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Purpose: Near-infrared autofluorescence is a new technology in thyroid surgery to better localize and preserve parathyroid glands. The purpose of this study is to assess if the adoption of NIR-AF can improve in short-, medium-, and long-term post-operative calcium and PTH levels compared to conventional “naked-eye” surgery in patients undergoing TT for benign or malignant conditions.Methods: 134 patients undergone total thyroidectomy between January 2020 and June 2022; 67 were treated with conventional thyroidectomy, the other 67 underwent surgery adopting an autofluorescence detecting device.Results: Significant differences were found between the two groups in percentage of patients with short-term hypocalcemia (p=0.04) and short-term hypoparathyroidism (p=0.011). Median short-term (p=0.01) and medium-term (p=0.03) PTH levels were significantly higher in autofluorescence group, while, short- (p= 0.001), medium- (pConclusion: The adoption of near-infrared autofluorescence during total thyroidectomy is related to lower short-term hypocalcemia and hypoparathyroidism rates, decreased variation of post-operative PTH levels in short- and medium- and long-term, reducing the necessity of supplementation therapy with oral calcium compared to conventional surgery.

The purpose of this study was to assess vestibular findings and clinical history in a large cohort of patients affected by Ménière's disease.We retrospectively analysed 511 adult patients fulfilling criteria for definite unilateral Ménière's disease according to Barany Society. Thorough clinical history, audiometric exam, central nervous system MRI, quantification of serum autoantibodies and complete vestibular function test were performed.Mean age at clinical record was 55.4 years, while age at onset of the first vertigo attack was 47.4 ± 14.3 years. Ménière's disease overlapped with migraine in 43.4% of patients. In 31.7% of cases, positivity was found for at least one autoantibody. Forty-nine patients (9.6%) had family history for Ménière's disease. Bedside examination resulted in 14.7% positivity for video head impulse test, 58.9% for skull vibration-induced nystagmus, 38.7% for the positional test and 23.1% for the post head shaking test. Complete negative examination was reported in 115 cases.Ménière's disease was seen to present a characteristic phenotypic pattern in our cohort, confirming the crucial role of thorough anamnesis and bedside examination in diagnosis.Sindrome di Ménière: valutazione dell’esame vestibolare e della storia clinica in un’ampia popolazione.Analizzare un’ampia casistica di pazienti affetti da sindrome di Ménière con particolare attenzione al dato anamnestico ed ai test di funzione vestibolare.Sono stati raccolti retrospettivamente i dati di 511 pazienti affetti da sindrome di Ménière monolaterale definita, che soddisfacevano i criteri della Barany Society. Ogni paziente è stato sottoposto a raccolta anamnestica, esame audiometrico tonale, RM encefalo, test di autoimmunità ed esame otovestibolare.L’età media alla presentazione clinica è stata di 55,4 anni mentre l’età del primo episodio di vertigine è risultata essere 47,4 ± 14,3. Il 43,4% della popolazione soffre contestualmente di emicrania. Nel 31,7% dei casi è stata quantificata una positività di almeno un autoanticorpo. Quarantanove pazienti hanno riferito un familiare affetto da possibile sindrome di Ménière. La video head impulse è risultata positiva nel 14,7%, il test vibratorio nel 58,9%, 38,6% il test posizionale nel 38,7% e la HST nel 23,1%; una completa negatività ai test vestibolari è stata rilevata in 115 casi.La sindrome di Ménière è spesso associata ad un fenotipo clinico e strumentale suggestivo che conferma il ruolo cruciale di una attentata raccolta anamnestica e dell’esame vestibolare nella diagnosi.

Objectives: To assess prevalence of Personal Protective Equipment (PPE)-related symptoms and adverse reactions during Coronavirus Disease 2019 pandemics. Methods: We conducted an observational study among people exposed to various degree of infectious risk. Data were collected with a self-administered online questionnaire. Results: The entire cohort complained about a wide range of adverse reactions: respiratory symptoms affected 80.3% of respondents, 68.5% referred pressure-related skin lesions, fewer manifested a dermatosis of different grade or ocular symptoms. Most of the affected individuals belonged to healthcare staff and manifestations were predicted by wearing time (more than 6 h/d). Moreover, symptoms were higher in the healthcare staff wearing N95/FFP2 respirator mask. Conclusions: Given the crucial role of PPE to contain the pandemic infection, more attention has to be paid to exposed categories, establishing preventive measure of side effects to ensure total safety.

