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Nasopharyngeal carcinoma (NPC) is an intriguing disease with unique epidemiological features. It shows a distinct geographical distribution with well-defined, high-risk ethnic groups, age and gender. This neoplasm exhibits strong associations with the Epstein-Barr virus, dietary and genetic factors. Radiation therapy is the mainstay of treatment and imaging plays a central role in tumor mapping and radiation therapy planning. The purpose of the current manuscript is to present a case of a 65-year-old male patient that examined in the outpatient ENT Department of our hospital, reported a persistent otitis media in the left ear, for about one year. It is important always to raise the suspicion of nasopharyngeal carcinoma, in patients with persistent otologic symptoms, that do not improve despite therapy.

Background: The aim of this study was to investigate the relation between tobacco smoking and chemosensory dysfunction in COVID-19 patients in Northwestern Greece. We also aimed to investigate if there is any relation between smoking and the need of hospitalization, in this West Greece population. Methods: We used a questionnaire to select information about patient demographics, medical history, habits such as tobacco smoking and alcohol consumption and reported symptoms, during infection. In this study were included three hundred covid_19 positive patients that were all undergone the RT-PCR test in the University Hospital of Ioannina, Grecce.150 of them recovered at home and 150 patients needed hospitalization. Statistical analysis based on ΙBM-SPSS Statistics 26.0. Results: The highest percentage of patients that were tobacco smokers was found in the subgroup of patients that recovered at home and was about 20%. The lowest percentage was 8% in the subgroup of patients that needed hospitalization. There is statistically difference between the subgroup of patients with use of tobacco smoking and decreased need for hospitalization. Conclusion: There is no relation between chemosensory dysfunction during SARS_COV2 infection and tobacco smoking. There is a statistically significant difference between active smokers with covid_19 infection and decreased risk for hospitalization.

Background: We present the case of a patient with a Merkel cell carcinoma (MCC) of the left preauricular area. Case presentation:A 84-year-old Greek man was examined at the outpatient ENT Department of our clinic with a lesion in the preauricular area that had appeared four months ago. The patient history included antihypertensive and antihyperlipidemic therapy as well as treatment for dementia. The excision of the skin lesion was performed under local anesthesia. The histological examination revealed a Merkel cell carcinoma. The patient underwent a computed tomography (CT) scan that showed a lesion with clear limits in the left parotid gland and lymph nodes. Under general anesthesia, he underwent a left superficial parotidectomy, left submandibular gland excision and radical neck dissection. Histological preparations were analyzed using an intraoperative flow cytometry (iFC) protocol. A radiation therapy concluded the patient's treatment. Conclusion:Even if MCC appears as a less common and more aggressive skin cancer type, a clinician always has to include it in the differential diagnosis of a skin lesion. We found the use of iFC very useful for the diagnosis of this skin cancer.

Objectives: To provide a detailed description and evaluation of therapeutic techniques for the management of nasal valve in rhinoseptoplasty. Method:An extensive review of the international bibliography has been conducted to highlight published articles on nasal valve pathology and therapeutic measures to address it. Results:To date, many techniques have been described for increasing the cross-sectional area of the nasal valve. Selection of the appropriate technique poses a significant challenge to the nasal valve surgeon. Long-term correction of NVD requires surgical intervention. Correction typically involves the use of various grafts or suture techniques to enlarge and/or support the nasal valve. Selection of the appropriate technique depends on the location and type of dysfunction (dynamic/static). Conclusion:The nasal valve plays an important role in nasal airflow. It is important for the otolaryngologist not only consider, but also fully evaluate the nasal valve when seeing a patient with nasal obstruction. If it is not the primary cause of obstruction, it is often a contributing factor. If NVD is discovered, it should be addressed during surgical intervention (functional rhinoplasty) to avoid a suboptimal outcome.

Gunshot injuries can be very threatening to the patient's life. A bullet in the neck area after a gunshot usually causes tissue damage and bleeding because of the presence of vital structures in this region. We present the case of a young man that arrived emergently to our hospital because of gunshot injury in the right neck area and the right shoulder. He was hemodynamically stable, with no laryngeal edema or hematoma. The cervical radiography showed a foreign body lying on the right side of the spine, in front of the third cervical vertebra. The CT scanning revealed a metallic foreign body, lying between the internal carotid artery and the external carotid artery, without causing bleeding in the surrounding tissues. A bullet was also found in the right shoulder area. A barium esophagography showed no contrast agent escape. An emergency operation was performed, under general anesthesia. The metallic bullet was found under an enlarged submandibular lymph node and was removed. The bullet removal caused vessel intraoperative bleeding, that was repaired satisfactory. No postoperative complications were noticed and patient was discharged home.

