Background: Laryngeal cancer affects quality of life (QoL), speech, and swallowing. Total laryngectomy (TL) causes severe impairments, while partial laryngectomy (PL) and chemoradiotherapy (CRT) preserve the organ but yield variable outcomes. This study assesses QoL, speech rehabilitation, swallowing, and social reintegration across these treatments. Methods: This prospective observational cohort study was conducted at the ENT Clinic, Victor Babeș University of Medicine and Pharmacy, Timișoara; recruitment was conducted between October 2019 and January 2024. Seventy-five patients diagnosed with laryngeal squamous cell carcinoma (LSCC) were initially enrolled but only 15 patients (20%) completed the 12-month follow-up, with an attrition rate of 80%. Tumor stages ranged from T1 to T4a, with TL patients having a higher proportion of advanced-stage disease (Stage III–IV: 76%) compared to PL (45%) and CRT (50%). Validated instruments, including the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire for Head and Neck Cancer (EORTC QLQ-H&N35), the Voice Handicap Index-30 (VHI-30), the Hospital Anxiety and Depression Scale (HADS), and the Dysphagia Outcome and Severity Scale (DOSS), were used to assess QoL, voice function, swallowing function, and psychological impact. Results: At 12 months, the global QoL score from the EORTC QLQ-H&N35 was lowest in TL patients (49.8 ± 10.9), significantly lower than both PL (61.2 ± 9.6, p = 0.002) and CRT (64.1 ± 7.8, p < 0.001). Post hoc Bonferroni analysis confirmed significant pairwise differences between TL vs. PL (p = 0.002) and TL vs. CRT (p < 0.001), while the difference between PL and CRT was non-significant (p = 0.14). TL patients had higher speech-related disability (VHI: 88.3 ± 12.6) and dysphagia prevalence (DOSS: 4.0 ± 1.2), with 16% remaining enteral feeding-dependent. Anxiety (HADS-A: 7.5 ± 2.9) and depression (HADS-D: 9.0 ± 3.2) were highest in TL patients, with 36% meeting clinical depression criteria at 12 months. Multivariable regression identified TL (OR = 3.92, 95% CI: 2.14–5.79, p < 0.001) and advanced tumor stage (OR = 2.85, 95% CI: 1.79–4.21, p = 0.002) as strong predictors of poor QoL. Kaplan–Meier analysis showed no significant OS differences (p = 0.12), but CRT patients had lower DFS (78%) compared to TL (82%) and PL (85%) (p = 0.048). Conclusions: TL patients experience the most significant impairments in QoL, speech, and social reintegration despite rehabilitation. CRT patients show higher recurrence rates but better QoL, while PL offers the best balance of function and survival. These findings highlight the need for long-term survivorship support tailored to treatment type.

The use of tobacco products is a major global public health issue, as it is the leading cause of preventable death worldwide. In addition, nicotine (NIC) is a key component of electronic and conventional cigarettes. Although nicotine’s addictive potential is well known, its health effects are not entirely understood. Thus, the main objective of the present study was to evaluate its toxicological profile both in vitro, at the level of three healthy cell lines, and in ovo, at the level of the chorioallantoic membrane. Five different concentrations of nicotine were used in keratinocytes, cardiomyocytes, and hepatocytes for the purpose of evaluating cell viability, cell morphology, and its impact on nuclei. Additionally, the hen’s egg test on the chorioallantoic membrane (HET-CAM) method was used to assess the biocompatibility and irritant potential of the chorioallantoic membrane. Across all cell lines studied, nicotine was proven to be significantly damaging to cell viability, with the highest concentration tested resulting in less than 2% viable cells. Moreover, the morphology of cells changed dramatically, with alterations in their shape and confluence. Nicotine-induced cell death appears to be apoptotic, based on its impact on the nucleus. In addition, nicotine was also found to have a very strong irritating effect on the chorioallantoic membrane. In conclusion, nicotine has an extremely strong toxicological profile, as demonstrated by the drastic reduction of cell viability and the induction of morphological changes and nuclear alterations associated with cellular apoptosis. Additionally, the HET-CAM method led to the observation of a strong irritating effect associated with nicotine.

Laryngeal cancer significantly affects not only survival but also core functions such as speech, swallowing, and breathing. These impairments often result in substantial psychological distress and reduced health-related quality of life (HRQoL). This review aims to synthesize current evidence regarding the psychological impact, quality of life outcomes, and system-level challenges faced by laryngeal cancer patients while identifying strategies for integrated survivorship care. Anxiety and depressive symptoms are highly prevalent among laryngeal cancer patients, particularly those undergoing total laryngectomy or chemoradiotherapy. HRQoL outcomes vary significantly depending on treatment modality, with long-term deficits noted in domains such as voice, swallowing, and emotional well-being. Access to psychological support and rehabilitation remains inconsistent, hindered by institutional, socioeconomic, and cultural barriers. Structured survivorship models, psychological screening, and patient-centered rehabilitation have demonstrated benefits but are not universally implemented. Comprehensive care for laryngeal cancer must extend beyond tumor control to address persistent functional and psychological sequelae. A multidisciplinary, anticipatory, and personalized approach—centered on integrated rehabilitation and mental health support—is essential to optimize survivorship outcomes and improve long-term quality of life.

