Current Trends in Otorhinolaryngology and Head and Neck Pathology: 2nd Edition

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Surgery".

Deadline for manuscript submissions: closed (31 March 2025) | Viewed by 20544

Special Issue Editors


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Guest Editor
ENT Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Interests: imaging; allergy; rhinology and skullbase; treatment of ENT pathology; interdisciplinary management into current practice; implants in ENT and head and neck pathology; sleep medicine
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E-Mail Website
Guest Editor
ENT Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Interests: oncology—head and neck surgery; artificial intelligence; interdisciplinary management into current practice; rhinology; allergy
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Chief of the Department of ORL & HNS, Istanbul Medeniyet University, Istanbul, Turkey
Interests: ENT pathology treatment; imaging ENT; sleep apnea; allergy; implants in ENT and head and neck pathology; artificial intelligence; cochlear implant; ear surgery
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
ENT Department, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Tirgu Mures, Romania
Interests: ENT pathology; imaging modalities; sleep apnea and quality of life; allergic reactions; implants in ENT and head and neck pathology; cochlear implants; ear surgery; artificial intelligence; translation of interdisciplinary management into current practice
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are grateful to you for submitting your valuable original articles to the previous Special Issue, ‘Current Trends in Otorhinolaryngology and Head and Neck Pathology’, which undeniably benefited the research community. In light of this success, we now present you the second edition of this Special Issue.

The incidence and prevalence rate of various pathologies of otorhinolaryngology and head and neck-related issues worldwide have increased substantially, with many of the conditions’ development being overlooked during the COVID-19 pandemics. In recent years, new directions in this medical branch have emerged, such as surgery of the skull base and infratemporal fossa, neuronavigation systems in rhinosinusal endoscopic surgery, new techniques of neck dissection that takes into account the cervical lymph nodes’ role in the immune system, modified protocols in HPV-positive cancer of head and neck, the use of biologics in chronic rhinosinusitis with nasal polyposis, electric hypoglossal stimulation in sleep apnea syndrome, and new advancements in cochlear implantation. Additionally, artificial intelligence systems are also being integrated into treatments to prevent the risks in head and neck surgery, thereby proving that an interdisciplinary approach is the key to solve complex cases.

In this Special Issue, we welcome submissions of manuscripts, including original articles, reviews and selected rare case series, reflecting the current trends and new directions in otorhinolaryngology and head and neck surgery. We hope this will increase the knowledge on the numerous pathologies that contribute to the high complexity of ENT&HNS and help to update the protocols and connect specialties worldwide in the aftermath of the COVID-19 pandemic.

Prof. Dr. Codrut Sarafoleanu
Dr. Daniela Vrinceanu
Prof. Dr. Mahmut Tayyar Kalcioglu
Dr. Adriana Neagos
Guest Editors

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Keywords

  • otorhinolaryngology
  • head neck
  • pathology
  • imaging
  • surgery
  • treatment
  • oncology
  • apnea
  • allergy
  • artificial intelligence
  • interdisciplinary
  • ear
  • cochlear implant

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Related Special Issue

Published Papers (9 papers)

