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From the first days of life, a female newborn suffered from nasal congestion and a runny nose. The first MRI, at 42 days of life, revealed a solid and expansive mass of 1 cm in the left nasal fossa. The radiological examination repeated at 4 months of life showed an increase in volume, up to 2 cm (

Objectives The aim of this article was to describe the surgical technique and report the oncological and functional outcomes of the partial glottic-subglottic laryngectomy (GSL). Methods A retrospective review of the clinical charts of patients who underwent GSL for laryngeal cancer from 1989 to 2020 at the Otolaryngology Unit of the Vittorio Veneto Hospital, a referral center for laryngeal cancer treatment. Results The present article considered 36 patients who were submitted to GSL for laryngeal cancer. The pathological exam found squamous cell carcinoma (SCC) in 16 cases, adenoid-cystic carcinoma (ACC) in 9 cases, laryngeal chondrosarcoma in 8 cases, 1 giant cell carcinoma, 1 carcinosarcoma, and 1 metastasis of colon adenocarcinoma. Considering the 16 SCC cases we observed a recurrence rate of 31%, the overall survival (OS) and disease-specific survival (DSS) were 75%. The 9 ACC cases had a recurrence rate of 23% and OS/DSS of 88%. In the 8 chondrosarcomas no relapses were reported and the OS/DSS were 100%. Among the patients without recurrence of the disease, a definitive decannulation was achieved in 21 cases (75%). Conclusions The GSL represents a valid alternative to total laryngectomy in selected cases of laryngeal cancer involving the glottic and subglottic regions.

Background: To report surgical outcomes of transsphenoidal surgery as first-line treatment and predictors of remission in a specialist centre for patients with Cushing’s disease and to investigate long-term remission and delayed recurrence. Methods: Clinical data was obtained from a retrospective CD database while all electronic medical, laboratory and surgical patient records between 2012 and 2022 with a minimum 23 months’ follow-up, were evaluated. Result: In this single-centre study a total of 50 consecutive patients with CD (34F, 16M) underwent TSS. Median (range) age and follow-up were 37.8 (15-69) and 76.5 (23-122) months respectively. The initial remission rate was 84% (n = 42/50). Initial non-remission occurred in 8 patients (16%), with three macro- and five microadenomas. Three (2 micro, 1 macro) of the 42 patients with initial remission had late (>50 months) recurrence of hypercortisolism that required repeat TSS. Seven patients (16.6%) with non-reduced postoperative cortisol levels showed a subsequent remission. Male gender was the only factor significantly associated with lower remission rates in either short- or long-term follow-up (p = 0.003 and 0.038 respectively).Conclusions: A team-based approach, in a specialized pituitary centre, can lead to initial and durable long-term remission in patients with CD. Additionally, we found that the risk of relapse in patients with CD persisting for more than 5 years after surgery is real but low. Moreover, non-initially reduced postoperative cortisol levels do not preclude a subsequent remission. Lifelong follow-up for patients with CD appears essential, for all patients who have shown recovery of their axis relationship.

Bilateral choanal atresia (CA) is a rare congenital malformation frequently associated with other anomalies. CHARGE association is closely linked to bilateral CA. The aim of this study was to describe the outcomes of the endoscopic repair in bilateral CA, and to assess the role of postoperative nasal stenting in two cohorts of CHARGE-associated and non-syndromic CA. Thirty-nine children were retrospectively analyzed (16 patients had CHARGE-associated CA). The rate of postoperative neochoanal restenosis was 31.3% in the CHARGE population, and 47.8% in the non-syndromic CA cohort. Data on postoperative synechiae and granulation tissue formation, need for endonasal toilette and dilation procedures, and number of procedures per patient were presented. Stent positioning led to a higher number of postoperative dilation procedures per patient in the non-syndromic cohort (p = 0.018), and to a higher rate of restenosis both in the CHARGE-associated, and non-syndromic CA populations. Children with CHARGE-associated and non-syndromic bilateral CA benefitted from endonasal endoscopic CA correction. The postoperative application of an endonasal stent should be carefully evaluated.

Orbital metastases represent a rare condition and only 33 cases of metastases from hepatocellular carcinoma (HCC), usually revealed by slowly progressive exophthalmos, have been described in the literature. A 62-year-old man affected by HCC reported a sudden left exophthalmos and amaurosis. A cranial CT scan revealed pathological tissue occupying the superior portion of the orbit. During endoscopic decompression of the optic nerve, an active venous intraorbital haemorrhage was noted. Following angiography, permanent occlusion was performed on a neoforming circulus fed by ramification of the anterior deep temporal artery, anterior ramification of the superficial temporal artery and sphenoidal ramification of the medial meningeal artery. A percutaneous incisional orbital biopsy showed features of metastatic foci of HCC. This is the first description of orbital metastasis from HCC revealed by a sudden exophthalmos.

An 80-year-old man referred with repeated episode of dacryocystitis from the left lacrimal drainage system and palpable swelling. For many years, he has being presented with epiphora unilaterally with chronic dacryocystitis. Investigations with dye-test revealed subocclusion of the natural passage of the tears, and CT and MRI scans revealed solid mass in the lacrimal sac. The lacrimal sac was opened by endonasal endoscopic approach, the sacral mass was identified and completely removed. The histopathological examination showed lacrimal gland in ectopic position. Patient followed for 18 months with complete recovery of symptoms. In our differential diagnosis, the ectopic lacrimal gland is also identified, when a mass in the lacrimal sac and duct is present. Successful surgical excision required considerable multidisciplinary teamwork between ophtalmologist–ENT (Otolaryngologist) and radiologist. Endonasal endoscopic approach is perfectly safe with direct control and ensures a smooth postoperative recovery.