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

The role of balloon sinuplasty in the treatment of sinus headache

Headache attributed to rhinosinusitis, commonly called sinus headache (SH), is probably one of the most prevalent secondary headaches. The purpose of our study was to examine further sinus headache comparing the effect of conventional functional endoscopic sinus surgery and the balloon sinuplasty

ENT manifestations of gastro-oesophageal reflux in children

Gastro-oesophageal reflux is common in children and is associated with morbidity rates that justify increasing interest in early diagnosis and appropriate medical or surgical treatment. In children ENT manifestations of gastro-oesophageal reflux mainly affect the larynx, ears, nose, paranasal sinuses and oral cavity. Main manifestations are laryngo-tracheal stenosis, laryngomalacia, otitis media with effusion, rhinosinusitis

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

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

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

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

Salivary biomarkers and proteomics: Future diagnostic and clinical utilities = Biomarkers e proteomica salivari: Prospettive future cliniche e diagnostiche

Saliva testing is a non-invasive and inexpensive test that can serve as a source of information useful for diagnosis of disease. As we enter the era of genomic technologies and –omic research, collection of saliva has increased. Recent proteomic platforms have analysed the human salivary proteome and characterised about 3000 differentially expressed proteins and peptides: in saliva, more than 90% of proteins in weight are derived from the secretion of three couples of “major” glands; all the other components are derived from minor glands, gingival crevicular fluid, mucosal exudates and oral microflora. The most common aim of proteomic analysis is to discriminate between physiological and pathological conditions. A proteomic protocol to analyze the whole saliva proteome is not currently available. It is possible distinguish two type of proteomic platforms: top-down proteomics investigates intact naturally-occurring structure of a protein under examination; bottom-up proteomics analyses peptide fragments after pre-digestion (typically with trypsin). Because of this heterogeneity, many different biomarkers may be proposed for the same pathology. The salivary proteome has been characterised in several diseases: oral squamous cell carcinoma and oral leukoplakia, chronic graft-versus-host disease Sjögren’s syndrome and other autoimmune disorders such as SAPHO, schizophrenia and bipolar disorder, and genetic diseases like Down’s Syndrome and Wilson disease. The results of research reported herein suggest that in the near future human saliva will be a relevant diagnostic fluid for clinical diagnosis and prognosis

F.E.S.S. Complications

Nasal Endoscopic Surgery still supports endonasal surgery expansion and this expansion can cause a real increase in complications due very often to superficial knowledge of endoscopic and radiologic anatomy, surgical inexperience and inadequate surgical instruments. The surgeons’ practical experience in the progressive use of the endoscope is fundamental such as practical training in surgical therapeutic procedures on the cadaver. Be reminded that the learning curve can have a decrease in the year when surgeons think being sufficiently expert and going through surgery without adequate thinking. Nose and paranasal sinuses anatomic complexity can be involved in sequaelae arising such as previous surgery, nature and extension of the illness. From a didactic point of view, we classify the complications of ESS as: intranasal complications; periorbital/orbital complications; intracranial complications; Systemic complications; other complications (bronchospamus, asthmatic crisis, cephalalgia, otalgia, atrophic rhinitis, dry rhinitis, anosmia, mucoceles). Even if we believe that endoscopic rhinosinus surgery is a safe technique and the results are superior in relation to conventional techniques, and the rate of complications inferior, successful results in endoscopic rhinosinus surgery require good knowledge of endosopic anatomy, good knowledge of TC scan anatomy and an adequate training in surgical procedures