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Research

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14 pages, 1324 KiB  
Article
A Clinical Evaluation of Calcium and Fluoride Supplementation for Tinnitus in Non-Surgical Otosclerosis: Insights from a Tertiary Care Center in Romania
by Andrei Osman, Alice Elena Ghenea, Ovidiu Mircea Zlatian, Lidia Boldeanu, Irina Enache, Madalina Gabriela Georgescu and Carmen Aurelia Mogoanta
Medicina 2025, 61(4), 569; https://doi.org/10.3390/medicina61040569 - 23 Mar 2025
Viewed by 587
Abstract
Background and Objectives: The management of chronic tinnitus in patients with otosclerosis presents a considerable clinical challenge, particularly as to those who are either ineligible for or reluctant to undergo surgical interventions. Surgical interventions improve hearing levels and may provide relief from [...] Read more.
Background and Objectives: The management of chronic tinnitus in patients with otosclerosis presents a considerable clinical challenge, particularly as to those who are either ineligible for or reluctant to undergo surgical interventions. Surgical interventions improve hearing levels and may provide relief from tinnitus; however, medical research is also focused on alternative non-surgical treatments aimed at symptomatic improvement. This is particularly relevant, considering that otosclerosis currently has no definitive cure, despite the existence of various surgical techniques and oral therapies. This study evaluates the effects of oral calcium and fluoride supplementation on tinnitus severity in otosclerosis patients who opted for non-surgical management. Materials and Methods: A total of 128 otosclerosis patients with tinnitus were included in this study, which was conducted over a five-year period. Patients were categorized into three groups based on the severity of their tinnitus (mild, moderate and severe), as assessed by the Tinnitus Handicap Inventory (THI). Patients in all three groups received Florical (Mericon Industries, Inc., Peoria, IL, USA), a calcium and fluoride supplement, and were monitored over three months. The severity of tinnitus was reassessed following supplementation. Statistical analyses were conducted to further investigate patient scores. Results: Evaluating patients based on the severity of their tinnitus, we consistently observed clinically significant reductions in THI scores, specifically a decrease of 10 points or more, among those with mild tinnitus. The moderate group exhibited a lower degree of reduction in their THI scores, while the severe group appeared to be unaffected. Statistical analyses reveal a significant correlation between the reduction of tinnitus and the supplementation of Florical, as the severity of tinnitus decreases. Conclusions: The present study suggests that oral calcium and fluoride supplementation may serve as a promising non-surgical approach for tinnitus management in otosclerosis (particularly in patients with mild symptoms), in addition to its marketing-indicated role, supporting the preservation of hearing levels in otosclerosis. Its efficacy seems to diminish as tinnitus severity increases, further pointing out a potential preventative role of this supplementation. Full article
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13 pages, 1187 KiB  
Article
A Double-Blinded Randomized Controlled Trial: Can Pulsed Electromagnetic Field Therapy Be a Novel Method for Treating Chronic Rhinosinusitis?
by Nessrien Afify Abed Elrashid, Olfat Ibrahim Ali, Zizi M. Ibrahim, Mohammed A. El Sharkawy, Bodor Bin sheeha and Wafaa Mahmoud Amin
Medicina 2024, 60(11), 1868; https://doi.org/10.3390/medicina60111868 - 14 Nov 2024
Viewed by 2312
Abstract
Background and Objectives: Pulsed electromagnetic field (PEMF) therapy offers a promising approach to treating inflammatory diseases. Its notable anti-inflammatory and antimicrobial effects and enhancement of microcirculation in the nasal mucosa make it a valuable treatment option. Despite its potential, the use of [...] Read more.
Background and Objectives: Pulsed electromagnetic field (PEMF) therapy offers a promising approach to treating inflammatory diseases. Its notable anti-inflammatory and antimicrobial effects and enhancement of microcirculation in the nasal mucosa make it a valuable treatment option. Despite its potential, the use of PEMF for chronic rhinosinusitis (CRS) is still in its early stages, with limited exploration of its effectiveness. This study aimed to assess the impact of PEMF on alleviating symptoms such as fatigue, headaches, sinus opacifications, and ostiomeatal complex issues associated with CRS. Materials and Methods: Forty-seven patients of both genders with CRS, aged 19 to 40 years, were involved in this study. The participants were randomly assigned to either a magnetic or a control group. The magnetic group underwent a 10 min PEMF session with a 20-gauss magnetic field strength at 7 Hz thrice a week for a month. The control group received the same PEMF application as an inactive device. Before and after the intervention, researchers assessed fatigue levels with a visual analog fatigue scale (VAFS), headache intensity via a numerical pain-rating scale, and the status of sinus opacifications and ostiomeatal complex obstructions by computerized tomography (CT). Results: The study findings showed a significant reduction in fatigue and headache scores in the magnetic group compared to the control group (p < 0.05). Additionally, there was a notable improvement in sinus opacifications and ostiomeatal complex obstructions among participants who received PEMF therapy. Conclusions: PEMF therapy effectively reduces fatigue, headaches, and sinus opacifications in CRS patients, suggesting its potential for inclusion in CRS management guidelines to improve patient outcomes and quality of life. The results of this study indicate that PEMF represents a noninvasive and cost-effective approach for treating adults with mild-to-moderate CRS. Full article
