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Objectives: To evaluate the prognostic value of pre-treatment prognostic-nutritional index (PNI) in patients with HPV-negative head and neck squamous cell carcinoma (HNSCC)., Methods: A multi-institutional retrospective series of HPV-negative, Stages II-IVB, HNSCCs treated with upfront surgery was evaluated. Correlation of pre-operative blood markers and PNI with 5-year overall (OS) and relapse-free (RFS) survival was tested using linear and restricted cubic spline models, as appropriate. The independent prognostic effect of patient-related features was assessed with multivariable models., Results: The analysis was conducted on 542 patients. PNI ≥ 49.6 (HR = 0.52; 95% CI, 0.37-0.74) and Neutrophil-to-Lymphocyte Ratio (NLR) > 4.2 (HR = 1.58; 95% CI, 1.06-2.35) confirmed to be independent prognosticators of OS, whereas only PNI ≥ 49.6 (HR = 0.44; 95% CI, 0.29-0.66) was independently associated with RFS. Among pre-operative blood parameters, only higher values of albuninaemia and lymphocyte count (> 1.08 x 10 3 /microL), and undetectable basophile count (= 0 10 3 /microL) were independently associated with better OS and RFS., Conclusions: PNI represents a reliable prognostic tool providing an independent measure of pre-operative immuno-metabolic performance. Its validity is supported by the independent prognostic role of albuminaemia and lymphocyte count, from which it is derived., (Copyright © 2023 Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale, Rome, Italy.)

Objective: The prognostic significance of the resection margins is still subject of conflicting opinions. The purpose of this paper is to report the results of a study on the margins in carcinoma of the oral cavity, oro-hypopharynx and larynx., Methods: A multicentre prospective study was carried out between 2015 and 2018 with the participation of 10 Italian reference hospitals. The primary objective was to evaluate local control in patients with well-defined clinical characteristics and comprehensive histopathological information., Results: During the study period, 455 patients were enrolled; the minimum follow-up was 2 years. Previous treatment, grading and fresh specimen examination were identified as risk factors for local control in multivariate analysis. On the basis of these results, it seems possible to delineate "risk profiles" for different oncological outcomes., Discussion: The prognostic significance of the margins is reduced, and other risk factors emerge, which require diversified treatment and follow-up., Conclusions: Multidisciplinary treatment with adjuvant therapy, if indicated, reduces the prognostic importance of margins. Collaboration with a pathologist is an additional favourable prognostic factor and quality indicator., An appendix with literature review is present in the online version., (Copyright © 2022 Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale, Rome, Italy.)

To determine the reliability of the vestibolo-ocular reflex test measured via Vorteq, 16 subjects underwent head-autorotation test at the frequencies 1-5 Hz. All patients underwent the re-test. No linear correlation was observed between the measurements, i.e., no repeatability of the same measurements at the various frequencies. The Head Auto-Rotation Test by Vorteq has demonstrated advantages: patients are not disturbed by the active head movements; the full test protocol, lasts only a few minutes; the method enables the vestibolo-ocular reflex to be evaluated at high head-rotation frequencies. However, the test has disadvantages: poor test-retest inter-individual repeatability, wide standard deviations of results with heterogeneous inter-individual spread with regard to phase and asymmetry values especially at high rotation frequencies. In the light of the above findings, it can be seen that the test-retest of the Vorteq system is not sufficiently reliable and hence cannot be used in clinical practice.

The bilobed flap is a reliable means for the reconstruction of facial defects in one stage. This reconstruction technique has been applied on a 69-years-old man affected by carcinoma of the cheek, involving overhanging skin and underlying oral mucosa. Stensen's duct reconstruction was also performed with a vein graft and, 8 months later, deviation of the rima oris was corrected by inserting a goretex strip at the level of the upper lip elevator muscle. The present work considers the bilobed flap as a means for cheek defects reconstruction compared with other reconstruction techniques.