The COVID-19 pandemic, which began in March 2020, has resulted in the deaths of hundreds of thousands of people around the world in just a few months, putting at great risk the commitment of healthcare workers unprepared to manage a worldwide phenomenon at great risk. In the early stages especially, medical staff had to deal with the pandemic at the expense of their physical and mental health, putting them particularly at risk for experiencing posttraumatic stress disorder (PTSD). The study aims to analyze the psychopathological aspects associated with PTSD, focusing on the emotional impact caused by the COVID-19 pandemic on healthcare professionals compared with a control group. The sample analyzed over 2 months, from March to May 2021, included 214 participants into two groups, i.e., healthcare professionals (N = 107) and a control group (N = 107). The online assessment instrument used consisted of an anonymous questionnaire, assembled ad hoc with demographic information and different standardized assessment scales (e.g., Fear of COVID-19 scale, Profile of Mood States, and Maslach Burnout Inventory-Human Services Survey), while a further section of the survey used the DSM-5 criteria to investigate Posttraumatic stress disorder (e.g., COVID-19—PTSD). The results reported that healthcare professionals had a consistent perception of stress (mean = 26.18, SD = 14.60), but not at a level significantly higher than other categories of workers (mean = 25.75, SD = 14.65; t = 0.20, p = 0.84). However, they showed less emotional disturbance than the control sample, better anxiety management skills, and lower levels of depressive disorder and mental confusion. Specifically, the healthcare professionals showed a condition of emotional exhaustion (T = 0.64, D = 0.74, A = 0.62, S = 0.75, C = 0.64) and depersonalization (T = 0.41, D = 0.52, A = 0.49, S = 0.60, C = 0.40), which is common in the burnout syndrome. In conclusion, the results obtained are useful in understanding the determinants of the emotional involvement of healthcare professions and the risk of burnout syndrome and, therefore, for planning activities and support paths for these workers who are particularly at risk during prolonged and pervasive crises, such as the pandemic.

Reductive rhinoplasty is generally intended as a facial plastic procedure aiming for functional and aesthetic outcomes in patients affected by nasal dysmorphism and/or obstruction. However, when applied to different pathologies of the nasal pyramid it holds great potentialities, beyond the solo cosmetic and functional objectives.We retrospectively analyzed preoperative conditions, surgical charts, and postoperative results of patients who underwent reductive rhinoplasty for different nasal diseases at our Institution.Principles and techniques of reductive rhinoplasty were described in the different possible applications to the treatment of nasal disease, from nasal septal perforation to benign and malignant diseases of the nose.Reductive rhinoplasty showed to play a crucial role in the curative purpose of different nasal diseases, representing a versatile tool in the expert hand of rhinoplasty surgeons who approach them.N/A.

Purpose: To describe a combinatory technique made of Mustardè cheek advancement flap and paramedian forehead flap as a reconstructive option after orbital exenteration. Methods: We retrospectively reviewed all patients who underwent orbital exenteration and subsequent reconstruction with this technique at our Head and Neck Department, Divisions of Ophthalmology and Otolaryngology, at San Raffaele Hospital, Milan, Italy. Results: Three patients were treated with the aforementioned technique, following orbital exenteration due to malignancies. All of them were affected by recurrent diseases arising from the ocular components or periorbital structures: one basal cell carcinoma and two squamous cell carcinomas. Excellent result was achieved considering skin texture and colour match, aesthetic results and intra and post-operative complications (only minor, surgically controlled haemorrhage and minimal dehiscence subsequent to defective healing occurred). Conclusion: The proposed technique can be considered by the head and neck reconstructive surgeon as a good option in extended orbital exenteration.