We present the case of an 80-year-old female patient with a lesion on the right antihelix of the pinna that examined in the outpatient ENT Department of our hospital. A surgical excision of the lesion was performed, under local anesthesia. We used a superficial based pre- auricular flap to reconstruct the defect. The final postoperative result was satisfactory. The histological examination revealed a basal cell carcinoma.

We present the case of a 41-year-old male patient that examined in the outpatient ENT Department of our hospital, reported a persistent otitis media for about six months. Despite medical therapy, his symptom did not improve. The suspicious of a nasopharyngeal mass was raised and the rhino endoscopy revealed a mucosal projection in the left fossa of the Rosenmuller. Computed tomography (CT) of temporal bone pneumatization showed a left mastoid cell occupation and a small projection in the left fossa of the Rosenmuller. The histological examination result of a biopsy of the lession that prepared under local anesthesia, revealed nasopharyngeal adenoid cystic carcinoma. Magnetic resonance imaging indicated the extent of the tumor. The positron emission tomography/computed tomography (PET/CT) scan staged the patient and concluded the diagnosis. The patient underwent both surgery and radiotherapy and addressed oncologists and radiotherapists for further treatment. The patient was diagnosed with lung and kidney metastasis. Adenoid cystic carcinoma is a rare type of adenocarcinoma with ominous prognosis. We always have to raise the suspicious of nasopharyngeal carcinoma, in patients with persistent otological symptoms, that do not improve despite therapy.

We present the case of a 59 year old male patient with pulsate tinnitus, referred as the first manifestation of a jugular parganglioma. The patient examined at the outpatient ENT Department of our hospital with a left lateral cervical swelling, difficulty in swallowing and pulsatile tinnitus. Tinnitus was the first reported symptom that appeared one month before. The patient had no medical history. The clinical examination showed an asymmetric swelling of the left tonsil, a left vocal cord paralysis, a retrotympanic mass otoscopically and conductive hearing loss in the left ear. The patient underwent a head-and-neck computed tomography that raised the suspicion of a paraganglioma. The magnetic resonance imaging and the magnetic angiography with the administration of a contrast agent set the diagnosis of a jugular paraganglioma. After the tumor embolization, the patient unerwent primary resection of the tumor. This is the first case of a patient with a jugular paraganglioma and pulsatile tinnitus as the first reported symptom.

The aim of this study is to explore if there is correlation between the typical voice classification and oropharyngeal anatomy, using cervical posterior-anterior radiography on professional singers in Epirus, Greece. Methods: 70 professional singers, 35 men and 35 women, were recruited for this study. All participants underwent a cervical posterior-anterior radiographic imaging of their oral pharyngeal and laryngeal area. Results: A statistically significant difference of mean distance was observed for the CI-MHP area (p=0,004), the MHP- SCV area (F=2,62, p=0,032), as well as SCV-AI area (F=11,82, p=0,000). For the average length measured in mm of the phonetic area PA, statistically significant differences were computed among all the singers in the group (F [5] = 5.368, p = 0.001), as well as the OPC area (F = 6,48, p = 0,000). Conclusions: The cervical posteroanterior radiography provided new correlations of the voice category of professional singers with their Oropharyngeal and Laryngeal Anatomy.

Otorhinolaryngology head and neck (ENT) surgeons are often challenged in their daily practice with patients presenting cutaneous cancer. Cutaneous basal cell carcinoma (cBCC) is the most common cancer diagnosed in human population, with 80% occurring in the head and the neck. We present the case of a 56-year-old male patient with an extensive lesion on the right zygomatic area that examined in the outpatient ENT Department of our hospital. A surgical excision of the lesion was performed, under local anesthesia and then we used a superficial based neck flap to reconstruct the defect. The final postoperative result was satisfactory. The histological examination revealed a basal cell carcinoma.