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12 pages, 5398 KiB  
Article
Biomarker Profiles and Clinicopathological Features in Head and Neck Squamous Cell Carcinoma Patients
by Timea Szatmari, Simona Mocan, Cristian Mircea Neagos and Zsuzsanna Pap
Medicina 2024, 60(10), 1681; https://doi.org/10.3390/medicina60101681 - 14 Oct 2024
Cited by 3 | Viewed by 1351
Abstract
Background and Objectives: Head and neck squamous cell carcinomas (HNSCCs) vary significantly in terms of invasiveness, growth rate, and metastatic potential. This study aimed to investigate the expression of several prognostic biomarkers (Ki67, p53, EGFR, COX-2, Cx43, and p16) in HNSCC from various [...] Read more.
Background and Objectives: Head and neck squamous cell carcinomas (HNSCCs) vary significantly in terms of invasiveness, growth rate, and metastatic potential. This study aimed to investigate the expression of several prognostic biomarkers (Ki67, p53, EGFR, COX-2, Cx43, and p16) in HNSCC from various anatomical regions and to correlate these expressions with clinicopathological parameters. Materials and Methods: We performed immunohistochemistry on 91 histologically verified HNSCC cases from the County Emergency Hospital, Targu Mures. Biomarker expression for Ki67, COX-2, and Cx43 was assessed using a standard immunoexpression scoring system: S1: 0–10%, S2: 11–25%, S3: 26–50%, S4 > 50%; EGFR was scored based on membrane staining intensity: 0, 1+, 2+, 3+; we classified p16 as positive or negative; p53 was grouped into mutant and wild-type; and we compared these across histopathological types, tumor grades, anatomical locations, gender, and different age groups. We performed a comparative analysis of Cx43 expression levels in relation to the expression of the rest of the markers. Statistical analysis was conducted using GraphPad InStat 3 software, version 3.06 (GraphPad Software Inc., San Diego, USA). Results: The majority of tumors were in males (95.6%) aged 51–60 years. Mutant p53 expression was prevalent in most cases. Elevated Ki67 and EGFR expression were associated with more aggressive tumors. COX-2 levels varied, with a higher proportion of moderate and high immunoexpression (S3 + S4) observed in patients under 70 years old. Cx43 expression was generally low, especially in extralaryngeal tumors. Conclusions: HNSCC primarily affects older males, with the larynx being the most common site. High levels of Ki-67 and EGFR suggest more aggressive tumors, while low COX-2 levels reflect varying prognoses. Women may develop more aggressive tumors, and extralaryngeal tumors often present with more challenging prognoses. Low Cx43 expression may be more likely to coincide with higher Ki67 and COX-2 levels, possibly indicating a link with more aggressive tumor behavior. Full article
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13 pages, 1644 KiB  
Article
The Effectiveness of Biological Agents on Chronic Rhinosinusitis with Nasal Polyposis in Patients with Comorbid Asthma: A Multicenter Real-Life Study from Türkiye
by Meryem Demir, Ceyda Tunakan Dalgic, Emine Nihal Mete Gokmen, Recep Savas, Suleyman Eroglu, Guzin Ozden, Cihan Orcen, Gulden Pacaci Cetin, Bahar Arslan, Ferda Bilgir, Gokten Bulut, Nurullah Yekta Akcam, Semiha Ozgul, Pamir Cerci, Raif Coskun, Sercan Gode, Insu Yilmaz and Aytul Zerrin Sin
Medicina 2024, 60(3), 448; https://doi.org/10.3390/medicina60030448 - 8 Mar 2024
Cited by 3 | Viewed by 2057
Abstract
Background and Objectives: Real-life data on the efficacy of biologic agents (BAs) on asthma-comorbid CRSwNP are needed. Our primary goal is to investigate the effects of BAs on CRSwNP symptoms, as well as endoscopic and tomography scores. Our secondary goal is to [...] Read more.
Background and Objectives: Real-life data on the efficacy of biologic agents (BAs) on asthma-comorbid CRSwNP are needed. Our primary goal is to investigate the effects of BAs on CRSwNP symptoms, as well as endoscopic and tomography scores. Our secondary goal is to show a reduction in the frequency of acute sinusitis exacerbations and the need for surgery. Materials and Methods: We conducted a multicenter, retrospective, real-life study. We screened the patients with asthma-comorbid CRSwNP treated with omalizumab or mepolizumab. A total of 69 patients (40 F/29 M; omalizumab n = 55, mepolizumab n = 14) were enrolled. We compared the visual analog scale (VAS), sinonasal outcome test-22 (SNOT-22), nasal congestion score (NCS), Lund–Mackay computed tomography score (LMS), and total endoscopic polyp scores (TPS) before and after BAs. We evaluated the endoscopic sinus surgery (ESS) and acute exacerbations of chronic rhinosinusitis (AECRS) frequencies separately, according to the BAs. Results: The overall median (min–max) age was 43 (21–69) years. The median (min–max) of biologic therapy duration was 35 (4–113) months for omalizumab and 13.5 (6–32) for mepolizumab. Significant improvements were seen in VAS, SNOT-22, and NCS with omalizumab and mepolizumab. A significant decrease was observed in TPS with omalizumab [95% CI: 0–4] (p < 0.001), but not with mepolizumab [95% CI: −0.5–2] (p = 0.335). The frequency of ESS and AECRS were significantly reduced with omalizumab [95% CI: 2–3] (p < 0.001) and [95% CI: 2–5] (p < 0.001); and mepolizumab [95% CI: 0–2] (p = 0.002) and [95% CI: 2–8.5] (p < 0.001), respectively. There was no significant difference in LMS with either of the BAs. Conclusions: Omalizumab and mepolizumab can provide a significant improvement in the sinonasal symptom scores. BAs are promising agents for CRSwNP patients with frequent exacerbations and multiple surgeries. Full article
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Review

