Objective: Tumours of the nasal septum are a rare and heterogeneous group of lesions in the sinonasal tract. The management of the different lesions of this site is debated. The aim of this study is to share our experience on a rare clinical condition and stimulate other centres to publish theirs. Methods: We retrospectively analysed the databases of sinonasal tumours treated at the Sections of Otolaryngology (ENT) of two University Hospitals (Palermo and Genova) between 2012 and 2020. Results: From the two databases, a cohort of 32 patients with tumours of nasal septum were selected. All patients underwent an endoscopic examination. Large tumours underwent preoperative computed tomography (CT) scan without contrast medium. In 22 (68.7%) cases, the preoperative radiologic evaluation also included magnetic resonance imaging (MRI) with gadolinium to obtain a better differentiation of the lesions and study the vascular pattern. All the large lesions were biopsied under endoscopic guidance using local anaesthesia; the same approach was used to remove the tumours and their attachment with safe resection margins. Conclusions: While malignant lesions require an excision of the mass with resection of all layers of the nasal septum, benign lesions must be typed according to histological considerations in order to plan the most appropriate type of surgical resection.

Narrow-band imaging (NBI) represents a valid aid in laryngeal squamous cell carcinoma (LSCC) diagnosis for detecting vascular changes. However, LSCC and laryngeal papillomatosis (LP) show similar vascular patterns that may lead to misdiagnosis and improper treatment. This review aims to deepen this NBI limit in order to stress a careful preoperative evaluation of laryngeal lesions. The research was carried out on PubMed, Web of Science and Scopus databases using specific keywords. The topic of research was assessed by these parameters: accuracy, sensitivity, specificity, and positive and negative predictive values. This review included only five articles: they demonstrated that NBI is better than white-light endoscopy in detecting LSCC and LP. They also reported that LP is frequently mistaken for LSCC, resulting in high rates of false positives using NBI. This is the first review that emphasized this NBI limitation in distinguishing between LP and LSCC in cases of a type V pattern of intraepithelial papillary capillary loop. Although NBI application increased the rate of early cancer detection, LP reduces NBI accuracy. This drawback may lead to misdiagnosis and improper treatment. Our advice is to be careful in cases of type V pattern on NBI and to research LP epithelial and clinical features because it could be a pitfall.

(1) Background: Inferior turbinates’ hypertrophy is often associated with Eustachian tube dysfunction (ETD); radiofrequency turbinate reduction (RTR) may provide a long-term improvement of nasal obstruction and ETD-related symptoms. (2) Aim: The study aimed to compare ETD in atopic and non-atopic patients before and after RTR and to investigate the correlation between tympanometry and Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7). (3) Methods: Ninety-seven patients, ranging from 33 to 68 years old, were screened by skin tests and divided into atopic (G1) and non-atopic (G2). Eustachian tube function (ETF) was evaluated through tympanometry, William’s test and ETDQ-7. (4) Results: A moderate to severe subjective ETDQ-7 was found in the 35.42% of G1 and in the 22.45% of G2 patients before RTR. William’s test resulted normal in 141 ears (72.68%), partially impaired in 15 (7.73%), and grossly impaired in 38 (19.59%) before surgery. A grossly ETD was evidenced in the 19.59% of cases before surgery and decreased to 6.18% after surgery with a significant difference among atopic patients (p < 0.001). (5) Conclusion: RTR may be considered a treatment option in patients suffering from ETD and inferior turbinates’ hypertrophy; RTR reduced the percentage of grossly impaired ET function (p < 0.001). ETDQ-7 and William’s test may represent valuable tools to assess ET function before and after surgery.

ChatGPT is an advanced language model developed by OpenAI, designed for natural language understanding and generation. It employs deep learning technology to comprehend and generate human-like text, making it versatile for various applications. The aim of this study is to assess the alignment between the Rhinology Board’s indications and ChatGPT’s recommendations for treating patients with chronic rhinosinusitis with nasal polyps (CRSwNP) using biologic therapy. An observational cohort study involving 72 patients was conducted to evaluate various parameters of type 2 inflammation and assess the concordance in therapy choices between ChatGPT and the Rhinology Board. The observed results highlight the potential of Chat-GPT in guiding optimal biological therapy selection, with a concordance percentage = 68% and a Kappa coefficient = 0.69 (CI95% [0.50; 0.75]). In particular, the concordance was, respectively, 79.6% for dupilumab, 20% for mepolizumab, and 0% for omalizumab. This research represents a significant advancement in managing CRSwNP, addressing a condition lacking robust biomarkers. It provides valuable insights into the potential of AI, specifically ChatGPT, to assist otolaryngologists in determining the optimal biological therapy for personalized patient care. Our results demonstrate the need to implement the use of this tool to effectively aid clinicians.

Background: Effective swallowing represents the main challenge in supraglottic laryngectomy. This study aimed to assess swallowing outcome comparing endoscopic supraglottic laryngectomy (ESL) and open partial horizontal laryngectomy type I (OPHL I). Methods: A retrospective study was carried out on 20 patients that underwent supraglottic laryngectomy from 2015 to 2021: 10 underwent ESL (group A) and 10 underwent OPHL I (Group B). Patients underwent fiberoptic endoscopic evaluation of swallowing (FEES) 3 months and 12 months after surgery and videofluoroscopy swallowing studies (VFSS) 12 months after surgery. A Swallowing Outcome After Laryngectomy (SOAL) questionnaire was administered to patients to assess their life quality. Results: A naso-gastric tube was placed in two patients of Group A and in all patients of Group B. Tracheostomy was performed in two patients of Group A and in all patients in Group B and it has been closed in 100% of them. According to Donzelli’s scale, FEES and VFSS showed better results in Group A at 3 months, while at 12 months they did not show statistically significant differences between ESL and OPHL I in terms of laryngeal penetration and aspiration. The SOAL questionnaire showed satisfactory life quality. Conclusion: Swallowing evaluation by FEES and VFSS did not demonstrate statistically significant differences at 12 months post-op between two surgeries, although ESL showed less cases of laryngeal penetration and aspiration at 3 months post-op. Anyway, good results of any surgery depend on careful patient selection and the surgeon’s experience.

To date, histological biomarkers expressed by laryngeal cancer are poorly known. The identification of biomarkers associated with laryngeal squamous cell carcinoma (SCC), would help explain the tumorogenesis and prevent the possible recurrence of the lesion after treatment. For this reason, the aim of this study is to investigate, for the first time, the Orphanin expression in 48 human specimens of laryngeal SCC and evaluate its possible correlation with patients prognosis. We analyzed pathological specimens from 48 patients with laryngeal SCC to detect the presence of Orphanin by using an immunohistochemistry test. We compared the findings with healthy tissue acquired from patients who underwent surgery for mesenchymal benign tumours of the larynx. The specimens were stained with anti-Orphanin monoclonal antibodies. Results were processed through a computerised image analysis system to determine a scale of staining intensity. All the tumoural specimens examined showed a significant immunoreaction for Orphanin when compared with healthy tissues (p < 0.05) but with a different immune reactivity related to clinical-pathological features. A high Orphanin expression was not significantly related to Histological Grading (HG), TNM, and stage (p > 0.05). In the multivariate analysis, the Orphanin expression was significantly related only to the malignant recurrence (p < 0.05). Our study suggests that Orphanin could have a role in tumorigenesis by increasing the recurrence of cancer; therefore, it should be further explored as a possible biomarker for laryngeal cancer.