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Purpose To estimate the prevalence of smell or taste impairment in household contacts of mildly symptomatic home-isolated SARS-CoV-2 positive patients.Methods Cross sectional study based on ad hoc questions.Results Of 214 mildly symptomatic COVID-19 patients managed at home under self-isolation, 179 reported to have at least one household contact, with the total number of no study participants contacts being 296. Among 175 household contacts not tested for SARS-CoV-2 infection, 67 (38.3%) had SARS-CoV-2 compatible symptoms, 39 (22.3%) had loss of smell or taste with 7 (4.0%) having loss of smell or taste in the absence of other symptoms. The prevalence of smell or taste impairment was 1.5% in patients tested negative compared to 63.0% of those tested positive for SARS-CoV-2 (pConclusion Smell or taste impairment are quite common in not-tested household contacts of mildly symptomatic home-isolated SARS-CoV-2 positive patients. This should be taken into account when estimating the burden of loss of sense of smell and taste during COVID-19 pandemic, and further highlights the value of loss of sense of smell and taste as a marker of infection.

Purpose: To evaluate the prevalence of two recurrent somatic mutations (−124 C>T and −146 C>T) within the promoter of the gene encoding telomerase reverse transcriptase (TERT) as well as their relationship with TERT level, telomeres length, and outcome in patients with head and neck squamous cell carcinomas (HNSCCs). Methods: We evaluate the prevalence of TERT promoter mutations, TERT levels, and telomere length in paired cancer tissue and adjacent mucosa (AM) in a series of HNSCCs. Results: Cancer tissue and AM specimens from 105 patients were analyzed. Telomere length and TERT mRNA levels were estimated using real-time polymerase chain reaction. TERT promoter mutations were assessed using Sanger sequencing. Out of 105 cases, 101 were considered suitable for the analysis. TERT promoter harbored mutations in 12 tumors (11.9%), with −124 C>T and −146 C>T accounting for 83.3% and 16.7% of the alterations, respectively. No mutations were detected in AM samples. The prevalence of TERT promoter mutations was significantly higher in oral cavity SCCs (10 out of 27 tumors; 37%), and telomere length in AM was shorter in patients with tumors carrying TERT promoter mutations than in patients with unmutated TERT promoter cancers (p = 0.023). TERT levels in tumor did not significantly differ according to the mutational status of TERT promoter. No significant association was found between TERT promoter status and overall survival. Conclusion: TERT promoter mutations are most likely a late event in tumor development, occurring in a context of critically short telomeres, mostly in patients with oral cavity SCC. TERT levels, but not TERT promoter mutational status impact clinical outcome.

Aim: The aim of this work is to report a rare case of Primary intraosseous squamous cell carcinoma, that is a cyst-like lesion in the mandible rarely developing into malignancies, with a reported incidence between 0.3 and 2%. The case here described is a rare case of primary intraosseous squamous cell carcinoma of the mandible arised from an odontogenic cyst. Methods: A 80-year-old male with history of diabetes type II, chronic renal insuf ciency and cardiac issues, was referred to Trieste University Maggiore Hospital (Trieste, Italy), with acute pain in the left retromolar area. At the rst visit a Warthin’s tumor affecting the left parotid gland was also reported. An initial examination revealed extraoral swelling without paresthesia of the omolateral NAI. Following intraoral examination, the oral mucosa was edematous, pain on percussion was experienced on the lower left second molar. Panoramic radiography revealed a retained lower left third molar and an irregular radiolucent area between it and the lower left second molar and a mandibular angle with mostly clear margins. In addition computer tomography revealed diffuse bone resorption and an extensive loss of cortical bone on the lingual side. During the surgery aimed to remove the second and third lower left molars, a biopsy was performed and the pathological diagnosis was of a squamous cell carcinoma arising from the epithelial lining of the odontogenic cyst. Computed tomography with contrast agent was performed showing a primitive neoformation located into the horizontal branch of the left mandible eroding both the cortical and lingual walls and extending from the lower left retromolar region towards the omolateral lower cuspid, in ltrating the buccinator and medial pterygoid muscles. The patient was proposed a segmented mandibulectomy with laterocervical radical neck dissection associated with plastic reconstruction using the bula and radial ap. During the surgical procedure it was assessed that it was not possible to use the bula ap. Results: The histopathological analysis showed a primary squamous cell carcinoma staged as follows: pG2. C2. T4a. N1. Conclusions: Primary Intraosseous squamous cell carcinoma has a predilection for adult men, occurs most frequently in the mandible and is associated mainly with an odontogenic cyst. Surgery alone or combined surgery and radiation therapy are the most common approaches. Following enucleation of a cystic jaw lesion, the entire surgical specimen should always be examined histopathologically.

