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This declaration will be treated by the Editor as confidential while the paper is under review, and will not be made known to Reviewers. &nbsp;Please indicate on the <strong>Authorship Statement Form</strong> whether or not you have or may have such a conflict of interest regarding the content of this article and is the nature of it.</p> <p><strong>COPYRIGHT TRANSFER AGREEMENT. </strong>(a) Authors assign to “Acta Otorhinolaryngologica Italica”, all copyright in and to the article, including but not limited to the right to publish, republish, transmit, sell, distribute and otherwise use the article in whole or in part, in electronic and print editions of the Journal and in derivative works throughout the world, in all languages and in all media of expression now known or later developed, and to license or permit others to do so. (b) The authors retain all proprietary rights, other than copyright, such as patent rights. The authors retain the right to reuse any portion of the work, without charge, in personal compilations or other publications consisting solely of the author(s’) own works, including the author(s’) personal web home page, and to make copies of all or part of the Work for the author(s’) use for lecture or classroom purposes. The corresponding author declares that any person named as co-author of the article is aware of the submission and has agreed to being so named. The corresponding author accepts responsibility for releasing this material on behalf of any and all co-authors. The corresponding author declares that statements and opinions given in the article are the expression of the authors. Responsibility for the content of the article rests upon the authors.</p> <p><strong>&nbsp;</strong></p> https://old.actaitalica.it/article/view/2790 <p><strong>Objective</strong>. Studies have demonstrated that tonsillectomy may alter the risk of oropharyngeal cancer (OPC). We systematically reviewed the evidence and pooled data to examine such an association. <br><strong>Methods</strong>. PubMed, Embase, and Scopus were searched up to 25th April 2023. Studies reporting an association between tonsillectomy and oropharyngeal cancer risk at any site were included. <br><strong>Results</strong>. Five studies were eligible. All examined the risk of tonsillar and base of the tongue (BOT) cancer with prior history of tonsillectomy. On meta-analysis of the data, prior history of tonsillectomy was associated with a significantly decreased risk of tonsillar cancer. The second meta-analysis showed that history of tonsillectomy did not significantly alter the risk of BOT cancer. However, after exclusion of one study, the results showed an increased risk of BOT cancer with a history of tonsillectomy. <br><strong>Conclusions</strong>. The scarce data available in the literature suggests that tonsillectomy may reduce the risk of tonsillar cancer but does not alter the risk of BOT cancer. Further studies are needed to explore the association between tonsillectomy and the risk of OPC.</p> Chengxiang Bai Mingfen He Shuang Li Jing Liu Linxiu Zhong Feng Chen Lanying Zhou Yanfeng Jiang Copyright (c) 2024 Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale http://creativecommons.org/licenses/by-nc-nd/4.0 2024-05-03 2024-05-03 44 143 149 10.14639/0392-100X-N2790 https://old.actaitalica.it/article/view/2442 <p><strong>Objective</strong>. To perform a dosimetric comparison between intensity modulated radiotherapy (IMRT) and 3D conformal radiotherapy in patients with locally advanced (stage III and IV) tumours of the supraglottic region treated with conservative surgery and post-operative radiotherapy. <br><strong>Methods</strong>. An in-silico plan using a 3D conformal shrinking field technique was retrospectively produced for 20 patients and compared with actually delivered IMRT plans. Eighteen structures (arytenoids, constrictor muscles, base of tongue, floor of mouth, pharyngeal axis, oral cavity, submandibular glands and muscles of the swallowing functional units [SFU]) were considered. <br><strong>Results</strong>. IMRT allowed a reduction of maximum and mean doses to 9 and 14 structures, respectively (p &lt; .05).<br><strong>Conclusions</strong>. IMRT achieved a reduction of unnecessary dose to the remnant larynx and the majority of surrounding SFUs. Further prospective analyses and correlations with functional clinical outcomes are required to confirm these dosimetric findings.</p> Daniela Alterio Simona Marani Sabrina Vigorito Valeria Zurlo Stefano Filippo Zorzi Annamaria Ferrari Stefania Volpe Francesco Bandi Maria Giulia Vincini Sara Gandini Aurora Gaeta Cristiana Iuliana Fodor Alessia Casbarra Mattia Zaffaroni Anna Starzynska Liliana Belgioia Mohssen Ansarin Cynthia Aristei Barbara Alicja Jereczek-Fossa Copyright (c) 2024 Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale http://creativecommons.org/licenses/by-nc-nd/4.0 2024-04-30 2024-04-30 44 150 160 10.14639/0392-100X-N2442 https://old.actaitalica.it/article/view/2806 <p><strong>Objective</strong>. The primary focus of this study was to analyze the adoption of ChatGPT among Ear, Nose, and Throat (ENT) trainees, encompassing its role in scientific research and personal study. We examined in which year ENT trainees become involved in clinical research and how many scientific investigations they have been engaged in.