132 results on '"Borsetto D"'
Search Results
2. Corrigendum to 'Prognostic indicators in clinically node-negative malignant primary salivary tumours of the parotid: A multicentre experience'. [Oral Oncol. 123 (2021) 105577](S1368837521006849)(10.1016/j.oraloncology.2021.105577)
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Fussey, J., Tomasoni, M., Tirelli, G., Giordano, L., Galli, A., Colangeli, R., Cazzador, D., Tofanelli, M., da Mosto, M. C., Bianchini, C., Pelucchi, S., Ubayasiri, K., Elsayed, M., Long, P., Saratziotis, A., Hajiioannou, J., Golusinski, P., Szewczyk, M., Piazza, C., Deganello, A., Lombardi, D., Nicolai, P., Pracy, P., Sharma, N., Nankivell, P., Borsetto, D., and Boscolo-Rizzo, P.
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- 2022
3. New onset of loss of smell or taste in household contacts of home-isolated SARS-CoV-2-positive subjects
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Boscolo-Rizzo P., Borsetto D., Spinato G., Fabbris C., Menegaldo A., Gaudioso P., Nicolai P., Tirelli G., Da Mosto M. C., Rigoli R., Polesel J., Hopkins C., BOSCOLO RIZZO, PAOLO, Boscolo-Rizzo, P., Borsetto, D., Spinato, G., Fabbris, C., Menegaldo, A., Gaudioso, P., Nicolai, P., Tirelli, G., Da Mosto, M. C., Rigoli, R., Polesel, J., Hopkins, C., and BOSCOLO RIZZO, Paolo
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Male ,Taste ,Cross-sectional study ,Olfaction Disorders ,Taste Disorders ,0302 clinical medicine ,Olfaction Disorder ,Prevalence ,Viral ,030223 otorhinolaryngology ,General Medicine ,respiratory system ,Smell ,Taste disorder ,030220 oncology & carcinogenesis ,Female ,medicine.symptom ,Coronavirus Infections ,psychological phenomena and processes ,Human ,medicine.medical_specialty ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Short Communication ,Anosmia ,Coronaviru ,Pneumonia, Viral ,Olfaction ,Dysgeusia ,Smell and taste loss ,Household contacts ,03 medical and health sciences ,Betacoronavirus ,Internal medicine ,medicine ,Humans ,Family ,Pandemics ,Cross-Sectional Studie ,Betacoronaviru ,Pandemic ,business.industry ,SARS-CoV-2 ,Coronavirus Infection ,fungi ,COVID-19 ,Pneumonia ,Household contact ,Coronavirus ,Cross-Sectional Studies ,Otorhinolaryngology ,Contact Tracing ,business ,Smell and taste lo ,Contact tracing - Abstract
Purpose To estimate the prevalence of smell or taste impairment in household contacts of mildly symptomatic home-isolated SARS-CoV-2 positive patients.Methods Cross sectional study based on ad hoc questions.Results Of 214 mildly symptomatic COVID-19 patients managed at home under self-isolation, 179 reported to have at least one household contact, with the total number of no study participants contacts being 296. Among 175 household contacts not tested for SARS-CoV-2 infection, 67 (38.3%) had SARS-CoV-2 compatible symptoms, 39 (22.3%) had loss of smell or taste with 7 (4.0%) having loss of smell or taste in the absence of other symptoms. The prevalence of smell or taste impairment was 1.5% in patients tested negative compared to 63.0% of those tested positive for SARS-CoV-2 (pConclusion Smell or taste impairment are quite common in not-tested household contacts of mildly symptomatic home-isolated SARS-CoV-2 positive patients. This should be taken into account when estimating the burden of loss of sense of smell and taste during COVID-19 pandemic, and further highlights the value of loss of sense of smell and taste as a marker of infection.
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- 2020
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4. Surgery of the lateral skull base: A 50-year endeavour
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Zanoletti, E., Mazzoni, Alberto, Martini, A., Abbritti, R. V., Albertini, R., Alexandre, E., Baro, V., Bartolini, S., Bernardeschi, D., Bivona, R., Bonali, M., Borghesi, I., Borsetto, D., Bovo, R., Breun, M., Calbucci, F., Carlson, M. L., Caruso, A., Caye-Thomasen, P., Cazzador, D., Champagne, P. -O., Colangeli, R., Conte, G., D'Avella, D., Danesi, G., Deantonio, L., Denaro, L., Berardino, F. D., Draghi, R., Ebner, F. H., Favaretto, N., Ferri, G., Fioravanti, A., Froelich, S., Giannuzzi, A., Girasoli, L., Grossardt, B. R., Guidi, M., Hagen, R., Hanakita, S., Hardy, D. G., Iglesias, V. C., Jefferies, S., Jia, H., Kalamarides, M., Kanaan, I. N., Krengli, M., Landi, A., Lauda, L., Lepera, D., Lieber, S., Lloyd, S. L. K., Lovato, A., Maccarrone, F., Macfarlane, R., Magnan, J., Magnoni, L., Marchioni, D., Marinelli, J. P., Marioni, G., Mastronardi, V., Matthies, C., Moffat, D. A., Munari, S., Nardone, M., Pareschi, R., Pavone, C., Piccirillo, E., Piras, G., Presutti, L., Restivo, G., Reznitsky, M., Roca, E., Russo, A., Sanna, M., Sartori, L., Scheich, M., Shehata-Dieler, W., Soloperto, D., Sorrentino, F., Sterkers, O., Taibah, A., Tatagiba, M., Tealdo, G., Vlad, D., Wu, H., Zanetti, D., Zanoletti E., Mazzoni A., Martini A., Abbritti R.V., Albertini R., Alexandre E., Baro V., Bartolini S., Bernardeschi D., Bivona R., Bonali M., Borghesi I., Borsetto D., Bovo R., Breun M., Calbucci F., Carlson M.L., Caruso A., Caye-Thomasen P., Cazzador D., Champagne P.-O., Colangeli R., Conte G., D'Avella D., Danesi G., Deantonio L., Denaro L., Berardino F.D., Draghi R., Ebner F.H., Favaretto N., Ferri G., Fioravanti A., Froelich S., Giannuzzi A., Girasoli L., Grossardt B.R., Guidi M., Hagen R., Hanakita S., Hardy D.G., Iglesias V.C., Jefferies S., Jia H., Kalamarides M., Kanaan I.N., Krengli M., Landi A., Lauda L., Lepera D., Lieber S., Lloyd S.L.K., Lovato A., Maccarrone F., Macfarlane R., Magnan J., Magnoni L., Marchioni D., Marinelli J.P., Marioni G., Mastronardi V., Matthies C., Moffat D.A., Munari S., Nardone M., Pareschi R., Pavone C., Piccirillo E., Piras G., Presutti L., Restivo G., Reznitsky M., Roca E., Russo A., Sanna M., Sartori L., Scheich M., Shehata-Dieler W., Soloperto D., Sorrentino F., Sterkers O., Taibah A., Tatagiba M., Tealdo G., Vlad D., Wu H., and Zanetti D.
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Male ,medicine.medical_treatment ,Schwannoma ,Neurosurgical Procedures ,Cohort Studies ,0302 clinical medicine ,Meningeal Neoplasms ,Medicine ,030223 otorhinolaryngology ,Skull Base ,Benign tumors of the skull base ,Lateral approaches to the skull base ,Malignant tumors of the skull base ,Neuroma, Acoustic ,Middle Aged ,Magnetic Resonance Imaging ,3. Good health ,Chirurgia della base cranio laterale ,General Energy ,medicine.anatomical_structure ,Approcci laterali alla base del cranio ,030220 oncology & carcinogenesis ,Head and neck surgery ,Female ,Neurosurgery ,Meningioma ,Research Article ,Adult ,Chirurgia della base del cranio ,medicine.medical_specialty ,Tumori benigni della base del cranio ,Lateral skull base surgery ,Tumori maligni della base del cranio ,Skull Base Neoplasms ,Skull base surgery ,Aged ,Endoscopy ,Hearing Loss ,Humans ,Mastoid ,Retrospective Studies ,Temporal Bone ,Young Adult ,03 medical and health sciences ,otorhinolaryngologic diseases ,business.industry ,General surgery ,medicine.disease ,Radiation therapy ,Skull ,Otorhinolaryngology ,business ,Jugular foramen - Abstract
Chirurgia della base del cranio laterale: 50 anni di impegno.La base del cranio non è anatomicamente divisa in anteriore e laterale, ma è per semplicità che comunemente si intendono i corridoi chirurgici con direzione antero-laterale, laterale pura e postero laterale come “Approcci chirurgici della base del cranio laterale”. Una relazione con titolo “Cinquant’anni di impegno”, di sforzo o di dedizione, vuole essere il riconoscimento a questa chirurgia che nel corso degli anni ha sviluppato interventi sempre più complessi con una morbidità sempre minore. Il principio della chirurgia della base del cranio laterale si fonda sulla possibilità di “fare spazio”, esporre adeguatamente, rimuovere osso per salvaguardare il cervello, insieme alla possibilità di preservare la funzione e adattare l’approccio chirurgico all’istologia della lesione. Il concetto che l’istologia detta l’entità della resezione chirurgica, bilanciando la morbidità intrinseca di ciascun approccio, è oggetto di trattazione nella prima sezione di questa relazione. Nella seconda sezione sono descritti i principali approcci chirurgici, intesi non come descrizione tecnica di ciascun tempo chirurgico, ma dei principi che sono alla base di ciascun approccio. La terza sezione è dedicata alle questioni aperte, quelle ancora irrisolte, inerenti alcuni tumori ed il loro trattamento. L’argomento del neurinoma sporadico dell’ottavo nervo cranico è trattato riportando l'attuale dibattito sulla osservazione, la chirurgia di preservazione dell’udito, la riabilitazione con l’impianto cocleare, la radioterapia e le ricerche recenti su marcatori tumorali predittivi di crescita. Il paraganglioma del forame giugulare è trattato nel contesto della chirurgia radicale, chirurgia parziale, osservazione e radioterapia. La terapia dei meningiomi della base del cranio analizza il punto di vista specifico dell’otochirurgo e del neurochirurgo. Cordomi e condrosarcomi, tumori del sacco endolinfatico, carcinomi dell’orecchio e colesteatoma della rocca sono le altre lesioni affrontate. Infine, nella quarta sezione è proposto un contributo a libera scelta ad autori di riconosciuta esperienza. Lo scopo di questa relazione è stato quello di fornire un aggiornamento della chirurgia della base del cranio laterale dopo 50 anni di duro lavoro e, o forse soprattutto, di permettere alle tante questioni irrisolte, alle domande che ancora non hanno risposta, di trovare espressione, affinchè il dibattito ed il progresso possano continuare con la condivisione di esperienze. Se al termine della lettura vi saranno più domande che risposte, potremo dirci che l’obiettivo di questa relazione è stato raggiunto.Disregarding the widely used division of skull base into anterior and lateral, since the skull base should be conceived as a single anatomic structure, it was to our convenience to group all those approaches that run from the antero-lateral, pure lateral and postero-lateral side of the skull base as “Surgery of the lateral skull base”. “50 years of endeavour” points to the great effort which has been made over the last decades, when more and more difficult surgeries were performed by reducing morbidity. The principle of lateral skull base surgery, “remove skull base bone to approach the base itself and the adjacent sites of the endo-esocranium”, was then combined with function preservation and with tailoring surgery to the pathology. The concept that histology dictates the extent of resection, balancing the intrinsic morbidity of each approach was the object of the first section of the present report. The main surgical approaches were described in the second section and were conceived not as a step-by-step description of technique, but as the highlighthening of the surgical principles. The third section was centered on open issues related to the tumor and its treatment. The topic of vestibular schwannoma was investigated with the current debate on observation, hearing preservation surgery, hearing rehabilitation, radiotherapy and the recent efforts to detect biological markers able to predict tumor growth. Jugular foramen paragangliomas were treated in the frame of radical or partial surgery, radiotherapy, partial “tailored” surgery and observation. Surgery on meningioma was debated from the point of view of the neurosurgeon and of the otologist. Endolymphatic sac tumors and malignant tumors of the external auditory canal were also treated, as well as chordomas, chondrosarcomas and petrous bone cholesteatomas. Finally, the fourth section focused on free-choice topics which were assigned to aknowledged experts. The aim of this work was attempting to report the state of the art of the lateral skull base surgery after 50 years of hard work and, above all, to raise questions on those issues which still need an answer, as to allow progress in knowledge through sharing of various experiences. At the end of the reading, if more doubts remain rather than certainties, the aim of this work will probably be achieved.
