Effects of sodium hyaluronate in children with recurrent upper respiratory tract infections: results of a randomised controlled study.

Hyaluronic acid is a major component of many extracellular matrices that plays a role in the regulation of vasomotor tone and mucous gland secretion, and in the modulation of the inflammatory process in upper and lower airways. This pilot study was aimed at evaluating the effects of nasal washes with 9 mg nebulised sodium hyaluronate given for 15 days per month over 3 months in 75 paediatric patients with recurrent upper respiratory tract infections (URTI). Eligible patients were randomized to treatment with nasal washes containing 9 mg sodium hyaluronate plus saline solution or saline alone, according to an open-label, parallel group design, with blind observer assessment.

Prevalence of occupational hazards in patients with different types of epithelial sinonasal cancers.

Background: Occupational exposure to carcinogens contributes greatly to the etiology of sinonasal cancer (SNC), but the role of different risk factors in determining different histological subtypes is disputed.

Methodology: All consecutive surgical epithelial SNC cases (case-series study) underwent a systematic occupational medicine examination to determine previous exposure to a wide range of work-related chemical hazards.

Results: We investigated 65 SNC cases including intestinal-type adenocarcinoma [ITAC] squamous-cell carcinoma [SCC], and others.

[Prospectic evaluation of the Italian Workers' Compensation Authority in a large case series of Occupational sino-nasal cancers].

Sino-nasal cancer (SNC) are rare tumours with an elevated occupational etiological fraction, due both to well-established risk factors (wood and leather) and to more rare carcinogens. We evaluated the assessment for workers' compensation performed by the Italian Authority (INAL) in a case-series of occupational SNC (N = 45). We observed an elevated proportion of cases that were recognised as occupational, overall (36 on 39) and for any histotype.

Mixed pituitary adenoma/craniopharyngioma: clinical, morphological, immunohistochemical and ultrastructural study of a case, review of the literature, and pathogenetic and nosological considerations.

Mixed pituitary adenoma/craniopharyngiomas are very rare tumors. Their pathogenesis is still unclear and it is not known whether they are collision tumors derived from independent stem cells or whether they originate from a single stem cell undergoing divergent differentiation. The latter hypothesis is supported by the close commixture between the two tumor components with transition areas that has been previously described.

Necrotizing craniocervical soft tissue infections: clinical experience and personal considerations.

Necrotizing cervical soft tissue infections (NCSTIs) are devastating uncommon clinical entities that are often life threatening. We report two patients suffering from NCSTI and treated at our institution. Diagnosis of NCSTI has been confirmed histologically and surgically.

Endoscopic endonasal anatomy of superior orbital fissure and orbital apex regions: critical considerations for clinical applications.

The superior orbital fissure is a critical three-dimensional space connecting the middle cranial fossa and the orbit. From an endoscopic viewpoint, only the medial aspect has a clinical significance. It presents a critical relationship with the lateral sellar compartment, the pterygopalatine fossa and the middle cranial fossa.

Prevention and treatment of postoperative infections after sinus elevation surgery: clinical consensus and recommendations.

Introduction. Maxillary sinus surgery is a reliable and predictable treatment option for the prosthetic rehabilitation of the atrophic maxilla. Nevertheless, these interventions are not riskless of postoperative complications with respect to implant positioning in pristine bone.

Endoscopic endonasal resection of sinonasal and skull base malignancies in children: feasibility and outcomes.

Background: The aim of this study is to present our experience in treating paediatric sinonasal and skull base malignancies with exclusively endonasal endoscopic approach and measure its feasibility.

Methods: This study is a retrospective review of seven patients under age of 19 years who have sinonasal and skull base malignancies and treated with endoscopic endonasal approach. The main outcome measures are the surgical resection, complications, survival rate, recurrence and gross facial growth.

Sinonasal mucosal melanoma: Molecular profile and therapeutic implications from a series of 32 cases.

Background: Primary sinonasal mucosal melanomas are aggressive tumors with a poor clinical control by current treatments, raising the urgent need of novel strategies.

Methods: By fluorescence in situ hybridization (FISH), direct sequencing, and immunohistochemistry, we investigate the spectrum of molecular abnormalities in a cohort of 32 cases of primary sinonasal mucosal melanomas.

Results: We found that all primary sinonasal mucosal melanomas lack BRAF V600E mutation; in addition, they are characterized by somatic mutations of NRAS (22%) and KIT (12.

Endoscopic transnasal resection of anterior skull base malignancy with a novel 3D endoscope and neuronavigation.

The surgical treatment of sinonasal malignancies is in continuous evolution. In selected patients, endoscopic resection has become a sound alternative to traditional external approaches. Further improvements are necessary to enhance the possibilities of endoscopic transnasal resection of sinonasal malignancies.

Mixed exocrine-neuroendocrine carcinoma of the nasal cavity: clinico-pathologic and molecular study of a case and review of the literature.

