Solitary fibrous tumour of the supraglottic larynx.

Solitary fibrous tumour (SFT) is a rare, benign, mesenchymal neoplasm that usually arises in the pleura, but rarely involves other sites outside the serosal space (mediastinum, lung, liver, thyroid gland); larynx involvement is very rare with only sporadic cases reported in the literature. We report a case of SFT in a 41-year-old woman with supraglottic laryngeal invovlement; symptoms included dysphonia and mild odynophagia lasting 2 years, and fibre-optic laryngeal evaluation showed a sub-mucosal mass involving the left supraglottis and medial wall of the pyriform sinus. MRI represents the gold standard tool for differential diagnosis (with schwannoma, paraganglioma and haemangioma) and correct staging, while immunohistochemical and cytomorphologic analysis (bcl-2 and CD34 positivity in 90% of cases) is needed for definitive diagnosis. Surgery is the main treatment (endoscopic and open conservative technique), and its goal is a balance between safe oncological resection and good preservation of laryngeal functions; in this particular case an open laryngeal approach was scheduled due to the size of the tumour. Prognosis is good and in only a few cases (especially in pleural SFT) does the biological behaviour take a malignant course

Transnasal endoscopic removal of malformation of the odontoid process in a patient with type I Arnold-Chiari malformation: a case report

The endoscopic endonasal approach is emerging as a feasible alternative to the trans-oral route for the resection of the odontoid process, when the latter produces a compression of the brainstem and cervicomedullary junction. This type of approach has some advantages, such as excellent pre-vertebral exposure of the cranio-vertebral junction in patients with small oral cavities and the possibility to avoid the use of mouth retractors. A typical case of a 24-year-old male patient with a previous diagnosis of type I Arnold-Chiari Malformation, suffering from a posterior dislocation of the odontoid process causing severe anterior compression of the brainstem, is presented to stress the potential of this technique. Trans-nasal endoscopic removal of the odontoid process was performed and resolution of the ventral compression of the brainstem was achieved. This report demonstrates that in selected cases, an endoscopic endonasal approach should now be considered an excellent alternative to the traditional trans-oral approach

Free Flaps for Advanced Oral Cancer in the Older Old and Oldest Old : A Retrospective Multi-Institutional Study

Introduction: Surgery followed by adjuvant therapy represents the most adequate treatment for advanced oral squamous cell carcinoma (OSCC). Free flaps are considered the best reconstructive option after major oral surgery. In the last decades, OSCC has increased in the elderly due to an augmented life span. The aim of this work is to evaluate the feasibility of microvascular surgery in patients older than 75 years, focusing on clinical and surgical prognosticators. Methods: "Older old" (aged >= 75) and "oldest old" (>85) patients who underwent microvascular reconstruction for OSCC from 2002 to 2018 were retrospectively evaluated in three referral Head and Neck Departments. Demographic, clinical, and surgical data were collected and analyzed. Pre-operative assessment was performed by ASA and ACE-27 scores. Complications were grouped as medical or surgical, an d major or minor according to the Clavien-Dindo scale. Results: Eighty-four patients (72 "older old" and 12 "oldest old") were treated with a free flap success rate of 94.1%. Thirty-seven (44.7%) and nine (10.7%) patients had minor and major medical complications, respectively; 18 (21.4%) and 17 (20.2%) had minor and major surgical complications, respectively. Twenty-one (25%) patients had both medical and surgical complications (with a statistically significant association, p = 0.018). Overall, 52 (61.9%) patients had at least one complication: ASA score, diabetes mellitus, and duration of general anesthesia (DGA) significantly impacted the complication rate at multivariate analysis. Conclusion: Our data confirm the feasibility of free flaps for OSCC reconstruction in appropriately selected elderly patients. Pre-operative assessment and aggressive management of glycemia in patients with diabetes is mandatory. DGA should be reduced as much as possible to prevent post-surgical complications. Comprehensive geriatric assessment is of paramount importance in this subset of patients

Tumore fibroso solitario della laringe sopraglottica

Il tumore fibroso solitario (SFT) è una neoplasia rara, benigna, di origine mesenchimale che generalmente origina nella pleura ma che raramente può coinvolgere altre sedi al di fuori degli spazi sierosi (mediastino, polmone, fegato, tiroide); il coinvolgimento laringeo è molto raro con solo pochi casi riportati in letteratura. Riportiamo un caso di SFT in una paziente di 41 anni con coinvolgimento della laringe sopraglottica. La sintomatologia è comparsa con disfonia e modesta odinofagia da 2 anni; L’esame fibrolaringoscopico ha evidenziato una massa sottomucosa con coinvolgimento della sovraglottide di sinistra e della parete mediale del seno piriforme. L’RMN rappresenta l’esame principale per escludere altre diagnosi (schwannoma, paragangliome ed emangioma) e per una corretta stadiazione mentre l’immunoistochimica e l’analisi citomorfologica (bcl-2 e CD34 positiva nel 90% dei casi) è la base per una diagnosi definitiva. La chirurgia (endoscopica o cielo aperto) è la prima scelta di trattamento e l’obbiettivo è un bilancio tra la radicalità oncologica e la funzione d’organo; nel caso riportato l’approccio è stato a cielo aperto per il volume della massa tumorale. La prognosi è buona e solo in alcuni casi (specialmente nei SFT pleurici) il comportamento biologico del tumore può essere di tipo maligno

