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Advances in Minimally Invasive Otolaryngology: Precision Techniques and Functional Outcomes

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Special Issue Editors

Dr. Giovanni Colombo

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Guest Editor

Otorhinolaryngol Head & Neck Department, Legnano Hospital, ASST Ovest Milanese, Legnano, 20025 Milan, Italy
Interests: otolaryngology; sinus surgery; skull base surgery; otoneurosurgery; exoscope; endoscopic surgery; nasal polyposis

Dr. Matteo Di Bari

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Guest Editor

Otorhinolaryngol Head & Neck Department, Legnano Hospital, ASST Ovest Milanese, Legnano, 20025 Milan, Italy
Interests: otolaryngology; otoneurosurgery; ear surgery; exoscope; cholesteatoma; otosclerosis; cochlear implant

Special Issue Information

Dear Colleagues,

Otolaryngology has entered a new era of technological and conceptual innovation. Rapid progress in surgical platforms and tools, imaging modalities, and functional rehabilitation strategies is transforming patient care across ear, sinonasal, and head and neck disorders. These developments reflect the growing need for precision, safety, and measurable improvements in quality of life.

This Special Issue aims to showcase recent advances and future directions in otolaryngology, highlighting how novel techniques and functional outcome monitoring contribute to more effective and patient-centered care. By encouraging interdisciplinary contributions, the Special Issue will provide a broad yet focused overview of the evolving landscape of surgical and non-surgical management in our specialty.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following:

New surgical and diagnostic techniques in otology, rhinology, and head and neck surgery;
Emerging technologies such as endoscopic, exoscopic, and robotic platforms;
Novel implants and grafts in otology, rhinology, and skull base surgery;
Functional outcome monitoring, including hearing, olfaction, swallowing, voice, and sleep disorders.

We look forward to receiving your contributions.

Dr. Giovanni Colombo
Dr. Matteo Di Bari
Guest Editors

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Research

14 pages, 1192 KB

Open AccessArticle

Global Variations in Surgical Techniques and Postoperative Care for Radial Forearm Free Flap (RFFF) in Head & Neck Surgery: A Cross-Sectional International Survey

by Elena Russo, Andrea Costantino, Giannicola Iannella, Filippo Marchi, Antonio Greco, Luca Calabrese, Antonella Polimeni, Remo Accorona, Armando De Virgilio and RFFFSurv Collaborative

J. Clin. Med. 2025, 14(22), 8023; https://doi.org/10.3390/jcm14228023 - 12 Nov 2025

Viewed by 458

Abstract

Objective: This cross-sectional survey aimed to comprehensively gather data on radial forearm free flap (RFFF) utilization and practices in head and neck reconstructive surgery. Methods: An online questionnaire was organized into seven sections: demographics, surgeon experience, harvesting techniques, microsurgical considerations, postoperative care, flap monitoring, and outcomes. It was distributed by email to 216 head and neck reconstructive surgeons who attended the International Federation of Head and Neck Oncologic Societies (IFHNOS) congress in Rome (21–25 June 2023) using the congress mailing list. Responses were collected from 54 surgeons (25% response rate), representing 15 countries across Europe, Asia, the Americas, and Oceania, underscoring the international scope of the survey between 5 February and 25 March 2024. The questionnaire was not formally piloted or validated. Missing data were managed on a per-question basis. Descriptive statistics were used, and 95% confidence intervals (CIs) were calculated for key surgical outcomes to indicate estimate precision. Associations between categorical variables were analyzed using Pearson’s χ² test with Cramér’s V as an effect size, and relationships between continuous variables were examined using Spearman’s rank correlation (ρ) with 95% confidence intervals (CIs). Given the exploratory design and limited sample size, no correction for multiple comparisons was applied, and the risk of both Type I and Type II errors was acknowledged. Results: Variations were observed in harvesting techniques, microsurgical preferences, and postoperative care protocols. Most surgeons initiated flap harvesting concurrently with tumor resection, primarily preserving superficial sensory nerves. Regarding venous outflow, 50% of respondents preferred the cephalic vein, 19% used comitant veins, and 29% utilized both systems when possible. Perioperative antibiotic use was standard practice, though anticoagulant preferences and flap monitoring methods varied. The study achieved a high success rate for RFFF procedures, exceeding 95%, with venous thrombosis identified as the main cause of flap failure. No significant correlations were found between flap failure rate and training method (p = 0.21), specialty (p = 0.37), annual number of RFFF procedures (p = 0.89), surgeon age (p = 0.42), or hospital type (p = 0.48). Effect sizes were small to moderate, indicating weak or negligible associations. Similarly, perioperative factors such as anticoagulant use (p = 0.84), preoperative antibiotics (p = 0.42), surgical instruments (p = 0.61), suture techniques (p = 0.51), and donor vein selection (p = 0.20) showed no statistically significant associations with flap loss. Patient satisfaction assessments were inconsistent, with only 39% of surgeons routinely performing them. Conclusions: The study provides valuable insights into current RFFF practices and outcomes across an international cohort of head and neck surgeons, highlighting patterns and variability in techniques, perioperative care, and monitoring strategies. Full article

(This article belongs to the Special Issue Advances in Minimally Invasive Otolaryngology: Precision Techniques and Functional Outcomes)

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14 pages, 686 KB

Open AccessFeature PaperArticle

Submucosal Mitomycin C Injection in the Endoscopic Treatment of Laryngotracheal Stenosis: Experience of a Tertiary Center

by Elena Russo, Luca Canali, Luca Cerri, Giuseppe Mangiameli, Umberto Cariboni, Giuseppe Marulli, Giuseppe Spriano, Giorgio Maria Ferraroli and Armando De Virgilio

J. Clin. Med. 2025, 14(22), 8022; https://doi.org/10.3390/jcm14228022 - 12 Nov 2025

Viewed by 564

Abstract

Background/Objectives: To assess the safety and efficacy of submucosal mitomycin C (MMC) injection as an adjunct in patients undergoing endoscopic treatment for laryngotracheal stenosis (LTS). Methods: All patients affected by LTS receiving endoscopic treatment with adjuvant MMC were screened and selected from a retrospective database spanning from May 2022 to July 2023 at IRCCS Humanitas Research Hospital (Rozzano, Italy). Demographic data, bronchoscopic findings, and treatment-related outcomes were recorded and analyzed. Results: A total of 16 patients were included in the study. Subglottic stenosis was the most common condition, occurring in 88.9% of cases. All procedures were completed safely without intraoperative or postoperative complications or conversion to open surgery. Re-stenosis occurred in 6 (37.5%) cases, with a median time to recurrence of 136.5 (±43.9) days, requiring additional treatments. At last follow-up, all included patients were asymptomatic, except for two who reported mild dyspnea. Conclusions: Submucosal MMC injections represent a safe and promising delivery method in the endoscopic treatment of LTS and may provide a more durable effect on the stenosis reducing the risk of recurrence. Further prospective studies are needed to evaluate MMC’s effectiveness and develop standardized treatment protocols. Full article

(This article belongs to the Special Issue Advances in Minimally Invasive Otolaryngology: Precision Techniques and Functional Outcomes)

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