Neck lymph node metastases from unknown primary.

Metastatic cervical carcinoma from unknown primary is a metastatic disease in the lymph nodes of the neck without any evidence of a primary tumour after appropriate investigation. The condition is rare and definite evidence is lacking for both diagnosis and treatment. In this review of the literature, we tried to draw some clinical indications based on the few available studies.

Development of an algorithm for the management of cervical lymphadenopathy in children: consensus of the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Society of Pediatric Infectious Diseases and the Italian Society of Pediatric Otorhinolaryngology.

Unlabelled: Cervical lymphadenopathy is a common disorder in children due to a wide spectrum of disorders. On the basis of a complete history and physical examination, paediatricians have to select, among the vast majority of children with a benign self-limiting condition, those at risk for other, more complex, diseases requiring laboratory tests, imaging and, finally, tissue sampling. At the same time, they should avoid expensive and invasive examinations when unnecessary.

The assessment of children with suspected laryngopharyngeal reflux: An Otorhinolaringological perspective.

The assessment of pediatric laryngopharyngeal reflux (LPR) is controversial. Otorhinolaryngologists may play a role in the evaluation of children with suspected LPR detecting typical airway endoscopic findings and/or associated diseases and may help in the selection of children to be subjected to further instrumental tests. In this perspective the present review aims at examining the available evidence in the literature regarding the assessment of LPR in children.

Drug induced sleep endoscopy in the decision-making process of children with obstructive sleep apnea.

Tonsillectomy and adenoidectomy (T&A) is currently recommended in children with Obstructive Sleep Apnea (OSA). However, the condition persists after surgery in about one third of cases. It has been suggested that Drug Induced Sleep Endoscopy (DISE) may be of help for planning a more targeted and effective surgical treatment but evidence is yet weak.

Nasopharyngeal tonsils (adenoids) contain extrathymic corticothymocytes.

Adenoidal tissue (also known as nasopharyngeal tonsils) of 58% of humans in the pediatric age group contains immature T-lymphoid cells with the phenotype of thymocytes (TdT+, CD1abc+, cytoplasmic CD3+, coexpressing CD4 and CD8, lacking an Intraepithelial Lymphocyte-associated phenotype). The notable difference in comparison to palatine tonsils is the clustering in groups and sheets, comprising hundreds or thousands of cells (1.7%±0.

Risk of recurrence in children operated for thyroglossal duct cysts: A systematic review.

Purpose: To determine the rate of recurrence following surgical treatment of thyroglossal duct cysts (TDGCs) in children.

Methods: A search of electronic databases (Pubmed and MEDLINE) was performed in order to identify studies concerning surgical treatment of TGDCs in children published between 1980 and 2012. The following terms were used: "thyroglossal duct cysts", "recurrent", "recurrence", "children", "pediatric".

Intratympanic steroid treatment for sudden deafness: a meta-analysis of randomized controlled trials.

Background: The efficacy of intratympanic steroid (ITS) treatment in sudden deafness (SD) remains controversial. To shed light on this issue, we performed a systematic review of randomized controlled trials to assess the overall efficacy of ITS therapy and to clarify whether it is more suitable as a first-line approach (primary treatment) or as a salvage treatment when traditional systemic agents have failed.

Methods: An electronic database search (MEDLINE and PubMed) was performed with the objective of identifying all studies published in the English language between January 1980 and November 2011 on the efficacy of ITS in the treatment of SD.

Lymphomas of head and neck in pediatric patients.

Cancer among children is relatively uncommon, with approximately 1 in 7,000 children 0 to 14 years of age being newly diagnosed each year in the United States, and Hodgkin and non-Hodgkin's lymphomas constitute 10-15% of all childhood cancers in the more developed countries, after acute leukemias and brain tumors. The diagnosis of lymphoma frequently involves otolaryngologists that play also an important role in the its management. A high index of suspicion for lymphoma as a cause of complaints in the head and neck region can lead an early diagnosis and improved outcome for lymphomas.

Nasal lavage in pregnant women with seasonal allergic rhinitis: a randomized study.

Background: Nasal rinsing appears particularly suitable in the management of pregnant women with seasonal allergic rhinitis since no deleterious effects on the fetus are to be expected. However, to date, no studies have specifically investigated this option.

Methods: Pregnant women with seasonal allergic rhinitis were randomized to intranasal lavage with hypertonic saline solution 3 times daily (n = 22) versus no local therapy (n = 23) during a 6-week period corresponding to the pollen season.

Effectiveness of adenotonsillectomy in PFAPA syndrome: a randomized study.

Objective: To evaluate whether adenotonsillectomy leads to complete resolution in children with PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) syndrome.

Study Design: Thirty-nine children with PFAPA syndrome were randomized to either adenotonsillectomy (surgery group; n = 19) or expectant management (control group; n = 20). All patients were then invited prospectively to record all PFAPA episodes, and were evaluated clinically every 3 months for 18 months after randomization.