Objective:Olfactory and gustatory dysfunction that relates with the infection from severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) has already improved. The relation between chemosensory dysfunction and age and gender in covid-19 positive patients is the main objective of the present study. Methods:We used a questionnaire to select information about medical history, patient demographics and reported symptoms during infection. Three hundred covid-19 positive patients, who underwent a RT-PCR test in the University Hospital of Ioannina, Grecce, were included in this study; 150 of them recovered at home and the remaining 150 were admitted to hospital. Statistical analysis based on ÉBM-SPSS Statistics 26.0 was done. Results:The total sample included 300 patients, of which 106 females and 194 males. There was a statistically significant difference between the subgroup of patients aged 21-25, 61-65 and 71-75 with loss of smell, that of hospitalized patients aged 41-45 with loss of smell and the subgroup of those aged 31-35 and 71-75 with loss of taste. Conclusion:There is a significant association between chemosensory dysfunction and younger age groups. Olfactory and gustatory dysfunction appears more frequently in women than men. Male gender relates with disease severity.

Background:Dizziness is a commonly referred symptom in emergency departments (EDs). The aim of this study is to describe the epidemiology of dizziness included acute vestibular syndrome (AVS) in the ED of the University Hospital of Ioannina, Grecce, during a six-month period. Methods:A total of 60 patients presenting with dizziness to the ED of our hospital during a short period of six months in 2021 were identified. Data were obtained through retrospective and prospective review of medical records. Statistical analysis was based on ÉBM-SPSS Statistics 26.0. Results:Among the 60 patients, 16.67% received the diagnosis of cerebellar stroke, 3.33% Meniere disease, 16.67% vestibular neuritis, 20% benign paroxysmal positional vertigo, 3.33% cardiovascular disease, and 1.67% had a neurological disease. Finally, 35% of patients left the ED undiagnosed. Conclusion:Benign paroxysmal positional vertigo was found to be the most common cause of dizziness in the ED, followed by cerebellar stroke and vestibular neuritis. A detailed neurological examination is recommended for the diagnosis of dizziness in the ED. Our data confirm the findings of previous studies in the GreeK population of patients presenting with dizziness to the ED of our hospital.

Backround: We aimed to assess the relation of chemosensory dysfunction with the reported symptoms in two subgroups of patients in Northwestern Greece: the first one included patients with moderate to severe symptomatology who needed hospitalization and the second one, patients with mild symptoms who recovered at home. Methods:We used a questionnaire to select information about patient demographics, medical history and reported symptoms during infection. Three hundred COVID-19 positive patients who were identified via RT-PCR test in the University Hospital of Ioannina, Greece, were included in the present study, of which 150 recovered at home and the remaining 150 needed hospitalization. Statistical analysis was based on IBM-SPSS Statistics 26.0. Results:The majority of patients had fever during infection, while o minor percentage of those who needed hospitalization (12.67%) suffered from sore throat. There was a statistically significant difference between the loss of smell and clinical symptoms including fatigue, nose congestion, body aches and headache, and loss of taste and reported symptoms including fatigue, body aches, runny nose, headache and sore throat. Conclusion: Fever was the symptom with the highest percentage rate, while sore throat was the symptom with the lowest percentage rate. There are reported clinical symptoms related with olfactory and gustatory dysfunction during COVID-19 infection.

Fibrous dysplasia (FD) is a rare, benign, chronic, slowly progressive bone disorder characterized by the replacement of normal bone and bone marrow by fibrous tissue, leading to deformity, pain and functional impairment. It was considered a disease of unknown etiology, uncertain pathogenesis and diverse histopathology. It was later discovered that was caused by a non-heritable activating mutation in the á-subunit gene of the stimulatory G-protein coding gene. Temporal bone involvement is the least frequently reported type, especially in children. The purpose of the current manuscript was to report a rare case of fibrous dysplasia of the left temporal bone of a 17-year-old child who came to the emergency room of our hospital with otalgia and progressive hearing loss on the left ear.

Funding Acknowledgements Type of funding sources: None. Purpose The administration of the 30mg hydrochloric delapril and 10mg hydrochloric manidipine formulation is indicated for patients with idiopathic hypertension whose arterial pressure cannot be sufficiently managed with monotherapy. The purpose of this study is to investigate the effect of the premade combination delapril/manidipine 30/10mg per day on the variation of HOMA-IR, HOMA-B and QUICKI values, in patients with stage 2 hypertension (systolic blood pressure (SBP) 160-180 mmHg and/or diastolic blood pressure (DBP) 100-110 mmHg) and with prediabetes (IFG/IGT) before and after the 3-month treatment with the fixed combination dual-therapy. Methods 53 patients (30 male/23 female, from whom 12 smokers and 7 alcohol users) who visited our outpatient clinic for lipid metabolism disorders and fulfilled the study’s criteria joined the study’s sample. They were randomized in the delapril/manidipine group. The patients’ BMI was 28.73 [27.73-30.3] and the SBP and DBP values were: 156 [151-161] and 100 [88-101] mmHg respectively. Results The resulting variations of SBP and DBP levels, as well as the variations of glucose and insulin levels and HOMA-IR, HOMA-B and QUICKI are presented on Table 1. Results From the sampled patients it seems that the 3-month treatment with delapril/manidipine improved statistically significantly the levels of both SBP and DBP (reduction by -11.54% and -12% respectively, p