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- 2019
5. Correction to: Multiple spontaneous skull base cerebrospinal fluid leaks: some insights from an international retrospective collaborative study (European Archives of Oto-Rhino-Laryngology, (2020), 277, 12, (3357-3363), 10.1007/s00405-020-06227-w)
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Dallan, I., Cambi, C., Emanuelli, E., Cazzador, D., Canevari, F. R., Borsetto, D., Tysome, J. R., Donnelly, N. P., Rigante, M., Georgalas, C., Alobid, I., Molteni, G., Marchioni, D., Shahzada, A. K., Scarano, M., Seccia, V., and Pasquini, E.
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- 2020
6. Surgical management of acquired anterior glottic web: a systematic review.
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Fussey, J M, Borsetto, D, Pelucchi, S, and Ciorba, A
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SURGICAL flaps , *GLOTTIS , *LARYNGEAL diseases , *LASERS , *ORAL mucosa , *TRANSPLANTATION of organs, tissues, etc. , *SYSTEMATIC reviews , *DISEASE management , *STENOSIS , *TREATMENT effectiveness , *MITOMYCINS - Abstract
Background: Acquired anterior glottic web poses a significant challenge to laryngologists given its propensity to recur following treatment, and there are a wide variety of described techniques. Methods: A systematic review of the medical literature was undertaken in order to identify all articles pertaining to the management of acquired anterior glottic web. Results: Thirteen studies meeting the inclusion criteria were identified and analysed. All were retrospective series, with varying surgical techniques and outcome measures. Only two studies reported on the use of topical mitomycin C. Conclusion: Mucosal graft techniques and keel placement appear to improve success rates, but both carry risks and disadvantages. Based on the available evidence, the use of topical agents such as mitomycin C cannot be recommended in the management of acquired anterior glottic web. [ABSTRACT FROM AUTHOR]
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- 2019
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7. Audiological outcome for hearing preservation surgery in acoustic neuroma: the need of agreement in reporting results.
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Franchella, S., Borsetto, D., Mazzocco, T., Cazzador, D., and Zanoletti, E.
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ACOUSTIC neuroma ,EAR surgery ,MEDICAL protocols ,POSTOPERATIVE period ,SURGEONS ,PSYCHOSOCIAL factors ,TREATMENT effectiveness - Abstract
Purpose: Early diagnosis in acoustic neuroma (AN) has increased the prevalence of small tumors with good hearing. Otoneurological centres have increasingly aimed to preserve hearing function. The managementoptions of small ANs range from observation to active treatments (surgery, radiotherapy). No firm agreement has been made on which is the best option for audiological function preservation. Nowadays, no definitive guidelines are present in order to suggest a standard way of evaluating and comparing the hearing quality. The lack of a universally agreed hearing classification leads to the impossibility of comparing data from different centres or different therapeutic options. Method: The paper wantst o show, analyzing our surgical experience in hearing preservation surgery for ANs, the different results that are demonstrable by just using different hearing classification. Results: About the 13 patients considered 'in protocol' who underwent HPS, 69% are considered to have 'good' hearing after surgery using the Tokyo or Sanna classifications; with the AAO-HNS or the GR classifications the outcome of 'good' hearing preservation was 77% and in 87% with the WRS classification. Conclusion: A shared hearing classification is potentially the solution in order to facilitate comparison of functional outcomes across different centres or different treatment modalities. [ABSTRACT FROM AUTHOR]
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- 2019
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8. Comments on 'Screening for vestibular schwannoma in the context of an ageing population'.
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Gair, J, Borsetto, D, Donnelly, N, Axon, P, Bance, M, Tysome, J R, and Basu, S
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ACOUSTIC neuroma , *ELDER care , *EARLY detection of cancer - Published
- 2020
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9. Self-reported smell and taste recovery in coronavirus disease 2019 patients: a one-year prospective study
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Luigi Angelo Vaira, Chiara Lazzarin, Riccardo Marzolino, Andrea D'Alessandro, Claire Hopkins, Margherita Tofanelli, Alberto Vito Marcuzzo, Giancarlo Tirelli, Jerry Polesel, Vincenzo Capriotti, Enrico Zanelli, Daniele Borsetto, Fiordaliso Cragnolini, Francesco Guida, Nicoletta Gardenal, Paolo Antonucci, Erica Sacchet, Paolo Boscolo-Rizzo, BOSCOLO RIZZO, Paolo, Guida, F., Polesel, J., Marcuzzo, A. V., Antonucci, P., Capriotti, V., Sacchet, E., Cragnolini, F., D'Alessandro, A., Zanelli, E., Marzolino, R., Lazzarin, C., Tofanelli, M., Gardenal, N., Borsetto, D., Hopkins, C., Vaira, L. A., and Tirelli, G.
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medicine.medical_specialty ,Taste ,Coronavirus disease 2019 (COVID-19) ,Short Communication ,Anosmia ,Coronaviru ,Olfaction ,New onset ,03 medical and health sciences ,Olfaction Disorders ,Taste Disorders ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Prospective Studies ,030223 otorhinolaryngology ,Prospective cohort study ,Outcome ,business.industry ,SARS-CoV-2 ,COVID-19 ,General Medicine ,Smell ,Coronavirus ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Neurosurgery ,Self Report ,medicine.symptom ,business - Abstract
Purpose: The aim of the present study was to estimate the 1 year prevalence and recovery rate of self-reported chemosensory dysfunction in a series of subjects with previous mild-to-moderate symptomatic COVID-19. Methods: Prospective study based on the SNOT-22, item “sense of smell or taste” and additional outcomes. Results: 268/315 patients (85.1%) completing the survey at baseline also completed the follow-up interview. The 12 months prevalence of self-reported COVID-19 associated chemosensory dysfunction was 21.3% (95% CI 16.5–26.7%). Of the 187 patients who complained of COVID-19 associated chemosensory dysfunction at baseline, 130 (69.5%; 95% CI 62.4–76.0%) reported complete resolution of smell or taste impairment, 41 (21.9%) reported a decrease in the severity, and 16 (8.6%) reported the symptom was unchanged or worse 1 year after onset. The risk of persistence was higher for patients reporting a baseline SNOT-22 score ≥ 4 (OR = 3.32; 95% CI 1.32–8.36) as well as for those requiring ≥ 22 days for a negative swab (OR = 2.18; 95% CI 1.12–4.27). Conclusion: A substantial proportion of patients with previous mild-to-moderate symptomatic COVID-19 characterized by new onset of chemosensory dysfunction still complained on altered sense of smell or taste 1 year after the onset.
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- 2022
10. Understanding COVID-19–Related Olfactory Dysfunction—Reply
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Claire Hopkins, Daniele Borsetto, Paolo Boscolo-Rizzo, Boscolo-Rizzo, Paolo., Borsetto, D., and Hopkins, C.
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2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Humans ,SARS-CoV-2 ,Smell ,Taste Disorders ,COVID-19 ,Olfaction Disorders ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,MEDLINE ,Taste Disorder ,Taste disorder ,Otorhinolaryngology ,Immunology ,Medicine ,Surgery ,business ,Human - Abstract
Understanding COVID-19–Related Olfactory Dysfunction
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- 2021
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11. Pretreatment High MCV as Adverse Prognostic Marker in Nonanemic Patients with Head and Neck Cancer
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Giancarlo Tirelli, Jerry Polesel, Paul Nankivell, Daniele Borsetto, Anna Menegaldo, Vittorio Baggio, Jonathan Fussey, Paul Pracy, Alessandro Gava, Paolo Boscolo-Rizzo, Borsetto, D., Polesel, J., Tirelli, G., Menegaldo, A., Baggio, V., Gava, A., Nankivell, P., Pracy, P., Fussey, J., and Boscolo Rizzo, P.
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Erythrocyte Indices ,Male ,medicine.medical_specialty ,HPV ,Anemia ,Macrocytosis ,Gastroenterology ,03 medical and health sciences ,Hemoglobins ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Head and neck squamous cell carcinoma ,macrocytic anemia ,Mean corpuscular volume ,platelets ,prognosis ,Serum Albumin ,Aged ,Neoplasm Staging ,Proportional Hazards Models ,Retrospective Studies ,platelet ,medicine.diagnostic_test ,business.industry ,Platelet Count ,Squamous Cell Carcinoma of Head and Neck ,Head and neck cancer ,Retrospective cohort study ,Chemoradiotherapy ,Middle Aged ,medicine.disease ,Head and neck squamous-cell carcinoma ,Survival Rate ,Otorhinolaryngology ,Head and Neck Neoplasms ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Female ,Macrocytic anemia ,Hemoglobin ,business - Abstract
Objective Mean corpuscular volume (MCV) has been shown in to be a reliable prognostic marker in other cancers; however, no evidence exists on its use in head and neck squamous cell carcinoma (HNSCC). This study aimed to investigate the association between MCV, hemoglobin, platelet count and albumin concentration, and survival in stage III/IVA-B HNSCC treated with concurrent chemoradiotherapy. Study design Retrospective cohort study. Methods In this multicenter retrospective study, we analyzed MCV, platelet count, hemoglobin concentration, and albumin concentration in peripheral blood samples from 260 patients with HNSCC undergoing organ preservation treatment with curative intent at the time of diagnosis. We then analyzed survival outcomes after accounting for confounders using multivariate analysis. Results After adjustment for potential confounders, patients with low hemoglobin had a 3.3-fold higher risk of death (95% confidence interval [CI]: 2.26-4.81) than those with normal hemoglobin. Patients with an elevated MCV had a 1.54-fold higher risk of death (95% CI: 1.06-2.24), independent of site, stage, and human papillomavirus status. Interestingly, the effect of MCV on overall and progression-free survival was limited to those with a normal pretreatment hemoglobin. We identified no associations between pretreatment platelet count or albumin concentration and survival. Conclusion These findings suggest that pretreatment anemia and macrocytosis are independent predictors of lower overall and progression-free survival in HNSCC patients undergoing organ preservation treatment. Level of evidence III Laryngoscope, 131:E836-E843, 2021.
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- 2021
12. Elective neck dissection in primary parotid carcinomas: A systematic review and meta-analysis
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Paolo Boscolo-Rizzo, Veronica Phillips, Oreste Iocca, Daniele Borsetto, Armando De Virgilio, Piero Nicolai, Giuseppe Spriano, Jonathan Fussey, Pasquale Di Maio, Borsetto, D., Iocca, O., De Virgilio, A., BOSCOLO RIZZO, Paolo, Phillips, V., Nicolai, P., Spriano, G., Fussey, J., and Di Maio, P.
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Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Locally advanced ,MEDLINE ,parotid gland carcinomas ,Cochrane Library ,meta-analysi ,Pathology and Forensic Medicine ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,Retrospective Studie ,medicine ,Humans ,elective neck dissection ,Lymph node ,Retrospective Studies ,Neoplasm Staging ,business.industry ,parotid gland carcinoma ,Carcinoma ,cervical occult lymph node metastase ,Lymph Node ,Neck dissection ,cN0 neck ,Lymphatic Metastasi ,030206 dentistry ,medicine.disease ,Occult ,Parotid Neoplasms ,meta-analysis ,medicine.anatomical_structure ,Otorhinolaryngology ,cervical occult lymph node metastases ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Meta-analysis ,Lymph Nodes ,Neck Dissection ,Periodontics ,Radiology ,Oral Surgery ,business ,Human - Abstract
Background To estimate the rate of occult cervical lymph node metastases in cN0 patients affected by primary parotid carcinomas and to scrutinize the evidence on the indication and extent of elective neck dissection in these neoplasms. Methods Medline, Embase, Web of Science, Cochrane Library and Scopus were searched until August 31, 2020, to identify studies reporting the use of elective neck dissection in the management of malignant parotid tumours. The PRISMA checklist was used. A single arm meta-analysis was then made to determine the pooled rate of occult lymph node metastases. Risk of bias of the included studies was assessed through the ROBINS-E tool. Results The initial search returned 20 541 articles, of which twelve met the inclusion criteria and were included in the meta-analysis. They comprised 1310 patients with parotid carcinoma, of whom 542 cN0 underwent elective neck dissection, which led to the diagnosis of lymph node metastasis (pN+/cN0) in 113 cases. Meta-analysis of the results of elective neck dissection showed an overall rate of occult metastases of 0.22 (99% CI: 0.14-0.30). Locally advanced or high-grade tumours were the commonest indications for elective neck dissection in the included studies. The most dissected lymph node levels were I-II-III, and level II was the commonest site of occult nodal metastases. Conclusions An occult metastasis rate of 0.22 (99% CI: 0.14-0.30) represents a not negligible percentage value, which should encourage further research to outline the most appropriate elective neck management in cN0 patients with parotid carcinomas.