MAP kinase modulation in squamous cell carcinoma of the oral cavity.

Background: Oral squamous cell carcinoma (OSCC) represents the sixth most diffused cancer in developed countries. Mitogen-activated protein kinases (MAPKs) are proteins which transduce a vast array of extracellular signals into intracellular responses. The role of MAPK signalling pathway in cancer is not completely understood.

Prognostic influence of gender in patients with oral tongue cancer.

Objectives: The purpose of this study was to evaluate the independent role of gender in affecting prognosis in patients with anterior tongue cancer.

Design: Patients recorded in the head and neck cancer registry of Milano-Bicocca School of Medicine between January 1981 and December 1998 were reviewed. Female patients with squamous cell carcinoma of the tongue were identified and matched to men for year of diagnosis, age, TNM classification, histologic grading, and treatment modalities.

Oral tongue cancer in young patients: a matched analysis.

Previous studies on squamous cell carcinoma of the tongue have reported conflicting results with respect to age and prognosis. The aim of this study is to elucidate if any differences in outcome exist between patients younger and older than 40 years. A case-control study was performed.

Selective reduction of extracellular signal-regulated protein kinase (ERK) phosphorylation in squamous cell carcinoma of the larynx.

Mitogen-activated protein kinase (MAPK) cascades transmit and amplify signals involved in cell proliferation as well as in cell death. In this study, the potential derangement of MAPK pathways has been evaluated in human squamous cell carcinomas (SCC) of the larynx. The expression and activity of the MAPK p38, ERK1/2p44/p42 and JNK/SAPKp46/p54 have been investigated by immunoblot analysis of tissue homogenates in 27 samples of primary laryngeal cancer and in 27 paired non-neoplastic laryngeal mucosa.

Risk factors for distant metastases in head and neck squamous cell carcinoma.

Objectives: To evaluate the frequency of distant metastases (DM) and to determine the ability of certain clinical and pathologic factors to predict the development of distant metastases.

Design: Retrospective analysis.

Setting: University hospital.

Incidence of inverted papilloma in recurrent nasal polyposis.

Objectives: A diagnosis of inverted papilloma in apparently normal bilateral polyps is a possible albeit rare event. The frequency of this diagnosis varies between 0.00% and 0.

Expression of cell cycle regulatory proteins and analysis of apoptosis in normal nasal mucosa and in nasal polyps.

Background: The etiopathogenesis of nasal polyps still is to be clarified. Although hyperplasia is a typical feature of these pathological processes, little attention has been paid to specific aspects of cellular growth in polyps. We have evaluated the expression and localization of some of the regulatory proteins that direct the cell through the specific sequence of events culminating in mitosis or apoptosis in nasal polyps.

Histopathology of routine nasal polypectomy specimens: a review of 2,147 cases.

Objectives: There is controversy about whether all nasal polyps removed at operation should be sent for histopathologic examination. The primary aim of this study was to assess the incidence of unsuspected clinically relevant diagnoses in a large series of patients undergoing nasal polypectomy. A review of the literature on the frequency of this event was also performed.

Nasal rinsing with hypertonic solution: an adjunctive treatment for pediatric seasonal allergic rhinoconjunctivitis.

Background: Recent but limited evidence suggests that nasal lavage with hypertonic saline may be useful as an adjunctive treatment modality in the management of pediatric allergic rhinitis. The aim of this study was to clarify whether nasal irrigation with hypertonic solution should be routinely recommended to children with seasonal grass pollen rhinoconjunctivitis.

Methods: Fourty-four children with seasonal grass pollen rhinoconjunctivitis were recruited.

Reversed ipsilateral acoustic reflex: a study on subjects treated with muscle relaxants.

Objectives: To rule out any possible involvement of the middle ear muscles in the genesis of the reversed ipsilateral acoustic reflex (RIAR).

Design: Prospective study to evaluate the effects of muscle relaxants on the RIAR of otosclerotic ears as well as on the acoustic reflex of individuals with normal middle ear function. Admittance recording during ipsilateral acoustic stimulation was performed in patients undergoing pharmacological treatment for surgical procedures.

Incidence of unexpected malignancies in routine tonsillectomy specimens in children.

Objectives: Controversy continues to exist regarding the necessity to routinely send for histologic examination those specimens obtained after tonsillectomy with or without adenoidectomy in children. Otolaryngologists fear missing an unsuspected diagnosis, such as a tonsil malignancy. However, given the rare incidence of this event, the cost-effectiveness ratio of routine microscopic analysis is questionable.

Hypersaline nasal irrigation in children with symptomatic seasonal allergic rhinitis: a randomized study.

Recent evidence suggests that nasal irrigation with hypertonic saline may be useful as an adjunctive treatment modality in the management of many sinonasal diseases. However, no previous studies have investigated the efficacy of this regimen in the prevention of seasonal allergic rhinitis-related symptoms in the pediatric patient. Twenty children with seasonal allergic rhinitis to Parietaria were enrolled in the study.