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Group 2 innate lymphoid cells (ILC2s) represent innate homologs of type 2 helper T cells (TH2) that participate in immune defense and tissue homeostasis through production of type 2 cytokines. While T lymphocytes metabolically adapt to microenvironmental changes, knowledge of human ILC2 metabolism is limited, and its key regulators are unknown. Here, we show that circulating ‘naive’ ILC2s have an unexpected metabolic profile with a higher level of oxidative phosphorylation (OXPHOS) than natural killer (NK) cells. Accordingly, ILC2s are severely reduced in individuals with mitochondrial disease (MD) and impaired OXPHOS. Metabolomic and nutrient receptor analysis revealed ILC2 uptake of amino acids to sustain OXPHOS at steady state. Following activation with interleukin-33 (IL-33), ILC2s became highly proliferative, relying on glycolysis and mammalian target of rapamycin (mTOR) to produce IL-13 while continuing to fuel OXPHOS with amino acids to maintain cellular fitness and proliferation. Our results suggest that proliferation and function are metabolically uncoupled in human ILC2s, offering new strategies to target ILC2s in disease settings., ILC2 metabolism has been largely unexplored. Di Santo and colleagues examine metabolic profiles from naive and cytokine-activated ILC2s and find that IL-33-triggered ILC2s rely on distinct metabolic pathways to sustain proliferation and function.

The masseteric nerve is often used as a donor nerve in the treatment of facial paralysis. Even if several anatomical studies described landmarks for its identification, their main disadvantages are the anatomical variability and the changes due to surgery. Sixteen dissections were performed on cadaveric specimens. The masseteric muscle (MM), the zygomatic arch (ZA), the masseteric nerve (MN) and the zygomatic branch of the facial nerve (ZB) were identified and their relationships were measured. The relationships between MN and ZB resulted to be constant, with MN intersecting ZB at a depth of 0,78 cm in the muscle, 1,6 cm below ZA and 0,8 cm from the posterior border of MM. The measures obtained demonstrated as the main zygomatic branch of the facial nerve can be a suitable landmark for the identification of the masseteric nerve, with no variations due to the surgical procedure or patient characteristics.

The aim of this study was to provide an accurate picture of the changes which have occurred during the COVID-19 pandemic, and the contributions given by Italian Otolaryngology Units.A 29-item questionnaire was completed and returned by 154 Otorhinolaryngology Units across Italy that investigated geographic distribution, the main changes which occurred in workload management and in clinical and surgical activities and screening procedures for COVID-19 in healthcare personnel and patients.Nearly half of the Otolaryngology Units that responded to the questionnaire were merged with other units, while 22% were converted into COVID-19 units or temporarily closed. A reduction of 8.55% in the number of team members was reported, and about 50% of the units applied uniform work shifts for all staff. Elective activities were uniformly stopped or delayed, passing from 30,295 (pre-COVID data) to 5,684 (COVID data) weekly procedures, with a mean decrease of 81.24% (p0.001).Most of the elective otolaryngology activities were suspended during the pandemic; the only procedures were for oncology and emergency patients. Italian Otolaryngologists have demonstrated a high availability to collaborate with non-surgical colleagues.Impatto della pandemia COVID-19 sulle Unità Operative di Otorinolaringoiatria in Italia: uno studio nazionale.Fornire un quadro accurato dei cambiamenti che si sono verificati e dei contributi forniti dalle Unità di Otorinolaringoiatria italiane durante la pandemia COVID-19.Un questionario di 29 domande è stato completato da 154 unità. Sono stati investigati la distribuzione geografica del loro coinvolgimento, i cambiamenti di gestione del carico di lavoro e delle attività clinico-chirurgiche e le procedure di screening applicate su personale sanitario e pazienti.Quasi la metà delle Unità che hanno risposto sono state fuse con altre unità operative, mentre il 22% è stato convertito in unità COVID-19 o temporaneamente chiuso. È stata segnalata una riduzione dell’8,55% nel numero dei membri del gruppo di lavoro e circa il 50% dei dipartimenti ha applicato turni di lavoro per tutto il personale. Tutte le attività elettive sono state uniformemente interrotte o ritardate, passando da 30.295 (dati pre-COVID) a 5.684 (dati COVID) procedure settimanali, con una diminuzione media dell’81,24% (p0,001).La maggior parte delle attività elettive in otorinolaringoiatria, a parte le procedure oncologiche e di emergenza, sono state sospese. Gli otorinolaringoiatri italiani hanno dimostrato un’alta disponibilità a collaborare con i reparti di medicina.

Purpose: Tinnitus and equilibrium disorders such as dizziness and vertigo have been reported by patients with COVID-19; however, they have been rarely investigated. The aim of this study was to study the prevalence of subjective tinnitus and dizziness in a sample of COVID-19 patients using an online 10-item close-ended questionnaire. Methods: A multicentric study that included 15 Italian hospitals in different regions was conducted using an online 10-item close-ended questionnaire developed to identify the presence of tinnitus and balance disorders in patients with COVID-19 between May 5 and June 10, 2020. The questionnaire was administered to 185 patients in a period of > 30 – < 60days after diagnosis of COVID-19; responses were recorded in an online Excel spreadsheet. The questionnaire was composed of three sections: (1) demographic information; (2) presence and characteristics of tinnitus and dizziness after COVID-19 diagnosis; (3) possible association with migraine. Results: Thirty-four patients (18.4%) reported equilibrium disorders after COVID-19 diagnosis. Of these, 32 patients reported dizziness (94.1%) and 2 (5.9%) reported acute vertigo attacks. Forty-three patients (23.2%) reported tinnitus; 14 (7.6%) reported both tinnitus and equilibrium disorders. Conclusion: This study suggests that the presence of subjective otoneurological symptoms such as tinnitus and balance disorders can affect COVID-19 patients; further studies are necessary to investigate the prevalence and pathophysiological mechanisms underlying these subjective symptoms in COVID-19 patients.

