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Diagnostics
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Advances in Diagnosis and Treatment in Otolaryngology
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Advances in Diagnosis and Treatment in Otolaryngology

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 7229

Special Issue Editor

Dr. Stefano Bondi

E-Mail Website
Guest Editor
Otorhinolaryngology Unit, Head and Neck Surgery, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Turin, Italy
Interests: head and neck surgery; ENT

Special Issue Information

Dear Colleagues,

In recent years, the field of ENT/head and neck surgery has experienced considerable changes regarding the diagnostic and therapeutic approaches to many diseases thanks to outstanding pharmacological and technological progress. For example, advances in the field of imaging are refining the diagnostic power of multiparametric MRI, as well as supporting the wider use of choline PET. The recently introduced biologic therapy for recurrent nasal polyposis is transforming its therapeutic paradigm, which has long been limited to surgery and systemic corticosteroids; correspondingly, monoclonal antibodies for specific oncological pathways represent an additional method that can be incorporated into the management of head and neck malignancies. New technologies are also improving surgical approaches, such as parathyroid autofluorescence detection for thyroid surgery, indocyanine green video angiography for the evaluation of flap vascularization, and robotically or exoscopically assisted procedures for tailored dissection. These radical changes represent exciting advancements for clinicians, but also highlight the importance of continuously updating our knowledge on the biological pathways of certain diseases and mastering the use of new technologies in the surgical theatre.

The aim of the present Special Issue is therefore to provide an overview of current developments in the head and neck field, with a particular focus on the most promising future perspectives.

Original research articles and reviews are particularly welcome. Case reports/series (preferably with literature reviews of previous cases), authors’ viewpoints, and other types of papers will be considered only if related to the original use of technologies/molecules/surgical techniques or if they discuss topics that could not be better investigated through reviews.

Dr. Stefano Bondi
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • head and neck surgery
  • ENT
  • diagnostic issues
  • technological advancement
  • surgical technique
  • molecular target
  • tailored medicine

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Published Papers (7 papers)

