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Current Challenges and Opportunities in Oto-Rhino-Laryngological Surgery
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Current Challenges and Opportunities in Oto-Rhino-Laryngological Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Otolaryngology".

Deadline for manuscript submissions: 20 June 2025 | Viewed by 7232

Special Issue Editors

Dr. Leonardo Franz

E-Mail Website
Guest Editor
Phoniatrics and Audiology Unit, Department of Neuroscience, University of Padova, 31100 Treviso, Italy
Interests: otology; neurotology; facial nerve disorders; laryngology; biological markers of head and neck cancers
Prof. Dr. Gino Marioni

E-Mail Website
Guest Editor
Phoniatrics and Audiology Unit, Department of Neuroscience, University of Padova, 31100 Treviso, Italy
Interests: otology; neurotology; vestibology; neuro-vestibology
Prof. Dr. Cosimo De Filippis

E-Mail Website
Guest Editor
Phoniatrics and Audiology Unit, Department of Neuroscience, University of Padova, 31100 Treviso, Italy
Interests: otology; cochlear implants; neurotology; hearing loss rehabilitation
Dr. Elisabetta Zanoletti

E-Mail Website
Guest Editor
Skull Base Unit, Otolaryngology Section, Department of Neuroscience, University of Padova, 35128 Padova, Italy
Interests: vestibular schwannoma; skull-base surgery; otology; neurotology; salivary gland tumors; temporal bone carcinomas
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In recent decades, the surgical perspectives of oto-rhino-laryngology has dramatically developed, pushing forward the technical limits and the indications of traditional ENT surgery. Along with the refinement of head and neck and otology procedures, the development of skull-base surgery, the spread of endoscopic techniques, and the application of computer-guided surgery paradigm have brought ENT surgeons to face more and more demanding challenges. Regardless of the subspeciality field, one of the most attractive issues in contemporary ENT surgery is the optimization of functional results, which has led the surgical paradigm to shift from the traditional disease-oriented approach to a more modern patient-oriented one.

The aim of this Special Issue is to showcase up-to-date evidence on the contemporary challenges in various fields of oto-rhino-laryngological surgery, focusing in particular on the optimization of functional results.

From this point of view, there is growing interest in identifying variables, new scales and associations between them to better analyze, both subjectively and objectively, the functional results of head and neck surgery.

Original papers from international leading groups, as well as review articles, focused on various surgical topics related to ENT subspecialities are welcome for submission.

Dr. Leonardo Franz
Prof. Dr. Gino Marioni
Prof. Dr. Cosimo De Filippis
Dr. Elisabetta Zanoletti
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • otolaryngology
  • surgery
  • otology
  • skull-base
  • head and neck
  • laryngology
  • rhinology

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Published Papers (4 papers)