<br><strong>Methods</strong>. An online survey was distributed to ENT residents employed in Italian University Hospitals. <br><strong>Results</strong>. Out of 609 Italian ENT trainees, 181 (29.7%) responded to the survey. Among these, 67.4% were familiar with ChatGPT, and 18.9% of them used artificial intelligence as a tool for research and study. In all, 32.6% were not familiar with ChatGPT and its functions. Within our sample, there was an increasing trend of participation by ENT trainees in scientific publications throughout their training. <br><strong>Conclusions</strong>. ChatGPT remains relatively unfamiliar and underutilised in Italy, even though it could be a valuable and efficient tool for ENT trainees, providing quick access for study and research through both personal computers and smartphones.</p> Virginia Dallari Carlotta Liberale Francesca De Cecco Riccardo Nocini Valerio Arietti Daniele Monzani Luca Sacchetto Copyright (c) 2024 Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale http://creativecommons.org/licenses/by-nc-nd/4.0 2024-04-30 2024-04-30 44 161 168 10.14639/0392-100X-N2806 https://old.actaitalica.it/article/view/2779 <p><strong>Objective</strong>. Despite multiple studies from high-income countries, reports from low- and middle-income countries on the impact of COVID-19 on head and neck cancer care remain sparse. This study aimed to assess the effects of the COVID-19 pandemic on head and neck cancer patients at a tertiary reference centre in Bosnia and Herzegovina. <br><strong>Methods</strong>. We included 228 patients with malignant head and neck tumours evaluated and treated between January 1, 2019, and December 31, 2021. Patient demographics, histological characteristics, and treatment modalities were retrospectively obtained and compared between the pre-pandemic period (pre-COVID-19 group) and the period after the implementation of COVID-19 restrictive measures (COVID-19 group). <br><strong>Results</strong>. Patients were significantly older during the COVID-19 pandemic. In particular, 63 patients (44.7%) were under 65 and 78 (55.3%) were 65 or older, while in the pre- COVID-19 period, 53 patients (60.9%) were under 65 and 34 (39.1%) were 65 or older (p = 0.017). The pre-COVID-19 and COVID-19 groups did not significantly differ regarding other patient- and tumour characteristics, or primary treatment modalities. <br><strong>Conclusions</strong>. During the COVID-19 pandemic, significantly fewer patients were under 65 at the time of initial work-up, potentially reflecting the more enhanced disease-related anxiety of the younger population. Future studies are warranted to address this population’s specific educational and psychological needs to ensure appropriate cancer care.</p> Alexander Lein Fuad Brkic David T. Liu Markus Haas Almir Salkic Azra Ibrisevic Sabrina Uscuplic Alen Harcinovic Thomas Thurner Faris F. Brkic Copyright (c) 2024 Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale http://creativecommons.org/licenses/by-nc-nd/4.0 2024-04-30 2024-04-30 44 169 175 10.14639/0392-100X-N2779 https://old.actaitalica.it/article/view/2739 <p><strong>Objective</strong>. Detection of laryngeal cartilage invasion is of great importance in staging of laryngeal squamous cell carcinoma (LSCC). The role of prognosticators in locally advanced laryngeal cancer are still widely debated. This study aimed to assess the impact of volume of thyroid cartilage infiltration, as well as other histopathologic variables, on patient survival.<br><strong>Materials and methods.</strong> We retrospectively analysed 74 patients affected by pT4 LSCC and treated with total laryngectomy between 2005 and 2021 at the Department of Otorhinolaryngology – Head and Neck Surgery of the University of Brescia, Italy. We considered as potential prognosticators histological grade, perineural (PNI) and lympho-vascular invasion (LVI), thyroid cartilage infiltration, and pTN staging. Pre-operative CT or MRI were analysed to quantify the volume of cartilage infiltration using 3D Slicer software. <br><strong>Results</strong>. The 1-, 3-, and 5-year disease free survivals (DFS) were 76%, 66%, and 64%, respectively. Using machine learning models, we found that the volume of thyroid cartilage infiltration had high correlation with DFS. Patients with a higher volume (&gt; 670 mm³) of infiltration had a worse prognosis compared to those with a lower volume. <br><strong>Conclusions</strong>. Our study confirms the essential role of LVI as prognosticator in advanced LSCC and, more innovatively, highlights the volume of thyroid cartilage infiltration as another promising prognostic factor.</p> Claudia Montenegro Alberto Paderno Marco Ravanelli Carlotta Pessina Fatima-Ezzahra Nassih Davide Lancini Francesca Del Bon Davide Mattavelli Davide Farina Cesare Piazza Copyright (c) 2024 Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale http://creativecommons.org/licenses/by-nc-nd/4.0 2023-12-29 2023-12-29 44 176 182 10.14639/0392-100X-N2739 https://old.actaitalica.it/article/view/2816 <p style="font-weight: 400;"><strong>Objective</strong>. The aims of this study was to analyse fibreoptic endoscopic evaluation of swallowing (FEES) findings in tube-fed patients with coronavirus disease 2019 (COVID-19). <br><strong>Methods</strong>. Seventeen patients who had been intubated during intensive care unit (ICU) stay were enrolled. Pooling of secretions, dysphagia phenotype, penetration/aspiration and residue after swallow were assessed through FEES. The Functional Oral Intake Scale (FOIS) scores were also collected. Patients with significant swallowing impairment were evaluated again after 2 weeks. <br><strong>Results</strong>. All patients were tube-fed at enrollment. According to the FEES results, 7 started total oral feeding with at least one consistency. The more common dysphagia phenotypes were propulsive deficit and delayed pharyngeal phase. Pooling of secretions, penetration/ aspiration, and residue after swallow were frequently documented. A significant improvement in FOIS scores was found during the second FEES examination.