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This study aims to analyse a single-centre cohort series of patients who underwent parotidectomy for primary malignant parotid tumours. A retrospective chart review of 64 consecutive patients treated from November 2010 to March 2022 was performed. Outcomes were analysed by Kaplan-Meier curves. Sixty-four patients with a primary parotid malignancy were included in the study, with one bilateral case in this cohort. Patients were classified as stage I–II in 39 cases and stage III–IV in 26 cases. The five-year overall survival (OS), disease-specific survival (DSS), local relapse-free survival (LRFS), and distant metastasis-free survival (DMFS) rates were 78.4%, 89%, 92.5%, and 87.1%, respectively. Univariate analysis showed that high-risk histology, stage IV disease, lymphovascular invasion, perineural invasion, node metastasis, skin involvement, facial nerve involvement, and positive or close margins were risk factors associated with poorer outcomes. At present, the best evidence suggests that radical surgery should be the standard approach, and adjuvant therapy, in terms of radiotherapy/chemoradiotherapy, is recommended in patients with risk factors.

BackgroundThe development of standardized treatments for idiopathic sudden sensorineural hearing loss (ISSNHL) is hampered by uncertainty over the etiology of this disorder. Systemic steroids are historically the primary therapy, with variable hearing outcomes. Over the last two decades, intratympanic steroids (ITS) and hyperbaric oxygen therapy (HBOT) have been proposed as salvage treatments in case of failure of systemic steroids. The present study aims to evaluate the effectiveness of these salvage treatments in addition to systemic steroids.MethodsWe performed a retrospective study on 75 consecutive patients with a diagnosis of ISSNHL who were admitted to the Department of Otorhinolaryngology of our hospital between December 2018 and December 2022. All patients received primary treatment with systemic steroids. In case of slight or no hearing recovery within the 5th day from the beginning of the therapy (T1), a salvage treatment with ITS or HBOT was proposed. Patients were divided into three groups according to the therapy received: systemic steroids (group A), systemic steroids + HBOT (group B), and systemic steroids + ITS (group C). Pure-tone average at 500, 1000, 2000, and 3000 Hz and the mean gain were evaluated at T1 and 3 months after the beginning of the salvage treatment (T2). The hearing recovery was assessed according to the Siegel's criteria.ResultsSixty-two patients (31 men and 31 women, mean age 56 years) with failure of the primary treatment were definitively enrolled in the study: 34 (54.8%) in group A, 16 (25.8%) in group B, and 12 (19.4%) in group C. The ratio of patients responding to therapy was higher in group A (29.4%) than in groups B (18.75%) and C (16.7%). We did not find any statistically significant difference between groups in terms of mean hearing gain at T2 (17.4 ± 15.4 dB in group A vs. 18.6 ± 21.1 dB in group B and 15.7 ± 14.2 dB in group C, p = 0.9).ConclusionIn our experience, ITS or HBOT associated with systemic steroids, as salvage treatment, did not show significant improvement in hearing outcomes. The evolution of ISSNHL, regardless of the treatment, remains unpredictable.

Introduction: Dysphonia in the pediatric population has effects on school, family and social activity. Among the benign pathologies causing dysphonia in children, concomitant bilateral vocal cord cysts are quite uncommon. Vocal cord cysts can be congenital or acquired. The diagnosis is not always straight, but when defined the only treatment is surgery. Objective: The authors reported a pediatric case of chronic dysphonia due to bilateral vocal cord retention cysts and discuss the etiopathogenetic hypothesis and surgical treatment with the CO2 laser mini-microflap technique. A review of the literature was also performed. Case report: A 12-year-old patient was admitted at the Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Italy for chronic dysphonia lasting from one year: Grade Roughness Breathiness Asthenia Strain scale was 3 in every specific area, and Pediatric Voice Handicap Index score was 48. Laryngoscopy showed a bilateral vocal cord swelling at the middle third of both vocal cords suspect for cystic lesions. The patient underwent microlaryngoscopy under general anesthetic and CO2 laser microsurgical excision with the mini-microflap technique. The procedure was performed with the aid of an UltraPulse® Duo (Lumenis®, Tel Aviv, Israel) CO2 laser (10 W, CW, UP, AB 2 mm and 1 mm) with an AcuBlade™ focusing system by Lumenis® (Tel Aviv, Israel). Histology confirmed the diagnosis of bilateral vocal fold epidermoid cyst. One month after surgery, indirect laryngoscopy showed complete healing of both vocal cords with an adequate vibratory pattern. Dysphonia recovered completely. Conclusion: CO2 laser microsurgery can be safely and effectively performed even in the pediatric population.