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Mueller SK, Wendler O, Mayr S, Traxdorf M, Koch M, Mantsopoulos K, Sievert M, Grundtner P, Iro H, Bleier BS. Comparison of mucus and serum biomarker sampling in chronic rhinosinusitis with nasal polyps. Int Forum Allergy Rhinol 2024; 14:887-897. [PMID: 37990964 DOI: 10.1002/alr.23295] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 08/12/2023] [Accepted: 09/14/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE The objective of this study was to analyze advantages and disadvantages of mucus and serum for biomarker analysis. METHODS This study includes prospective study of 61 CRS with nasal polyps patients who were followed over 24 months and over nine time points after functional endoscopic sinus surgery. At each time points, the nasal polyp score (NPS) was assessed and mucus as well as serum was collected. Selected were measured in mucus and serum. Mean, standard deviation and variance, undetectable values, and the correlation of the biomarkers to the NPS over time and to early recurrences were calculated, and the effect of surgery on the biomarkers was assessed. Additionally, the diurnal rhythm of all biomarkers was measures in order to assure stable biomarker values during sampling times. RESULTS All biomarkers showed stable values during sampling times. Serum biomarker levels displayed higher percentages of undetectable values compared to mucus biomarkers. Mucus periostin (p < 0.001, r = 0.89), mucus IgE (p < 0.001, r = 0.51), serum periostin (p < 0.001, r = 0.53), mucus CST1 (p < 0.001, r = 0.27), and serum IgE (p < 0.01, r = -0.18) were the best marker and medium combinations to track the NPS over time and to predict recurrences. Mucus serpinF2 was negatively correlated and predicted early recurrences (p = 0.026, R2 = 0.015). CONCLUSIONS Serum and mucus both represent viable mediums for "liquid biopsies." The most promising biomarker/medium combinations over time to track disease severity were mucus periostin, mucus IgE, serum periostin, mucus CST1, and serum IgE. Mucus serpinF2 was the best biomarker to predict early recurrences.
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Affiliation(s)
- Sarina Katrin Mueller
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Olaf Wendler
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Susanne Mayr
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Maximilian Traxdorf
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Koch
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Konstantinos Mantsopoulos
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Matti Sievert
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Philipp Grundtner
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Heinrich Iro
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Benjamin S Bleier
- Department of Otolaryngology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
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Benchetrit L, Thomson E, Paz-Lansberg M, Platt MP, Brook CD. Evaluation of narrow-band imaging in the diagnosis of sinonasal inverted papilloma. Int Forum Allergy Rhinol 2024; 14:720-723. [PMID: 37548133 DOI: 10.1002/alr.23251] [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: 04/08/2023] [Revised: 07/22/2023] [Accepted: 08/03/2023] [Indexed: 08/08/2023]
Abstract
KEY POINTS Narrow-band imaging (NBI) can be used to differentiate benign sinonasal lesions NBI can be used in the preoperative identification of sinonasal inverted papilloma Future studies can focus on NBI for recurrent inverted papilloma and surgical margin guidance.
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Affiliation(s)
- Liliya Benchetrit
- Department of Otolaryngology - Head and Neck Surgery, Boston University School of, Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | - Evan Thomson
- Department of Otolaryngology - Head and Neck Surgery, Boston University School of, Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | - Marianella Paz-Lansberg
- Department of Otolaryngology - Head and Neck Surgery, Boston University School of, Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | - Michael P Platt
- Department of Otolaryngology - Head and Neck Surgery, Boston University School of, Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | - Christopher D Brook
- Department of Otolaryngology - Head and Neck Surgery, Boston University School of, Medicine, Boston Medical Center, Boston, Massachusetts, USA
- Division of Otolaryngology - Head and Neck Surgery, Beth Israel Deaconess Medical Center, Harvard University School of Medicine, Boston, Massachusetts, USA
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3