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Research

12 pages, 4363 KiB  
Article
A Multimodal Protocol Combining 99mTc-Tilmanocept with Indocyanine Green Fluorescence Lympho-Angiography for Sentinel Lymph Node Biopsy in Early-Stage Oral Cancer: A Case Series
by Andrea Galli, Carla Canevari, Emilio Salerno, Ayhan Irem, Marco Familiari, Carlo Pettirossi, Rosa Alessia Battista, Arturo Chiti, Mario Bussi and Leone Giordano
Diagnostics 2024, 14(16), 1805; https://doi.org/10.3390/diagnostics14161805 - 19 Aug 2024
Viewed by 751
Abstract
Sentinel lymph node biopsy (SLNB) is currently considered as a viable alternative to elective neck dissection (END) for the management of cN0 oral cavity squamous cell carcinoma (OCSCC). However, some difficulties were detected in sentinel lymph node (SLN) identification in floor of mouth [...] Read more.
Sentinel lymph node biopsy (SLNB) is currently considered as a viable alternative to elective neck dissection (END) for the management of cN0 oral cavity squamous cell carcinoma (OCSCC). However, some difficulties were detected in sentinel lymph node (SLN) identification in floor of mouth (FOM) and ventral tongue tumors because of the so-called “shine-through radioactivity” of the injection site, which may mask nodal hotspots in proximity. We assessed the feasibility and the potential strengths of combining 99mTc-Tilmanocept with indocyanine green (ICG) fluorescence lympho-angiography in a dedicated multimodal protocol for SLNB in T1/T2N0 oral cancer to evaluate the synergistic role of each of these two tracers in providing the appropriate sensitivity and ease of learning, even in such a critical anatomical subsite. A detailed, stepwise description of our multimodal protocol is provided, together with the presentation of its application in two cases of early-stage ventral tongue tumors. Radioactive guidance with 99mTc-Tilmanocept was used preoperatively to perform planar lymphoscintigraphy and single-photon emission computed tomography/computed tomography and to define the nodal hotspot(s) and the surgical “roadmap”. In addition, it was used intraoperatively to pinpoint the SLN location within each nodal hotspot with high specificity but limited spatial resolution. Optical guidance with ICG injection at the tumor bed and near-infrared fluorescence imaging was then added, providing intuitive intraoperative guidance within each nodal hotspot with high spatial resolution. Our small experience with this protocol is illustrated and future perspectives are highlighted. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment in Otolaryngology)
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11 pages, 1009 KiB  
Article
Sinus Irrigation with N-Acetylcysteine after Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Preliminary Report of a Single-Blind Randomized Controlled Trial
by Jee Hye Wee, Joo Hyun Park, Min Woo Park, Young Seok Choi and Hahn Jin Jung
Diagnostics 2024, 14(15), 1678; https://doi.org/10.3390/diagnostics14151678 - 2 Aug 2024
Viewed by 1339
Abstract
Nasal irrigation is crucial following endoscopic sinus surgery (ESS), especially for managing chronic rhinosinusitis (CRS). This study assessed the effectiveness of N-acetylcysteine (NAC) irrigation during the post-ESS period of patients with CRS without nasal polyposis. In this prospective, single-blind randomized controlled trial, 49 [...] Read more.
Nasal irrigation is crucial following endoscopic sinus surgery (ESS), especially for managing chronic rhinosinusitis (CRS). This study assessed the effectiveness of N-acetylcysteine (NAC) irrigation during the post-ESS period of patients with CRS without nasal polyposis. In this prospective, single-blind randomized controlled trial, 49 patients (NAC, n = 24; saline, n = 25) undergoing ESS were assigned to receive either NAC or saline irrigations twice daily for a month. The preoperative and postoperative assessments conducted included Lund–Macka (LM) and Lund–Kennedy (LK) endoscopic scores, the Nasal Obstruction Symptom Evaluation (NOSE) scale, and the Sino-Nasal Outcome Test-20 (SNOT-20). At 2 weeks, 1 month, and 3 months after the operation, endoscopic findings and symptoms were evaluated. Both groups showed no differences in age, sex, LM and LK scores, NOSE scale, and SNOT-20 preoperatively. In terms of the endoscopic findings regarding the sinonasal mucosa after ESS, the NAC group had slightly lower scores 2 weeks, 1 month, and 3 months after the operation, but this difference was not statistically significant. The NAC group showed significant improvement in VAS scores, namely, postnasal drip (1.0, p = 0.041), smell dysfunction (0.8, p = 0.003), and crust (1.5, p = 0.034), compared to the control group’s scores of 2.6, 4.7, and 3.6, respectively, 2 weeks after the operation, although no significant differences were observed in VAS scores for any symptoms 1 and 3 months after the operation. NAC was well tolerated, and no adverse events were reported. NAC irrigation showed benefits over saline irrigation in terms of improving postnasal drip, smell dysfunction, and crust after ESS for CRS without nasal polyposis in the immediate postoperative period. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment in Otolaryngology)
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16 pages, 2770 KiB  
Article
Nasal Microbiome in Granulomatosis with Polyangiitis Compared to Chronic Rhinosinusitis
by Eliza Brożek-Mądry, Zofia Burska, Katarzyna Życińska and Janusz Sierdziński
Diagnostics 2024, 14(15), 1673; https://doi.org/10.3390/diagnostics14151673 - 2 Aug 2024
Viewed by 957
Abstract
Rhinosinusitis in granulomatosis with polyangiitis (GPA) is categorised as a secondary, diffuse and inflammatory chronic rhinosinusitis (CRS). It is one of the conditions that impacts the nasal microbiota. This study aimed to compare the nasal microbiomes of patients with GPA, CRS and NSP. [...] Read more.