Funding Acknowledgements Type of funding sources: None. Introduction-Purpose The combination of valsartan with amlodipine is more effective than monotherapy for managing HT. The purpose of this study was to investigate the effect of the fixed combination of valsartan/amlodipine 160/5 mg per day on HOMA-IR (homeostatic model assessment for insulin resistance), HOMA-B (HOMA for β cell function) and QUICKI (quantitative insulin-sensitivity check index) values in patients with stage 2 hypertension (systolic arterial pressure 160-179 mmHg and/or diastolic pressure 100-109 mmHg) and prediabetes (IFG/IGT) before and after 3 months of treatment with the dual therapy. Methods Data from 54 patients who visited our outpatient clinic for lipid metabolism during the period 2014-2018. 54 persons were randomized in the valsartan/amlodipine group 160/5 mg per day (33 males/21 females from whom 14 were smokers and 8 were alcohol consumers) with BMI: 28.09[26.81-29.89], all of whom successfully completed the study. The median values of systolic and diastolic arterial pressure for the study population: 162 [159.25-165] and 100 [92-103.75] mmHg, respectively. Results The resulting variations of systolic and diastolic arterial pressure as well as the variations of HOMA-IR, HOMA-B and QUICKI are presented on Table 1. Conclusions From the studied group it is concluded that the 3-month treatment with valsartan/amlodipine improved with statistical significance the values of both systolic and diastolic arterial pressure (reduction by -13.58% and -13% for systolic and diastolic arterial pressure, respectively, p

Funding Acknowledgements Type of funding sources: None. Introduction-Purpose The combination of telmisartan and amlodipine in tablet form indicated for patients whose arterial blood pressure cannot be fully managed with monotreatment. The purpose of this study was to investigate the effect of the fixed combination telmisartan/amlodipine 80/5mg per day on arterial pressure levels and the variation of HOMA-IR, HOMA-B and QUICKI values in patients with stage 2 hypertension (systolic blood pressure (SBP) 160-179 mmHg and/or diastolic blood pressure (DBP) 100-109 mmHg) and with prediabetes (IFG/IGT) before and after the 3-month treatment with the administration of the fixed combination. Methods Data collected from 51 patients who have visited our outpatient clinic for lipid metabolism disorders during the period 2014-2018. 51 persons with BMI: 29.32 [27.37-31.65] (25 male, 16 female) had been randomized in the group for telmisartan/amlodipine 80/5mg per day. The median values for the study’s sample in SBP and DBP were: 163[158-168] and 100[95-106] mmHg, respectively. Their somatometric and demographic characteristics were recorded in the beginning of the study and are presented on Table 1Α. Results The results of the variations in SBP and DBP, as well as the variations in glucose, insulin, HOMA-IR, HOMA-B and QUICKI before and after the 3-month treatment are presented on Table 1B. Conclusions From the sampled patients it can be observed that the 3-month treatment with telmisartan/amlodipine statistically significantly improved (p=0.005) the HOMA-IR values while improving fasting glucose and insulin levels. Finally, there was a statistically significant reduction in QUICKI values and a statistically insignificant reduction in HOMA-B.

Funding Acknowledgements Type of funding sources: None. Introduction-Purpose The combination of telmisartan with amlodipine is a commonly administered combination of an agonist ATII (angiotensin receptor II) and CCB (calcium channel blocker) for the management of hypertension. The purpose of this study is to evaluate the effect of the fixed of combination telmisartan/amlodipine 80/5mg per day on the levels of serum lipids, as well as the levels of serum apolipoproteins and the TRG/ApoA-1, TRG/HDL-C ratios, in patients with stage 2 hypertension (systolic blood pressure (SBP) 160-180 mmHg and/or diastolic blood pressure (DBP) 100-110 mmHg) and with prediabetes (IFG/IGT), before and after the 3-month treatment. Methods Data from 51 patients who had visited our outpatient clinic for lipid metabolism disorders during the period 2014-2018 and had been randomized in the telmisartan/amlodipine group 80/5mg per day. The patients (35 male/16 female) had BMI: 29.32 [27.37-31.65]. The levels serum lipids and of apolipoproteins B, A1, Lp(a) and E were measured before the beginning of the treatment and 3-months after its administration. Results The resulting variations of SBP and DBP levels before and after the 3-month treatment, as well as the variations of serum lipid, apolipoprotein levels and TRG/ApoA-1, TRG/HDL-C ratios are presented on Table 1. Conclusion The 3-month telmisartan/amlodipine therapy seems to improved, statistically significant both SBP and DBP levels (decreased by -13.58 % and -13 % respectively, p

