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BACKGROUND. Fractures of the naso-orbito-ethmoido-maxillary (NOEM) complex are frequently acquired post-traumatic lesions, with both aesthetic and functional consequences, if the diagnosis is not promptly established and the surgical correction is delayed. OBJECTIVES. This study was conducted in order to facilitate the diagnosis of NOEM complex fractures by using anthropometric measures. The aim was to obtain normal mean values of the evaluated parameters from a lot of healthy volunteers. MATERIAL AND METHODS. The measurements were conducted on patient-specific three-dimensional models obtained from processing the CT scan images and building further stereolithographic models. 64 Caucasian patients were enrolled, with ages between 19 and 93 years, both female and male volunteers, without previous surgical history of the middle floor of the face. Measurements were performed between certain craniometric points (Nasion, Dacryon, Infraorbital foramen, Rhinion and Frontomalare orbitale) and a database was created. RESULTS. Although some expected variation arised, we have obtained normal-considered intervals for each of the defined and measured segments between the mentioned craniometric points. We find these measurements useful especially for elaborating a presurgical plan for the best outcome. CONCLUSION. Simple measurements could orient a fast diagnosis, could help establish a surgical plan, an optimal surgical timing by combining clinical and imaging data.

Mucoceles are benign, expansive, cystic tumors, affecting especially the adult, with development in the paranasal sinuses. Clinical symptoms are not specific. These are rare conditions that originate within the sinusal mucosa, favoured by the obstruction of the sinus ostium. Due to the inflammation and the expansive character of the tumor, with the erosion of the bony walls, combined forms can develop, with the involvement of two or more sinuses, most frequently with fronto-ethmoidal localization. The authors carry out a clinical retrospective study on 25 cases of mucoceles of the paranasal sinuses, diagnosed and treated in the ENT Clinic of the “Sfantul Spiridon” Emergency Clinical Hospital Iasi, during 2015-2019. The authors insist on aspects related to clinical and radiological diagnosis (CT scanner), as well as surgical treatment by external approach. The postoperative evolution is generally simple, with full recovery, without complications or recurrences. The diagnosis of the mucoceles of the paranasal sinuses consists in radiologic techniques by preoperative CT scan examination, intraoperative macroscopic aspect and histopathological result. Surgical approach with complete excision of the tumor and creating a new sinusal drainage path prevents the occurrence of recurrences.

Immunotherapy represents a promising strategy for the treatment of cancer, which functions via the reprogramming and activation of antitumor immunity. However, adverse events resulting from immunotherapy that are related to the low specificity of tumor cell-targeting represent a limitation of immunotherapy’s efficacy. The potential of nanotechnologies is represented by the possibilities of immunotherapeutical agents being carried by nanoparticles with various material types, shapes, sizes, coated ligands, associated loading methods, hydrophilicities, elasticities, and biocompatibilities. In this review, the principal types of nanovectors (nanopharmaceutics and bioinspired nanoparticles) are summarized along with the shortcomings in nanoparticle delivery and the main factors that modulate efficacy (the EPR effect, protein coronas, and microbiota). The mechanisms by which nanovectors can target cancer cells, the tumor immune microenvironment (TIME), and the peripheral immune system are also presented. A possible mathematical model for the cellular communication mechanisms related to exosomes as nanocarriers is proposed.

Background and objectives: Knowledge of the interactions and influences of infectious, genetic, and environmental factors on the evolution and treatment response of malignant tumors is essential for improving the management of the disease and increasing patient survival. The objective of this study was to establish the contribution of human papillomavirus (HPV), as well as p53 and p16 tumor markers, alongside associated factors (smoking and alcohol consumption), in the progression of malignancies located in the oropharynx and at the retromolar trigone&ndash, oropharyngeal junction. Materials and Methods: We performed a prospective study including 50 patients with malignant tumors of the oropharynx and retromolar trigone&ndash, oropharyngeal junction. In all patients, the presence and type of HPV were determined, as well as the status of the tumor markers p53 and p16. The associated risk factors, biopsy results, treatment method, and post-treatment evolution were all documented. Statistical analyses were performed to evaluate the correlations between the determining factors and their influence on the post-treatment evolution. An overall increased survival rate was found in HPV(+) patients. Results: Our study outlined the prevalence of different high-risk subtypes of HPV from the ones presented by other studies, suggesting a possible geographic variation. Correlations between the p53 and p16 statuses and patient survival could be established. The association of smoking and alcohol consumption strongly correlated with an unfavorable evolution. Conclusions: Awareness of the differences in the post-treatment evolution of the patients in relation to the presence of the factors determined in our study could change the future management of such cases for ensuring improved treatment outcomes.

The aim of this study is to enhance knowledge regarding the behavior of human papilloma virus (HPV)-associated malignancies between two territories - maxillofacial and otorhinolaryngology. The HPV status and genotype, p16 and p53 expression were performed in 50 patients with malignancies located at the junction between the oropharynx and retromolar trigone alone or oropharynx spread to the junction. These were correlated with the treatment response, prognosis and survival of this kind of tumor located in oral posterior region, marking the transition between two territories (maxillofacial and otorhinolaryngology) of the selected cases. Results showed better treatment outcome and improved prognosis in HPV-positive compared to HPV-negative patients, and a strong link between HPV presence and p16 expression. Multimodal treatment including surgery, radiotherapy and chemotherapy provided the best results, although surgery was only an option in a limited number of cases, due to the advanced stage at presentation and extension in the surrounding tissues, considering the complex anatomy of the area. In the context of the increasing incidence of HPV-positive head and neck cancer, HPV testing together with molecular profiling for p16 and p53 tumor markers could help diagnose malignancies in the initial stages, and also provide important clues towards a targeted, more efficient treatment.

Lipomas are rarely encountered in the thoracic cavity. A pleural origin of lipoma is extremely rare. In fewer occasions it infiltrates the intercostal space and has an hourglass development. Therefore, the intrathoracic and extrathoracic dumbbell-shaped lipoma is a very rare finding. We present the case of a 77-year-old Caucasian woman with an hourglass-shaped lipoma originating from the left parietal pleura and passing outside the thorax through the first intercostal space. The one-year follow-up revealed no changes. Intrathoracic and extrathoracic hourglass type lipomas are a very rare pathology. When they occur, a non-surgical approach may be adopted as long as compression symptoms are absent and the follow-up imaging examinations reveal no lesion growth. In our case, the patient’s history and the imaging investigations support the benign nature of the tumor. Particularly, in our case, the size of the lipoma was small compared to the long duration of its evolution and there were no signs and symptoms of intra-thoracic compression. The taken therapeutic approach complies with the patient’s options and fits in the current generally accepted recommendations.