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Introduction/Objective. Fungal rhinosinusitis comprises of a wide range of immune-pathological responses, including invasive, chronic, granulomatous, and allergic diseases. Aim of this study was to determine total number of patients, their characteristics, frequency of symptoms, the manner of disease manifestation and the success of therapy. Methods. Study included 21 patients with fungal rhinosinusitis diagnosis made according to the 2020 EPOS guidelines. Results. Based on the visual analogue scale, feeling of localized pressure, i.e., facial pain, was dominant with a score of 9.57 ± 0.98, followed by the secretion from the nose with 8.14 ± 1.62, problems with breathing through the nose with 6.67 ± 3.25, and reduction the sense of smell with 2.14 ± 3.00. The t-test showed a statistically significant difference between mucosal changes on the diseased and healthy sides of the patient‘s face (p < 0.0001). Only one sinus was affected intraoperatively in 18 (85.71%) patients. The most commonly affected sinus was the maxillary one, in 13 (54.17%) patients, followed by the sphenoid sinus in five (20.83%) patients. Aspergillus was proven аs the couse of rhinosinusitis in 12 (57.14%) patients. Conclusion. The dominant symptom of patients with fungal rhinosinusitis was localized pain/pressure in the area of the affected sinus. Endoscopically, on the side of the affected sinus, the pathological mucosa with thick, pithy, mucous secretion dominated. The maxillar sinus was primarily unilaterally affected, in more than half of the patients. Aspergillus has been proven to be the most common cause of rhinosinusitis.

Introduction/Objective. Aesthetically, the nose adds special signature to a person’s look. This results in many nasal pyramid surgeries, either functional or aesthetic. The problem arises in aesthetic surgeries. Patients often tend to present their dissatisfaction with the appearance of the nose as a breathing difficulty, as they often lack the support of the environment in the decision to undergo cosmetic surgery. The objective of the paper was to examine, using subjective assessment and objective measurements, the change in the nasal respiratory function in patients who undergo aesthetic nose surgeries, despite having a straight nasal septum before the surgery. Methods. The study was conducted as a prospective, cross-sectional one, and involved 32 patients of both genders. Before and at six months after surgery all patients underwent subjective nasal breathing assessment using visual analog scale (grade 0–10) as well as objective nasal respiratory function assessment using rhinomanometry and acoustic rhinometry after anemization. Results. There were seven male and 25 female patients, age ranging 18–27 years. Objective measurements after surgery showed that the nasal cavity volume, minimum cross-sectional area, as well as the airflow through the nose reduced, while resistance to the nasal airflow increased, but with no statistical significance. The subjective assessment of nasal breathing statistically significantly improved after the surgery. Conclusion. The subjective assessment of nasal breathing postoperatively is not a relevant indicator of the objective state of the nasal respiratory function in patients after aesthetic rhinoplasty.

Introduction/Objective. Chronic rhinosinusitis is one of the most frequent chronic disorders which significantly influences the patients‘ quality of life. The objectivе of this paper was to examine which are the most frequent and intensive symptoms in patients with chronic rhinosinusitis, and also to determine whether there is a correlation between a subjective assessment of the disease as a whole and individual symptoms. Methods. The study encircled 90 patients with clinical diagnosis of chronic rhinosinusitis that was endoscopically proven and computer tomography of the nose and paranasal sinuses. Every possible symptom was recorded in every patient (nasal congestion, nasal discharge, facial pain/pressure, reduction or loss of smell, headache, fatigue, cough, halitosis and ear pain/fullness), the intensity of every possible symptom as well as the disorder as a whole. The patients assessed the intensity of their symptoms on the visual analogue scale. Results. Nose congestion is the most frequent symptom. It occured in 82 patients (91.1%), followed by nasal discharge in 81 patients (90%) and there was no difference in frequency of these two symptoms. Nasal discharge has been recorded as the most intensive symptom (x– = 5.4) and it is significantly more intensive in comparison to nasal congestion which was the second on the intesity list (x– = 4.1, p = 0.002). All other symptoms were significantly less frequently and less intensive. The average intensity value of the disease as a whole is the same as the average intensity value of the nasal discharge (x– = 5.4) while the average intensity values of all other symptoms are statistically significantly lower than the average intensity value of the disease as a whole; in all comparisons p < 0.001. Conclusion. Nasal congestion and nasal discharge are the most common symptoms in the patients with chronic rhinosinusitis. Nasal discharge is the most intensive symptom in patients with chronic rhinosinusitis while its intensity determines the sensation of the intesity of the disorder as a whole.

