders must be taken into serious consideration in female professional voice users, who may primarily complain of vocal dysfunction rather than upper and lower respiratory diseases

The impact of allergic rhinitis in clinical practice: an italian survey

Allergic rhinitis (AR) is a very common disorder. The current Survey was conducted on a sample of about 5,000 adult subjects in 5 Italian cities. A questionnaire, containing 15 questions, was administered on the road. AR affects about 20% of the general population. The most common diagnostic test was the skin prick test, but only 12% of patients performed an allergy test to confirm the diagnosis. About 50% of patients did not take any medicine. Even about 40% of treatments were suggested by friends or pharmacists. In conclusion, the current Survey demonstrated that AR is a common disorder in Italy, the diagnostic work-up is still incorrect, and the therapeutic approach does not adhere to the guidelines. Therefore, there is a need to implement adequate information on this topic in Italy