Rhinosinusitis in granulomatosis with polyangiitis (GPA) is categorised as a secondary, diffuse and inflammatory chronic rhinosinusitis (CRS). It is one of the conditions that impacts the nasal microbiota. This study aimed to compare the nasal microbiomes of patients with GPA, CRS and NSP. A total of 31 patients were included in the study (18 GPA, 6 CRS and 7 nasal septum perforation (NSP)). In all patients, SNOT 22, a nasal endoscopy (Lund–Kennedy scale) and a brush swab were performed. The metagenomic analysis was carried out based on the hypervariable V3-V4 region of the 16S rRNA gene. At the genus level, statistically significant differences were observed in two comparisons: the GPA/NSP and the GPA/CRS groups. In the GPA/NSP group, the differences were related to four genera (Actinomyces, Streptococcus, Methylobacterium-Methylorubrum, Paracoccus), while in the GPA/CRS group, they were related to six (Kocuria, Rothia, Cutibacterium, Streptococcus, Methylobacterium-Methylorubrum, Tepidimonas). Patients with GPA had lower diversity compared to CRS and NSP patients. There were no statistically significant differences found for the Staphylococcus family and Staphylococcus aureus between the three groups. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment in Otolaryngology)
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10 pages, 3923 KiB  
Article
The Auditory Steady-State Response and the Relationship between Electrophysiological and Behavioural Thresholds
by Cyntia Barbosa Laureano Luiz, Daniela Gil, Piotr Henryk Skarzynski, Magdalena Beata Skarżyńska, Milaine Dominici Sanfins and Marisa Frasson de Azevedo
Diagnostics 2024, 14(15), 1617; https://doi.org/10.3390/diagnostics14151617 - 26 Jul 2024
Viewed by 732
Abstract
Background: This study examined the relationship between behavioural thresholds as measured by pure tone audiometry and electrophysiological thresholds measured by the Auditory Steady-State Response (ASSR) in children with normal hearing and sensorineural hearing loss. Materials and Methods: After being assessed, 45 children of [...] Read more.
Background: This study examined the relationship between behavioural thresholds as measured by pure tone audiometry and electrophysiological thresholds measured by the Auditory Steady-State Response (ASSR) in children with normal hearing and sensorineural hearing loss. Materials and Methods: After being assessed, 45 children of both sexes, ranging in age from 5 to 15, were split into four groups: 10 with moderate to moderately severe sensorineural hearing loss (G2M); 10 with steeply sloping sensorineural hearing loss (G2D); 10 with profound and severe sensorineural hearing loss (G2S); and 15 with normal hearing (G1). ASSR, tympanometry, acoustic reflex testing, pure tone audiometry, and speech audiometry (SRT and SDT) were performed. Results: The electrophysiological maximum in the group with normal hearing thresholds varied from 19 to 27 dB NA. The correlation in the group with moderate to moderately severe hearing loss was 0.42–0.74. The correlation in the steeply sloping hearing loss group was 0.68–0.94. The correlation in the group of people with profound and severe hearing loss was 0.59–0.86. The normal hearing group’s mean differences in ASSR threshold and audiometric threshold ranged from −0.3 to 12 dB, in the moderate and moderately severe hearing loss group from −9 to 2 dB, in the steeply sloping hearing loss group from 1.4 to 7.5 dB, and in the severe and profound hearing loss group from −0.40 to 8.5 dB. Conclusion: As expected, there was no strong relationship between behavioural and electrophysiological thresholds in the group with normal hearing. But in children with hearing loss, there was a strong correlation between electrophysiological and behavioural thresholds; this relationship was especially evident in children with severe and profound hearing loss and those with steeply sloping hearing loss. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment in Otolaryngology)
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8 pages, 1586 KiB  
Article
Automated Laryngeal Invasion Detector of Boluses in Videofluoroscopic Swallowing Study Videos Using Action Recognition-Based Networks
by Kihwan Nam, Changyeol Lee, Taeheon Lee, Munseop Shin, Bo Hae Kim and Jin-Woo Park
Diagnostics 2024, 14(13), 1444; https://doi.org/10.3390/diagnostics14131444 - 6 Jul 2024
Viewed by 911
Abstract
We aimed to develop an automated detector that determines laryngeal invasion during swallowing. Laryngeal invasion, which causes significant clinical problems, is defined as two or more points on the penetration–aspiration scale (PAS). We applied two three-dimensional (3D) stream networks for action recognition in [...] Read more.
We aimed to develop an automated detector that determines laryngeal invasion during swallowing. Laryngeal invasion, which causes significant clinical problems, is defined as two or more points on the penetration–aspiration scale (PAS). We applied two three-dimensional (3D) stream networks for action recognition in videofluoroscopic swallowing study (VFSS) videos. To detect laryngeal invasion (PAS 2 or higher scores) in VFSS videos, we employed two 3D stream networks for action recognition. To establish the robustness of our model, we compared its performance with those of various current image classification-based architectures. The proposed model achieved an accuracy of 92.10%. Precision, recall, and F1 scores for detecting laryngeal invasion (≥PAS 2) in VFSS videos were 0.9470 each. The accuracy of our model in identifying laryngeal invasion surpassed that of other updated image classification models (60.58% for ResNet101, 60.19% for Swin-Transformer, 63.33% for EfficientNet-B2, and 31.17% for HRNet-W32). Our model is the first automated detector of laryngeal invasion in VFSS videos based on video action recognition networks. Considering its high and balanced performance, it may serve as an effective screening tool before clinicians review VFSS videos, ultimately reducing the burden on clinicians. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment in Otolaryngology)