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- 2021
13. Advanced lung cancer inflammation index and its prognostic value in HPV-negative head and neck squamous cell carcinoma: a multicentre study
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Marco Benazzo, Roberto Di Carlo, Andrea Ciorba, Anna Menegaldo, Daniele Marchioni, Paolo Bossi, Chiara Bianchini, Piergiorgio Gaudioso, Giancarlo Tirelli, Gabriele Molteni, Jerry Polesel, Vittorio Giacomarra, Stefano Pelucchi, Daniele Borsetto, Piero Nicolai, Margherita Tofanelli, Mantegh Sethi, Cristoforo Fabbris, Fiordaliso Cragnolini, Simone Mauramati, Jonathan Fussey, Paolo Boscolo-Rizzo, Boscolo-Rizzo, Paolo [0000-0002-4635-7959], Apollo - University of Cambridge Repository, Gaudioso, P., Borsetto, D., Tirelli, G., Tofanelli, M., Cragnolini, F., Menegaldo, A., Fabbris, C., Molteni, G., Marchioni, D., Nicolai, P., Bossi, P., Ciorba, A., Pelucchi, S., Bianchini, C., Mauramati, S., Benazzo, M., Giacomarra, V., Di Carlo, R., Sethi, M., Polesel, J., Fussey, J., and BOSCOLO RIZZO, Paolo
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Oncology ,Male ,Inflammatory indexes ,medicine.medical_specialty ,Lung Neoplasms ,Survival ,medicine.medical_treatment ,Advanced lung cancer inflammation index ,Head and neck cancer ,Nutrition ,Inflammatory indexe ,Inflammation ,Head and neck cancer, Nutrition, Advanced lung cancer inflammation index, Inflammatory indexes, Survival ,NO ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,HPV Negative ,medicine ,Humans ,Lung cancer ,030304 developmental biology ,Aged ,Retrospective Studies ,0303 health sciences ,business.industry ,Squamous Cell Carcinoma of Head and Neck ,Retrospective cohort study ,Pneumonia ,Middle Aged ,medicine.disease ,Prognosis ,Head and neck squamous-cell carcinoma ,Progression-Free Survival ,Female ,030220 oncology & carcinogenesis ,Cohort ,Original Article ,medicine.symptom ,business ,Adjuvant - Abstract
Funder: Università degli Studi di Trieste, PURPOSE: The aim of this study is to evaluate the prognostic value of pre-treatment advanced lung cancer inflammation index (ALI) in patients with HPV-negative HNSCC undergoing up-front surgical treatment. METHODS: The present multi-centre, retrospective study was performed in a consecutive cohort of patients who underwent upfront surgery with or without adjuvant (chemo)-radiotherapy for head and neck squamous cell carcinoma (HNSCC). Patients were stratified by ALI, and survival outcomes were compared between groups. In addition, the prognostic value of ALI was compared with two other indices, the prognostic nutritional index (PNI) and systemic inflammatory index (SIM). RESULTS: Two hundred twenty-three patients met the inclusion criteria (151 male and 72 female). Overall and progression-free survival were significantly predicted by ALI < 20.4 (HR 3.23, CI 1.51-6.90 for PFS and HR 3.41, CI 1.47-7.91 for OS). Similarly, PNI < 40.5 (HR = 2.43, 95% CI: 1.31-4.51 for PFS and HR = 2.40, 95% CI: 1.19-4.82 for OS) and SIM > 2.5 (HR = 2.51, 95% CI: 1.23-5.10 for PFS and HR = 2.60, 95% CI: 1.19-5.67 for OS) were found to be significant predictors. Among the three indices, ALI < 20.4 identified the patients with the worst 5-year outcomes. Moreover, patients with a combination of low PNI and low ALI resulted to be a better predictor of progression (HR = 5.26, 95% CI: 2.01-13.73) and death (HR = 5.68, 95% CI: 1.92-16.79) than low ALI and low PNI considered alone. CONCLUSIONS: Our results support the use of pre-treatment ALI, an easily measurable inflammatory/nutritional index, in daily clinical practice to improve prognostic stratification in surgically treated HPV-negative HNSCC.
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- 2021
14. Prognostic indicators in clinically node-negative malignant primary salivary tumours of the parotid: A multicentre experience
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Neil Sharma, Jiannis Hajiioannou, Piero Nicolai, Margherita Tofanelli, Roberta Colangeli, Andrea Galli, Mahmoud Elsayed, Athanasios Saratziotis, Maria Cristina Da Mosto, Daniele Borsetto, Patrick Long, Alberto Deganello, Paul Pracy, Diego Cazzador, Davide Lombardi, Kishan Ubayasiri, Michele Tomasoni, Jonathan Fussey, Stefano Pelucchi, Paul Nankivell, Cesare Piazza, Chiara Bianchini, Giancarlo Tirelli, Paolo Boscolo-Rizzo, Leone Giordano, Fussey, J., Tomasoni, M., Tirelli, G., Giordano, L., Galli, A., Colangeli, R., Cazzador, D., Tofanelli, M., Da Mosto, M. C., Bianchini, C., Pelucchi, S., Ubayasiri, K., Elsayed, M., Long, P., Saratziotis, A., Hajiioannou, J., Piazza, C., Deganello, A., Lombardi, D., Nicolai, Piero, Pracy, P., Sharma, N., Nankivell, P., Borsetto, D., Boscolo-Rizzo, Paolo, Fussey, Jonathan, Tomasoni, Michele, Tirelli, Giancarlo, Giordano, Leone, Galli, Andrea, Colangeli, Roberta, Cazzador, Diego, Tofanelli, Margherita, Da Mosto, Maria Cristina, Bianchini, Chiara, Pelucchi, Stefano, Ubayasiri, Kishan, Elsayed, Mahmoud, Long, Patrick, Saratziotis, Athanasio, Hajiioannou, Jianni, Piazza, Cesare, Deganello, Alberto, Lombardi, Davide, Pracy, Paul, Sharma, Neil, Nankivell, Paul, and Borsetto, Daniele
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,adenoid cystic ,Lymphatic metastasis ,mucoepidermoid ,Neck dissection ,Carcinoma, adenoid cystic ,Carcinoma, mucoepidermoid ,Parotid neoplasms ,Prognosis ,Humans ,Middle Aged ,Neck Dissection ,Neoplasm Staging ,Retrospective Studies ,Parotid Neoplasms ,Internal medicine ,medicine ,In patient ,Stage (cooking) ,Lymphatic metastasi ,business.industry ,Nodal metastasis ,Parotid neoplasm ,Carcinoma ,Histology ,Occult ,Node negative ,Parotid cancer ,Oral Surgery ,business - Abstract
Objectives Nodal metastasis is an important prognosticator in primary parotid cancers. The management of the clinically node-negative neck is an area lacking consensus. This study investigates the occult nodal metastasis rate, and prognostic indicators in primary parotid cancers. Materials and methods We performed a multicentre retrospective case note review of patients diagnosed and treated surgically with curative intent between 1997 and 2020. Demographic, clinic-pathological and follow-up data was recorded. Results After exclusions, 334 patients were included for analysis, with a median follow-up of 48 months. The overall rate of occult lymph node metastasis amongst patients undergoing elective neck dissection was 22.4%, with older age, high-grade and more advanced primary tumours being associated with higher rates. On multivariable analysis, age ≥ 60 years (HR = 2.69, p = 0.004), high-grade tumours (HR = 2.70, p = 0.005) and advanced primary tumours (pT3-4, HR = 2.06, p = 0.038) were associated with worse overall survival. Occult nodal metastasis on final pathology was associated with a close-to-significant reduction in regional recurrence free survival (HR = 3.18, p = 0.076). Conclusion This large series confirms the significant occult lymph node metastasis rate in primary parotid cancer, and demonstrates the importance of primary histology, tumour grade and stage in predicting survival outcome. This data supports the use of elective neck dissection in patients with high-risk tumours.
- Published
- 2021
15. Is oro/nasopharyngeal swab for SARS-CoV-2 detection a safe procedure? Complications observed among a case series of 4876 consecutive swabs
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Anna Menegaldo, Daniele Borsetto, Ananth Vijendren, Walter Cestaro, Daniele Frezza, Cristoforo Fabbris, Giacomo Spinato, Paolo Boscolo-Rizzo, Fabbris, C., Cestaro, W., Menegaldo, A., Spinato, G., Frezza, D., Vijendren, A., Borsetto, D., and BOSCOLO RIZZO, Paolo
- Subjects
Adult ,Male ,2019-20 coronavirus outbreak ,Complications ,Septal absce ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Oropharynx ,Article ,Epistaxi ,COVID-19 Testing ,Pandemic ,Medicine ,Humans ,Viral ,Pandemics ,Aged ,business.industry ,SARS-CoV-2 ,Septal abscess ,COVID-19 ,Epistaxis ,Nasopharyngeal swab ,Female ,Middle Aged ,RNA, Viral ,Virology ,Otorhinolaryngology ,RNA ,business ,Complication ,Human - Abstract
The coronavirus disease 2019 (COVID-19) caused by the Severe-Acute-Respiratory-Syndrome Coronavirus 2 (SARS-CoV-2) has widely spread throughout the world since December 2019 . One of the main symptoms of COVID-19 is alteration of smell or taste, suggesting that high viral load can be found in the nose . CDC guidelines have recommended that diagnostic swabs should be performed in specific areas of the respiratory tract such as the nasopharynx, oropharynx, nasal turbinate, and anterior nares. Nasal and nasopharyngeal swabbing requires the introduction of a foreign body into a delicate area that can result in harm to the patient. In this paper we present the complications encountered in a series of health workers who underwent oro/nasopharyngeal swab for detection of SARS-CoV-2.
- Published
- 2021
16. Design of a study to investigate the mechanisms of obstructive sleep apnoea by means of drug-induced sleep endoscopy
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Piergiorgio Gaudioso, Martino F. Pengo, Valeria Bisogni, Mario Plebani, Alessandro Martini, Gian Paolo Rossi, Laura Brugnolo, Silvia Lerco, Giulio Ceolotto, Daniele Borsetto, Carlo Artusi, Rosario Marchese Ragona, Giuseppe Maiolino, Bisogni, V, Maiolino, G, Ceolotto, G, Pengo, M, Marchese Ragona, R, Artusi, C, Brugnolo, L, Lerco, S, Borsetto, D, Gaudioso, P, Martini, A, Plebani, M, and Rossi, G
- Subjects
Adult ,Male ,Sympathetic nervous system ,medicine.medical_specialty ,obstructive sleep apnoea ,catechol-O-methyltransferase ,Clinical Biochemistry ,Hemodynamics ,Pilot Projects ,030204 cardiovascular system & hematology ,Catechol O-Methyltransferase ,Plasma renin activity ,Endothelial activation ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Catecholamines ,Internal medicine ,Renin–angiotensin system ,Renin ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,drug-induced sleep endoscopy ,endothelin-1 ,renin-angiotensin-aldosterone system ,sympathetic nervous system ,Protein Precursors ,Aldosterone ,Sleep Apnea, Obstructive ,Catechol-O-methyl transferase ,business.industry ,Biochemistry (medical) ,Endoscopy ,General Medicine ,medicine.anatomical_structure ,chemistry ,Research Design ,Cardiology ,medicine.symptom ,business ,Sleep ,Hypercapnia - Abstract
Background Obstructive sleep apnoea (OSA) is an independent risk factor of hypertension and cardiovascular diseases. Recurrent episodes of upper airways collapse during sleep causing blood oxygen desaturation, hypercapnia, and micro-arousals, are known to activate the sympathetic nervous system (SNS). However, whether changes in the renin-angiotensin-aldosterone system and endothelial activation also occur remains contentious. Methods Based on routine use of drug-induced sleep endoscopy (DISE) for the work-up of OSA patients in our centre, we designed a prospective study to investigate the haemodynamic and humoral changes occurring during the apnoeic episodes reproduced in vivo in the course of DISE. Specifically, plasma aldosterone concentration and renin activity, C-terminal fragment of proendothelin-1, as a marker of endothelial damage, and free plasma catecholamines, will be measured at fixed times during DISE. The activity of catechol-O-methyltransferase (COMT), a key catecholamine-inactivating enzyme that has been scantly investigated thus far owing to the lack of commercially available kits, will be also determined by a newly developed high performance liquid chromatography method, which is herein described. Results and conclusions The aim of this study is to provide novel information on the haemodynamic, hormonal, and SNS changes, and also on COMT activity modification concomitantly occurring during apnoea, thus contributing substantively to the understanding of the pathophysiology of OSA.
