Introduction: Obstructive sleep apnea (OSA) is a highly prevalent, yet underdiagnosed sleep disorder associated with cardiovascular, metabolic, and neurocognitive morbidity, as well as impaired quality of life. Limited access to diagnostics, low public awareness, and underreporting of symptoms contribute to a substantial gap in detection. Community pharmacies, given their accessibility and frequent interaction with patients managing multiple comorbidities, represent a promising but underexplored setting for identifying individuals at high risk. Objective: To investigate the feasibility of pharmacy-based screening for OSA and to provide preliminary insights into the prevalence of at-risk individuals among pharmacy clients. Methods: A cross-sectional study was conducted in 22 Italian community pharmacies, where participants completed a three-section questionnaire recording demographic data, the Berlin Questionnaire (BQ) for OSA screening and the Pittsburgh Sleep Quality Index (PSQI) for sleep quality assessment. Multivariate regression was performed to explore the association between poor questionnaire outcomes, demographic variables, and ongoing medication use. A sensitivity analysis was conducted to minimize the risk of bias. Results: A total of 301 individuals were included (females: n = 169/301, 56.15%). One-hundred-sixteen subjects (38.5%, n = 301) scored positively in at least two categories of the BQ and were hence classified as at-risk. At sensitivity analysis, BMI (OR = 1.15, 95%CI: 1.07–1.24, p < 0.001), and ongoing antihypertensive medications (OR = 2.02, 95%CI: 1.78–3.11, p = 0.002) were associated with poor BQ outcome. A significantly higher PSQI score was observed compared to previously reported values in healthy individuals. However, no significant associations were observed between poor sleep quality and patients’ demographics, or ongoing medication use. Conclusion: Community pharmacies can serve as a valuable setting for the early identification of individuals at risk for sleep-related breathing disorders, particularly among patients with multiple comorbidities. By leveraging their accessibility and frequent patient contact, pharmacies may complement existing healthcare pathways and support efforts aimed at reducing the current diagnostic gap in OSA.

Objective: To objectively assess nasal flow obstruction improvement through anterior active rhinomanometry (AAR) in patients with severe chronic rhinosinusitis with nasal polyps treated with dupilumab. Methods: Dupilumab-treated patients were evaluated at baseline (T0), 3rd month (T1) and 6th month (T2) after therapy initiation by AAR, and nasal airway resistances were measured using the Rinopocket ED200 system™. The Lund-Mackay Score (LMS), the Nasal Polyp Score (NPS) and the Lund-Kennedy Score (LKS) were assessed. Also, patients were required to fill in the Nasal Obstruction Symptom Evaluation scale, the 22-Item Sinonasal Outcome Test and the Visual Analogue Scale for sinonasal symptoms. Results: Twenty-one patients (n = 21) were included. By T1, both inspiratory and expiratory resistances, as well as total nasal resistance, showed a significant reduction. At T2, these improvements were sustained but did not differ significantly from T1. Patient-reported outcomes followed a similar trend, showing marked improvement at T1 but no further significant changes at T2. Conversely, endoscopic and radiologic outcomes (NPS, LKS, LMS) demonstrated significant improvements across all timepoints. Conclusions: This preliminary study shows the rapid effectiveness of dupilumab in relieving nasal obstruction. Interestingly, while endoscopic and radiologic assessments showed ongoing improvement at each time point, nasal airway resistance measured with AAR did not significantly decrease beyond the initial 3 months of treatment.

Background/Objectives: To assess the safety and efficacy of submucosal mitomycin C (MMC) injection as an adjunct in patients undergoing endoscopic treatment for laryngotracheal stenosis (LTS). Methods: All patients affected by LTS receiving endoscopic treatment with adjuvant MMC were screened and selected from a retrospective database spanning from May 2022 to July 2023 at IRCCS Humanitas Research Hospital (Rozzano, Italy). Demographic data, bronchoscopic findings, and treatment-related outcomes were recorded and analyzed. Results: A total of 16 patients were included in the study. Subglottic stenosis was the most common condition, occurring in 88.9% of cases. All procedures were completed safely without intraoperative or postoperative complications or conversion to open surgery. Re-stenosis occurred in 6 (37.5%) cases, with a median time to recurrence of 136.5 (±43.9) days, requiring additional treatments. At last follow-up, all included patients were asymptomatic, except for two who reported mild dyspnea. Conclusions: Submucosal MMC injections represent a safe and promising delivery method in the endoscopic treatment of LTS and may provide a more durable effect on the stenosis reducing the risk of recurrence. Further prospective studies are needed to evaluate MMC’s effectiveness and develop standardized treatment protocols.

Introduction: Obstructive sleep apnea syndrome (OSAS) is caused by anatomical and non-anatomical factors which lead to upper airway (UA) obstruction during sleep. Intrinsic UA collapse is the most frequent determinant of OSA. In the era of personalized medicine, adopting a tailored diagnostic approach is essential to rule out secondary causes of UA collapse, particularly those stemming from extrinsic anatomical factors. Although being rarely considered in the differential diagnosis, space-occupying lesions of deep cervical spaces such as the parapharyngeal space (PPS) may be responsible for airway obstruction and lead to OSAS. Objective: This study aimed to present an atypical case of OSAS caused by extrinsic PPS compression, outlining the relevance of modern personalized medicine in the diagnostic and therapeutic protocols, and to enhance understanding through a comprehensive literature review. Methods: A 60-year-old female presented with sleep-disordered complaints and was diagnosed with severe OSAS after polysomnography. At physical examination, a swelling of the right posterior oropharyngeal mucosa was noticed. Imaging confirmed the suspicion of a PPS tumor, and transcervical resection was planned. Case presentation was adherent to the CARE checklist. A comprehensive literature review was conducted using the most reliable scientific databases. Results: Surgery was uneventful, and the patient made a full recovery. The histopathology report was consistent with the diagnosis of pleomorphic adenoma. Postoperative outcomes showed marked improvement in polysomnographic parameters and symptom burden. Conclusions: Parapharyngeal space tumors are a rare, often overlooked cause of OSA. This case highlights the role of a personalized head and neck assessment in OSA patients, particularly in identifying structural causes and offering definitive surgical management when indicated.