La recidiva e la persistenza del cancro della laringe dopo radioterapia rappresentano eventi insidiosi, i cui tassi di incidenza variano dal 13% al 36%. L’intervento di laringectomia sopracricoidea (LSC), con cricoioidopessia (CIP) o cricoioidoepiglottopessia (CIEP), è in grado di garantire risultati oncologici e funzionali affidabili per i pazienti selezionati affetti da carcinoma glottico o sopraglottico, sia in caso di neoplasia primitiva che di recidiva. La presente metanalisi ha lo scopo di valutare i parametri oncologici e funzionali nei pazienti trattati con LSC per recidiva di carcinoma squamocellulare della laringe dopo fallimento di radioterapia. La ricerca è stata effettuata sui databases MEDLINE, PubMed ed EMBASE (da gennaio 1990 a dicembre 2015, solo in lingua inglese). Per la metanalisi è stato impiegato il metodo DerSimonian e Laird con effetto “midex random”; l’eterogeneicità è stata misurata mediante I. Sono stati inclusi nella ricerca 276 articoli, tra i quali ne sono stati selezionati 14 per la metanalisi, per un totale di 291 pazienti. L’analisi statistica ha mostrato una sopravvivenza globale (OS) a 5 anni del 80,2% (IC 0,719-0,885; I= 62%; p = 0,003) e una sopravvivenza libera da malattia (DFS) a 5 anni del 89,5% (IC 0,838-0,952; I= 52%; p = 0,022). Le indicazioni chirurgiche per una LSC dopo fallimento di radioterapia non cambiano rispetto a quelle adottate per pazienti con tumore primitivo. Pertanto, è stato ipotizzato che l’attenta valutazione dell’estensione del tumore, in caso di recidiva, potrebbe essere responsabile dell’alto tasso di OS e DFS a 5 anni. Per quanto riguarda i parametri di valutazione funzionale precoce postoperatoria, il tempo medio di decannulazione è stato di 35,6 giorni (IC 24,3-46,9; I= 95%; p < 0,001), mentre il tempo medio di rimozione del sondino naso-gastrico (SNG) o della gastrostrostomia percutanea endoscopica (PEG) è stato di 28,3 giorni (IC 22,7-33,8; I= 86%; p

Innate lymphoid cells (ILCs) represent innate versions of T helper and cytotoxic T cells that differentiate from committed ILC precursors (ILCPs). How ILCPs give rise to mature tissue-resident ILCs remains unclear. Here, we identify circulating and tissue ILCPs in humans that fail to express the transcription factors and cytokine outputs of mature ILCs but have these signature loci in an epigenetically poised configuration. Human ILCPs robustly generate all ILC subsets in vitro and in vivo. While human ILCPs express low levels of retinoic acid receptor (RAR)-related orphan receptor C (RORC) transcripts, these cells are found in RORC-deficient patients and retain potential for EOMES+ natural killer (NK) cells, interferon gamma-positive (IFN-γ+) ILC1s, interleukin (IL)-13+ ILC2s, and for IL-22+, but not for IL-17A+ ILC3s. Our results support a model of tissue ILC differentiation ("ILC-poiesis"), whereby diverse ILC subsets are generated in situ from systemically distributed ILCPs in response to local environmental signals. A.I.L. is a scholar in Pasteur-Paris University (PPU) International PhD program and supported by FP7 under grant agreement 317057 (HOMIN) and the Fondation ARC. R.S. was supported by EMBO (ALTF 1201-2014) and Marie Curie (H2020-MSCA-IF-2014). Other support included grants from the Institut Pasteur, Inserm, Laboratoire d'Excellence REVIVE (ANR-10-LBX-73), and FP7 under grant agreement HEALTH-F3-2012-305578 (PathCO) and 317057 (HOMIN). J.P.D. is a founder of AXENIS and a member of its advisory board.

Among all the possible complications of aesthetic rhinoplasty, a rare one is the development of cystic masses on the nasal dorsum: several theories suggest that cysts develop commonly by entrapment of nasal mucosa in the subcutaneous space, but they can also originate from foreign body reactions. This report deals with two cases of nasal dorsum cysts with different pathogenesis: both patients had undergone aesthetic rhinoplasty in the past (26 years ago and 14 years ago, resp.). Both cystic masses were removed via a direct open approach and nasal reconstruction was performed successfully with autologous vomer bone. The pathologic investigations showed a foreign body inclusion cyst associated with latex rubber in the first case and a sequestration of a mucosal-lined nasal bone was not removed at the time of primary rhinoplasty in the second case. A brief review of the literature focuses on the pathophysiology and treatment options for nasal dorsal cysts following aesthetic rhinoplasty.