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10 pages, 718 KiB  
Article
The Clinical and Surgical Characteristics of Parotid Tumors with Parapharyngeal Space Involvement—A Multicenter Experience of the Polish Salivary Network
by Dominik Stodulski, Bogusław Mikaszewski, Paweł Witkowski, Ewelina Bartkowiak, Wioletta Pietruszewska, Izabela Olejniczak, Jarosław Markowski, Aleksandra Piernicka-Dybich, Paweł Burduk, Małgorzata Wierzchowska, Joanna Czech, Katarzyna Radomska, Alicja Chańko, Daniel Majszyk, Antoni Bruzgielewicz, Patrycja Gazińska and Małgorzata Wierzbicka
J. Clin. Med. 2024, 13(15), 4574; https://doi.org/10.3390/jcm13154574 - 5 Aug 2024
Viewed by 1575
Abstract
Backgrounds/Objectives: Parotid gland tumors (PGTs) with parapharyngeal space (PPS) involvement have a specific clinical course and they can be a great challenge for surgeons, especially due to more difficult approaches and the risk of serious complications. The aim of this study is to [...] Read more.
Backgrounds/Objectives: Parotid gland tumors (PGTs) with parapharyngeal space (PPS) involvement have a specific clinical course and they can be a great challenge for surgeons, especially due to more difficult approaches and the risk of serious complications. The aim of this study is to present the characteristics of PGTs with PPS involvement. Methods: Retrospective, multicenter analysis of 1954 primary PGTs from 5 years (2017–2021) was performed. Comparative analysis was performed between groups with and without PPS involvement and included the following clinical and histopathological data: age, sex, place of residence, tumor size, FNAC result, percentage of malignant tumors, histological diagnosis, radicality of resection, and postoperative facial nerve (FN) dysfunction. Results: PPS involvement was found in 114 patients (5.83%). Secondary tumors affecting the deep lobe or the entire gland were predominant (46 and 60 cases, respectively). In a univariate analysis of tumors with and without PPS involvement, statistically significant differences were found in their size > 4 cm (12.97% vs. 37.72%), percentage of malignant tumors (7.12% vs. 17.55%), incidence of Warthin Tumors (WTs) (43.58% vs. 24.56%), percentage of R1 resection (5.53% vs. 12.50%), and rate of FN paresis (17.15% vs. 53.34%). Multivariate analysis showed that tumors with PPS involvement were statistically significantly characterized by larger size (tumors > 4 cm were 2.9 times more frequent), 2 times less frequent occurrence of WTs, and 1.6 times higher risk of FN paresis. Conclusion: PGTs with PPS involvement show certain clinical and histological differences and require more complex surgical accesses. Therefore, they cannot be treated as "ordinary" tumors occupying the deep lobe. Full article
(This article belongs to the Special Issue Current Challenges and Opportunities in Oto-Rhino-Laryngological Surgery)
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11 pages, 238 KiB  
Article
Age-Specific Differences in Laryngotracheal Trauma Characteristics: A Retrospective Study of Clinical Profiles, Outcomes, and Mortality Risk
by Ahmad K. Alnemare
J. Clin. Med. 2024, 13(12), 3508; https://doi.org/10.3390/jcm13123508 - 15 Jun 2024
Viewed by 801
Abstract
Background: Laryngotracheal trauma is associated with a substantial risk of mortality. Age can be a critical factor in trauma management, as older adults often have diminished airway protective reflexes and preexisting respiratory conditions. Objective: This study aimed to characterize the clinical profiles [...] Read more.
Background: Laryngotracheal trauma is associated with a substantial risk of mortality. Age can be a critical factor in trauma management, as older adults often have diminished airway protective reflexes and preexisting respiratory conditions. Objective: This study aimed to characterize the clinical profiles and outcomes in different age groups of adult patients with laryngotracheal trauma using data from the National Trauma Data Bank (NTDB). Methods: We retrospectively analyzed the NTDB and included adult patients (aged ≥ 18 years) who had laryngotracheal fractures (closed or open) and were admitted directly after the injury. The patients were categorized into different age groups for analysis. A multivariate logistic regression analysis was performed to assess whether the elderly population (age ≥ 65 years) was predisposed to post-trauma death under care. Results: The study included 1171 patients, with the following age distributions: 13.7% aged 18–24 years, 21.6% aged 25–34 years, 55.2% aged 35–64 years, and 9.6% aged ≥ 65 years. Notable differences were observed in comorbidities, mechanisms, types of injuries, and associated injuries among age groups. There was no significant trend in airway surgical outcomes according to age. In-hospital mortality was highest among patients aged ≥ 65 years (22.3%), compared to 14.4% for those aged 18–24 years. Regression analysis indicated that age ≥ 65 was an independent mortality predictor. Conclusions: These findings underscore significant age-related differences in the presentation and outcomes of laryngotracheal trauma, emphasizing the need for age-specific treatment protocols, primarily to address the elevated risk among elderly patients. Full article