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22 pages, 3762 KiB  
Review
Management of Deep Neck Infection Associated with Descending Necrotizing Mediastinitis: A Scoping Review
by Bogdan Mihail Cobzeanu, Liliana Moisii, Octavian Dragos Palade, Mihai Ciofu, Florentina Severin, Mihai Dumitru, Luminita Radulescu, Cristian Martu, Mihail Dan Cobzeanu and Geanina Bandol
Medicina 2025, 61(2), 325; https://doi.org/10.3390/medicina61020325 - 12 Feb 2025
Cited by 1 | Viewed by 2687
Abstract
Deep neck infection is a pathology at the border of two specialties, otorhinolaryngology and maxillofacial surgery, and represents a medico-surgical emergency. In terms of its evolution, it can extend to the level of the thorax and result in mediastinitis, with difficult evolution and [...] Read more.
Deep neck infection is a pathology at the border of two specialties, otorhinolaryngology and maxillofacial surgery, and represents a medico-surgical emergency. In terms of its evolution, it can extend to the level of the thorax and result in mediastinitis, with difficult evolution and poor prognosis. The aims of this scoping review are to present the etiology, bacteriology, clinical manifestations, and diagnostics, as well as treatment, in light of the research published in the last 5 years on deep neck infection associated with descending necrotizing mediastinitis. The most common primary sources of deep neck infection are odontogenic and tonsillar. The other sources that are involved in deep neck infection are salivary glands, foreign bodies, malignancies, and iatrogenic causes after endoscopic maneuvers. The bacteriologic aspect is polymorphic, including both aerobic and anaerobic species. Complications that may appear include jugular vein thrombosis, airway obstruction, acute respiratory distress syndrome, sepsis, and disseminated intravascular coagulation. Timely diagnosis is important for ensuring the positive evolution of a deep neck infection. A CT scan is important for characterizing the nature of a deep neck lesion and identifying the spaces involved, and this method represents the gold standard for diagnosis of these lesions. Following the establishment of a definitive diagnosis, antibiotic therapy is initiated empirically, and is modified according to bacteriological exam results. The administration of antibiotics is an essential part of the treatment strategy for patients with a deep neck infection. Based on CT results, different surgical methods are applied under general anesthesia. The surgical strategy involves opening and draining the cervical spaces and debriding the necrotic tissue. In the cases of odontogenic causes, drainage and extraction of the infected teeth are performed. It is especially important to follow up on the dynamic progression of the patient. In the management of a deep neck infection associated with descending necrotizing mediastinitis, a multidisciplinary team is necessary. Full article
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16 pages, 3314 KiB  
Review
Ocular Movement Examination in Peripheral Vestibular Disorders as a Tool to Improve Diagnosis: A Literature Review
by Gabriela Cornelia Musat, Calin Petru Tataru, Ovidiu Musat, Mihai Alexandru Preda, Mihnea Radu, Andreea Alexandra Mihaela Musat and Mihaela Roxana Mitroi
Medicina 2024, 60(10), 1665; https://doi.org/10.3390/medicina60101665 - 11 Oct 2024
Cited by 1 | Viewed by 2689
Abstract
Background and Objectives: This study reviews the current literature on ocular movements, specifically focusing on nystagmus associated with peripheral vestibular disorders, to enhance diagnostic accuracy. The evaluation of ocular movements, particularly nystagmus, provides essential insights into the function and dysfunction of the [...] Read more.
Background and Objectives: This study reviews the current literature on ocular movements, specifically focusing on nystagmus associated with peripheral vestibular disorders, to enhance diagnostic accuracy. The evaluation of ocular movements, particularly nystagmus, provides essential insights into the function and dysfunction of the vestibular system, helping clinicians distinguish between peripheral and central causes of vertigo and imbalance. Materials and Methods: A comprehensive search of PubMed was conducted using key terms such as “ocular movements”, “nystagmus”, “vestibular nystagmus”, and “peripheral vestibular disorders”. Results: The search yielded 2739 titles, and after a rigorous selection process, 52 articles were reviewed in full. Discussion: The review highlights different classifications and types of nystagmus, including physiological and pathological forms, and their diagnostic relevance in vestibular disorders such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, and Meniere’s disease. Diagnostic techniques like video/electro-oculography are emphasized for their role in assessing vestibular function and identifying abnormalities. The study underscores the importance of detailed ocular examination in the diagnosis of peripheral vestibular disorders and proposes an algorithm to aid this process. Conclusions: While not a systematic review, this study highlights the importance of detailed ocular examination in diagnosing peripheral vestibular disorders and presents an algorithm to facilitate this process. It also emphasizes the need for continued research and advancements in vestibular medicine to further understand ocular movements and their clinical significance, ultimately contributing to improved patient outcomes. Full article
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17 pages, 376 KiB  
Review
Paragangliomas of the Head and Neck: A Review of the Latest Diagnostic and Treatment Methods
by Dragos Octavian Palade, Razvan Hainarosie, Adina Zamfir, Daniela Vrinceanu, Mihaela Pertea, Mihail Tusaliu, Florin Mocanu and Catalina Voiosu
Medicina 2024, 60(6), 914; https://doi.org/10.3390/medicina60060914 - 30 May 2024
Cited by 7 | Viewed by 3885
Abstract