Funding Acknowledgements Type of funding sources: None. Introduction-Purpose Both manidipine and delapril have been proven to have a neutral effect on lipids. Patients with idiopathic hypertension are being administered with the 30mg hydrochloric delapril and 10mg hydrochloric manidipine formulation. The purpose of this study was to investigate the effect of the fixed combination of delapril/manidipine 30/10mg on lipid and apolipoprotein levels as well as on TRG/ApoA-1 and TRG/HDL-C ratios as indicative markers of insulin resistance, in patients with stage 2 hypertension (systolic blood pressure (SBP) 160-179 mmHg and/or diastolic blood pressure (DBP) 100-109 mmHg) and with prediabetes (IFG/IGT), before and after the 3-month treatment. Methods 53 patients referred to our outpatient clinic for lipid metabolism disorders and met the study’s criteria were included, during the period 2014-2018. In the group of delapril/minidipine there were randomized 30 males and 23 females from whom 12 were smokers and 7 alcohol users). The patients’ BMI was 28.73 [27.73-30.3] and the values of SBP and DBP were: 156 [151-161] και 100 [88-101] mmHg, respectively. The serum lipid and apolipoprotein levels were measured before and after the 3-month treatment. Results The resulting variations of SBP and DBP levels, as well as the changes in lipid levels, apolipoprotein levels and TRG/ApoA-1 and TRG/HDL-C ratios are presented on Table 1. Conclusion From the sample group it can be observed that the 3-month combination therapy with manidipine/delapril improved statistically significantly both SBP and DBP levels (reduction by -13.58% and -13%, respectively). Concerning serum lipid levels, the combination therapy statistically significantly improved TCHOL, LDL-CHOL, and non-HDL-CHOL levels (decrease by 4.01%, 6.7% and 5.4%, p= 0.009, 0.006 and 0,08 respectively). The changes in apolipoprotein values were small and only ApoB values showed a statistically significant variation. Finally, there wasn’t a statistically significant improvement on neither TRG/ApoA-1 nor TRG/HDL-C ratios.

Funding Acknowledgements Type of funding sources: None. Introduction-Purpose The combination of valsartan with amlodipine is a commonly administered combination of an agonist ATII (angiotensin receptor II) and CCB (calcium channel blocker) for the management of hypertension. There is already data from different studies that describe the effect of each of those medications in the lipidemic profile. Ratios TRG/ApoA-1, TRG/HDLC are useful markers of insulin resistance. The purpose of this study is to investigate the effect of the fixed combination of valsartan/amlodipine 160/5mg per day on the levels of serum lipids, as well as the levels of serum apolipoproteins and the TRG/ApoA-1, TRG/HDLC ratios, in patients with stage 2 hypertension (systolic blood pressure (SBP) 160-179 mmHg and/or diastolic blood pressure (DBP) 100-109 mmHg) and prediabetes (IFG/IGT), before and after the 3-month treatment. Methods Data from 54 patients who were referred to our outpatient clinic for lipid metabolism disorders during the period 2014-2018 and had been randomized in the valsartan/amlodipine group 160/5mg per day. Those patients (33 male/21 female from whom 14 were smokers and 8 alcohol users) all completed the study successfully with mean BMI: 28.09[26.81-29.89]. The median values of SBP and DBP for the sample group were: 162 [159.25-165] και 100 [92-103.75] mmHg, respectively. The levels of apolipoproteins B, A-1, Lp(a) and E were measured prior to the beginning of treatment and 3-months after its administration. Results The resulting alternations of SBP and DBP levels before and after the 3-month treatment, as well as the changes of serum lipid, apolipoprotein levels and TRG/ApoA-1, TRG/HDL-C ratios are presented in Table 1. Conclusions From the sample group it seems like that the 3-month therapy with valsartan/amlodipine improved statistically significant both SBP and DBP levels (decreased by -13.58% and -13% respectively, p