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Pu Q, Wu Z, Li AL, Guo XX, Hu JJ, Li XY. Association between poor sleep quality and an increased risk of dry eye disease in patients with obstructive sleep apnea syndrome. Front Med (Lausanne) 2022; 9:870391. [PMID: 36388897 PMCID: PMC9659957 DOI: 10.3389/fmed.2022.870391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 10/05/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose Obstructive sleep apnea (OSA) is related to an increased incidence of dry eye disease (DED). However, their exact relationship is unknown and requires further well-designed studies with advanced mechanisms detection. Patients and methods This case–control study included 125 OSA cases and 125 age–gender-matched controls enrolled in the hospital between 1 January and 1 October 2021. OSA diagnosis and classification were performed using a polysomnography (PSG) assay. Detailed ophthalmological examinations, including the Schirmer I test, corneal staining, and ocular surface disease index (OSDI), were used to detect DED-related parameters. A comprehensive ocular surface assay was performed to measure a series of parameters, including first non-invasive first tear film break-up time (f-NIBUT), average non-invasive first tear film break-up time (av-NIBUT), tear meniscus height (TMH), and loss of meibomian gland. In addition, the Pittsburgh Sleep Quality Index (PSQI) scale was used to assess sleep quality. Results Compared to the control, the OSA group showed an increased DED risk (P = 0.016) along with an increased PSQI score and a higher rate of poor quality sleep (P < 0.001 and P = 0.007, respectively). Stratification of OSA cases indicated that DED-related parameters were impaired in patients with severe OSA (P < 0.05). The analysis of DED-parameters-related factors showed significant correlations between OSA-related indexes and PSQI (P < 0.05). Moreover, the poor sleep quality group in the OSA cases showed worse DED-related parameters (P < 0.05), which was not observed in the control group. Conclusion OSA, especially the severe stage OSA, was related to an increased risk of DED. Also, sleep quality was correlated with the onset of both OSA and DED, where poor sleep quality revealed a relationship between OSA and the risk of DED. Overall, our findings provided evidence for advanced management of DED and OSA in future.
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Affiliation(s)
- Qi Pu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhen Wu
- Department of Ear, Nose, and Throat, Changshu No. 2 People’s Hospital, Changshu, China
| | - Ao-Ling Li
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao-Xiao Guo
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing-Jie Hu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xin-Yu Li
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Xin-Yu Li,
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Ferraz PD, Francisco I, Borges MI, Guimarães A, Carvalho F, Caramelo F, Figueiredo JP, Vale F. Pharyngeal Airspace Alterations after Using the Mandibular Advancement Device in the Treatment of Obstructive Sleep Apnea Syndrome. Life (Basel) 2022; 12:life12060835. [PMID: 35743866 PMCID: PMC9224702 DOI: 10.3390/life12060835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 05/28/2022] [Accepted: 06/01/2022] [Indexed: 11/24/2022] Open
Abstract
Background: Mandibular Advancement Devices (MADs), inserted in non-surgical treatments for obstructive sleep apnea and hypopnea syndrome (OSAHS), are used intra-orally during the sleep period, with the aim of promoting mandibular protrusion. The aim of the study is to analyze the changes in the upper airway after the use of an MAD in the treatment of OSAHS. Methods: 60 patients diagnosed with OSAHS, as established by the Sleep Medicine Service, underwent treatment with the Silensor SL device at the Stomatology Service of the University Hospital Center of Coimbra, from January 2018 to January 2019. All patients completed two polysomnographies and two lateral teleradiographies: one before starting treatment (T0) and one after 1 year of treatment (T1). In the lateral teleradiography performed after one year of treatment, the patient had the MAD placed intra-orally. The linear measurements of the airspace proposed by the Arnett/Gunson FAB Surgery cephalometric analysis were measured at four craniometric points: A, MCI, B, Pog. Results: The results demonstrate an anteroposterior airway enlargement in two of the four points studied with the MAD placed intra-orally (B and Pog point). The greatest average increase is observed at point Pog (3 mm), followed by B (1 mm), and finally, point A (0.6 mm). Conclusions: This study proved that there is an improvement in anteroposterior measurements at various points in the upper airways after treatment with MAD.
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Affiliation(s)
- Pedro Dias Ferraz
- Coimbra Hospital and University Centre (CHUC), 3000-075 Coimbra, Portugal; (M.I.B.); (F.C.); (J.P.F.)