HPV-driven oropharyngeal carcinomas (OPCs) show geographical variations with increasing temporal trends in several areas. We investigated their frequency and clinical outcomes within a prospective multicenter cohort study in North-East Italy. A tumor was defined as HPV-driven by using at least two different biomarkers, usually HPV-DNA positivity and p16INK4A overexpression. Different survival outcomes were compared among patients with HPV-driven and non-HPV-driven tumors. Overall, 42/130 (32.3%) patients with newly diagnosed OPC during the period 2000–2018 resulted HPV-driven; HPV16 was involved in 37 cases (88%), HPV33 in 3 cases (7%), HPV58 and HPV18 in 1 case each. Over time, HPV-driven cases raised from 16.7% (6/36) during 2000–2006 to 46.1% (24/52) during 2013–2018 (p

The aim of this study was to assess whether the chronic preoperative administration of intranasal corticosteroids (INCs) in chronic rhinosinusitis with/without nasal polyposis (CRSwNP/CRSsNP, respectively) could significantly influence bleeding during functional endoscopic sinus surgery (FESS). We prospectively enrolled 109 patients (56 CRSwNP and 53 CRSsNP) candidate for FESS who underwent clinical evaluation and anamnestic data collection. They were allocated to 2 groups depending on whether or not they were chronic INC users, as declared at their first medical evaluation: chronic “INC users” represented the treated group, while “INC nonusers” formed the control group. Lund-Mackay and American Society of Anesthesiology (ASA) scores, blood loss expressed both in milliliters and using the Boezaart scale, operation time in minutes, pre- and postoperative 22-item Sino Nasal Outcome Scores (SNOT-22) were collected. Each sample underwent histopathological evaluation. The results showed that anamnestic information, Lund-Mackay, and SNOT-22 scores were similar between the 2 groups ( P > .05). The average blood loss expressed in milliliters and operative time were slightly, but not significantly, higher in the INC user group, while the Boezaart scores proved significantly higher in the INC users ( P = .038). No differences emerged between CRSwNP and CRSsNP within each group in terms of bleeding. The pathologist described common features in the majority (78%) of INC group samples: ectatic venules embedded in a fibrous stroma and hypertrophy of the arterial muscular layer. In our experience, despite the presence of NP, chronic preoperative administration of INCs was associated with increased intraoperative bleeding according the Boezaart scale although objective recordings of blood loss were not statistically different between the INC users and nonusers.

Sia in Europa che negli Stati Uniti, le protesi fonatorie e i filtri scambiatori di calore e umidità per la riabilitazione polmonare dei pazienti laringectomizzati sono inclusi nei budgets ospedalieri e nelle assicurazioni sanitarie delle singole nazioni.

Background To enforce the evidence for causality between high-risk human papillomavirus (hrHPV) infections and neck squamous cell carcinoma from unknown primary (NSCCUP) and provide biological basis for treatment de-intensification, we searched for TP53 mutations in association with HPV status. Methods TP53 mutations were searched for by amplification of exons 4 to 10. Results Of the 70 NSCCUP, 27 (39%) harbored HPV infection. TP53 sequencing resulted in the identification of 19 patients harboring single mutations including 16 disruptive alterations (84%). The association of TP53 mutations and HPV could be evaluated in 48 NSCCUP including those with disruptive mutation in any exon (n = 16) and those without mutations but with complete sequence of exons 4 to 9 (n = 32): no disruptive mutations were found in the 17 HPV-driven NSCCUP but in 16 of the 31 non-HPV-driven NSCCUP (P = .0002). Conclusion In a fraction of cases, NSCCUP is an HPV-driven entity harboring wild-type TP53 gene or nondisruptive TP53 mutations. HPV-driven NSCCUP might benefit from treatment de-intensification.

On one hand the incessant and constant technological and instrumental progress in the medical fieldhas allowed to increase knowledge and to reach new objectives. On the other hand, however, it has also raised the risk linked to professional responsibility, regarding informed consent and law 24/2017 of the Italian Republic, better known as Gelli Bianco. In this work an analysis of relevant literature will be presented, followed by a study on the role of new devices on responsibility profiles in otolaryngology. According to the analysis of the Italian law and considering the weaknesses ofthe above mentioned guidelines, pending legal administrative clarifications, we believe an operational protocol can be proposed in case of application of therapeutical innovations, especially about experimental introductions. Consequently, in our opinion, the risk of incrimination persists in case of use of innovative procedures in the absence of a formal shared opinion expressed in guidelines or in good practices, which still need a satisfactory definition.