(This article belongs to the Special Issue Current Challenges and Opportunities in Oto-Rhino-Laryngological Surgery)
13 pages, 2938 KiB  
Article
Facial Surface Electromyography: A Novel Approach to Facial Nerve Functional Evaluation after Vestibular Schwannoma Surgery
by Leonardo Franz, Gino Marioni, Antonio Daloiso, Elia Biancoli, Giulia Tealdo, Diego Cazzador, Piero Nicolai, Cosimo de Filippis and Elisabetta Zanoletti
J. Clin. Med. 2024, 13(2), 590; https://doi.org/10.3390/jcm13020590 - 19 Jan 2024
Cited by 3 | Viewed by 1738
Abstract
Background: Vestibular schwannoma (VS) surgery may cause facial nerve damage. However, a comprehensive evaluation of post-operative facial outcomes may be difficult to achieve. Surface electromyography (sEMG) is a promising non-invasive evaluation tool. However, its use in the follow-up after VS surgery has not [...] Read more.
Background: Vestibular schwannoma (VS) surgery may cause facial nerve damage. However, a comprehensive evaluation of post-operative facial outcomes may be difficult to achieve. Surface electromyography (sEMG) is a promising non-invasive evaluation tool. However, its use in the follow-up after VS surgery has not been reported yet. The main objective was to develop and validate a new sEMG application specifically for the post-VS surgery setting. Secondary goals were to provide a systematic description of facial muscle activity after VS surgery and assess the association between sEMG parameters and Sunnybrook scale scores. Methods: Thirty-three patients with facial palsy following VS surgery were included. The clinical outcomes (Sunnybrook symmetry, movement, and synkinesis scores) and sEMG parameters (signal amplitude normalized by the maximal voluntary contraction (NEMG) and sEMG synkinesis score (ESS, number of synkinesis per movement sequence)) were evaluated at the end of the follow-up. Results: In all tested muscles, NEMG variance was significantly higher on the affected side than the contralateral (variance ratio test, p < 0.00001 for each muscle). In total, 30 out of 33 patients (90.9%) showed an ESS ≥ 1 (median: 2.5, IQR: 1.5–3.0). On the affected side, NEMG values positively correlated with both dynamic and overall Sunnybrook scores (Spearman’s model, p < 0.05 for each muscle, except orbicularis oculi). ESS significantly correlated with the Sunnybrook synkinesis score (Spearman’s rho: 0.8268, p < 0.0001). Conclusions: We described and preliminarily validated a novel multiparametric sEMG approach based on both signal amplitude and synkinesis evaluation specifically for oto-neurosurgery. Large-scale studies are mandatory to further characterize the semiological and prognostic value of facial sEMG. Full article
(This article belongs to the Special Issue Current Challenges and Opportunities in Oto-Rhino-Laryngological Surgery)
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26 pages, 1544 KiB  
Systematic Review
Pott’s Puffy Tumor in Young Age: A Systematic Review and Our Experience
by Antonio Daloiso, Tiziana Mondello, Francesco Boaria, Enrico Savietto, Giacomo Spinato, Diego Cazzador and Enzo Emanuelli
J. Clin. Med. 2024, 13(21), 6428; https://doi.org/10.3390/jcm13216428 - 26 Oct 2024
Viewed by 2312
Abstract
Background: Pott’s Puffy Tumor (PPT) in young-age patients is a rare clinical entity characterized by osteomyelitis of the frontal bone with a subperiosteal abscess collection. Previous reviews primarily consist of small, retrospective case series and anecdotal reports. This study aims to present [...] Read more.
Background: Pott’s Puffy Tumor (PPT) in young-age patients is a rare clinical entity characterized by osteomyelitis of the frontal bone with a subperiosteal abscess collection. Previous reviews primarily consist of small, retrospective case series and anecdotal reports. This study aims to present the largest, most up-to-date systematic review of essential clinical findings, diagnostic modalities, microbiologic considerations, and treatment approaches for managing PPT in pediatric and adolescent populations. Methods: PubMed, Scopus, and Web of Science databases were systematically screened until 3 January 2024. The protocol of this investigation was registered on PROSPERO in January 2024, and the systematic review was performed according to the PRISMA statement. The study included 184 patients from 109 articles and an additional case from the authors’ institution. Results: PPT commonly stems from untreated rhinosinusitis, respectively, acute pansinusitis, frontal acute rhinosinusitis and chronic rhinosinusitis, and direct head trauma. Infections typically involve a polymicrobial anaerobe-predominant microbiome. Computed tomography and magnetic resonance imaging are routinely used for presurgical assessment and posttreatment surveillance. Intracranial complications were significantly associated with the type of surgical treatment (p value < 0.0001). Conclusions: PPT is a significant and relatively morbid disease often under-recognized and misdiagnosed due to its variable clinical presentation. Management includes both antimicrobial therapy and surgical intervention, emphasizing the importance of an interdisciplinary approach. Full article
(This article belongs to the Special Issue Current Challenges and Opportunities in Oto-Rhino-Laryngological Surgery)
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