Background: T2 glottic carcinoma is a nonhomogenous localization of laryngeal carcinoma with two subcategories. The aim of the study was to retrospectively analyze the results of surgically treated pT2 glottic carcinomas and to determine the importance of subcategories of glottic carcinomas in diagnostics, surgical treatment, and patients’ survival. Methods: During the period 1990-2000, 71/701 (10%) patients were diagnosed. with pT2 glottic carcinoma. All patients were treated with different surgical techniques. Results: Total laryngectomy was performed in 14/71 patients. Involvement of anterior commisure in local spreading of the cancer was found in 24/71 patients; total laryngectomy was performed in 13/24 and reconstructive surgery in 11/24. Selective resection of neck was done in 49 patients and metastases were found in 2 of these patients. Out of fifty-seven patients who had reconstructive laryngeal surgery local disease recurrence appeared in 8 patients. These 8 patients were treated with total laryngectomy. Overall 5-year survival was 90.1% with a slight difference between subcategories (89.1% subcategory I; 93.7% subcategory II) which was not statistically significant (p>0.05). Disease free 5-year survival was 83.6% with a difference between subcategories (81.1% subcategory I; 93.3% subcategory II) which was not statistically significant (p>0.05). Conclusion: Spreading of glottic carcinoma toward supraglottic and subglottic structures complicates exact preoperative evaluation of tumor size regardless to preoperative diagnostic procedures. Just owing to that, larger surgical resections performed bring more radicalness with less percentage of local recurrence and better effects on overall survival and disease free survival rate.

Uvod: Najadekvatnija,ekonomski najopravdanija, a po mnogim autorima i prva metoda izbora u rehabilitaciji govora totalno laringektomisanih pacijenata jeste korišćenje ezofagusnog glasa i govora. U toku savladavanja ove metode je neophodno osposobiti pacijente da formiraju i koriste rezervoar vazduha u gornjoj trećini jednjaka koji služi kao aktivator glasa, čija će vazdušna struja dovesti do vibracija faringoezofagusnog segmenta, kao novog generatora glasa. Cilj: Prikaz faktora koji mogu imati uticaj na uspešnost edukacije ezofagusnog glasa i govora u kliničkoj praksi kao i ukazivanje na značaj sagledavanja istih tokom vokalne rehabilitacije laringektomisanih pacijenata, u svrhu daljeg usavršavanja ove metode rehabilitacije. Metode: Sveobuhvatan pregled literature izvršen je koristeći sledeće baze podataka: Google Scholar, SCIndex, PubMed i ResearchGate. Termini po kojima je vršena pretraga bili su “laryngectomy”, “esophageal speech”, “education”, “factors”, “success”, “treatment outcome”, te njihovi pandani na srpskom jeziku. Rezultati: Brojni su faktori koji mogu uticati na uspešnost edukacije ezofagusnog glasa i govora (anatomsko fiziološki, psihosocijalni, faktori vezani za pacijenta, lečenje i rehabilitaciju, sociodemografski, hirurški, psihološki, socijalni, fiziološki i drugi) pri čemu motivacioni status pacijenta ima najveći značaj. Zaključak: Još uvek ne postoje jasno definisani, opšteprihvaćeni i sveobuhvatni kriterijumi za vrednovanje stepena uspešnosti ezofagusnog glasa i govora, što za posledicu ima i nepostojanje uniformnih faktora koji utiču na taj stepen uspešnosti, pozitivno ili negativno. Od brojnih posmatranih faktora najveći značaj ima motivacioni status pacijenta. [ABSTRACT FROM AUTHOR]

