Background: This study aims to explore the applicability of narrow-band imaging (NBI) involving the Ni classification for the diagnosis of nasopharyngeal mucosal lesions in order to distinguish malignant tumours (NPT) from non-malignant lesions. Methods: Each patient (n = 53) with a suspected nasopharyngeal lesion underwent a trans-nasal flexible video endoscopy with an optical filter for NBI. We assessed the suspected area using white light imaging (WLI) in terms of location and morphology as well as the vascular pattern (using Ni classification of nasopharyngeal microvessels) and surrounding tissue by using NBI. Based on the results of the NBI and WLI, patients were classified into "positive" or "negative" groups. All lesions of the nasopharynx were biopsied and submitted for final histological evaluation. Results: NBI showed higher sensitivity, specificity, and accuracy than WLI. There was a significant correlation between the final histological result and the NBI pattern of the NPT: Chi²(1) = 31.34; p = 0.000001 and the WLI assessment of the NPT: Chi²(1) = 14.78; p = 0.00012. Conclusions: The assessment of the NPT in NBI using Ni NBI classification proved valuable in suspected mucosa assessment. NBI not only confirms the suspicious areas in WLI, but it also shows microlesions beyond the scope of WLI and allows for proper sampling.

The paper aims to define the variables that elevate the risk of VFL recurrence after adequate primary treatment, and to present the Recurrence Risk Model with practical conclusions to handle pVFL and rVFL. Out of 207 patients with primary vocal fold leukoplakia (pVFL), in 41 (19.8%) recurrent VFL (rVFL) was diagnosed. All patients were assessed by using a trans-nasal flexible video-endoscope using white light, and NBI. The primary measure of our study was to investigate whether morphological features of pVFL in WL, vascular pattern in NBI, and primary histological findings could predict VFL recurrence. To create a model of risk factors, two methods were used: logistic regression and a conditional inference decision tree. The study showed smoking was the factor that significantly and most strongly increased the likelihood of rVFL, as well as the older age groups have a greater odds of rVFL. Types IV, V and VI, according to Ni 2019 classification, were associated with a significantly higher risk of rVFL. The algorithm combining patients’ dependent variables and the combination of two classifications improves the predictive value of the presented VFL Recurrence Risk Model.

Facial nerve (FN) palsy is the most serious complication of parotid gland surgery, with risk influenced by tumor size, location and pathology. To assess the incidence, severity, duration, and risk factors of FN palsy following parotidectomy, based on the Polish Salivary Network Database. This multicenter study included 2650 patients treated surgically between 2018 and 2022. FN function was evaluated using the House-Brackmann scale, consider-ing extent, severity and duration of FN dysfunction. Multiple potential risk factors were examined. FN palsy occurred in 20% of patients: 17.2% transient and 4.5% permanent. The marginal mandibular branch was most frequently affected. Multivariate analysis showed that parapharyngeal space involvement, presence of malignant neoplasm and preoperative FN dysfunction independently predicted complete paralysis. Additional risk factors for more extensive, severe, and prolonged FN impairment included clinical signs of malignancy, prior radiation, non-radical margins, larger tumor size (>4 cm), and advanced stage of malignancy. A greater number of affected regions (defined by the European Salivary Gland Society (ESGS) classification) was identified as the most significant adverse risk factor for both the degree and persistence of postoperative facial nerve palsy. FN palsy remains a relevant risk in parotid surgery, particularly with large or malignant tumors. Early diagnosis and radical excision of smaller lesions are key to preserving nerve function.

Objectives: To investigate the impact on local relapse rate (LRR) and disease-specific survival (DSS) of intraoperative margins (FS) obtained by circumferential sampling method, corresponding to the lesion shape and marked using clock-face orientation combined with narrow band imaging (NBI) in head and neck squamous cell carcinoma. Material and methods: 147 consecutive patients who underwent primary surgery with radical intent for oral and oropharyngeal cancer between 2011 and 2016 were prospectively enrolled. Patients were assigned to 3 groups with different sampling methods. In group A (n = 44), a classic FS sampling method was used. In group B (n = 73), the clock-face orientation sampling method (FS o'clock) was used, whereas in group C (n = 30), the FS o'clock method combined with NBI. The primary outcome measure was the interdependence between FS sampling methods and oncological outcomes measured by LRR and DSS. Results: In total, 1534 FS samples were obtained with a range of 3-24 FS taken per case, median 7.25 in group A, 8.15 in group B, and 7.52 in group C. When comparing the FS histology and final histology in all groups, the sensitivity, specificity, and accuracy were 61.54%, 98.51%, and 95.24%, respectively. The overall LRR equaled 8.8%. The lowest LRR was observed in FS o'clock method combined with NBI (6.67%) followed by FS o'clock (6.85%) and FS classic (13.64%). For all patients, DSS achieved 95.92% - 95.45% in FS classic, 95.89% in FS o'clock, and 96.67% in FS o'clock combined with NBI. Conclusions: The FS o'clock sampling method combined with NBI increases the chance of achieving tumor-negative margins and as a result improves the treatment outcome reflected by LRR and DSS.

Recurrent respiratory papillomatosis (RRP), caused mainly by human papillomavirus types 6 and 11 (HPV6/11), can persist despite the absence of recognized systemic immunodeficiency. We reanalyzed three transcriptomic datasets using the same predefined immune-gene programs: paired papilloma and autologous laryngeal mucosa from 12 patients, single-cell RNA sequencing from papillomas of four RRP donors and pharyngopalatine mucosa from three controls, and paired papilloma samples from 17 patients before and after INO-3107, a DNA immunotherapy encoding HPV6/11 antigens and interleukin-12. In untreated tissue, cluster of differentiation 8 (CD8)- and natural killer (NK)-associated cytotoxic program scores were lower and the transforming growth factor beta (TGF-β) suppressive program score was higher, reproducing findings from the same cohort. The lower cytotoxic pattern was not reproduced within the recovered combined T-cell and NK-cell population, although no single-cell comparison remained significant after correction for multiple testing. After INO-3107, CD8- and NK-associated cytotoxic, T helper 1 (Th1)/interferon gamma (IFN-γ), and C-X-C motif chemokine receptor 3 (CXCR3)-associated trafficking program scores increased significantly, whereas TGF-β and M2-like suppressive programs showed no comparable statistically supported change. Together, these findings show that different components of the local immune response do not change in parallel and support a model of selective treatment-associated immune remodeling. This pattern may inform future biomarker and combination-treatment studies.