Background and objectives: Paragangliomas of the head and neck are rare, slow-growing neuroendocrine tumors, benign in their vast majority, but with a possibility of developing distant metastases. They show great inheritable character, and their behavior has proven to be unpredictable; therefore, they [...] Read more.
Background and objectives: Paragangliomas of the head and neck are rare, slow-growing neuroendocrine tumors, benign in their vast majority, but with a possibility of developing distant metastases. They show great inheritable character, and their behavior has proven to be unpredictable; therefore, they are considered malignant. Material and methods: This article aims to offer a more comprehensive presentation of the pathogenesis, epidemiology, diagnostic methods, imaging development, and treatment guidelines. We tried to bring together all the necessary data that, in our opinion, a head and neck practitioner should know when managing this type of tumor. Our main focus is on the most recent studies, with the purpose of a homogenous presentation of all current guidelines and approaches to this pathology. Results: Paragangliomas of the head and neck are still a disputed topic. One of the main reasons for that is their low incidence of 0.3 to 1 per 100,000 every year. The most frequent locations are the carotid body, the temporal bone, the jugular and mastoid foramen, and the vagal nerve. Their clinical presentation usually involves a painless lateral mass associated with symptoms such as hoarseness, hearing loss, tinnitus, and cranial nerve deficits. Up to 40% of them are inherited, mostly linked with mutations of succinate dehydrogenase complex. Imaging evaluation consists of CT and MRI, and new functional explorations such as 18F-FDA and 18F-FDG PET/CT, 18F-DOPA PET, 123I-MIBG, and 68Ga-DOTATE PET/CT. Measuring the catecholamine levels in the plasma and urine is mandatory, even though paragangliomas of the head and neck rarely display secretory behavior. Treatment mainly consists of surgery, with different approaches and techniques, but conservative management methods such as wait and scan, radiotherapy, proton therapy, and chemotherapy have proven their efficiency. The therapeutical decision lacks consensus, and current studies tend to recommend an individualized approach. Guidelines regarding long-term follow-up are still a matter of debate. Full article
12 pages, 339 KiB  
Review
Comorbidities and Laryngeal Cancer in Patients with Obstructive Sleep Apnea: A Review
by Beata Kiss, Cristian Mircea Neagos, Gabriela Jimborean, Hédi Katalin Sárközi, Mioara Szathmary and Adriana Neagos
Medicina 2023, 59(11), 1959; https://doi.org/10.3390/medicina59111959 - 6 Nov 2023
Cited by 3 | Viewed by 3145
Abstract
Introductions: The global prevalence of obstructive sleep apnea shows that this disease appears in 1 billion people, with the prevalence exceeding 50% in some countries. Treatment is necessary to minimize negative health impacts. Obstructive sleep apnea (OSA) is defined as a cause [...] Read more.
Introductions: The global prevalence of obstructive sleep apnea shows that this disease appears in 1 billion people, with the prevalence exceeding 50% in some countries. Treatment is necessary to minimize negative health impacts. Obstructive sleep apnea (OSA) is defined as a cause of daytime sleepiness, as well as a clinical manifestation of sleep-disordered breathing. In the literature, there are numerous controversial studies regarding the etiology of this condition, but it is universally accepted that reduced activity in the upper airway muscles plays a significant role in its onset. Additionally, OSA has been associated with a series of comorbidities, such as type II diabetes, metabolic syndrome, and cardiovascular and pulmonary conditions, as well as head and neck tumors, especially oropharyngeal and laryngeal tumors. This is a review of the subject of OSA that considers several aspects: an analysis of the comorbidities associated with OSA, the involvement of tumor pathology in the onset of OSA, and the association of OSA with various types of laryngeal cancers. Additionally, it includes an evaluation of postoperative and medical outcomes for patients with OSA and laryngeal tumors treated surgically and medically, including chemotherapy. Relevant Sections: By taking into consideration the stated objective, a systematic analysis of the available literature was conducted, encompassing the PubMed, Medline, and Scopus databases. The evaluation was based on several keywords, including head and neck cancer, diabetes, diabetic, overlap syndrome, cardiovascular conditions, laryngeal neoplasm, radiotherapy, and chemotherapy, as well as the concept of quality of life in laryngectomized patients and patients with OSA. Discussions: The review evaluates the involvement of OSA in the presence of comorbidities, as well as the increased incidence of OSA in patients with laryngeal cancer. It is important to note that surgical and post-surgical treatment can play a significant role in triggering OSA in these patients. Conclusions: The studies regarding the correlations between OSA, comorbidities, and head and neck tumors indicate a significantly increased risk of OSA in association with conditions such as diabetes, metabolic syndrome, cardiovascular diseases, and head and neck tumors, particularly laryngeal tumors. This association has a physio-pathological basis. The various surgical methods followed by radiation and chemotherapy for tumor treatment do not exclude an increased risk of developing OSA after treatment. This significantly influences the quality of life of patients who survive these types of tumors. Future directions: Due to the multiple comorbidities associated with OSA, the extension of polysomnography associated with investigations during sleep, such as drug-induced sleep endoscopy, represents a tendency for the early diagnosis of this pathology, which affects the quality of life of these patients. Patients with head and neck cancer are at high risk of developing obstructive sleep apnea; this is why it is necessary to expand the polysomnographic investigation of these patients after surgical procedures or after radiotherapy and chemotherapy. Full article