Background: Successful speech rehabilitation has a great impact on the quality of life in totally laryngectomized patients. Objectives: The aim of this paper was to compare the self-assessed voice handicap of totally laryngectomized patients with two different methods of alaryngeal speech – esophageal (ES) and tracheoesophageal speech (TES). Method: The research comprised 83 totally laryngectomized, disease-free patients, split into two groups. The first group included 43 participants with successfully rehabilitated ES, and the second group included 40 participants with successfully established TES after secondary implantation of Provox 2TM voice prosthesis. All subjects filled in the Serbian version of the Voice Handicap Index (VHI-30). The results (overall score and three VHI subscales) were analyzed and compared with those of the subjects of both groups. The impact of age in the subgroups (<65 years old and ≥65 years old) and previous irradiation on the examined VHI values were also analyzed. Results: The median value of the overall VHI score in the participants with TES was 29.03 ± 23.479 (range: 0–97), and in the participants with ES it was 64.51 ± 21.089 (range: 19–99). The VHI scores (overall and three VHI subscales) were significantly higher in participants with ES compared to those with TES (p < 0.01), indicating a larger voice handicap. No significant difference was found in the overall VHI score and VHI subgroups in terms of age subgroups and previous irradiation (p > 0.05). Conclusions: Our data reveal a significantly higher voice handicap in participants with ES compared to the TES group, with a large interindividual variation within both groups. VHI values are not significantly different between the two age subgroups, nor are they significantly influenced by irradiation. [ABSTRACT FROM AUTHOR]

Introduction. Foreign body aspiration into the respiratory tract remains a diagnostic and therapeutic challenge in clinical practice, especially in young children, who are the most frequently affected age group. The aim of this study was to present the results of treating the patients with foreign body aspiration in all age groups. Material and Methods. The medical and radiological records of 64 patients with confirmed foreign body out of 146 patients with suspected foreign body aspiration were retrospectively analyzed during the period of 13 years (from 2001 to 2013). Results. A foreign body was found in 64 (44%) of the 146 patients of all age groups with suspected foreign body aspiration. The patients' age ranged between 11 months and 80 years. There were 84% children and 16% adults, and 63% of patients were male. Time between the moment of aspiration and admission to the Department ranged between 0.5 hours and 14 days, with majority of patients (70%) being admitted during the first 24 hour. History of respiratory drama was present in 92% of patients. Physical and radiological findings were positive in 66% and 47% of patients, rescpectively. Organic vegetable foreign bodies accounted for 75% of all cases, and they were most frequently found in the right main bronchus (63%). All foreign bodies were successfully extracted by rigid bronchoscopy, without serious complications and fatal outcomes. Conclusion. Bronchoscopy should be performed in any case of suspected foreign body aspiration, even if clinical and radiological findings are normal, in order to avoid serious and possible life-threatening complications. More should be done to raise awareness of this potentially preventable condition. [ABSTRACT FROM AUTHOR]

Introduction. The aim of this study was to present oncological and functional results of surgical treatment of the base of tongue cancer by analyzing retrospectively 115 patients treated during a ten-year period. During this period, 150 patients with cancer of the base of tongue were diagnosed, which accounts for 5.6% of all diagnosed head and neck cancers and 24.1% of all oropharyngeal cancers. In 111 patients (96.5%), planocellular carcinoma with various degrees of differentiation was pathohistologically verified. Neck metastases were found in 88 (76.5%) patients. Advanced III and IV stages of disease were verified in 92.9% of patients (stage III in 23.4%, IV A in 59.1%, IV % B in 10.4%). Transmandibular approach was performed in 5.2% of patients, while 94.8% of patients were approached through pharynx The defects were covered by primary reconstruction; the pectoralis major myocutaneousflap was used in 4 patients . During immediate postoperative period, 17 (14.7%) patients developed complications: bleeding occurred in 7 patients (6%), fistula and wound infection developed in 5 (4.3%) and 11 (9.5%) patients, respectively. Postoperatively, 61 (53%) patients were treated by radiation therapy. Swallowing function was resumed in all patients except in three, who underwent gastrostomy due to the lesion of both hypoglossal nerves. Gasrostoma was closed after six months when swallowing was resumed. Local and regional recurrence developed in 13 (11.3%) and 24 (20.8%) patients, respectively, and distant metastases developed in 4 (3.5%) patients. Second primary cancer was diagnosed in 9 (7.8%) patients Disease-specific 3-year survival rate (according to the T category) was 73%, 60%, 45% and 21% in patients with T1, T2, T3 and T4, respectively. Disease-specific 3-year survival rate (according to category N) was 68% in N0 and 32%) in N +. The overall 3-year survival rate was 42%. [ABSTRACT FROM AUTHOR]