- Published
- 2019
17. Taste disturbance following cochlear implantation: a systematic review and meta-analysis.
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Fitzgerald M, Fleet A, Tomasoni M, Phillips V, Donnelly N, Axon P, Tysome J, Smith M, Bance M, Boscolo-Rizzo P, and Borsetto D
- Abstract
Objectives: This systematic review and meta-analysis aimed to estimate the rate of taste disturbance following cochlear implantation., Methods: The review was designed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies psychophysically measured taste. DerSimonian and Laird random-effects models were used. An overall mean from studies reporting a single mean of taste strip performance was calculated using inverse variance method for pooling., Results: Of 380 studies identified, 9 were included across which 55 cases of postoperative taste disturbance were reported in 498 patients. Taste was tested at variable timepoints, from <1 week to ≥6 months postoperatively. The overall rate of postoperative taste disturbance was 13.5% (95% CI, 7.6-20.7%) with high heterogeneity between studies (I
2 = 62%)., Discussion: 13.5% might indicate a higher prevalence of taste disturbance following cochlear implantation compared to the general population. However, the confidence we can assign to our calculated rate is limited by significant heterogeneity and potential publication bias. Studies reporting mean taste strip scores generally found reduced taste function on the side of the tongue ipsilateral to implantation, but this reduction wasn't statistically significant., Conclusion: Further research, employing more robust and standardised methodologies, is necessary to accurately ascertain the rate and nature of taste disturbance following cochlear implantation.- Published
- 2024
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18. Cochlear implant cost analysis in adults: a European narrative review.
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Gatto A, Tofanelli M, Valentinuz G, Mascherin A, Costariol L, Rizzo S, Borsetto D, Boscolo-Rizzo P, and Tirelli G
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- Humans, Europe, Adult, Cochlear Implantation economics, Cochlear Implants economics, Cost-Benefit Analysis
- Abstract
Purpose: The aim of this study was to provide an updated European narrative review spanning the last decade, focusing on the cost-effectiveness of cochlear implants (CIs) for adults with severe to profound post-lingual hearing loss., Methods: This review encompasses both prospective and retrospective approaches, as well as cross-sectional and longitudinal trials conducted on CIs in adults. All studies related to European countries (Austria, Germany, Switzerland, the Netherlands, Sweden, the UK and Poland) were conducted in English and were published between 2012 and June 2023., Results: Nine studies were included in the analysis. The patients' ages ranged from 18 years to over 67 years, with sample sizes ranging from 20 to 100 patients; two of these studies were focused on single-sided deafness in adults. The Markov model was identified as the most commonly utilized analysis method., Conclusions: This review identified a general consensus on CI cost-effectiveness, despite substantial variability among countries in factors such as observation time horizons, cost-effectiveness thresholds, methods of cost collection, discount rates, CI eligibility criteria and country-specific health systems. Generally, CIs yield positive societal benefits for working-age individuals, potentially less for seniors. Early unilateral CI enhances cost-effectiveness, highlighting the importance of prompt candidate identification. A consistent undersupply of CIs relative to the percentage of potential recipients emerged across countries. Therefore, further investigation into subcategories such as single-sided deafness is warranted, along with country-specific cost analyses. Emphasizing the significance of detailed information on health systems and associated costs and benefits is crucial for facilitating comparisons across different settings., (© 2024. The Author(s).)
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- 2024
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19. Endoscopic-assisted transorbital extended orbital exenteration: A multi-institutional preclinical study.
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Roccuzzo G, Vyskocil E, Hirtler L, Kandathil SA, Peris-Celda M, Agosti E, Kuan EC, Wang EW, Leong S, Sharma R, Borsetto D, Herman P, Vinciguerra A, Verillaud B, Bresson D, Taboni S, Erovic BM, Vural A, Dallan I, Doglietto F, Schreiber A, Mattavelli D, Rampinelli V, Arosio AD, Battaglia P, Valentini M, Turri-Zanoni M, Pozzi F, Volpi L, Bignami M, Castelnuovo P, Nicolai P, and Ferrari M
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- Humans, Surveys and Questionnaires, Paranasal Sinus Neoplasms surgery, Paranasal Sinus Neoplasms pathology, Orbital Neoplasms surgery, Female, Male, Neoplasm Invasiveness pathology, Endoscopy methods, Orbit Evisceration, Feasibility Studies
- Abstract
Background: Sinonasal malignancies with orbital invasion have dismal prognosis even when treated with orbital exenteration (OE). Sugawara et al. developed a surgical strategy called "extended-OE (EOE)," showing encouraging outcomes. We hypothesized that a similar resection is achievable under endoscopic guidance through the exenterated orbit (endoscopic-EOE)., Methods: The study was conducted in three institutions: University of Vienna; Mayo Clinic; University of Insubria; 48 orbital dissections were performed. A questionnaire was developed to evaluate feasibility and safety of each step, scoring from 1 to 10, ("impossible" to "easy," and "high risk" to "low risk," respectively), most likely complication(s) were hypothesized., Results: The step-by-step technique is thoroughly described. The questionnaire was answered by 25 anterior skull base surgeons from six countries. Mean, median, range, and interquartile range of both feasibility and safety scores are reported., Conclusions: Endoscopic-EOE is a challenging but feasible procedure. Clinical validation is required to assess real-life outcomes., (© 2024 Wiley Periodicals LLC.)
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- 2024
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20. Intraoperative Detection of Extracochlear Electrodes Using Stimulation Current Induced Non-Stimulating Electrode Voltage (SCINSEV) Measures (Transimpedance Measures)-A Case Series.
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Ayas M, Tam YC, Bysouth-Young D, Eitutis ST, Salorio-Corbetto M, Axon PR, Donnelly NP, Tysome JR, Borsetto D, Smith ME, and Bance ML
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- 2024
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21. Immunosuppression in stem cell clinical trials of neural and retinal cell types: A systematic review.
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Gowrishankar S, Smith ME, Creber N, Muzaffar J, and Borsetto D
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- Humans, Retina immunology, Immunosuppressive Agents therapeutic use, Clinical Trials as Topic, Stem Cell Transplantation methods, Immunosuppression Therapy methods
- Abstract
Background: Pharmacologic immunosuppression regimes are commonly employed in stem cell clinical trials to mitigate host immune rejection and promote survival and viability of transplanted cells. Immunosuppression and cell survival has been extensively studied in retinal and spinal tissues. The applicability of stem cell therapy is rapidly expanding to other sensory organs such as the ear and hearing. As regenerative therapy is directed to new areas, a greater understanding of immunosuppression strategies and their efficacy is required to facilitate translation to organ-specific biologic microenvironments., Objective: This systematic review appraises the current literature regarding immunosuppression strategies employed in stem cell trials of retinal and neural cells., Methods: This systematic review was performed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria included studies presenting data on neural or retinal cells as part of an in-human clinical trial that detailed the immunosuppression regime used. Exclusion criteria included non-English language studies, animal studies, review articles, case reports, editorials, and letters. The databases Medline, Embase, Scopus, Web of Science, and the Cochrane Library were searched from inception to February 2024. Risk of bias was evaluated using the ROBINS-I tool., Results: Eighteen articles fit the inclusion criteria. Nine articles concerned retinal cells, 5 concerned spinal cord injury, and 4 concerned amyotrophic lateral sclerosis. A multi-drug and short-term immunosuppression regime were commonly employed in the identified studies. Detected immune responses in treated patients were rare. Common immunosuppression paradigms included tacrolimus, mycophenolate mofetil and tapering doses of steroids. Local immunosuppression with steroids was employed in some studies concerning retinal diseases., Discussion: A short-term course of systemic immunosuppression seemed efficacious for most included studies, with some showing grafted cells viable months to years after immunosuppression had stopped. Longer-term follow-up is required to see if this remains the case. Side effects related to immunosuppression were uncommon., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Gowrishankar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2024
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22. Late-onset, progressive sensorineural hearing loss in the paediatric population: a systematic review.
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Corazzi V, Fordington S, Brown TH, Donnelly N, Bewick J, Ehsani D, Pelucchi S, Bianchini C, Ciorba A, and Borsetto D
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- Adolescent, Child, Child, Preschool, Humans, Infant, Infant, Newborn, Age of Onset, Cytomegalovirus Infections complications, Cytomegalovirus Infections diagnosis, Disease Progression, Risk Factors, Hearing Loss, Sensorineural diagnosis, Hearing Loss, Sensorineural etiology, Hearing Loss, Sensorineural epidemiology, Neonatal Screening
- Abstract
Purpose: To review possible risk factors for permanent delayed-onset, progressive sensorineural hearing loss (SNHL) in the paediatric population to recommend follow-up protocols for early detection., Methods: PRISMA-compliant systematic review was performed, including observational studies on the paediatric population up to 16 years old who have passed the newborn hearing screening programme (NHSP), investigating the development of late-onset, progressive SNHL. Electronic searches were performed through Medline, Embase, Cochrane, and Emcare., Results: 37 studies were included. 21 showed an association between late-onset SNHL and congenital cytomegalovirus (cCMV) infection (age at hearing loss diagnosis 0.75 to 204 months, mean 45.6 ± 43.9), while 16 between late-onset SNHL and other congenital or perinatal factors, namely Neonatal Intensive Care Unit (NICU) stay, prematurity, neonatal respiratory failure, mechanical ventilation, extracorporeal membrane oxygenation (ECMO) support, hypocapnia, hypoxia, alkalosis, seizure activity, congenital diaphragmatic hernia (CDH), inner ear malformation, and gene mutations (age at hearing loss diagnosis 2.5 to 156 months, mean 38.7 ± 40.7)., Conclusions: cCMV infection may cause late-onset SNHL, which can be missed on standard NHSP. There is, therefore, evidence to support universal screening programmes to enable detection in even asymptomatic neonates. Ongoing audiological follow-up for all children with cCMV is advisable, to enable timely treatment. In the paediatric population presenting conditions such as NICU stay > 5 days, prematurity ≤ 34 weeks gestation, severe neonatal respiratory failure, mechanical ventilation, ECMO support, and CDH surgery, an audiological follow-up from 3 months of age up to at least 3-4 years of age, and at least annually, should be recommended., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2024
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23. Intraoperative surgical navigation as a precision medicine tool in sinonasal and craniofacial oncologic surgery.
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Gaudioso P, Contro G, Taboni S, Costantino P, Visconti F, Sozzi M, Borsetto D, Sharma R, De Almeida J, Verillaud B, Vinciguerra A, Carsuzaa F, Thariat J, Vural A, Schreiber A, Mattavelli D, Rampinelli V, Battaglia P, Turri-Zanoni M, Karligkiotis A, Pistochini A, Arosio AD, Lambertoni A, Nair D, Dallan I, Bonomo P, Molteni M, El Khouzai B, Busato F, Zanoletti E, Krengli M, Orlandi E, Nicolai P, and Ferrari M
- Subjects
- Humans, Paranasal Sinus Neoplasms surgery, Paranasal Sinus Neoplasms pathology, Female, Male, Biopsy methods, Middle Aged, Precision Medicine methods, Surgery, Computer-Assisted methods
- Abstract
Introduction: Recent evidence supports the efficacy of surgical navigation (SN) in improving outcomes of sinonasal and craniofacial oncologic surgery. This study aims to demonstrate the utility of SN as a tool for integrating surgical, radiologic, and pathologic information. Additionally, a system for recording and mapping biopsy samples has been devised to facilitate sharing of spatial information., Materials and Methods: SN was utilized for biopsy mapping in 10 sinonasal/craniofacial oncologic procedures. Twenty-five raters with experience in anterior skull base oncology were interviewed to identify 15 anatomical structures in preoperative imaging, relying on topographical descriptions and surgical video clips. The difference in the localization of anatomical structures by raters was analyzed, using the SN-mapped coordinates as a reference (this difference was defined as spatial error)., Results: The analysis revealed an average spatial error of 9.0 mm (95 % confidence interval: 8.3-9.6 mm), with significant differences between surgeons and radiation oncologists (7.9 mm vs 12.5 mm, respectively, p < 0.0001). The proposed model for transferring SN-mapped coordinates can serve as a tool for consultation in multidisciplinary discussions and radiotherapy planning., Conclusions: The current standard method to evaluate disease extension and margin status is associated with a spatial error approaching 1 cm, which could affect treatment precision and outcomes. The study emphasizes the potential of SN in increasing spatial precision and information sharing. Further research is needed to incorporate this method into a multidisciplinary workflow and measure its impact on outcomes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2024
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24. A Multicenter Validity Study of Four Smartphone Hearing Test Apps in Optimized and Home Environments.