- Correspondence: (P.D.F.); (F.V.)
| | - Inês Francisco
- Faculty of Medicine, Institute of Orthodontics, University of Coimbra, 3000-075 Coimbra, Portugal; (I.F.); (A.G.)
- Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3000-075 Coimbra, Portugal;
| | - Maria Inês Borges
- Coimbra Hospital and University Centre (CHUC), 3000-075 Coimbra, Portugal; (M.I.B.); (F.C.); (J.P.F.)
| | - Adriana Guimarães
- Faculty of Medicine, Institute of Orthodontics, University of Coimbra, 3000-075 Coimbra, Portugal; (I.F.); (A.G.)
| | - Fátima Carvalho
- Coimbra Hospital and University Centre (CHUC), 3000-075 Coimbra, Portugal; (M.I.B.); (F.C.); (J.P.F.)
| | - Francisco Caramelo
- Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3000-075 Coimbra, Portugal;
- Laboratory of Biostatistics and Medical Informatics (LBIM), Faculty of Medicine, University of Coimbra, 3004-531 Coimbra, Portugal
- Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-075 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3030-370 Coimbra, Portugal
| | - José Pedro Figueiredo
- Coimbra Hospital and University Centre (CHUC), 3000-075 Coimbra, Portugal; (M.I.B.); (F.C.); (J.P.F.)
- Clinical Academic Center of Coimbra (CACC), 3030-370 Coimbra, Portugal
| | - Francisco Vale
- Faculty of Medicine, Institute of Orthodontics, University of Coimbra, 3000-075 Coimbra, Portugal; (I.F.); (A.G.)
- Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3000-075 Coimbra, Portugal;
- Correspondence: (P.D.F.); (F.V.)
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3
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Schlee W, Simoes J, Pryss R. Auricular Acupressure Combined with Self-Help Intervention for Treating Chronic Tinnitus: A Longitudinal Observational Study. J Clin Med 2021; 10:jcm10184201. [PMID: 34575312 PMCID: PMC8466364 DOI: 10.3390/jcm10184201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 08/22/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022] Open
Abstract
Tinnitus is a phantom sound perception in the ears or head and can arise from many different medical disorders. Currently, there is no standard treatment for tinnitus that reliably reduces tinnitus. Individual patients reported that acupressure at various points around the ear can help to reduce tinnitus, which was investigated here. With this longitudinal observational study, we report a systematic evaluation of auricular acupressure on 39 tinnitus sufferers, combined with a self-help smartphone app. The participants were asked to report on tinnitus, stress, mood, neck, and jaw muscle tensions twice a day using an ecological momentary assessment study design for six weeks. On average, 123.6 questionnaires per person were provided and used for statistical analysis. The treatment responses of the participants were heterogeneous. On average, we observed significant negative trends for tinnitus loudness (Cohen’s d effect size: −0.861), tinnitus distress (d = −0.478), stress (d = −0.675), and tensions in the neck muscles (d = −0.356). Comparison with a matched control group revealed significant improvements for tinnitus loudness (p = 0.027) and self-reported stress level (p = 0.003). The positive results of the observational study motivate further research including a randomized clinical trial and long-term assessment of the clinical improvement.
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Affiliation(s)
- Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany;
- Correspondence:
| | - Jorge Simoes
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany;
| | - Rüdiger Pryss
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, 97080 Würzburg, Germany;
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Preoperative Management of a Jehovah's Witness Patient Undergoing Head and Neck Surgery With High Risk of Bleeding. J Craniofac Surg 2021; 32:e159-e162. [PMID: 33705059 DOI: 10.1097/scs.0000000000006945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
ABSTRACT Surgery in head and neck district is often associated with bleeding as major complication and need of blood transfusions. Homologous blood transfusions may be unacceptable to some patient groups such as the Jehovah's Witness (JW) patients. Refusal of potentially life-saving treatment creates ethical dilemmas for treating clinicians.This is the first report in literature which examines the management and treatment of a female JW patient who underwent major surgical procedure for squamous cell carcinoma of the jaw with a high risk of hemorrage which rejected any possibility of blood and hemocomponent transfusion by virtue of her religious principles.
