Current Challenges and Opportunities in Oto-Rhino-Laryngological Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Otolaryngology".

Deadline for manuscript submissions: 10 January 2025 | Viewed by 1506

Special Issue Editors


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Guest Editor
Phoniatrics and Audiology Unit, Department of Neuroscience, University of Padova, 31100 Treviso, Italy
Interests: otology; neurotology; facial nerve disorders; laryngology; biological markers of head and neck cancers

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Guest Editor
Phoniatrics and Audiology Unit, Department of Neuroscience, University of Padova, 31100 Treviso, Italy
Interests: otology; neurotology; vestibology; neuro-vestibology

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Guest Editor
Phoniatrics and Audiology Unit, Department of Neuroscience, University of Padova, 31100 Treviso, Italy
Interests: otology; cochlear implants; neurotology; hearing loss rehabilitation

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Guest Editor
Skull Base Unit, Otolaryngology Section, Department of Neuroscience, University of Padova, 35128 Padova, Italy
Interests: vestibular schwannoma; skull-base surgery; otology; neurotology; salivary gland tumors; temporal bone carcinomas
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Special Issue Information

Dear Colleagues,

In recent decades, the surgical perspectives of oto-rhino-laryngology has dramatically developed, pushing forward the technical limits and the indications of traditional ENT surgery. Along with the refinement of head and neck and otology procedures, the development of skull-base surgery, the spread of endoscopic techniques, and the application of computer-guided surgery paradigm have brought ENT surgeons to face more and more demanding challenges. Regardless of the subspeciality field, one of the most attractive issues in contemporary ENT surgery is the optimization of functional results, which has led the surgical paradigm to shift from the traditional disease-oriented approach to a more modern patient-oriented one.

The aim of this Special Issue is to showcase up-to-date evidence on the contemporary challenges in various fields of oto-rhino-laryngological surgery, focusing in particular on the optimization of functional results.

From this point of view, there is growing interest in identifying variables, new scales and associations between them to better analyze, both subjectively and objectively, the functional results of head and neck surgery.

Original papers from international leading groups, as well as review articles, focused on various surgical topics related to ENT subspecialities are welcome for submission.

Dr. Leonardo Franz
Prof. Dr. Gino Marioni
Prof. Dr. Cosimo De Filippis
Dr. Elisabetta Zanoletti
Guest Editors

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Keywords

  • otolaryngology
  • surgery
  • otology
  • skull-base
  • head and neck
  • laryngology
  • rhinology

Published Papers (2 papers)

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Research

11 pages, 238 KiB  
Article
Age-Specific Differences in Laryngotracheal Trauma Characteristics: A Retrospective Study of Clinical Profiles, Outcomes, and Mortality Risk
by Ahmad K. Alnemare
J. Clin. Med. 2024, 13(12), 3508; https://doi.org/10.3390/jcm13123508 - 15 Jun 2024
Viewed by 334
Abstract
Background: Laryngotracheal trauma is associated with a substantial risk of mortality. Age can be a critical factor in trauma management, as older adults often have diminished airway protective reflexes and preexisting respiratory conditions. Objective: This study aimed to characterize the clinical profiles [...] Read more.
Background: Laryngotracheal trauma is associated with a substantial risk of mortality. Age can be a critical factor in trauma management, as older adults often have diminished airway protective reflexes and preexisting respiratory conditions. Objective: This study aimed to characterize the clinical profiles and outcomes in different age groups of adult patients with laryngotracheal trauma using data from the National Trauma Data Bank (NTDB). Methods: We retrospectively analyzed the NTDB and included adult patients (aged ≥ 18 years) who had laryngotracheal fractures (closed or open) and were admitted directly after the injury. The patients were categorized into different age groups for analysis. A multivariate logistic regression analysis was performed to assess whether the elderly population (age ≥ 65 years) was predisposed to post-trauma death under care. Results: The study included 1171 patients, with the following age distributions: 13.7% aged 18–24 years, 21.6% aged 25–34 years, 55.2% aged 35–64 years, and 9.6% aged ≥ 65 years. Notable differences were observed in comorbidities, mechanisms, types of injuries, and associated injuries among age groups. There was no significant trend in airway surgical outcomes according to age. In-hospital mortality was highest among patients aged ≥ 65 years (22.3%), compared to 14.4% for those aged 18–24 years. Regression analysis indicated that age ≥ 65 was an independent mortality predictor. Conclusions: These findings underscore significant age-related differences in the presentation and outcomes of laryngotracheal trauma, emphasizing the need for age-specific treatment protocols, primarily to address the elevated risk among elderly patients. Full article
13 pages, 2938 KiB  
Article
Facial Surface Electromyography: A Novel Approach to Facial Nerve Functional Evaluation after Vestibular Schwannoma Surgery
by Leonardo Franz, Gino Marioni, Antonio Daloiso, Elia Biancoli, Giulia Tealdo, Diego Cazzador, Piero Nicolai, Cosimo de Filippis and Elisabetta Zanoletti
J. Clin. Med. 2024, 13(2), 590; https://doi.org/10.3390/jcm13020590 - 19 Jan 2024
Cited by 1 | Viewed by 857
Abstract
Background: Vestibular schwannoma (VS) surgery may cause facial nerve damage. However, a comprehensive evaluation of post-operative facial outcomes may be difficult to achieve. Surface electromyography (sEMG) is a promising non-invasive evaluation tool. However, its use in the follow-up after VS surgery has not [...] Read more.
Background: Vestibular schwannoma (VS) surgery may cause facial nerve damage. However, a comprehensive evaluation of post-operative facial outcomes may be difficult to achieve. Surface electromyography (sEMG) is a promising non-invasive evaluation tool. However, its use in the follow-up after VS surgery has not been reported yet. The main objective was to develop and validate a new sEMG application specifically for the post-VS surgery setting. Secondary goals were to provide a systematic description of facial muscle activity after VS surgery and assess the association between sEMG parameters and Sunnybrook scale scores. Methods: Thirty-three patients with facial palsy following VS surgery were included. The clinical outcomes (Sunnybrook symmetry, movement, and synkinesis scores) and sEMG parameters (signal amplitude normalized by the maximal voluntary contraction (NEMG) and sEMG synkinesis score (ESS, number of synkinesis per movement sequence)) were evaluated at the end of the follow-up. Results: In all tested muscles, NEMG variance was significantly higher on the affected side than the contralateral (variance ratio test, p < 0.00001 for each muscle). In total, 30 out of 33 patients (90.9%) showed an ESS ≥ 1 (median: 2.5, IQR: 1.5–3.0). On the affected side, NEMG values positively correlated with both dynamic and overall Sunnybrook scores (Spearman’s model, p < 0.05 for each muscle, except orbicularis oculi). ESS significantly correlated with the Sunnybrook synkinesis score (Spearman’s rho: 0.8268, p < 0.0001). Conclusions: We described and preliminarily validated a novel multiparametric sEMG approach based on both signal amplitude and synkinesis evaluation specifically for oto-neurosurgery. Large-scale studies are mandatory to further characterize the semiological and prognostic value of facial sEMG. Full article
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