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Swords C, Twumasi E, Fitzgerald M, Fitzsimons-West E, Luo M, Dunne H, Lim KH, Jones O, Law S, Myuran T, Smith G, Tailor BV, Wakelam O, de Cates C, Borsetto D, Tysome J, Donnelly N, Axon P, Bance M, and Smith ME
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Young Adult, Auditory Threshold physiology, Feasibility Studies, Hearing Loss diagnosis, Prospective Studies, Reproducibility of Results, Audiometry, Pure-Tone instrumentation, Audiometry, Pure-Tone methods, Mobile Applications, Smartphone
- Abstract
Objective: Pure tone audiometry (PTA) is the gold standard for hearing assessment. However, it requires access to specialized equipment. Smartphone audiometry applications (apps) have been developed to perform automated threshold audiometry and could allow patients to perform self-administered screening or monitoring. This study aimed to assess the validity and feasibility of patients using apps to self-assess hearing thresholds at home, with comparison to PTA., Methods: A multi-center, prospective randomized study was conducted amongst patients undergoing PTA in clinics. Participants were randomly allocated to one of four publicly-available apps designed to measure pure tone thresholds. Participants used an app once in optimal sound-treated conditions and a further three times at home. Ear-specific frequency-specific thresholds and pure tone average were compared using Pearson correlation coefficient. The percentage of app hearing tests with results within ±10 dB of PTA was calculated. Patient acceptability was assessed via an online survey., Results: One hundred thirty-nine participants submitted data. The results of two at-home automated smartphone apps correlated strongly/very strongly with PTA average and their frequency-specific median was within ±10 dB accuracy. Smartphone audiometry performed in sound-treated and home conditions were very strongly correlated. The apps were rated as easy/very easy to use by 90% of participants and 90% would be happy/very happy to use an app to monitor their hearing., Conclusion: Judicious use of self-performed smartphone audiometry was both valid and feasible for two of four apps. It could provide frequency-specific threshold estimates at home, potentially allowing assessments of patients remotely or monitoring of fluctuating hearing loss., Level of Evidence: 2 Laryngoscope, 134:2864-2870, 2024., (© 2024 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)
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- 2024
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25. Multi-Magnet Cochlear Implant Technology and Magnetic Resonance Imaging: The Safety Issue.
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Canzi P, Carlotto E, Zanoletti E, Frijns JHM, Borsetto D, Caruso A, Chiapparini L, Ciorba A, Conte G, Creber N, Criscuolo S, Di Lella F, Franchella S, Hensen EF, Lauda L, Malpede S, Mandalà M, Rotteveel LJC, Simoncelli A, Stellato AC, Zanetti D, and Benazzo M
- Abstract
Despite the spread of novel-generation cochlear-implant (CI) magnetic systems, access to magnetic resonance imaging (MRI) for CI recipients is still limited due to safety concerns. The aim of this study is to assess and record the experiences of Hires Ultra 3D (Advanced Bionics) recipients who underwent an MRI examination. A multicentric European survey about this topic was conducted focusing on safety issues, and the results were compared with the current literature. We collected a total of 65 MRI scans performed in 9 otologic referral centers for a total of 47 Hires Ultra 3D recipients, including, for the first time, 2 children and 3 teenagers. Preventive measures were represented by scanning time and sedation for children. Head wrapping was used in eight cases, and six of the eight cases received local anesthesia, even if both measures were not needed. Only three patients complained of pain (3/65 examinations, 4.6%) due to the tight head bandage, and one of the three cases required MRI scan interruption. No other adverse events were reported. We believe that these results should encourage MRI execution in accordance with manufacturer recommendations for Ultra 3D recipients.
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- 2024
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26. Temporal bone management in external and middle ear carcinoma.
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Gowrishankar S, Borsetto D, Marinelli J, and Panizza B
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- Humans, Neoplasm Staging, Temporal Bone surgery, Ear, Middle surgery, Ear Neoplasms pathology, Ear Neoplasms surgery, Carcinoma pathology
- Abstract
Purpose of Review: The purpose of this review is to outline the temporal bone management of external and middle ear carcinoma. The review will outline the current evidence involved in deciding which surgical approach to take, as well as new advances in auditory rehabilitation and immunotherapy., Recent Findings: Traditional surgical approaches include lateral temporal bone resection, subtotal temporal bone resection and total temporal bone resection. They can also involve parotidectomy and neck dissection depending on extension of disease into these areas. Options for auditory rehabilitation include osseointegrated hearing aids, transcutaneous bone-conduction implants, and active middle ear implants. Recent advances in immunotherapy have included the use of anti-PD-1 monoclonal antibodies., Summary: The mainstay of management of temporal bone disease involves surgical resection. Early-stage tumours classified according to the Pittsburgh staging tool can often be treated with lateral temporal bone resection, whereas late-stage tumours might need subtotal or total temporal bone resection. Parotidectomy and neck dissection might also be indicated if there is a risk of occult regional disease. Recent advances in immunotherapy have been promising, particularly around anti-PD-1 inhibitors. However, larger clinical trials will be required to test the extent of efficacy, particularly around combination use with surgery., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2024
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27. Is the evolving role of artificial intelligence and chatbots in the field of otolaryngology embracing the future?
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Chiesa-Estomba CM, Speth MM, Mayo-Yanez M, Liu DT, Maniaci A, and Borsetto D
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- Humans, Artificial Intelligence
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- 2024
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28. A scoping review on the clinical effectiveness of Trans-Impedance Matrix (TIM) measurements in detecting extracochlear electrodes and tip fold overs in Cochlear Ltd devices.
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Ayas M, Muzaffar J, Borsetto D, Eitutis S, Phillips V, Tam YC, Salorio-Corbetto M, and Bance ML
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- Humans, Cochlea surgery, Electric Impedance, Electrodes, Implanted, Treatment Outcome, Cochlear Implantation methods, Cochlear Implants
- Abstract
Background: Extrusion of electrodes outside the cochlea and tip fold overs may lead to suboptimal outcomes in cochlear implant (CI) recipients. Intraoperative measures such as Trans-Impedance Matrix (TIM) measurements may enable clinicians to identify electrode malposition and direct surgeons to correctly place the electrode array during surgery., Objectives: To assess the current literature on the effectiveness of TIM measurements in identifying extracochlear electrodes and tip fold overs., Methods: A scoping review of studies on TIM-based measurements were carried out using the Databases-Medline/PubMed, AMED, EMBASE, CINAHL and the Cochrane Library following PRISMA guidelines. Eleven full texts articles met the inclusion criteria. Only human studies pertaining to TIM as a tool used in CI were included in the review. Further, patient characteristics, electrode design, and TIM measurement outcomes were reported., Results: TIM measurements were available for 550 implanted ears with the subjects age ranged between 9 months to 89 years. Abnormal TIM measurements were reported for 6.55% (36). Tip fold over was detected in 3.64% (20) of the cases, extracochlear electrodes in 1.45% (8), and 1.45% (8) were reported as buckling. Slim-modiolar electrode array designs were more common (54.71%) than pre-curved (23.34%) or lateral wall (21.95%) electrode array. Abnormal cochlear anatomy was reported for five ears (0.89%), with normal cochlear anatomy for all other patients., Conclusion: TIM measurement is a promising tool for the intraoperative detection of electrode malposition. TIM measurement has a potential to replace intraoperative imaging in future. Though, TIM measurement is in its early stages of clinical utility, intuitive normative data sets coupled with standardised criteria for detection of abnormal electrode positioning would enhance its sensitivity., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ayas et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2024
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29. Blood Markers Predicting Clinically Occult Lymph Node Metastasis in Head and Neck Squamous Cell Carcinoma.
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Gaudioso P, Borsetto D, Polesel J, Tirelli G, Emanuelli E, Menegaldo A, Molteni G, Nicolai P, Tomasoni M, Montenegro C, Piazza C, Bossi P, Ciorba A, Canzi P, Giacomarra V, Giudici F, Fussey J, and Boscolo-Rizzo P
- Subjects
- Humans, Squamous Cell Carcinoma of Head and Neck pathology, Lymphatic Metastasis pathology, Retrospective Studies, Prognosis, Lymph Nodes pathology, Lymphocytes pathology, Head and Neck Neoplasms pathology
- Abstract
Introduction: The presence of cervical lymph node metastases is an unfavorable prognostic factor in head and neck squamous cell carcinoma (HNSCC) and a potential cause of treatment failure. Occult lymph node metastasis occurs in approximately 15-20% of HNSCC patients with a clinically negative neck (cN0), greatly impacting on their prognosis. The present study aimed to investigate the role of pre-treatment peripheral blood markers in predicting clinically occult cervical lymph node metastasis., Methods: This multicenter, retrospective study was performed in a cohort of 472 patients diagnosed with cN0 HNSCC who underwent up-front surgery. Baseline neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic inflammatory marker (SIM), and systemic immune-inflammation index (SII) were calculated from available blood parameters., Results: Oro-hypopharyngeal and oral cancers, locally advanced stage, moderately (G2), and poorly (G3) differentiated grade were associated with an increased risk of pathological lymph node involvement. NLR, LMR, PLR, SIM, and SII were significantly associated at multivariable analysis. NLR >2.12 was the most reliable at predicting occult lymph node metastasis (OR = 5.22; 95% CI: 2.14-12.75). We describe a predictive score integrating cancer site, local stage, and NLR which is effective at predicting positive lymph node pathological status., Conclusions: The present study provides evidence that pre-treatment peripheral blood markers, in particular NLR, represent reliable predictors of clinically occult cervical lymph node metastasis in cN0 HNSCC. Therefore, the present study provides a novel useful predictive score for directing the elective management of the neck in patients with cN0 HNSCC., (© 2023 S. Karger AG, Basel.)
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- 2024
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30. Reported baseline variables in transsphenoidal surgery for pituitary adenoma over a 30 year period: a systematic review.
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Layard Horsfall H, Loh RTS, Venkatesh A, Khan DZ, Lawrence A, Jayapalan R, Koulouri O, Borsetto D, Santarius T, Gurnell M, Dorward N, Mannion R, Marcus HJ, and Kolias AG
- Subjects
- Humans, Prospective Studies, Retrospective Studies, Treatment Outcome, Adenoma surgery, Adenoma pathology, Pituitary Neoplasms surgery, Pituitary Neoplasms pathology
- Abstract
Purpose: Heterogeneous reporting in baseline variables in patients undergoing transsphenoidal resection of pituitary adenoma precludes meaningful meta-analysis. We therefore examined trends in reported baseline variables, and degree of heterogeneity of reported variables in 30 years of literature., Methods: A systematic review of PubMed and Embase was conducted on studies that reported outcomes for transsphenoidal surgery for pituitary adenoma 1990-2021. The protocol was registered a priori and adhered to the PRISMA statement. Full-text studies in English with > 10 patients (prospective), > 500 patients (retrospective), or randomised trials were included., Results: 178 studies were included, comprising 427,659 patients: 52 retrospective (29%); 118 prospective (66%); 9 randomised controlled trials (5%). The majority of studies were published in the last 10 years (71%) and originated from North America (38%). Most studies described patient demographics, such as age (165 studies, 93%) and sex (164 studies, 92%). Ethnicity (24%) and co-morbidities (25%) were less frequently reported. Clinical baseline variables included endocrine (60%), ophthalmic (34%), nasal (7%), and cognitive (5%). Preoperative radiological variables were described in 132 studies (74%). MRI alone was the most utilised imaging modality (67%). Further specific radiological baseline variables included: tumour diameter (52 studies, 39%); tumour volume (28 studies, 21%); cavernous sinus invasion (53 studies, 40%); Wilson Hardy grade (25 studies, 19%); Knosp grade (36 studies, 27%)., Conclusions: There is heterogeneity in the reporting of baseline variables in patients undergoing transsphenoidal surgery for pituitary adenoma. This review supports the need to develop a common data element to facilitate meaningful comparative research, trial design, and reduce research inefficiency., (© 2023. The Author(s).)