Other

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12 pages, 3290 KiB  
Case Report
Efficacy of Radiotherapy in Patients with Relapsing Primary Rosai–Dorfman Disease of the Nasal Cavity
by Caius-Codrut Sarafoleanu, Florentina-Carmen Badea, Alina-Maria Georgescu, Gabriela-Cornelia Musat, Anica Andrei and Ionut Tanase
Medicina 2025, 61(4), 585; https://doi.org/10.3390/medicina61040585 - 25 Mar 2025
Viewed by 401
Abstract
Rosai–Dorfman disease (RDD) is a rare proliferative disorder characterized by an overproduction of a type of immune cell called histiocytes, with unknown etiology. Although extranodal involvement is not uncommon, it is rarely seen within the nose. The available data are limited, and currently, [...] Read more.
Rosai–Dorfman disease (RDD) is a rare proliferative disorder characterized by an overproduction of a type of immune cell called histiocytes, with unknown etiology. Although extranodal involvement is not uncommon, it is rarely seen within the nose. The available data are limited, and currently, there are no established guidelines for managing RDD. Different therapeutic options have been described, including corticosteroids, surgery, radiotherapy, or chemotherapy. This study aims to evaluate the potential benefit of radiotherapy in patients with nasal Rosai–Dorfman disease to improve the current diagnostic and therapeutic management. Herein, we report the case of a 54-year-old female patient with nasal RDD refractory to systemic corticosteroid therapy and transnasal endoscopic resection. She received fractionated low-dose radiotherapy with a total dose of 30 cGy administered in 2 cGy daily fractions. Complete remission was achieved, highlighting the potential role of radiotherapy as an effective therapeutic option for relapsing or steroid-refractory cases. This is one of the few well-documented cases reported with nasal Rosai–Dorfman disease treated with radiotherapy. Ongoing research on novel therapies offers hope for improved outcomes in relapsing cases that fail to respond to conventional treatments. Full article
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