Sinonasal intestinal-type adenocarcinomas (ITACs) are rare neoplasms histologically resembling intestinal adenocarcinomas. Although a neuroendocrine differentiation in ITACs has been described, true mixed exocrine-neuroendocrine carcinomas, neoplasms in which each component represents at least 30 % of the lesion, are extremely rare and their molecular alterations are largely unknown. We describe herein the clinico-pathologic features, the methylation profile, chromosomal gains and losses, and mutation analysis of KRAS, BRAF and p53 in a nasal mixed exocrine-neuroendocrine carcinoma resected in a 79-year-old man.

Frontoethmoidal and intraorbital osteomas: exploring the limits of the endoscopic approach.

Objective: To review our experience with the surgical treatment of frontoethmoidal osteomas, focusing on the osteomas that were either localized laterally in the frontal sinus or showing intraorbital involvement.

Design: Retrospective evaluation.

Setting: Tertiary care center.

Anatomical landmarks for transoral robotic tongue base surgery: comparison between endoscopic, external and radiological perspectives.

Purpose: To describe the transoral viewpoint of the tongue base anatomy, focusing on a superior to inferior perspective, which is less familiar to the head and neck surgeon but, at the same time, worthy to be known given the expanding interest and diffusion of the transoral robotic technique.

Methods: Seven heads were dissected, two with the Da Vinci(®) robotic system, three by means of a transoral endoscopic approach and another two by means of a lateral "traditional" external approach. Ten normal patients, with normal oral cavity and oropharynx, were studied as control samples by means of a 3-T MRI scanner.

Combined transnasal transcervical robotic dissection of posterior skull base: feasibility in a cadaveric model.

The current surgical trend is to expand the variety of minimally invasive approaches and, in particular, the possible application of robotic surgery in head and neck surgery. For this purpose, we explored the feasibility of a combined transcervical-transnasal approach to the posterior skull base, using the da Vinci Surgical System in 3 cadaver heads. Superb visualization of the sellar, suprasellar and clival regions was possible in all three specimens.

Efficacy and safety of ribosome-component immune modulator for preventing recurrent respiratory infections in socialized children.

Attending day care is associated with recurrent respiratory infections (RRIs) and asthma. Ribosomal immunotherapy may confer protection against RRIs in children. This study was designed to assess the efficacy of a ribosome-component immune modulator (RCIM) as preventive treatment of respiratory infections in socialized children aged ≤5 years, with or without a history of frequent RRI.

Recurrent acute rhinosinusitis: a single blind clinical study of N-acetylcysteine vs ambroxol associated to corticosteroid therapy.

The aim of rhinosinusitis treatment is to restore sinusal eutrophism and to normalize ventilation and mucociliary transport. Frequently the improvement of sinusal physiological conditions is associated with a reduction of infections and pulmonary symptoms. The treatment of these diseases often requires the combination of medical and surgical strategies.

A novel technique for tailoring frontal osteoplastic flaps using the ENT magnetic navigation system.

Conclusion: The ENT magnetic navigation system is potentially useful and offers the most accurate technique for harvesting frontal osteoplastic flaps. It represents a valid tool in the wide range of instruments available to rhinologists.

Objective: Precise delineation of the boundaries of the frontal sinus is a crucial step when harvesting a frontal osteoplastic flap.

The natural evolution of endoscopic approaches in skull base surgery: robotic-assisted surgery?

The current surgical trend is to expand the variety of minimally invasive approaches and, in particular, the possible applications of robotic systems in head and neck surgery. This is particularly intriguing in skull base regions. In this paper, we review the current literature and propose personal considerations on the role of robotic techniques in this field.

Sphenoid sinus fungus ball: our experience.

Background: Fungal rhinosinusitis is a common disease of the paranasal sinuses. The fungus ball (FB) is defined as an extramucosal mycotic proliferation that fills one or more paranasal sinuses. Sphenoid sinus is an uncommon localization of this disease, as reported in the literature.

Aerosol therapy with thiamphenicol glycinate: a retrospective study on efficacy and safety in a group of sixty-six oncological patients.

The purpose of this paper is to present the effectiveness of aerosol administration of TG in a group of oncological patients. Thiamphenicol is an antimicrobial agent active in the treatment of infection of different etiology and localisation due to its broad spectrum of antimicrobial activity as well as its pharmacokinetic properties. The data of the retrospective study analysis of the activity of TG, administered to oncological patients affected by infections of the respiratory tract, showed that TG administered alone or in association with other antibiotics was globally effective in more than 95% of patients.

Combined transoral transnasal robotic-assisted nasopharyngectomy: a cadaveric feasibility study.

Surgical management of the nasopharynx is complex. Both traditional and endoscopic transnasal techniques are demanding. Purely transoral robotic nasopharyngectomy has been described but it needs a palatal splitting and is performed with an inferior to superior perspective with a difficult vision of the upper regions.