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Sacchetto L, Raguso G, Confuorto G, Arietti V, Torroni L, Marchioni D, Nocini R. A comparison between endoscopic and microscopic approaches for stapes surgery: experience of a tertiary referral center. Eur Arch Otorhinolaryngol 2024; 281:2959-2965. [PMID: 38158420 DOI: 10.1007/s00405-023-08411-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/08/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE Otosclerosis is a common ear disease causing ankylosis of the stapedio-vestibular joint and conductive hearing loss. Stapedoplasty is the most advisable surgical solution. The restoration of hearing depends on the condition of the patient and the surgery itself. The aim of our work was to compare the surgical and audiological results of stapedoplasty performed with endoscopic versus microscopic technique. METHODS This is a retrospective study of 254 patients treated with stapedoplasty with a microscopic approach (91/254) or with an endoscopic approach (163/254) between 2014 and 2021 at our tertiary referral center. Statistical significance of differences between the two methods was determined using the Mann-Whitney test for quantitative variables and the Wilcoxon matched-pairs signed-rank test for repeated measures. Categorical variables were assessed with Fisher's exact test. RESULTS Both techniques improved the hearing status of patients, with no statistically significant difference between them. There was also no statistically significant difference in reported complications between the two techniques. There is a statistical difference (p < 0.001) in operating time between the two techniques: the endoscopic technique had a mean operating time of 39 min versus 45 min for the microscopic technique. CONCLUSIONS The two techniques are comparable in terms of results and the choice depends on the surgeon's preferences and experience.
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Affiliation(s)
- L Sacchetto
- Unit of Otolaryngology, Head and Neck Department, University of Verona, P.Le L.A. Scuro 10, 37134, Verona, Italy
| | - G Raguso
- Unit of Otolaryngology, Head and Neck Department, University of Verona, P.Le L.A. Scuro 10, 37134, Verona, Italy
| | - G Confuorto
- Unit of Otolaryngology, Head and Neck Department, University of Verona, P.Le L.A. Scuro 10, 37134, Verona, Italy
| | - V Arietti
- Unit of Otolaryngology, Head and Neck Department, University of Verona, P.Le L.A. Scuro 10, 37134, Verona, Italy.
| | - L Torroni
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - D Marchioni
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Modena, Modena, Italy
| | - R Nocini
- Unit of Otolaryngology, Head and Neck Department, University of Verona, P.Le L.A. Scuro 10, 37134, Verona, Italy
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Dallari V, Liberale C, De Cecco F, Nocini R, Arietti V, Monzani D, Sacchetto L. The role of artificial intelligence in training ENT residents: a survey on ChatGPT, a new method of investigation. Acta Otorhinolaryngol Ital 2024:1-9. [PMID: 38712520 DOI: 10.14639/0392-100x-n2806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/02/2024] [Indexed: 05/08/2024]
Abstract
Objective 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. Methods An online survey was distributed to ENT residents employed in Italian University Hospitals. Results 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. Conclusions 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.
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Affiliation(s)
- Virginia Dallari
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Verona, Italy
- Member of the Young Confederation of European ORL-HNS
| | - Carlotta Liberale
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Verona, Italy
| | - Francesca De Cecco
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Verona, Italy
| | - Riccardo Nocini
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Verona, Italy
- Member of the Young Confederation of European ORL-HNS
| | - Valerio Arietti
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Verona, Italy
| | - Daniele Monzani
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Verona, Italy
| | - Luca Sacchetto
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Verona, Italy
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Nocini R, Soloperto D, Arietti V, De Cecco F, Fulco G, Monzani D, Marchioni D, Sacchetto L. Subtotal Petrosectomy: Pictorial Review of Clinical Indications and Surgical Approach. Indian J Otolaryngol Head Neck Surg 2024; 76:224-236. [PMID: 38440666 PMCID: PMC10909040 DOI: 10.1007/s12070-023-04131-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 07/31/2023] [Indexed: 03/06/2024] Open
Abstract
Subtotal petrosectomy (STP) is characterized by obliteration of the middle ear and occlusion of the external auditory canal. The advent of the endoscope has allowed a reduction in morbidity for some conditions such as cholesteatoma and other middle ear disorders, but STP still plays an important role. A retrospective review of medical records and videos of patients who had undergone STP was performed. Perioperative data and images were collected from various clinical cases who had undergone subtotal petrosectomy at our tertiary referral university hospital in Verona. We confronted our experience with a review of the literature to present the main indications for this type of procedure. STP allows a variety of diseases to be managed effectively as it offers the possibility of a definitive healing with radical clearance of temporal bone. Moreover, it can be safely combined with other procedures with a very low complication rate. Although the endoscope represents a revolution in ear surgery, STP, when indicated, is nowadays a surgical option that should be included in the otosurgeon's portfolio.