Background: Cisplatin, a widely used chemotherapeutic agent, is associated with significant ototoxicity, leading to progressive and irreversible sensorineural hearing loss in up to 93% of patients. Cisplatin generates reactive oxygen species (ROS) in the cochlea, activating apoptotic and necroptotic pathways that result in hair cell death. Inflammatory processes and nitrative stress also contribute to cochlear damage. Methods: This literature review was conducted to explore the mechanisms underlying cisplatin-induced ototoxicity and evaluate protective strategies, including both current and emerging approaches. A structured search was performed in multiple scientific databases, including PubMed and ScienceDirect, for articles published up to November 2024. Results: Current otoprotective strategies include systemic interventions such as antioxidants, anti-inflammatory agents, and apoptosis inhibitors, as well as localized delivery methods like intratympanic injection and nanoparticle-based systems. However, these approaches have limitations, including potential interference with cisplatin’s antitumor efficacy and systemic side effects. Emerging strategies focus on genetic and biomarker-based risk stratification, novel otoprotective agents targeting alternative pathways, and combination therapies. Repurposed drugs like pravastatin also show promise in reducing cisplatin-induced ototoxicity. Conclusions: Despite these advancements, significant research gaps remain in translating preclinical findings to clinical applications and developing selective otoprotective agents that do not compromise cisplatin’s efficacy. This review examines the mechanisms of cisplatin-induced ototoxicity, current otoprotective strategies, and emerging approaches to mitigate this adverse effect.

Otorhinolaryngological (ORL) cancers, including malignancies of the oral cavity, pharynx, and larynx, show significant challenges in oncology. Cisplatin, a platinum-based chemotherapy drug, remains a cornerstone of treatment but is often limited by systemic toxicity and resistance. A comprehensive literature review was conducted using recent studies and clinical trials focused on nanotechnology-based cisplatin delivery systems. The analysis covered various types of nanocarriers, their mechanisms, and advantages. Additionally, the limitations of nanotechnology-based cisplatin delivery systems were discussed. Findings indicate that lipid-based nanoparticles, polymeric nanoparticles, inorganic nanoparticles, and extracellular vesicles have demonstrated improved drug targeting, bioavailability, and reduced systemic toxicity in preclinical and clinical studies. Nanocarriers also offer potential for overcoming drug resistance and enabling combination therapy. However, challenges related to biocompatibility, scalability, and regulatory approval remain significant barriers to widespread clinical adoption. Nanotechnology offers a novel and promising approach to optimizing cisplatin delivery for ORL cancers. While preclinical studies demonstrate significant potential, further research and clinical validation are essential to translate these advancements into routine clinical practice. Addressing manufacturing and regulatory challenges will be critical for future research.

Background/Objectives: Hearing impairment is a frequent but under-recognized sequela of (chemo)radiotherapy for head and neck cancer (HNC). We assessed the frequency of early post-treatment hearing changes and their association with cochlear radiation exposure and concurrent platinum-based chemotherapy. Methods: We conducted a single-center retrospective cohort study of 70 consecutive patients with HNC treated with radiotherapy between November 2024 and September 2025. Patients receiving concurrent chemoradiotherapy (CRT, n = 48) were compared with patients receiving radiotherapy alone (RT, n = 22). The primary outcome was clinically documented post-treatment hearing change. Cochlear maximum point doses (Dmax) were extracted from treatment plans. Analyses included Fisher exact and Mann–Whitney U tests, Spearman correlations, Firth penalized logistic regression, a Cochran–Armitage trend test, and restricted cubic splines. Results: Post-treatment hearing changes were documented in 38/70 patients (54.3%): 58.3% after CRT versus 45.5% after RT alone (odds ratio (OR) 1.68, 95% confidence interval (CI) 0.61–4.49, p = 0.439). Mean cochlear Dmax was higher in patients with hearing change (median 5.5 vs. 2.5 Gy, p = 0.045) and correlated with the outcome (ρ = 0.244, p = 0.043), with hearing-change rates of 34.8%, 65.2%, and 65.2% across cochlear-dose tertiles (trend p = 0.038). In Firth regression adjusted for age, pre-treatment hearing loss, and concurrent CRT, the association was attenuated and not statistically significant (adjusted OR 1.31 per 10 Gy, 95% CI 0.82–2.08, p = 0.253), and it was attenuated further after accounting for tumor site (OR 1.09 per 10 Gy, 95% CI 0.66–1.80, p = 0.735), with oropharyngeal primary the strongest correlate of hearing change (OR 4.02, 95% CI 1.28–12.6). Paired audiograms were available in only 10 patients, seven of whom showed audiometric deterioration; a conductive component could not be excluded in 14/38 events. No patient exceeded the QUANTEC mean cochlear-dose constraint of 45 Gy. Conclusions: Early, clinically apparent hearing changes affected more than half of this contemporary cohort. The univariable association with cochlear dose did not persist after adjustment, particularly for tumor site, and the available audiometric data do not allow hearing changes to be attributed specifically to cochlear injury. These findings underscore the need for systematic baseline and follow-up audiometry rather than demonstrating that further cochlear-dose reduction would improve hearing outcomes.