BACKGROUNDS Rhinoplasty necessarily concerns functional and cosmetic aspects, and outcomes of both should be assessed in each patient. There has been a lack in the literature in Italian for a comprehensive tool for assessing both aspects of rhinoplasty. The objective is to translate and validate the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) into Italian. METHODS Forward and back-translation was used. Content validity was evaluated by experts and by patient interviews. Internal consistency was assessed by a Cronbach's alpha. The structure validity was assessed by an exploratory factor analysis. RESULTS Cognitive interviews of 10 rhinoplasty patients resulted in a good overall comprehension of the SCHNOS. Of the 411 respondents, 281 (32%) were women, and the average age was 33.6 (11.3) years. The alpha was excellent for both the obstruction domain (SCHNOS-O) (0.90) and the cosmetic domain (SCHNOS-C) (0.94). All the correlations between repeated measures were moderate to very strong. The exploratory factor analysis demonstrated unidimensionality of both the SCHNOS-O and the SCHNOS-C scores. CONCLUSIONS The SCHNOS was successfully translated and validated in Italian and can be recommended for a clinical use among rhinoplasty patients. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Background Patients with coronavirus disease 2019 (COVID-19) exhibit high thrombotic risk. The evidence on a potential independent prognostic role of antiplatelet treatment in those patients is limited. The aim of the study was to evaluate the prognostic impact of pre-admission low-dose acetylsalicylic acid (ASA) in a wide series of hospitalized patients with COVID-19. Methods This cohort study included 984 COVID-19 patients stratified according to ASA intake before hospitalization: ASA+ (n = 253) and ASA− (n = 731). Patients were included in ASA+ group if they received it daily in the 7 days before admission. 213 (83%) were on ASA 100 mg daily. Primary endpoint was a composite of in-hospital death and/or need for respiratory support upgrade, secondary endpoints were in-hospital death and need for respiratory support upgrade. Results Mean age was 72 [62; 81] with 69% of male patients. ASA+ patients were significantly older, with higher prevalence of comorbidities. No significant differences regarding the degree of respiratory dysfunction were observed. At 30-day Kaplan-Meier analysis, ASA+ patients had higher survival free from the primary endpoint and need for respiratory support upgrade, conversely in-hospital death did not significantly differ between groups. At multivariate analysis ASA intake was independently associated with a lower probability of reaching primary endpoint (HR 0.697, 95% C.I. 0.525–0.924; p = 0.012). Conclusions In COVID-19 patients undergoing hospitalization, pre-admission treatment with ASA is associated with better in-hospital outcome, mainly driven by less respiratory support upgrade.

Social distancing and face masks are considered the best tools to prevent COVID-19 spread despite an impact on communication, hearing perception and quality of life. An observational study was performed among a population of normal hearing subjects (NHS) referring to Department of Otorhinolaryngology. Data were collected with a self-administered online questionnaire which included the Italian SF-36 Health Survey Questionnaire referred to face masks use, the Hamilton Rating Scale for Anxiety (HAM-A) and four questions focussed on communication difficulties due to facial masks use and social distancing (COVID-19 restrictions questions, CRQs). 200 NHS answered the online survey. Mean age was 40.46 (SD 13.6). The cohort was distributed according to the job performed: 137 were workers in contact with the public (Job in contact with Public, JP), while 63 were people who don’t work with the public (Job Non in contact with Public, JNP). An overall decrease in quality of life, related to the use of face masks, was detected. In fact, significant differences in the SF-36 Health Survey among our sample and the Italian normative sample were observed in 4 over 8 multi-item scales: Physical Functioning (PF), Role Functioning Physical (RP), Social Functioning (SF) and Role Functioning Emotional (RE). Furthermore, a worst general mental health (GMH) score was observed in the JNP group (p = .0008). The CRQs analysis showed that facial masks were more frequently held responsible for communication difficulties compared to social distancing, particularly due to an attenuation of sound volume and difficulties in rendering facial expressions. Significantly higher anxiety scores were reported in the JNP group, according to the HAM-A, although not reaching pathological level. An impact on communication and general health perception due to COVID-19 restrictions was referred in a large part of the population with differences between the two groups (JP vs. JNP).