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Affiliation(s)
- Riccardo Nocini
- Unit of Otolaryngology - Head and Neck Department, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - Davide Soloperto
- Unit of Otolaryngology - Head and Neck Department, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - Valerio Arietti
- Unit of Otolaryngology - Head and Neck Department, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - Francesca De Cecco
- Unit of Otolaryngology - Head and Neck Department, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - Gianfranco Fulco
- Unit of Otolaryngology - Head and Neck Department, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - Daniele Monzani
- Unit of Otolaryngology - Head and Neck Department, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - Daniele Marchioni
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Modena, Modena, Italy
| | - Luca Sacchetto
- Unit of Otolaryngology - Head and Neck Department, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
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Monzani D, Liberale C, Segato E, De Cecco F, Arietti V, Palma S, Sacchetto L, Nocini R. The Role of Fibrinogen, Homocysteine and Metabolic Syndrome's Alterations in Sudden Sensorineural Hearing Loss (SSHL): A Narrative Review. Medicina (Kaunas) 2023; 59:1977. [PMID: 38004026 PMCID: PMC10673203 DOI: 10.3390/medicina59111977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/05/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023]
Abstract
Fibrinogen and homocysteine (HCY) are molecules known to play a role in vascular homeostasis, and their blood levels are often elevated in patients with metabolic syndrome. Recent evidence suggests that sudden sensorineural hearing loss (SSHL) may have a vascular origin. This has led many authors to advocate that fibrinogen, homocysteine, and metabolic syndrome (MetS) may play a direct role in SSHL. The aim of this brief review is to examine the role and influence of these molecules and MetS on the mechanisms of SSHL. Elevated fibrinogen levels have been associated with a worse prognosis in SSHL, possibly due to increased blood viscosity and decreased blood flow. Similarly, HCY has been associated with vascular damage, particularly in hyperhomocysteinemia, although the exact association with SSHL remains controversial. MetS has been demonstrated to function both as a causative factor and as a contributor to poorer recovery in cases of SSHL. However, although some studies suggest a possible role for these biomarkers and MetS in the prognosis and treatment of SSHL, specific therapeutic and preventive strategies based solely on these factors have yet to be developed. Given their potential role in prognosis and treatment and the global epidemic of metabolic syndrome, this issue needs to be analyzed comprehensively. Thus, further quality studies need to be conducted, even though it is difficult to determine the actual impact of MetS on the development of SSHL, as it is a multifactorial disease affecting multiple organs.
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Affiliation(s)
- Daniele Monzani
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (D.M.); (C.L.); (F.D.C.); (V.A.)
| | - Carlotta Liberale
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (D.M.); (C.L.); (F.D.C.); (V.A.)
| | - Erika Segato
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (D.M.); (C.L.); (F.D.C.); (V.A.)
| | - Francesca De Cecco
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (D.M.); (C.L.); (F.D.C.); (V.A.)
| | - Valerio Arietti
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (D.M.); (C.L.); (F.D.C.); (V.A.)
| | - Silvia Palma
- Otolaryngology and Audiology Unit, University of Modena and Reggio Emilia, 41100 Modena, Italy;
| | - Luca Sacchetto
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (D.M.); (C.L.); (F.D.C.); (V.A.)
| | - Riccardo Nocini
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (D.M.); (C.L.); (F.D.C.); (V.A.)
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Molteni G, Gazzini L, Sacchetto A, Nocini R, Comini LV, Arietti V, Locatello LG, Mannelli G. Mandibular reconstruction in head and neck cancer: which is the gold standard? Eur Arch Otorhinolaryngol 2023; 280:3953-3965. [PMID: 37269408 DOI: 10.1007/s00405-023-08050-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 05/30/2023] [Indexed: 06/05/2023]
Abstract
INTRODUCTION The aim of this study is to perform a systematic review to compare the outcomes of the different surgical options for mandibular reconstruction in head and neck cancer. MATERIAL AND METHODS 93 articles were selected. Four groups were identified: titanium plate without flaps, titanium plate covered by soft tissue flap, bone tissue flaps and double flaps. We compared patients' characteristics, site of mandibulectomy, type of reconstruction and complications. RESULTS 4697 patients were reported. The groups were not homogeneous regarding the type of defect and the treatment history. A significant difference in terms of post-operative complications was found between group 1 and group 2 (p < 0.00001), and between group 2 and group 3 (p < 0.00001). Total complications rate for group 4 was significantly higher when compared to group 3 (p < 0.00001), but no significant difference was found with group 2. CONCLUSION These results suggest that mandibular reconstruction using a microvascular bone flap is the best surgical option in patients without significant comorbidities.