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Kim SH, Kim D, Lee JM, Lee SK, Kang HJ, Yeo SG. Review of Pharmacotherapy for Tinnitus. Healthcare (Basel) 2021; 9:healthcare9060779. [PMID: 34205776 PMCID: PMC8235102 DOI: 10.3390/healthcare9060779] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 11/16/2022] Open
Abstract
Various medications are currently used in the treatment of tinnitus, including anesthetics, antiarrhythmics, anticonvulsants, antidepressants, antihistamines, antipsychotics, anxiolytics, calcium channel blockers, cholinergic antagonists, NMDA antagonists, muscle relaxants, vasodilators, and vitamins. To date, however, no medications have been specifically approved to treat tinnitus by the US Food and Drug Administration (FDA). In addition, medicines used to treat other diseases, as well as foods and other ingested materials, can result in unwanted tinnitus. These include alcohol, antineoplastic chemotherapeutic agents and heavy metals, antimetabolites, antitumor agents, antibiotics, caffeine, cocaine, marijuana, nonnarcotic analgesics and antipyretics, ototoxic antibiotics and diuretics, oral contraceptives, quinine and chloroquine, and salicylates. This review, therefore, describes the medications currently used to treat tinnitus, including their mechanisms of action, therapeutic effects, dosages, and side-effects. In addition, this review describes the medications, foods, and other ingested agents that can induce unwanted tinnitus, as well as their mechanisms of action.
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Affiliation(s)
- Sang Hoon Kim
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul 02447, Korea; (S.H.K.); (J.-M.L.); (S.K.L.); (H.J.K.)
| | - Dokyoung Kim
- Department of Anatomy and Neurobiology, College of Medicine, Kyung Hee University, Seoul 02447, Korea;
| | - Jae-Min Lee
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul 02447, Korea; (S.H.K.); (J.-M.L.); (S.K.L.); (H.J.K.)
| | - Sun Kyu Lee
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul 02447, Korea; (S.H.K.); (J.-M.L.); (S.K.L.); (H.J.K.)
| | - Hee Jin Kang
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul 02447, Korea; (S.H.K.); (J.-M.L.); (S.K.L.); (H.J.K.)
| | - Seung Geun Yeo
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul 02447, Korea; (S.H.K.); (J.-M.L.); (S.K.L.); (H.J.K.)
- Correspondence: ; Tel.: +82-2-958-8980; Fax: +82-2-958-8470
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Multimodal Imaging in Susac Syndrome: A Case Report and Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073435. [PMID: 33810247 PMCID: PMC8038062 DOI: 10.3390/ijerph18073435] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 03/11/2021] [Accepted: 03/23/2021] [Indexed: 12/03/2022]
Abstract
Susac syndrome (SS) is a rare microangiopathy that involves arterioles of the brain, retina, and cochlea. Diagnosis is extremely difficult because of the rarity of the disease and because the signs and symptoms often occur at different times. Multidisciplinary approaches and multimodal images are mandatory for diagnosis and prompt therapy. In this report, we describe a case of SS and the application of multimodal retinal imaging to evaluate the ophthalmologic changes and to confirm diagnosis. Early diagnosis and therapy based on the associations of steroids and immunosuppressants are necessary to limit the sequelae of the disease.
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Rhino-Orbito-Cerebral Mucormycosis in Diabetic Disease Mucormycosis in Diabetic Disease. J Craniofac Surg 2020; 31:e321-e324. [PMID: 32028364 DOI: 10.1097/scs.0000000000006191] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The authors present their experience about clinical evidences that include patients with an untreated diabetes who developed rhino-orbito-cerebral mucormycosis (ROCM). They were treated with endoscopic sinus surgery and medical treatment with intravenous, intradural therapy, and sinus washes with amphotericin B. The ROCM is a disease with a rapid evolution and an increase in mortality rate, especially if the fungus enters the cranial cavity. Therefore, it would be necessary in all diabetic patients with sinus symptoms, headaches, visual changes, suspect a mucormycosis, and perform a careful radiology assessment and a nasal endoscopy. Often, despite an early diagnosis and rapid treatment for ROCM, it is not possible to stem the disease, which ends with the patient's death.
