Congenital Pyriform Sinus Fistula: Systematic Review and Proposal for Treatment Using a Novel Endoscopic Approach

The pyriform sinus fistula (PSF) is a congenital developmental defect of the third or fourth branchial pouch. It presents as acute inflammatory swelling of the neck with recurrent deep neck abscesses, recurrent neck cystic lesions or suppurative thyroiditis. The literature reports various surgical approaches to treat this condition in children. A systematic review of the literature related to management protocols for PSF was conducted and we report a case exemplifying treatment in our department. Traditionally, treatment for PSF has been open surgery; however, in the last few decades, the minimally invasive transoral endoscopic approach has gained in importance, demonstrating long-term outcomes comparable to open surgery and with lower morbidity, and it has now become the first-choice treatment. We further describe a case of PSF treated by a transoral endoscopic approach with electric cauterization, fibrin glue obliteration of the fistula and Polydimethylsiloxane (Vox-Implants®, Bioplasty, Geleen, The Netherlands) submucosal injection. According to the authors, application of Vox-Implants® injection, in addition to standard techniques, may be helpful to reduce fistula recurrence rate after surgery

A snapshot of knowledge about oral cancer in italy: A 505 person survey

Objectives: Patients’ knowledge about oral squamous cell carcinoma (OSCC) plays an important role in primary prevention, early diagnosis, and prognosis and survival rate. The aim of this study was to assess OSCC awareness attitudes among general population in order to provide information for educational interventions. Methods: A survey delivered as a web-based questionnaire was submitted to 505 subjects (aged from 18 to 76 years) in Italy, and the answers collected were statistically analyzed. Information was collected about existence, incidence, features of lesions, risk factors of oral cancer, and self-inspection habits, together with details about professional reference figures and preventive behaviors. Results: Chi-square tests of independence with adjusted standardized residuals highlighted correlations between population features (age, gender, educational attainment, provenance, medical relationship, or previous diagnoses of oral cancer in family) and knowledge about oral cancer. Conclusions: Knowledge about OSCC among the Italian population is limited, and it might be advisable to implement nudging and sensitive customized campaigns in order to promote awareness and therefore improve the prognosis of this disease

Covid-19 and ENT practice: Our experience: ENT outpatient department, ward and operating room management during the SARS-CoV-2 pandemic

Coronavirus COVID-19 SARS-CoV-2 ENT Otolaryngolog

Expanded Endoscopic Approach for Anterior Skull Base Tumors: Experience of a Multidisciplinary Skull Base Team

Abstract: The aim of this study is to describe the experience of a multidisciplinary skull base team with transnasal endoscopic surgery for anterior cranial base tumors. A retrospective chart review was conducted on patients who underwent an exclusive expanded transnasal approach to the anterior skull base in the period from December 2014 to November 2015. Data on patient demographics, tumor characteristics, surgical information, imaging, and postoperative complications were collected and analyzed. From a total of 120 patients with skull base diseases managed by the skull base team, 36 were admitted to this study. The overall complication rate in this series was 16.7%, gross total resection was achieved in 32 cases (88.9%) and postoperative CSF leakage occurred in 5 cases (13.9%). Our preliminary results confirm that an exclusive endoscopic transnasal approach to the anterior cranial base

Trans-nasal endoscopic and intra-oral combined approach for odontogenic cysts

Maxillary cysts are a common finding in maxillofacial surgery, dentistry and otolaryngology. Treatment is surgical; a traditional approach includes Caldwell-Luc and other intra-oral approaches. In this article, we analyse the outcomes of 9 patients operated on using a combined intra-oral and trans-nasal approach to the aforementioned disease. Although the number of patients is small, the good results of this study suggest that the combined approach might be a reliable treatment option

Subspace Energy Monitoring for Anomaly Detection @Sensor or @Edge

The amount of data generated by distributed monitoring systems that can be exploited for anomaly detection, along with real time, bandwidth, and scalability requirements leads to the abandonment of centralized approaches in favor of processing closer to where data are generated. This increases the interest in algorithms coping with the limited computational resources of gateways or sensor nodes. We here propose two dual and lightweight methods for anomaly detection based on generalized spectral analysis. We monitor the signal energy laying along with the principal and anti-principal signal subspaces, and call for an anomaly when such energy changes significantly with respect to normal conditions. A streaming approach for the online estimation of the needed subspaces is also proposed. The methods are tested by applying them to synthetic data and real-world sensor readings. The synthetic setting is used for design space exploration and highlights the tradeoff between accuracy and computational cost. The real-world example deals with structural health monitoring and shows how, despite the extremely low computations costs, our methods are able to detect permanent and transient anomalies that would classically be detected by full spectral analysis

A Deep Learning Method for Optimal Undersampling Patterns and Image Recovery for MRI Exploiting Losses and Projections

Compressed Sensing was recently proposed to reduce the long acquisition time of Magnetic Resonance Imaging by undersampling the signal frequency content and then algorithmically reconstructing the original image. We propose a way to significantly improve the above method by exploiting a deep neural network to tackle both problems of frequency sub-sampling and image reconstruction simultaneously, thanks to the introduction of a new loss function to drive the training and the addition of a post-processing non-neural stage. Furthermore, we highlight how some of the quantities along the processing chain can be used as a proxy of the quality of the recovered image, thus allowing a self-assessment of the whole technique. All improvements hinge on the possibility of identifying constraints to which the final image must obey and suitably enforce them. The effectiveness of our approach is tested on real-world MRI acquisitions from the fastMRI public database and achieves an appreciable improvement in Peak Signal-to-Noise Ratio with respect to the original CS-based proposal with speed-up factors 4 and 8

Leiomyosarcoma of the Larynx: A Complex Diagnosis

An 84-year-old man was referred to our institution for dysphonia present for 2 months. Fiberoptic laryngoscopy demonstrated a polypoid lesion of the right true vocal fold with normal motility. Excisional biopsy of a submucosal thickening of the right vocal fold with vocal ligament calcification was performed. Histology revealed squamous cell epithelium without malignancy. Postoperative endoscopic follow-up was regular. Six months after surgery, dysphonia and dyspnea occurred. Flexible laryngoscopy demonstrated right hemilaryngeal paralysis, edema, and partial airway obstruction. Necrotic tissue and purulent secretions were visible at the anterior commissure, right vocal fold, and ipsilateral vestibule. A second microlaryngoscopic surgery included multiple biopsies and debridement of the necrotic tissue. Histological report was negative for malignancy, and purulent chondritis was diagnosed. Intravenous antibiotic therapy was administered with improvement of infection, inflammation, dysphonia, and dyspnea. The patient was discharged

Low-power fixed-point compressed sensing decoder with support oracle

Approaches for reconstructing signals encoded with Compressed Sensing (CS) techniques, and based on Deep Neural Networks (DNNs) are receiving increasing interest in the literature. In a recent work, a new DNN-based method named Trained CS with Support Oracle (TCSSO) is introduced, relying the signal reconstruction on the two separate tasks of support identification and measurements decoding. The aim of this paper is to improve the TCSSO framework by considering actual implementations using a finite-precision hardware. Solutions with low memory footprint and low computation requirements by employing fixed-point notation and by reducing the number of bits employed are considered. Results using synthetic electrocardiogram (ECG) signals as a case study show that this approach, even when used in a constrained-resources scenario, still outperform current state-of-art CS approaches