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Affiliation(s)
- Gabriele Molteni
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Head and Neck Department, University Hospital of Verona, Verona, Italy
- Department of Surgery, Dentistry and Pediatrics, University of Verona, Verona, Italy
| | - Luca Gazzini
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Otorhinolaryngology-Head and Neck Surgery Department, San Maurizio Hospital, Bolzano, Italy
| | - Andrea Sacchetto
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria.
- Department of Otolaryngology, Ospedale San Bortolo, AULSS 8 Berica, Vicenza, Italy.
| | - Riccardo Nocini
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Department of Surgery, Dentistry and Pediatrics, University of Verona, Verona, Italy
| | - Lara Valentina Comini
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Otorhinolaryngology Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Valerio Arietti
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Department of Surgery, Dentistry and Pediatrics, University of Verona, Verona, Italy
| | - Luca Giovanni Locatello
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Department of Otorhinolaryngology, Sant'Antonio Abate Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Tolmezzo, Italy
| | - Giuditta Mannelli
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Nocini R, Arietti V, Barausse E, Torroni L, Trotolo A, Sanna G. Proposal for Perioperative Pharmacological Protocol for the Reduction in Early Complications in Orthorhinoseptoplasty: Five Years of Experience. J Pers Med 2023; 13:1330. [PMID: 37763098 PMCID: PMC10532652 DOI: 10.3390/jpm13091330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
Septorhinoplasty is a crucial intervention in functional and aesthetic facial surgery. Although rare and usually manageable, complications could lead to disfiguring consequences. There is no universal protocol for perioperative management in the literature. The aim of this article is to analyze the surgical complications in patients who underwent open rhinoseptoplasty and were treated in the perioperative period with the standardized protocol used in our department, in order to propose it as a standardized protocol for a more global application. METHODS The patients included underwent rhinoplasty between 2017 and 2022 and were managed with the same treatment protocol. Perioperative and intraoperative data, as well as possible complications, were collected. RESULTS A total of 129 patients were included, 73% of which reported either mild or no complications. Abnormal scar healing was the most frequent complaint (9%), followed by edema (6.2%), nasal dyspnea (3.9%), infection (2.3%), and bleeding (2.3%). No severe complications were reported. CONCLUSIONS Our protocol appears to be effective in minimizing complications such as infection and bleeding, although it is very difficult to compare the results with the literature.
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Affiliation(s)
- Riccardo Nocini
- Unit of Otolaryngology, Head and Neck Department, AOUI University of Verona, 37100 Verona, Italy
| | - Valerio Arietti
- Unit of Otolaryngology, Head and Neck Department, AOUI University of Verona, 37100 Verona, Italy
| | - Eleonora Barausse
- Unit of Maxillo-Facial Surgery, Head and Neck Department, AOUI University of Verona, 37100 Verona, Italy (A.T.)
| | - Lorena Torroni
- Unit of Epidemiology and Medical Statics, Department of Diagnostics and Public Health, AOUI University of Verona, 37100 Verona, Italy;
| | - Alessandro Trotolo
- Unit of Maxillo-Facial Surgery, Head and Neck Department, AOUI University of Verona, 37100 Verona, Italy (A.T.)
| | - Giangiacomo Sanna
- Unit of Maxillo-Facial Surgery, Head and Neck Department, AOUI University of Verona, 37100 Verona, Italy (A.T.)
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Laura E, Arietti V, Gazzini L. Video Type: "How I Do It". Endoscopic Type I Tympanoplasty: the procedure step by step with video. Eur Ann Otorhinolaryngol Head Neck Dis 2021; 138 Suppl 3:85-86. [PMID: 34092545 DOI: 10.1016/j.anorl.2021.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/15/2021] [Accepted: 01/26/2021] [Indexed: 11/30/2022]
Affiliation(s)
- E Laura
- Division of Otolaryngology, Department of Surgery, Dentistry Pediatrics and Gynecology, University of Verona, Piazzale Aristide Stefani, 1, 37126 Verona, Italy
| | - V Arietti
- Division of Otolaryngology, Department of Surgery, Dentistry Pediatrics and Gynecology, University of Verona, Piazzale Aristide Stefani, 1, 37126 Verona, Italy.
| | - L Gazzini
- Division of Otolaryngology, "San Maurizio" Hospital, Bolzano, Italy
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