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- 2023
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31. Evaluating long-term smell or taste dysfunction in mildly symptomatic COVID-19 patients: a 3-year follow-up study.
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Boscolo-Rizzo P, Spinato G, Hopkins C, Marzolino R, Cavicchia A, Zucchini S, Borsetto D, Lechien JR, Vaira LA, and Tirelli G
- Subjects
- Adult, Humans, Smell, Follow-Up Studies, SARS-CoV-2, RNA, Viral, Taste Disorders epidemiology, Taste Disorders etiology, Taste, COVID-19 complications, COVID-19 epidemiology, Olfaction Disorders diagnosis, Olfaction Disorders epidemiology, Olfaction Disorders etiology
- Abstract
Introduction: No studies have reported data on 3-year prevalence and recovery rates of self-reported COVID-19-related olfactory and gustatory dysfunction. The aim of the present study was to estimate the 3-year prevalence and recovery rate of self-reported COVID-19-related chemosensory dysfunction in a cohort of patients with antecedent mild COVID-19., Methods: This is a prospective observational study, measuring the prevalence of altered sense of smell or taste at follow-up and their variation from baseline, on adult patients consecutively assessed at Treviso and Trieste University Hospitals, who tested positive for SARS-CoV-2 RNA by polymerase chain reaction during March 2020., Results: Overall, out of 403 respondents, 267 patients (66.3%) reported an altered sense of smell or taste (SNOT-22 > 0) at baseline, while 56 (13.9%), 29 (7.2%), and 21 (5.2%) reported such alterations at 6-24 months, 2 years, and 3 years, respectively. Among the 267 patients with COVID-19-associated smell or taste dysfunction at baseline, 246 (92.1%) reported complete resolution at 3 years. Of the patients who still experienced smell or taste dysfunction 2 years after COVID-19, 27.6% and 37.9% recovered completely and partially, respectively, at the 3-year follow-up., Conclusion: Among subjects with antecedent mildly symptomatic SARS-CoV-2 infection, the 3-year prevalence and recovery rate of COVID-19-related alteration in sense of smell or taste was 5% and 92%, respectively. In approximately two-thirds of patients experiencing chemosensory dysfunction still 2 years after COVID-19, it is still possible to observe a delayed complete or partial recovery after a period of 3 years, while the remaining one-third of individuals continues to have unchanged persistent chemosensory alteration., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2023
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32. Antibiotics versus non-antibiotic treatments for acute otitis externa: A systematic review and meta-analysis.
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Di Traglia R, Tudor-Green B, Muzaffar J, Borsetto D, and Smith ME
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- Adult, Child, Humans, Anti-Bacterial Agents therapeutic use, Inflammation, Acute Disease, Steroids, Otitis Externa drug therapy, Anti-Infective Agents, Local therapeutic use
- Abstract
Background: Otitis externa is a condition causing inflammation of the outer ear canal, which presents with itching, discharge and pain. Most cases of acute otitis externa are caused by bacterial infection and are thus treated with antibiotics. This systematic review and meta-analysis of randomised controlled trials aims to assess the effectiveness of topical non-antibiotic treatments compared to topical antibiotic treatment for the treatment of acute otitis externa., Methods: Systematic review and meta-analysis databases searched: Cochrane Library including ClinicalTrials.gov; MEDLINE; World Health Organisation International Clinical Trials Registry Platform and Web of Science to identify randomised clinical trials evaluating topical antibiotics and topical non-antibiotic agents in adults and children with acute otitis externa. Non-antibiotic therapeutics for comparison with topical antibiotics included antiseptics, steroids, non-pharmaceuticals and astringents., Results: Seventeen trials were eligible for inclusion, with 10 combined in meta-analysis. Data could be pooled comparing antiseptic and steroid monotherapies with topical antibiotic agents. There were no significant differences in cure rates in any pairwise comparisons. Individually, the majority of studies favoured topical antiseptics or steroids over antibiotics, however these differences were not significant when pooled in meta-analysis., Conclusion: Antiseptic, steroid and antibiotic monotherapies are all effective for the management of acute otitis externa. There is insufficient evidence to suggest that topical antiseptic or steroid agents are superior or inferior to topical antibiotics., (© 2023 The Authors. Clinical Otolaryngology published by John Wiley & Sons Ltd.)
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- 2023
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33. A narrative review of the management of pars flaccida tympanic membrane retractions without cholesteatoma.
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Bateman L, Borsetto D, Boscolo-Rizzo P, Mochloulis G, and Vijendren A
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Objective: Review the effectiveness of surgical and non-surgical management strategies for isolated pars flaccida and combined pars tensa and flaccida tympanic membrane retractions in preventing progression or recurrence, improving hearing and preventing development of cholesteatoma., Design: Narrative review., Setting: ENT and otology services worldwide., Participants: Patients with non-cholesteatoma tympanic membrane retractions., Main Ouctome Measure: Changes in retraction (progression or resolution, or development of a known sequela such as perforation)., Results: Eight full text papers are included: three randomised controlled trials and five case series or cohort studies of more than five patients (a total of 238 ears). Data exists for the use of conservative management, ventilation tubes, laser tympanoplasty, cartilage and fascia tympanoplasty, lateral attic reconstruction as well as mastoid procedures., Conclusion: Few high-quality studies on the management of isolated and combined pars flaccida retractions exist. For isolated pars flaccida retractions deemed to require surgical intervention, this review suggests that lateral attic reconstruction and cartilage tympanoplasty carries least risk of recurrence., (© 2023 John Wiley & Sons Ltd.)
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- 2023
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34. Otological Planning Software-OTOPLAN: A Narrative Literature Review.
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Gatto A, Tofanelli M, Costariol L, Rizzo S, Borsetto D, Gardenal N, Uderzo F, Boscolo-Rizzo P, and Tirelli G
- Abstract
The cochlear implant (CI) is a widely accepted option in patients with severe to profound hearing loss receiving limited benefit from traditional hearing aids. CI surgery uses a default setting for frequency allocation aiming to reproduce tonotopicity, thus mimicking the normal cochlea. One emerging instrument that may substantially help the surgeon before, during, and after the surgery is a surgical planning software product developed in collaboration by CASCINATION AG (Bern, Switzerland) and MED-EL (Innsbruck Austria). The aim of this narrative review is to present an overview of the main features of this otological planning software, called OTOPLAN
® . The literature was searched on the PubMed and Web of Science databases. The search terms used were "OTOPLAN", "cochlear planning software" "three-dimensional imaging", "3D segmentation", and "cochlear implant" combined into different queries. This strategy yielded 52 publications, and a total of 31 studies were included. The review of the literature revealed that OTOPLAN is a useful tool for otologists and audiologists as it improves preoperative surgical planning both in adults and in children, guides the intraoperative procedure and allows postoperative evaluation of the CI.- Published
- 2023
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35. Psychophysical assessment of olfactory and gustatory function in post-mild COVID-19 patients: A matched case-control study with 2-year follow-up.
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Boscolo-Rizzo P, Hummel T, Invitto S, Spinato G, Tomasoni M, Emanuelli E, Tofanelli M, Cavicchia A, Grill V, Vaira LA, Lechien JR, Borsetto D, Polesel J, Dibattista M, Menini A, Hopkins C, and Tirelli G
- Subjects
- Humans, Smell, SARS-CoV-2, Case-Control Studies, Follow-Up Studies, Taste Disorders diagnosis, Taste Disorders epidemiology, COVID-19 diagnosis, COVID-19 epidemiology, Olfaction Disorders diagnosis, Olfaction Disorders epidemiology
- Abstract
Background: The aim of this study was to psychophysically evaluate the prevalence of smell and taste dysfunction 2 years after mildly symptomatic severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection compared to that observed at 1-year follow-up and while considering the background of chemosensory dysfunction in the no-coronavirus disease 2019 (COVID-19) population., Method: This is a prospective case-control study on 93 patients with polymerase chain reaction (PCR)-positive SARS-CoV-2 infection and 93 matched controls. Self-reported olfactory and gustatory dysfunction was assessed by 22-item Sino-Nasal-Outcome Test (SNOT-22), item "Sense of smell or taste." Psychophysical orthonasal and retronasal olfactory function and gustatory performance were estimated using the extended Sniffin' Sticks test battery, 20 powdered tasteless aromas, and taste strips test, respectively. Nasal trigeminal sensitivity was assessed by sniffing a 70% solution of acetic acid., Results: The two psychophysical assessments of chemosensory function took place after a median of 409 days (range, 366-461 days) and 765 days (range, 739-800 days) from the first SARS-CoV-2-positive swab, respectively. At 2-year follow-up, cases exhibited a decrease in the prevalence of olfactory (27.9% vs. 42.0%; absolute difference, -14.0%; 95% confidence interval [CI], -21.8% to -2.6%; p = 0.016) and gustatory dysfunction (14.0% vs. 25.8%; absolute difference, -11.8%; 95% CI, -24.2% to 0.6%; p = 0.098). Subjects with prior COVID-19 were more likely than controls to have an olfactory dysfunction (27.9% vs. 10.8 %; absolute difference, 17.2%; 95% CI, 5.2% to 28.8%) but not gustatory dysfunction (14.0% vs. 9.7%; absolute difference, 4.3%; 95% CI, -5.8% to 14.4% p = 0.496) still 2 years after the infection. Overall, 3.2% of cases were still anosmic 2 years after the infection., Conclusions: Although a proportion of subjects recovered from long-lasting smell/taste dysfunction more than 1 year after COVID-19, cases still exhibited a significant excess of olfactory dysfunction 2 years after SARS-CoV-2 infection when compared to matched controls., (© 2023 ARS-AAOA, LLC.)
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- 2023
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36. The Risk of Meningitis After Cochlear Implantation: A Systematic Review and Meta-Analysis.
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Gowrishankar SV, Fleet A, Tomasoni M, Durham R, Umeria R, Merchant SA, Shah SFH, Muzaffar J, Mohammed H, Kuhn I, Tysome J, Smith ME, Donnelly N, Axon P, Bance M, and Borsetto D
- Subjects
- Humans, Pneumococcal Vaccines, Cochlear Implantation adverse effects, Cochlear Implants adverse effects, Meningitis epidemiology, Meningitis etiology, Otitis Media
- Abstract
Objective: This study aims to estimate the rate of postoperative meningitis (both immediate and long-term) in patients following cochlear implants (CIs). It aims to do so through a systematic review and meta-analysis of published studies tracking complications after CIs., Data Sources: MEDLINE, Embase, and Cochrane Library., Review Methods: This review was performed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies tracking complications following CIs in patients were included. Exclusion criteria included non-English language studies and case series reporting <10 patients. Bias risk was evaluated using the Newcastle-Ottawa Scale. Meta-analysis was performed through DerSimonian and Laird random-effects models., Results: A total of 116/1931 studies met the inclusion criteria and were included in the meta-analysis. Overall, there were 112 cases of meningitis in 58,940 patients after CIs. Meta-analysis estimated an overall rate of postoperative meningitis of 0.07% (95% confidence interval [CIs], 0.03%-0.1%; I
2 = 55%). Subgroup meta-analysis showed this rate had 95% CIs crossing 0% in implanted patients who received the pneumococcal vaccine, antibiotic prophylaxis, those with postoperative acute otitis media (AOM), and those implanted less than 5 years., Conclusion: Meningitis is a rare complication following CIs. Our estimated rates of meningitis after CIs appear lower than prior estimates based on epidemiological studies in the early 2000s. However, the rate still appears higher than the baseline rate in the general population. The risk was very low in implanted patients who received the pneumococcal vaccine, antibiotic prophylaxis, received unilateral or bilateral implantations, developed AOM, those implanted with a round window or cochleostomy techniques, and those under 5 years., (© 2023 The Authors. Otolaryngology-Head and Neck Surgery published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology-Head and Neck Surgery Foundation.)- Published
- 2023
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37. Recovery from olfactory and gustatory dysfunction following COVID-19 acquired during Omicron BA.1 wave in Italy.