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Cammaroto G, Stringa LM, Iannella G, Meccariello G, Zhang H, Bahgat AY, Calvo-Henriquez C, Chiesa-Estomba C, Lechien JR, Barillari MR, Galletti B, Galletti F, Freni F, Galletti C, Vicini C. Manipulation of Lateral Pharyngeal Wall Muscles in Sleep Surgery: A Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155315. [PMID: 32718065 PMCID: PMC7432019 DOI: 10.3390/ijerph17155315] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 12/03/2022]
Abstract
Background: Obstructive sleep apnea syndrome (OSAS) occurs due to upper airway obstruction resulting from anatomical and functional abnormalities. Upper airway collapsibility, particularly those involving the lateral pharyngeal wall (LPW), is known to be one of the main factors contributing to the pathogenesis of OSAS, leading the authors of the present study to propose different strategies in order to stiffen the pharyngeal walls to try to restore normal airflow. Methods: An exhaustive review of the English literature on lateral pharyngeal wall surgery for the treatment of OSAS was performed using the PubMed electronic database. Results: The research was performed in April 2020 and yielded approximately 2000 articles. However, considering the inclusion criteria, only 17 studies were included in the present study. Conclusions: The analyzed surgical techniques propose different parts of LPW on which to focus and a variable degree of invasivity. Despite the very promising results, no gold standard for the treatment of pharyngeal wall collapsibility has been proposed. However, thanks to progressive technological innovations and increasingly precise data analysis, the role of LPW surgery seems to be crucial in the treatment of OSAS patients.
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Affiliation(s)
- Giovanni Cammaroto
- Head and Neck Department, ENT & Oral Surgery Unit, G.B. Morgagni, L. Pierantoni Hospital, Forlì, FC 47100 ASL of Romagna, Italy; (G.I.); (G.M.); (C.V.)
- Young Otolaryngologists-International Federations of Oto-rhinolaryngological Societies (YO-IFOS), 75000 Paris, France; (C.C.-H.); (C.C.-E.); (J.R.L.); (M.R.B.)
- Correspondence: ; Tel.: +39-054-363-5651
| | - Luigi Marco Stringa
- Department of Otolaryngology, Head and Neck Surgery, University of Ferrara, FE 44121 Ferrara, Italy;
| | - Giannicola Iannella
- Head and Neck Department, ENT & Oral Surgery Unit, G.B. Morgagni, L. Pierantoni Hospital, Forlì, FC 47100 ASL of Romagna, Italy; (G.I.); (G.M.); (C.V.)
| | - Giuseppe Meccariello
- Head and Neck Department, ENT & Oral Surgery Unit, G.B. Morgagni, L. Pierantoni Hospital, Forlì, FC 47100 ASL of Romagna, Italy; (G.I.); (G.M.); (C.V.)
| | - Henry Zhang
- Department of Otolaryngology, Head and Neck, Royal London Hospital, London E1 1FR, UK;
| | - Ahmed Yassin Bahgat
- Department of Otorhinolaryngology, Alexandria University, Alexandria 21526, Egypt;
| | - Christian Calvo-Henriquez
- Young Otolaryngologists-International Federations of Oto-rhinolaryngological Societies (YO-IFOS), 75000 Paris, France; (C.C.-H.); (C.C.-E.); (J.R.L.); (M.R.B.)
- Department of otolaryngology, University Hospital Complex of Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - Carlos Chiesa-Estomba
- Young Otolaryngologists-International Federations of Oto-rhinolaryngological Societies (YO-IFOS), 75000 Paris, France; (C.C.-H.); (C.C.-E.); (J.R.L.); (M.R.B.)
- Department of Otorhinolaryngology, Head & Neck Surgery, Hospital Universitario Donostia, 20014 San Sebastian, Spain
| | - Jerome R. Lechien
- Young Otolaryngologists-International Federations of Oto-rhinolaryngological Societies (YO-IFOS), 75000 Paris, France; (C.C.-H.); (C.C.-E.); (J.R.L.); (M.R.B.)
- Department of Otolaryngology, Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 75000 Paris, France
| | - Maria Rosaria Barillari
- Young Otolaryngologists-International Federations of Oto-rhinolaryngological Societies (YO-IFOS), 75000 Paris, France; (C.C.-H.); (C.C.-E.); (J.R.L.); (M.R.B.)
- Department of Mental and Physical Health and Preventive Medicine, University of L. Vanvitelli, CE 81100 Naples, Italy
| | - Bruno Galletti
- Department of Adult and Development Age Human Pathology “Gaetano Barresi”, Unit of Otorhinolaryngology, University of Messina, ME 98125 Messina, Italy; (B.G.); (F.G.); (F.F.)
| | - Francesco Galletti
- Department of Adult and Development Age Human Pathology “Gaetano Barresi”, Unit of Otorhinolaryngology, University of Messina, ME 98125 Messina, Italy; (B.G.); (F.G.); (F.F.)
| | - Francesco Freni
- Department of Adult and Development Age Human Pathology “Gaetano Barresi”, Unit of Otorhinolaryngology, University of Messina, ME 98125 Messina, Italy; (B.G.); (F.G.); (F.F.)
| | - Cosimo Galletti
- Comprehensive Dentistry Department, Faculty of Dentistry, Universitat de Barcelona, L’Hospitalet de Llobregat (Barcelona), 08907 Catalonia, Spain;
| | - Claudio Vicini
- Head and Neck Department, ENT & Oral Surgery Unit, G.B. Morgagni, L. Pierantoni Hospital, Forlì, FC 47100 ASL of Romagna, Italy; (G.I.); (G.M.); (C.V.)