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13 pages, 585 KiB  
Article
Side- and Sinus-Specific Relationships between Chronic Rhinosinusitis and Ischemic Stroke Using Imaging Analyses
by Eun Hyun Cho, Kyung Hoon Park, Ji Hee Kim, Heejin Kim, Hyo-Jeong Lee and Jee Hye Wee
Diagnostics 2024, 14(12), 1266; https://doi.org/10.3390/diagnostics14121266 - 15 Jun 2024
Viewed by 833
Abstract
Recent studies have reported chronic rhinosinusitis (CRS) as an independent risk factor for stroke. However, the association with stroke depending on the affected sinuses has not been explored. This study aimed to elucidate the side- and sinus-specific relationship between CRS and ischemic stroke [...] Read more.
Recent studies have reported chronic rhinosinusitis (CRS) as an independent risk factor for stroke. However, the association with stroke depending on the affected sinuses has not been explored. This study aimed to elucidate the side- and sinus-specific relationship between CRS and ischemic stroke through imaging analyses. We retrospectively reviewed the medical records of patients who were diagnosed with ischemic stroke at a tertiary center. CRS was defined as having a total score of greater than or equal to 4, according to the Lund–Mackay scoring system, through brain magnetic resonance imaging or computed tomography. We investigated the side- and sinus-specific correlation between CRS and ischemic stroke. Subgroup analyses were performed for different age groups. CRS prevalence in patients with ischemic stroke was 18.4%, which was higher than the previously reported prevalence in the general population. Overall, there was no correlation between the directions of the CRS and ischemic stroke (p > 0.05). When each sinus was analyzed, the frontal (Cramer’s V = 0.479, p < 0.001), anterior (Cramer’s V = 0.396, p < 0.001)/posterior (Cramer’s V = 0.300, p = 0.008) ethmoid, and sphenoid (Cramer’s V = 0.383, p = 0.005) sinuses showed a statistically significant correlation with the side of stroke, but the maxillary sinus (Cramer’s V = 0.138, p = 0.208) did not. In subgroup analyses, a significant right-side correlation between the two diseases was observed in the older-age subgroup (≥65 years old, Cramer’s V = 0.142, p = 0.040). Diabetes mellitus (odds ratio = 1.596, 95% confidence interval = 1.204–2.116) was identified as an independent risk factor for having CRS in patients with ischemic stroke. CRS of the frontal, anterior/posterior ethmoid, and sphenoid sinuses has a directional relationship with ischemic stroke. Our results on which sinuses correlate with stroke advocate for the active surveillance of CRS in patients at high risk of ischemic stroke. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment in Otolaryngology)
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11 pages, 4232 KiB  
Article
High-Frequency Vestibular Function Is Vulnerable to Presbyvestibulopathy
by Seonghoon Bae, Jimin Yun, Seungmin Kwak, Hyuntaek Jung, Hancheol Lee, Juyoung Kim, Chanhee Kim, Yujin Lee and Sunghuhn Kim
Diagnostics 2024, 14(12), 1224; https://doi.org/10.3390/diagnostics14121224 - 11 Jun 2024
Viewed by 805
Abstract
Introduction: In 2019, mild vestibular function deficiency in elder populations was defined as presbyvestibulopathy (PVP) by the Classification Committee of the Bárány Society. The diagnostic criteria include tests for low-, mid-, and high-frequency vestibular function, represented by caloric testing, rotary chair testing, and [...] Read more.
Introduction: In 2019, mild vestibular function deficiency in elder populations was defined as presbyvestibulopathy (PVP) by the Classification Committee of the Bárány Society. The diagnostic criteria include tests for low-, mid-, and high-frequency vestibular function, represented by caloric testing, rotary chair testing, and head impulse testing, respectively. However, there is still a lack of large-scale reports supporting the relationship between vestibular function tests (VFTs) and aging. In this study, we evaluated whether each test is correlated with aging in the elderly population aged over 50. Methods: This study retrospectively enrolled 1043 subjects from a single university hospital database after excluding those with unilateral and bilateral vestibulopathy, central dizziness, and acute dizziness. Enrolled subjects had caloric canal paresis <20%, vHIT lateral canal gain >0.6, vHIT interaural difference <0.3, and age >50 years old. Results: Significant negative correlations with age were identified in the vHIT (p < 0.001) and rotary chair test (RCT) 1.0 Hz gain (p = 0.030). However, the caloric test (p = 0.739 and 0.745 on the left and right sides, respectively) and RCT 0.12 Hz gain (p = 0.298) did not show a significant correlation with age. A total of 4.83% of subjects aged 70 years or older showed sub-normal vHIT gain that met the criteria of PVP, whereas only 0.50% of subjects aged 60 to 69 did. The prevalence of sub-normal caloric test results, however, was not significantly different between the two age groups (21.55% in the 60–69 age group and 26.59% in the >70 age group). Conclusions: The high-frequency range vestibular function seems vulnerable to aging, and this is more discernible at age >70 years. The weak correlation between age and low-frequency vestibular function tests, such as the caloric test and low-frequency rotary chair testing, suggests the need to revisit the diagnostic criteria for PVP. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment in Otolaryngology)
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