Luigi Settembrini. Periodico letterario educativo mensile. A. 2, n.1(1892)-A. 3, n.10(1894)

A.2, n.1(nov.1892): G. Olivieri, Ad Antonio Bartolini, P. 1-2 ; G. Olivieri, Prospero Viani, P. 2-11; R. Sabbatini, Ancora Quom o Quum?, P. 11-2 ; Pensieri del Settembrini, P. 12-3 ; E. Perito, Ad nubem, P. 13; F. Lagrance, Dell’educazione fisica, p. 14-15 ; Cronaca dell’Istituto L. Settembrini, P. 15-6.A. 2, n. 2(dic. 1892): G. Lanzalone, La morale nell’arte, P. 17-23 ; B. ( dal Bibliografo), Per i libri di testo nelle scuole elementari, P. 23-5 ; V. Notari, In Gutembergium artis typograficae inventorem, P. 25; Progressi della navigazione aerea, P. 26-8 ; Pensieri del Settembrini, P. 28-9 ; Il nostro concorso, P. 29 ; G. Lanzalone, La prima pioggia d’autunno, P. 30-1A. 2, n.3(gen. 1893): Bonghi, Una lettera del Bonghi, P. 33-4 ; G. Lanzalone, Ancora della morale nell’arte, P. 34-8 ; Pensieri del Settembrini, P. 38-9 ; C. Arlìa, Buon dì e tre anguille, P. 39-41 ; G. Lanzalone , All’amico G. Olivieri , P. 42-3 ; P. Lioy, Bagni e villeggiature, P. 43-5.A. 2, n. 4(feb. 1893): C. A. Alemagna, Per la morale nell’arte, P. 49-55.A. 2, n. 5(mar. 1893): R. Sabbatini, L’epistola di Saffo a Faone, P. 65-6 ; G. Lanzalone, Il drammaturgo(caricatura), P. 66-7 ; G. Lanzalone, Ancora per la morale dell’arte, P. 67-70 ; F. De Falco, Un’altra lettera!, P. 71-2 ; Il Settembrini, Per una petizione al Parlamento, P. 72; E. Perito, A mia sorella morta, P. 73-4.A. 2, n.6(apr. 1893): Il Settembrini, Petizione al Parlamento, P. 81-3 ; C. Arlia, Noterelle filologiche, P. 84-5 ; G. Bigoni, Ricordi Picentini (2 sonetti), P. 85 ; C. A. Alemagna, Lettera con annotazioni, P. 86-90 ; V. Caputo, Il giuramento, P. 90-1 ; A. Buscaino Campo, Il piè fermo di Dante, P. 92-3.A.2, n.7(apr. 1893): G. Lanzalone, Professori e maestri, P. 97-9 ; il Settembrini, Petizione al Parlamento, P. 100-2 ; Lista delle adesioni, P. 102-4 ; Guido Bigoni, Domenica Rusticana, P. 105 ; Pensieri del Settembrini, P. 105-7 ; Dal Gazzettino d’oro, Utili varietà, P. 107-8 ; G. Lanzalone, Al maggiore Vincenzo Notari, P. 108 ; V. Notarius, Risposta, P. 109 ; F. Accinelli, La poesia della vita, P. 109-10.A. 2, n.8(giu. 1893): C. Arlìa, Noterelle filologiche, P. 113-16 ; Guido Bigoni, La quercia del Tasso, P. 116 ; G. Lanzalone, La ginnastica con la neve, P. 116-17 ; Luigi Settembrini, Una lettera inedita di L. Settembrini, P. 118-19 ; V. Notaro, In Ariostum, P. 119 ; L’arte di respirare, P. 120-21 ; F. De Falco, Il suicidio e la religione, P. 122-24.A.2, n.9/10(lug.-ago. 1893): R. Mariano, Ad un banchetto nunziale, P. 129-132 ; G. Lanzalone, A Cristoforo Colombo, P. 132-34 ; C. Arlìa, Note filologiche, P. 135-36 ; G. Olivieri, Il terzo libro della vita di G. Cristo, P. 136-39 ; F. Persico, La pace, P. 140-41 ; L. A. Villari, Cesare Dalbono, P. 141-45.A.2, n.11/12(sett.-ott. 1893): Luigi Settembrini, Una lettera inedita di L. Settembrini, P. 153-54 ; A. De Leo, Vite di illustri salernitani, P. 154-62 ; G. Franciosi, I sogni, P. 162-63 ; A. Frabasile, Bozzetti ellenici, P. 164-70 ; L. A. Villari , Errori Giudiziari, P. 171-75 ; G. Lanzalone, Verismo, P. 175-76.A.3,n.1/2 (nov.-dic. 1893): M. Giordano, La pubblica educazione e l’ateismo, P. 1-4 ; il Settembrini, Concorso, P. 4 ; Per una forca conservata in un museo, P. 5 ; G. Lanzalone, L’Ora presente, P. 5 ; C. Mariano Pilar, Silvio Spaventa, P. 6-19 ; C. Arlìa, Note filologiche, P. 20-1 ; G. Grammatica, Ideale, P. 22 ; G. Olivieri, Funesta rimembranza, P. 31-2 ; G. Olivieri, La notte della vigilia del Natale, P. 32.A.3, n.3/4(gen.-feb. 1894): G. Lanzalone, E la nostra petizione?, P. 33-5 ; Dall’albo di Luigi Antonio Villari, P. 36 ; G. Olivieri, Una visita inaspettata, P. 37-46 ; A. Frabasile, Alla signora G. P., P. 47 ; M. Giordano, Il Governo, i Municipi e l’istruzione religiosa, P. 48-53 ; G. Lanzalone, Esercizi militari, P. 53 ; C. Arlìa, Note filologiche, P. 54 ; G. Lanzalone, Un dubbio proposto al prof. Sabbadini, P. 54-5 ; G. L., Risultato del passato concorso e concorso nuovo, P. 55-6 ; R. Galdi, Epistola di Catullo ad Ortalo, P. 57.A.3, n.5/6(mar-apr 1894): G. Lanzalone, Dell’educazione nelle scuole classiche, P. 65-70 ; G. L., Un epigramma di Leone XIII, P. 70-1 ; V. Caputo, Vita di borso, P. 72-6 ; C. Arlìa, Note filologiche, P. 76-7 ; G. Lanzalone, Amore, P. 78 ; Aniello Gaeta, Dulcissime Rerum, P. 79-81 ; Francesco De Falco, La duchessa Ravaschieri e il dormitorio, P. 81-2 ; Carmine Zottoli, Risultato del passato concorso e concorso nuovo, P. 82-6.A.3, n. 7/8(mag. – giu 1894): C. Arlìa, Note filologiche, P. 97-8 ; G. Lanzalone, Per il 1°Maggio, P. 98-101 ; M. Giordano, La libertà d’insegnamento e di coscienza, P. 101-10 ; L. A. Villari, Il capitano Tim- Tim, P. 111- 15 ; C. A. Alemagna, L’opera recente di Herbert Spencer, P. 115-16 ; Nicc. Castagna, Sospiro, P. 116 ; G. Cuomo, Sovra un passo del carme “I Sepolcri”, P. 117-20.A.3, n.9(lug. 1894): Concorso nuovo, P. 125 ; C. Arlìa, Note filologiche, P. 126-27 ; Il manicomio dei genii, P. 127 ; G. Lanzalone, Elena, P. 128 ; Giovanni Cuomo, Nunzio del giorno, P. 128-29 ; Giovanni Manfredi, Ofelia, P. 129 ; G. Lanzalone, Da Anacreonte, P. 139.A.3, n.10(ago. 1894): R. Sabbadini, L’anno della nascita di Gasparino Barziza, P. 141-42 ; G. Lanzalone, Il Discredito dei versi, P. 142-46 ; C. Arlìa, Note filologiche, P. 147-48 ; E. Perito, L’ultima rosa d’estate, P. 148 ; D’Aloja, L’arte e la critica, P. 149-51 ; Epigrammi, P. 151-52