Rhabdomyosarcoma is the most common type of soft tissue sarcoma in childhood. When localized in the middle ear and temporal bone, they are highly aggressive, whereas the outcome directly depends on an accurate and timely diagnosis, stage of the disease, and adequate multimodal therapy. Early clinical diagnosis of the temporal bone rhabdomyosarcoma is often difficult since clinical signs are not specific for this disease. We present a case of an embryonal rhabdomyosarcoma, botryoid subtype, of the middle ear in a girl aged 4 years and 4 months, diagnosed 34 days after the first symptoms - right ear pain with peripheral facial nerve palsy on the same side. The overall symptoms were poor, in no way suggesting such a serious condition. After the treatment, control follow-ups for more than 3 years showed no recurrence of the disease, while signs of the right peripheral facial palsy persist. Conclusion: In cases of prolonged peripheral facial nerve palsy in children, not responding to conservative treatment, a temporal bone rhabdomyosarcoma should be considered in a differential diagnosis. [ABSTRACT FROM AUTHOR]

Aim: The aim of this paper is to present two case reports of patients with hemangiomas of the external auditory canal, and to overview all cases published in English language literature so far. Methods: Two patients with hemangiomas of the external auditory canal have undergone clinical and morphofunctional examination, surgical procedures, histopathological examination, and postoperative follow up. Results: In a 38-year-old female patient transmeatal approach was used to remove the cavernous hemangioma of the external auditory canal. The postoperative period was eventless, with normal morphofunctional findings during a 5-month postoperative follow-up period. In the second patient, a 68-year-old female, a capillary-cavernous hemangioma was removed using retroauricular approach. Conclusion: Cavernous hemangiomas are rare lesions of the external auditory canal. In the morphological diagnosis, computed tomography of the temporal bones is the leading diagnostic procedure, along with otoendoscopy and endocranial magnetic resonance imaging which are important in evaluation of the spread of the lesion. Biopsy of vascular lesions is not recommended. Complete surgical excision of hemangioma of the external auditory canal is the therapy of choice with a minor risk of hearing impairment. [ABSTRACT FROM AUTHOR]

Local allergic rhinitis is a localized allergic response of the nasal mucosa to aeroallergens in the absence of atopy with characteristic production of specific local immunoglobulin E antibodies in the nasal mucosa, T helper type 2 cellular infiltration response during the exposure to aeroallergens and positive results via the nasal allergic provocation test with the release of inflammatory mediators (triptase and eosinophil cationic proteins). Even though the prevalence of local allergic rhinitis has been and is still being investigated, a large number of patients with diagnosed non-allergic rhinitis or idiopathic rhinitis are currently classified as having local allergic rhinitis. The causes of local allergic rhinitis are most commonly house dust, dust mites, pollens and many others. Diagnosis of local allergic rhinitis is made using nasal allergen provocation tests when the prick test for standard inhalation allergens and the serum specific immunoglobulin analysis for aeroallergens are negative. The increasing amount of data on localized allergic response in non-atopic patients asks for many answers regarding local allergic rhinitis. These answers can be obtained by a study on the prevalence and incidence in children and adults, the impact of positive family atopy in the development of disease, the impact of associated diseases of the lower respiratory tract and conjunctiva, the effectiveness of drug treatment and the issue of administration of specific immunotherapy. [ABSTRACT FROM AUTHOR]