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Boscolo-Rizzo P, Tirelli G, Meloni P, Hopkins C, Lechien JR, Madeddu G, Bonini P, Gardenal N, Cancellieri E, Lazzarin C, Borsetto D, De Vito A, De Riu G, and Vaira LA
- Subjects
- Humans, Italy epidemiology, SARS-CoV-2, Smell, Taste Disorders epidemiology, Taste Disorders etiology, Prospective Studies, COVID-19 complications, COVID-19 epidemiology, Olfaction Disorders epidemiology, Olfaction Disorders etiology, Olfaction Disorders diagnosis
- Abstract
Background: Despite alterations in the sense of smell and taste have dominated the symptoms of SARS-CoV-2 infection, the prevalence and the severity of self-reporting COVID-19 associated olfactory and gustatory dysfunction has dropped significantly with the advent of the Omicron BA.1 subvariant. However, data on the evolution of Omicron-related chemosensory impairment are still lacking., Objective: The aim of the present study was to estimate the prevalence and the recovery rate of self-reported chemosensory dysfunction 6-month after SARS-CoV-2 infection acquired during the predominance of the Omicron BA.1 subvariant in Italy., Methods: Prospective observational study based on the sino-nasal outcome tool 22 (SNOT-22), item "sense of smell or taste" and additional outcomes conducted in University hospitals and tertiary referral centers in Italy., Results: Of 338 patients with mild-to-moderate COVID-19 completing the baseline survey, 294 (87.0 %) responded to the 6-month follow-up interview. Among them, 101 (34.4 %) and 4 (1.4 %) reported an altered sense of smell or taste at baseline and at 6 months, respectively. Among the 101 patients with COVID-19-associated smell or taste dysfunction during the acute phase of the disease, 97 (96.0 %) reported complete resolution at 6 months. The duration of smell or taste impairment was significantly shorter in vaccinated patients (p = 0.007)., Conclusions: Compared with that observed in subjects infected during the first wave of the pandemic, the recovery rate from chemosensory dysfunctions reported in the present series of patients infected during the predominance of the Omicron BA.1 subvariant was more favorable with a shorter duration being positively influenced by vaccination., Competing Interests: Declaration of competing interest The Authors declare that there is no conflict of interest., (Copyright © 2023. Published by Elsevier Inc.)
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- 2023
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38. Meningitis Risk in Patients with Inner Ear Malformations after Cochlear Implants: A Systematic Review and Meta-Analysis.
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Gowrishankar S, Fleet A, Tomasoni M, Kuhn I, Tysome J, Smith ME, Donnelly N, Axon P, Borsetto D, and Bance M
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- Humans, Treatment Outcome, Retrospective Studies, Cochlear Implantation adverse effects, Cochlear Implants adverse effects, Ear, Inner surgery, Meningitis epidemiology, Meningitis etiology
- Abstract
Objective: The objective of this study is to determine the rate of postoperative meningitis after cochlear implantation in those with inner ear malformations (IEMs) via meta-analysis., Data Sources: Medline, EMBASE, and the Cochrane Library., Methods: This study was reported following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist. Proportion meta-analysis was conducted through an inverse variance random-effect model based on arcsin transformation and presented as forest plots. Quality assessment of the included studies was performed through the National Institutes of Health Quality Assessment Tool., Results: Overall, 38 of 2966 studies met the inclusion criteria and were included in the analysis. There were 10 cases of meningitis after cochlear implantation in 1300 malformed ears. The overall rate of meningitis after cochlear implantation in IEMs was 0.12% (95% confidence interval, 0.006-0.380%; I2 = 0%). Cases occurred in incomplete partition (n = 5), Mondini deformity (n = 2), common cavity (n = 2), and enlarged internal auditory canal (n = 1). Six of 10 cases of postoperative meningitis occurred with an intraoperative cerebrospinal fluid leak., Conclusion: In those with IEMs, the risk of meningitis after cochlear implantation is very low., Competing Interests: The authors disclose no conflicts of interest., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of Otology & Neurotology, Inc.)
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- 2023
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39. Frequency of electrode migration after cochlear implantation in the early postoperative period. What are associated risk factors?
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Goh X, Harvey L, Axon PR, Donnelly NP, Tysome JR, Borsetto D, Smith ME, and Bance ML
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- Child, Adult, Humans, Cohort Studies, Electrodes, Implanted, Retrospective Studies, Postoperative Period, Cochlear Implantation methods, Cochlear Implants adverse effects
- Abstract
Objectives: To estimate the prevalence of, and risk factors associated with electrode migration (EM) in cochlear implant (CI) recipients., Design: Historical cohort study of all CIs performed between 1 January 2018 and 1 August 2021 in a single tertiary adult and paediatric CI centre in the UK., Main Outcome Measures: The primary aim is to determine the prevalence of electrode migration, comparing intraoperative surgeon report and examination of a routine plain radiograph performed 2 weeks after surgery. EM is defined as the detection of movement of two or more electrodes out of the cochlea from the time of surgery. Multivariate analysis was performed to investigate preoperative and intraoperative risk factors that might predispose to migration., Results: Four hundred and sixty-five patients, having 516 distinct surgeries, with 628 implants were analysed. EM occurred following 11.5% of implant operations. Pre-existing cochlear abnormality was an independent associated risk factor for EM (OR: 3.40 ⟨1.20-9.62⟩ p = .021). Demographics, surgical technique, usage of a precurved electrode, CSF leak, surgeon seniority and intraoperative telemetry did not influence risk of migration. There were 5 implants (0.8%) which migrated later than 2 weeks, with a median date of imaging diagnosis (x-ray or CT scan) of 263 days ⟨IQR:198⟩, for which head injury was a common precipitating factor. There were differences in the risk of migration between different lateral wall electrodes., Conclusion: EM in the early postoperative period is a common occurrence and is more likely in implant recipients with obstructed or malformed cochleae., (© 2023 John Wiley & Sons Ltd.)
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- 2023
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40. Functional Outcomes Following Delayed Laryngeal Reinnervation Of Patients with Vagal Paralysis After Paraganglioma and Schwannoma Surgery.
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Candelo E, Borsetto D, Obholzer R, Clarke P, MatBaki M, and Birchall M
- Subjects
- Humans, Treatment Outcome, Recurrent Laryngeal Nerve surgery, Vocal Cord Paralysis diagnosis, Vocal Cord Paralysis etiology, Vocal Cord Paralysis surgery, Larynx surgery, Paraganglioma complications, Paraganglioma diagnosis, Paraganglioma surgery, Neurilemmoma complications, Neurilemmoma surgery
- Abstract
Purpose: We present a prospective case series that aimed to report the functional (voice and swallowing) outcomes of delayed laryngeal reinnervation following vagal interruption by resection of vagal paraganglioma and schwannoma., Materials and Methods: A dedicated, anonymized database was established in 2012 with a minimum eighteen-month follow up set for this report. Internationally validated self- and observer-reported measures were recorded preoperatively and at six, 12 and, 18 months together with demographics, diagnoses, and operative details., Results: A total of eight patients with a median age of 46 (37-54) underwent excision of vagal paraganglioma (five) and schwannoma (three) with few mild complications. Three underwent selective and five non selective reinnervation. Seven out of eight patients underwent synchronous injection medialization. The voice handicap index (VHI-30) improved from a baseline median 83 (range 52-102) to 7.5 (5-58) at 18 months; maximum phonation time improved from median 8 (range 5-15) to 10.5 (8.5-11); voice grade ("G" in grade, roughness, breathiness, asthenia, and strain [GRBAS] scoring) improved from median three (severe impairment, range 0-3) to one (mild impairment, 0-2); Eating Assessment Tool (EAT-10) score improved from median 12 (range 3.5-27) preoperatively to one (0-16); and reflux symptom index (RSI) improved from median 25 (range 17-36) to 7 (0-36). One patient exhibited no discernible reinnervation, while the remainder exhibited good cord bulk and tone, though without purposive abduction., Conclusion: Delayed laryngeal reinnervation for high vagal paralysis is a safe technique associated with good voice and swallowing outcomes by 12-18 months. Potential confounders in this small series and the absence of a control arm both limit conclusions, but this study suggests that further prospective, controlled studies, and/or case registration are merited., (Copyright © 2021 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
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41. Aetiology and management options for secondary referred otalgia: a systematic review and meta-analyses.
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Ally M, Moinie A, Lomas J, Borsetto D, Mochloulis G, Bance M, Boscolo-Rizzo P, and Vijendren A
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- Humans, Causality, Earache etiology, Earache therapy, Physical Examination adverse effects
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- 2023
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42. The prognostic-nutritional index in HPV-negative head and neck squamous cell carcinoma treated with upfront surgery: a multi-institutional series.
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Tomasoni M, Piazza C, Deganello A, Bossi P, Tirelli G, Nicolai P, Da Mosto MC, Molteni G, Giacomarra V, Canzi P, Pelucchi S, Polesel J, Borsetto D, and Boscolo-Rizzo P
- Subjects
- Humans, Squamous Cell Carcinoma of Head and Neck surgery, Nutrition Assessment, Prognosis, Retrospective Studies, Neoplasm Recurrence, Local, Papillomavirus Infections, Head and Neck Neoplasms surgery
- Abstract
Objectives: To evaluate the prognostic value of pre-treatment prognostic-nutritional index (PNI) in patients with HPV-negative head and neck squamous cell carcinoma (HNSCC)., Methods: A multi-institutional retrospective series of HPV-negative, Stages II-IVB, HNSCCs treated with upfront surgery was evaluated. Correlation of pre-operative blood markers and PNI with 5-year overall (OS) and relapse-free (RFS) survival was tested using linear and restricted cubic spline models, as appropriate. The independent prognostic effect of patient-related features was assessed with multivariable models., Results: The analysis was conducted on 542 patients. PNI ≥ 49.6 (HR = 0.52; 95% CI, 0.37-0.74) and Neutrophil-to-Lymphocyte Ratio (NLR) > 4.2 (HR = 1.58; 95% CI, 1.06-2.35) confirmed to be independent prognosticators of OS, whereas only PNI ≥ 49.6 (HR = 0.44; 95% CI, 0.29-0.66) was independently associated with RFS. Among pre-operative blood parameters, only higher values of albuninaemia and lymphocyte count (> 1.08 x 10
3 /microL), and undetectable basophile count (= 0 103 /microL) were independently associated with better OS and RFS., Conclusions: PNI represents a reliable prognostic tool providing an independent measure of pre-operative immuno-metabolic performance. Its validity is supported by the independent prognostic role of albuminaemia and lymphocyte count, from which it is derived., (Copyright © 2023 Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale, Rome, Italy.)- Published
- 2023
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43. SpeedCAP: An Efficient Method for Estimating Neural Activation Patterns Using Electrically Evoked Compound Action-Potentials in Cochlear Implant Users.