Ultrasound-guided percutaneous laser ablation (LA) in treating symptomatic solid benign thyroid nodules: Our experience in 45 patients

Background: Laser ablation may be useful in debulking of benign thyroid nodules. Methods: To evaluate retrospectively the effectiveness and safety of LA, 45 patients with benign solid thyroid nodules, with a fluid component 6420%, were included in our series between October 2009 and January 2011. All reported pressure and/or cosmetic complaints. Nd:YAG laser at 1064 nm was used, with a fix-power (3W), changing the application time. All patients were evaluated at baseline, 6 and 12 months. Complications were recorded. Results: mean nodule volume reduction decreased from 24.2 mL \ub119.4 to 4.5 \ub1 5.2 at 12 months (p<0.001). Mean nodule volume reduction was 84% \ub1 13. Cosmetic signs were completely resolved in 87%, reduced in 9%, unchanged in 2%; pressure symptoms were resolved in 88%. One patient experienced transient dysphonia. Conclusions: US-guided LA is an effective tool for treatment of symptomatic benign thyroid nodules in patients not eligible for surgery. This article is protected by copyright. All rights reserved

COVID-19 and Total Laryngectomy—A Report of Two Cases

Objective: To date, no cases have been reported on the effects of COVID-19 in laryngectomees. Case Presentation: We herein presented two clinical cases of laryngectomized patients affected by COVID-19, detailing their clinical course and complications. Discussion: In our experience, permanent tracheostomy did not significantly affect the choice of treatment. However, dedicated devices and repeated tracheal toilettes may be needed to deal with oxygen-therapy-related tracheal crusting. Conclusion: In conclusion, laryngectomees should be considered a vulnerable population that may be at risk for worse outcomes of COVID-19 due to anatomical changes in their airways. The role of the ENT specialist is to guide airway management and inform the support-staff regarding specific needs of these patients