<br><strong>Conclusions</strong>. Swallowing impairment in patients with severe COVID-19 after discharge from the ICU is characterised by propulsive deficit and delayed pharyngeal phase. Most of these patients required feeding restrictions even if feeding abilities seem to improve over time.</p> Francesco Mozzanica Nicole Pizzorni Sibora Rama Marco Gitto Dejan Radovanovic Pierachille Santus Antonio Schindler Copyright (c) 2024 Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale http://creativecommons.org/licenses/by-nc-nd/4.0 2024-06-06 2024-06-06 44 183 191 10.14639/0392-100X-N2816 https://old.actaitalica.it/article/view/2386 <p><strong>Objective</strong>. Olfactory dysfunction (OD) represents a frequent complaint in general population and especially in patients with chronic sinonasal diseases. The aim of this study was the cross-cultural adaptation and validation of the Self-reported Mini Olfactory Questionnaire (Self-MOQ) into Italian. <br><strong>Methods</strong>. One hundred fifty patients affected by chronic sinonasal diseases and reporting hyposmia were enrolled. Other 150 normosmic subjects without inflammatory or neoplastic sinonasal disorders were used as a control group. The Short-form 36 (SF-36) questionnaire was used for clinical validity. <br><strong>Results</strong>. Cronbach’s alpha coefficient was 0.825. The test-retest reliability was excellent. The good correlation between the Self-MOQ and the Visual Analogue Scale scores (p &lt; 0.05) demonstrated the construct validity of the questionnaire. The Self-MOQ was able to distinguish between subjects with or without OD (p &lt; 0.05). Higher Self-MOQ score was found in case of nasal obstruction and posterior rhinorrhoea (p &lt; 0.05). Self-MOQ showed significant correlation with SF-36 general health, SF-36 role functioning/physical, and SF- 36 pain (p &lt; 0.05).<br><strong>Conclusions</strong>. The Italian version of the Self-MOQ showed good internal consistency, testretest reliability, construct, and clinical validity.</p> Giuseppe Riva Giancarlo Pecorari Gian Marco Motatto Marianna Rivero Andrea Canale Roberto Albera Andrea Albera Copyright (c) 2024 Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale http://creativecommons.org/licenses/by-nc-nd/4.0 2024-04-30 2024-04-30 44 192 197 10.14639/0392-100X-N2386 https://old.actaitalica.it/article/view/2508 <p><strong>Objective</strong>. We describe an uncharacteristic vestibular-ocular reflex (VOR) pattern, studied by video head impulse tests (VHIT) in patients suffering from unilateral isolated posterior semicircular canal (PSC) hypofunction. In these patients, we found an upward sliding of the eyes, followed by an oblique downward catch-up saccade during horizontal head impulse to the healthy side. <br><strong>Methods</strong>. We present a retrospective study of all VHIT exams presenting isolated PSC hypofunction between May 2020 and November 2022. <br><strong>Results</strong>. We found 37 patients, which led to the discovery of such incongruent eye movement in 19 cases; their gain data are shown and compared to the remaining 18 cases in which such an anomaly was absent. A control group of 31 healthy subjects was recruited to define the reference criteria for VHIT gain values. The correlation between the amplitude of the vertical saccade and the relative functional imbalance of the vertical semicircular canals was studied. <br><strong>Conclusions</strong>. We have observed that in approximately half of the subjects with isolated CSP deficiency, there is a VOR anomaly. A possible pathophysiological explanation of the unbalanced effect of vertical semicircular canal stimulation of a labyrinth during horizontal head thrust toward the opposite side is proposed. The planar incongruity of the response of the VOR described here appears more evident at the onset of the CSP deficit. Current VHIT systems do not detect this incongruent eye reflex. They can lead to an error in gain evaluation (pseudo-deficit) of the lateral semicircular canal of the healthy side and problems in performing the test (trace rejected). In the future, software for VHIT should take into account the possibility of non-coplanar ocular responses to cephalic stimuli.</p> Francesco dD'Onofrio Letizia Neri Giampiero Neri Copyright (c) 2024 Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale http://creativecommons.org/licenses/by-nc-nd/4.0 2024-05-03 2024-05-03 44 198 203 10.14639/0392-100X-N2508 https://old.actaitalica.it/article/view/2833 Italo Cantore Francesca Cianfrone Francesco Tauro Pio Bevilacqua Maurizio Tilli Simone Lo Verde Paolo Ruscito Copyright (c) 2024 Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale http://creativecommons.org/licenses/by-nc-nd/4.0 2024-05-03 2024-05-03 44 204 206 10.14639/0392-100X-N2833