- ENT department, University of Ferrara, FE 44121 Ferrara, Italy
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Gazia F, Freni F, Galletti C, Galletti B, Bruno R, Galletti C, Meduri A, Galletti F. Pneumoparotid and Pneumoparotitis: A Literary Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113936. [PMID: 32498334 PMCID: PMC7313030 DOI: 10.3390/ijerph17113936] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/13/2020] [Accepted: 05/26/2020] [Indexed: 11/16/2022]
Abstract
Pneumoparotid is a rare condition of parotid swelling. The presence of the air in gland parenchyma is caused by an incompetent Stensen’s duct with high pressure may cause the acini’s rupture. We reviewed 49 manuscripts, from 1987 to today, that enrolled a total of 54 patients with pneumoparotid. Our review evaluated the following evaluation parameters: gender, age, etiology, clinical presentation, treatment, days of resolution after diagnosis, relapse and complications. The most frequent etiology is self-induction by swelling the cheeks (53.7%). This cause mainly involves children (74%), for conflicts with parents, excuses for not going to school, nervous tics or adults (16%) with psychiatric disorders. Iatrogenic causes are also frequent (16.6%), for dental treatments (55.5%) or use of continuous positive airway pressure (CPAP) (33.4%). Medical therapy is the most practiced (53.7%), in most cases it is combined with behavioral therapy (25.9%) or psychotherapy (25.9%). Surgery is rarely used (9.2%) as a definitive solution through parotidectomy (50%) or ligation of the duct (50%). The most common complication is subcutaneous emphysema (24.1%), sometimes associated with pneumomediastinum (5.5%). Careful treatment and management are necessary to ensure the resolution of the pathology and counteract the onset of complications.
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Affiliation(s)
- Francesco Gazia
- Department of Adult and Development Age Human Pathology “Gaetano Barresi”, Unit of Otorhinolaryngology, University of Messina, 98125 Messina, Italy; (F.F.); (C.G.); (B.G.); (R.B.); (F.G.)
- Correspondence: ; Tel.: +39-0902212248; Fax: +39-0902212242
| | - Francesco Freni
- Department of Adult and Development Age Human Pathology “Gaetano Barresi”, Unit of Otorhinolaryngology, University of Messina, 98125 Messina, Italy; (F.F.); (C.G.); (B.G.); (R.B.); (F.G.)
| | - Cosimo Galletti
- Department of Adult and Development Age Human Pathology “Gaetano Barresi”, Unit of Otorhinolaryngology, University of Messina, 98125 Messina, Italy; (F.F.); (C.G.); (B.G.); (R.B.); (F.G.)
| | - Bruno Galletti
- Department of Adult and Development Age Human Pathology “Gaetano Barresi”, Unit of Otorhinolaryngology, University of Messina, 98125 Messina, Italy; (F.F.); (C.G.); (B.G.); (R.B.); (F.G.)
| | - Rocco Bruno
- Department of Adult and Development Age Human Pathology “Gaetano Barresi”, Unit of Otorhinolaryngology, University of Messina, 98125 Messina, Italy; (F.F.); (C.G.); (B.G.); (R.B.); (F.G.)
| | - Cosimo Galletti
- Comprehensive Dentistry Department, Faculty of Dentistry, Universitat de Barcelona, L’Hospitalet de Llobregat (Barcelona), 08907 Catalonia, Spain;
| | - Alessandro Meduri
- Department of Scienze Biomediche, Odontoiatriche e Delle Immagini Morfologiche e Funzionali, Unit of Ophthalmology, University of Messina, 98125 Messina, Italy;
| | - Francesco Galletti
- Department of Adult and Development Age Human Pathology “Gaetano Barresi”, Unit of Otorhinolaryngology, University of Messina, 98125 Messina, Italy; (F.F.); (C.G.); (B.G.); (R.B.); (F.G.)
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