- Author
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Garcia C, Deeks JM, Goehring T, Borsetto D, Bance M, and Carlyon RP
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- Humans, Cochlea physiology, Evoked Potentials, Evoked Potentials, Auditory physiology, Action Potentials physiology, Cochlear Nerve physiology, Electric Stimulation, Cochlear Implants, Cochlear Implantation methods
- Abstract
Objectives: Electrically evoked compound action-potentials (ECAPs) can be recorded using the electrodes in a cochlear implant (CI) and represent the synchronous responses of the electrically stimulated auditory nerve. ECAPs can be obtained using a forward-masking method that measures the neural response to a probe and masker electrode separately and in combination. The panoramic ECAP (PECAP) analyses measured ECAPs obtained using multiple combinations of masker and probe electrodes and uses a nonlinear optimization algorithm to estimate current spread from each electrode and neural health along the cochlea. However, the measurement of ECAPs from multiple combinations of electrodes is too time consuming for use in clinics. Here, we propose and evaluate SpeedCAP, a speedy method for obtaining the PECAP measurements that minimizes recording time by exploiting redundancies between multiple ECAP measures., Design: In the first study, 11 users of Cochlear Ltd. CIs took part. ECAPs were recorded using the forward-masking artifact-cancelation technique at the most comfortable loudness level (MCL) for every combination of masker and probe electrodes for all active electrodes in the users' MAPs, as per the standard PECAP recording paradigm. The same current levels and recording parameters were then used to collect ECAPs in the same users with the SpeedCAP method. The ECAP amplitudes were then compared between the two conditions, as were the corresponding estimates of neural health and current spread calculated using the PECAP method previously described by Garcia et al. The second study measured SpeedCAP intraoperatively in 8 CI patients and with all maskers and probes presented at the same current level to assess feasibility. ECAPs for the subset of conditions where the masker and probe were presented on the same electrode were compared with those obtained using the slower approach leveraged by the standard clinical software., Results: Data collection time was reduced from ≈45 to ≈8 minutes. There were no significant differences between normalized root mean squared error (RMSE) repeatability metrics for post-operative PECAP and SpeedCAP data, nor for the RMSEs calculated between PECAP and SpeedCAP data. The comparison achieved 80% power to detect effect sizes down to 8.2% RMSE. When between-participant differences were removed, both the neural-health (r = 0.73) and current-spread (r = 0.65) estimates were significantly correlated ( p < 0.0001, df = 218) between SpeedCAP and PECAP conditions across all electrodes, and showed RMSE errors of 12.7 ± 4.7% and 16.8 ± 8.8%, respectively (with the ± margins representing 95% confidence intervals). Valid ECAPs were obtained in all patients in the second study, demonstrating intraoperative feasibility of SpeedCAP. No significant differences in RMSEs were detectable between post- and intra-operative ECAP measurements, with the comparison achieving 80% power to detect effect sizes down to 13.3% RMSE., Conclusions: The improved efficiency of SpeedCAP provides time savings facilitating multi-electrode ECAP recordings in routine clinical practice. SpeedCAP data collection is sufficiently quick to record intraoperatively, and adds no more than 8.2% error to the ECAP amplitudes. Such measurements could thereafter be submitted to models such as PECAP to provide patient-specific patterns of neural activation to inform programming of clinical MAPs and identify causes of poor performance at the electrode-nerve interface of CI users. The speed and accuracy of these measurements also opens up a wide range of additional research questions to be addressed., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2022 The Authors. Ear & Hearing is published on behalf of the American Auditory Society, by Wolters Kluwer Health, Inc.)
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- 2023
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44. TERT promoter mutations in head and neck squamous cell carcinoma: A systematic review and meta-analysis on prevalence and prognostic significance.
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Boscolo-Rizzo P, Tirelli G, Polesel J, Sia E, Phillips V, Borsetto D, De Rossi A, and Giunco S
- Subjects
- Humans, Squamous Cell Carcinoma of Head and Neck genetics, Prognosis, Prevalence, Mutation, Mouth Neoplasms genetics, Laryngeal Neoplasms, Telomerase genetics, Head and Neck Neoplasms genetics
- Abstract
Objectives: To estimate the prevalence of two most common and mutually exclusive -124 C > T and -146 C > T TERT promoter mutations in HNSCC and analyse their prognostic role., Materials and Methods: The databases Medline (via Ovid), Embase (via Ovid), Cochrane Library, Scopus, and Web of Science (Core Collection) were searched from inception to December 2022 to identify studies analysing TERT promoter mutations in HNSCC. Pooled prevalence of TERT promoter mutations and hazard ratio (sHR) of death/progression, with corresponding confidence intervals (CI), were estimated., Results: The initial search returned 6416 articles, of which 17 studies, including 1830 patients, met the criteria for prevalence meta-analysis. Among them, 8 studies fitted the inclusion criterion to analyse the prognostic impact of TERT promoter mutations. Overall, 21% (95% CI: 12%-31%) of HNSCCs harboured TERT promoter mutation. TERT promoter mutations were more commonly found in oral cavity cancer (prevalence = 47%, 95% CI: 33%-61%), followed by laryngeal/hypopharyngeal cancer (prevalence = 12%, 95% CI: 4%-25%), while they were quite rare in oropharyngeal cancer (prevalence = 1%, 95% CI: 0%-4%). TERT promoter mutation -124 C > T was associated with a higher risk of death (sHR = 2.01, 95% CI: 1.25-3.23) and progression (sHR = 2.79, 95% CI: 1.77-4.40), while -146 C > T TERT promoter mutation did not show any significant correlation neither to overall nor progression-free survival., Conclusion: TERT promoter mutations were mainly topographically restricted to oral cavity cancer. -124 C > T was the most common TERT promoter mutation and was significantly associated to worse outcome in HNSCC., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)
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- 2023
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45. General anaesthetic vs local anaesthetic myringoplasties: a systematic review and meta-analysis.
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Kaleva AI, Raithatha A, Tomasoni M, Borsetto D, and Vijendren A
- Subjects
- Humans, Anesthesia, General adverse effects, Anesthesia, Local adverse effects, Anesthetics, Local, Myringoplasty methods, Retrospective Studies, Treatment Outcome, Anesthetics, General, Tympanic Membrane Perforation surgery, Tympanic Membrane Perforation etiology
- Abstract
Aims: To assess all available data and determine the success rates and tolerability of local anaesthetic myringoplasty in comparison with those undertaken under general anaesthetic myringoplasty., Materials and Methods: The study was designed following a PRISMA-P protocol and registered with the PROSPERO database. MEDLINE, Cochrane Library (CDSR/Central), EMBASE and CINHAL-were directly searched for studies, which met the inclusion criteria., Objectives: Primary objective was to compare perforation closure rates between patients undergoing myringoplasty under local anaesthetic and those under general anaesthetic from all available published data. Secondary outcomes include complications, such as 'any minor complications', infection rates in the first 6 month post-op, facial nerve weakness, dysgeusia and patient satisfaction., Results: 27 studies were included in the final analysis and found that myringoplasty had an overall perforation closure rate of 89%. The pooled proportion of closures after myringoplasty under local anesthesia was 87% and for myringoplasties under general anesthesia was 91%. Analysis of myringoplasty under local anaesthesia focusing on 'in-office' performed procedures only, found a closure rate of 88%., Conclusions: There is no significant difference in the success rate of myringoplasty surgery when performed under local or general anaesthetic as measured by perforation closure rates. However, there are other factors, which can drive choosing local anaesthetic surgery, such as minimising anaesthetic risks, reducing costs and reducing environmental impact., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2023
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46. Recurrence in cholesteatoma surgery: what have we learnt and where are we going? A narrative review.
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Bovi C, Luchena A, Bivona R, Borsetto D, Creber N, and Danesi G
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- 2023
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47. Head and neck squamous cell carcinoma in HIV patients.
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Rampinelli V, Gennarini F, Borsetto D, and Piazza C
- Subjects
- Humans, Squamous Cell Carcinoma of Head and Neck, Incidence, Head and Neck Neoplasms, HIV Infections, Carcinoma, Squamous Cell pathology
- Abstract
Purpose of Review: The introduction of antiretroviral therapy has significantly impacted the incidence of head and neck squamous cell carcinoma (HNSCC) in people living with HIV (PLWH). This manuscript aims to give an overview of the evidence in the literature about this population., Recent Findings: PLWH have an increased incidence of HNSCC, with earlier age and more advanced stage at diagnosis. This epidemiologic trend may be explained by combining traditional and HIV-related risk factors. With the improvement of global health status, more patients are candidate for complex therapeutic strategies with curative intent. To date, it is still debated whether HIV-infected patients possess a profile of increased risk regarding treatment-related toxicity and survival outcomes, with the literature still lacking substantial evidence. Among the prognostic factors that can guide the clinician in selecting the most appropriate treatment strategy, age, site/subsite, stage, HIV viral load, and CD4+ T-cell count at diagnosis are the most relevant., Summary: Pathogenesis, treatment characteristics, oncologic outcomes, and prognostic factors of HNSCC in PLWH are still debated. Given the increasing incidence of HNSCC in PLWH, the need for dedicated evidence-based studies represents a significant research gap to be addressed., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2023
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48. Dizziness, psychological disorders and cognitive decline.
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Borsetto D, Corazzi V, Obholzer R, Bianchini C, Pelucchi S, Solmi M, Jiang D, Amin N, Pai I, and Ciorba A
- Subjects
- Humans, Aged, Retrospective Studies, Cohort Studies, Quality of Life, Dizziness diagnosis, Dizziness epidemiology, Dizziness etiology, Cognitive Dysfunction diagnosis
- Abstract
Introduction: Dizziness is a common disorder, particularly among the elderly population. Aim of this paper was to revise the current concepts surrounding the relationship between dizziness, psychological disorders and cognitive decline., Evidence Acquisition: This is a PRISMA-compliant systematic review, including observational studies in people with dizziness. Database inception, Medline/Cochrane/Embase/Web of Science/Scopus/NHS evidence were searched until October 30, 2019., Evidence Synthesis: Overall 22 studies, and 65,730 participants were included. Eleven studies were cross-sectional, 7 cross-sectional controlled, 2 prospective case-control, 1 retrospective case series, and 1 cohort study. The persistence of vestibular impairment (for 6 months or more) was correlated to the presence of psychological disorders affecting patient's Quality of Life and causing social anxiety, particularly in some conditions such as Ménière's disease. Interestingly, vestibular loss has been also correlated to cognitive impairment, with certain vestibular dysfunctions reported to be more prevalent in cognitive impaired individuals., Conclusions: The current literature suggests that there is an association between vestibular function, psychological disorders and cognitive functions. The findings from this review could be useful in informing on the need for a multidimensional diagnostic and rehabilitative programs for patients with dizziness. More studies could explore the role of counseling or behavioral therapy with an aim to reduce the perceived dizziness-related disability.
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- 2023
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49. Central Compartment Neck Dissection in Laryngeal and Hypopharyngeal Squamous Cell Carcinoma: Clinical Considerations.
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Deganello A, Ruaro A, Gualtieri T, Berretti G, Rampinelli V, Borsetto D, Russo S, Boscolo-Rizzo P, Ferrari M, and Bussu F
- Abstract
Metastatic lymph node involvement represents the most relevant prognostic factor in head and neck squamous cell carcinomas (HNSCCs), invariably affecting overall survival, disease-specific survival, and relapse-free survival. Among HNSCCs, laryngeal and hypopharyngeal cancers are known to be at highest risk to metastasize to the central neck compartment (CNC). However, prevalence and prognostic implications related to the CNC involvement are not well defined yet, and controversies still exist regarding the occult metastasis rate. Guidelines for the management of CNC in laryngeal and hypopharyngeal cancers are vague, resulting in highly variable selection criteria for the central neck dissection among different surgeons and institutions. With this review, the authors intend to reappraise the existing data related to the involvement of CNC in laryngeal and hypopharyngeal malignancies, in the attempt to define the principles of management while highlighting the debated aspects that are lacking in evidence and consensus. Furthermore, as definition and boundaries of the CNC have changed over the years, an up-to-date anatomical-surgical description of the CNC is provided.
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- 2023
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50. Exploratory tympanotomy in conductive hearing loss with normal pre-operative investigations.
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Tomasoni M, Borsetto D, Deretti A, Arcuri M, Sordi A, Zorzi S, Redaelli de Zinis LO, Piazza C, Deganello A, and Sorrentino T
- Subjects
- Humans, Hearing Loss, Conductive diagnosis, Hearing Loss, Conductive surgery, Ear, Middle surgery, Audiometry, Retrospective Studies, Treatment Outcome, Otosclerosis surgery, Stapes Surgery
- Abstract
Objective: To investigate whether patients with conductive hearing loss (CHL) and normal preoperative investigations may benefit from exploratory tympanotomy (ET) and tailored treatment performed according to intraoperative findings., Methods: Patients treated with ET for CHL with normal pre-operative otoscopy, tympanometry and CT scan from 2011 to 2019 were reviewed. Data regarding demographics, audiometry, intraoperative findings and surgery were collected and analysed to assess if they can predict post-operative air bone gap (ABG) closure and patient satisfaction., Results: Forty-eight cases were included. Mean ABG significantly reduced (p < 0.001) from preoperative (38.4 dB) to postoperative (14.8 dB). Post-operative ABG closure within 10 dB was observed in 20 cases (41.7%). Overall satisfaction was reported in 60% of cases. Stapes fixation was the most common diagnosis (47.9%) and significantly associated with lower post-operative ABG and higher satisfaction., Conclusions: In CHL with normal pre-operative investigations, ET represents the mainstay of treatment, even if audiological outcomes may widely vary. Intraoperative finding of stapes fixation (thus stapedotomy) ensures the best audiological and satisfaction outcomes., (Copyright © 2022 Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale, Rome, Italy.)
- Published
- 2022
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