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Miglani A, Soler ZM, Smith TL, Mace JC, Schlosser RJ. A comparative analysis of endoscopic sinus surgery versus biologics for treatment of chronic rhinosinusitis with nasal polyposis. Int Forum Allergy Rhinol 2023; 13:116-128. [PMID: 35980852 PMCID: PMC9877092 DOI: 10.1002/alr.23059] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/30/2022] [Accepted: 07/07/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Comparative effectiveness research between endoscopic sinus surgery (ESS) and biologic therapy for severe chronic rhinosinusitis with nasal polyposis (CRSwNP) is a nascent field as new therapeutic modalities become clinically available. METHODS A prospective, multicenter cohort of CRSwNP patients, undergoing ESS between 2011 and 2019, were compared to phase-3 biologic trial data. Patients undergoing ESS received baseline nasal endoscopy quantified via Lund-Kennedy (LK) grading. Patients meeting inclusion criteria, modified from Dupilumab-LIBERTY-NP-24&52, omalizumab-POLYP-1&2, and Mepolizumab-SYNAPSE clinical trials, were included in this study. Baseline characteristics and outcome measures were compared between these cohorts at 24 weeks and 52 weeks, when possible. RESULTS A total of 111 CRSwNP patients met modified inclusion criteria. There were no statistically significant differences in baseline age, sex, asthma status, aspirin-exacerbated respiratory disease status, smell identification, LK-polyp score, and Lund-Mackay computed tomography (CT) scores between ESS and biologic groups. At 24 weeks, ESS demonstrated significantly greater improvements in 22-item Sino-Nasal Outcome Test (SNOT-22) compared to one (of two) dupilumab trials (p < 0.05) and both omalizumab trials (p < 0.001). ESS associated with significantly lower nasal polyp scores (NPS) compared to dupilumab (p < 0.001) and omalizumab (p < 0.001), despite comparable improvements in smell identification (p > 0.05). At 52 weeks, ESS resulted in statistically similar improvement in SNOT-22 scores compared to dupilumab (p = 0.21), but NPS remained significantly lower in the ESS group compared to dupilumab (p < 0.001) and mepolizumab (p < 0.001). CONCLUSION At 24 weeks and 52 weeks, ESS offers comparable SNOT-22 improvements compared to dupilumab. ESS and dupilumab offer comparable improvement in smell identification at 24 weeks. Compared to omalizumab, ESS offers superior SNOT-22 improvements. ESS offers significantly greater reductions in polyp size compared to omalizumab, dupilumab, and mepolizumab therapies.
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Affiliation(s)
- Amar Miglani
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina; Charleston, SC
| | - Zachary M. Soler
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina; Charleston, SC
| | - Timothy L. Smith
- Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University; Portland, OR
| | - Jess C Mace
- Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University; Portland, OR
| | - Rodney J. Schlosser
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina; Charleston, SC
- Department of Surgery, Ralph H. Johnson VA Medical Center; Charleston, SC
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4
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Wangberg H, Spierling Bagsic SR, Levy JM, White A. Perioperative management and perceived risks of sinus surgery in patients with aspirin-exacerbated respiratory disease. Int Forum Allergy Rhinol 2021; 11:1132-1134. [PMID: 33723921 DOI: 10.1002/alr.22789] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/04/2021] [Accepted: 02/08/2021] [Indexed: 11/07/2022]
Affiliation(s)
- Hannah Wangberg
- Scripps Clinic Department of Allergy, Asthma, and Immunology, San Diego, CA
| | | | - Joshua M Levy
- Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, GA
| | - Andrew White
- Scripps Clinic Department of Allergy, Asthma, and Immunology, San Diego, CA
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Patel TR, Tajudeen BA, Brown H, Gattuso P, LoSavio P, Papagiannopoulos P, Batra PS, Mahdavinia M. Association of Air Pollutant Exposure and Sinonasal Histopathology Findings in Chronic Rhinosinusitis. Am J Rhinol Allergy 2021; 35:761-767. [PMID: 33567858 DOI: 10.1177/1945892421993655] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Ambient air pollution is well known to cause inflammatory change in respiratory epithelium and is associated with exacerbations of inflammatory conditions such as asthma and chronic obstructive pulmonary disease. However, limited work has been done on the impact of air pollution on pathogenesis of chronic rhinosinusitis and there are no reports in the literature of how pollutant exposure may impact sinonasal histopathology in patients with chronic rhinosinusitis. OBJECTIVE This study aims to identify associations between certain histopathologic characteristics seen in sinus tissue of patients with chronic rhinosinusitis (CRS) and levels of particulate air pollution (PM2.5) and ground-level ozone in their place of residence. METHODS A structured histopathology report was created to characterize the tissues of CRS patients undergoing sinus surgery. An estimate for each patient's exposure to air pollutants including small particulate matter (PM2.5) and ground-level ozone was obtained using the Environmental Protection Agency's (EPA) Environmental Justice Screening and Mapping Tool (EJSCREEN). Mean pollutant exposures for patients whose tissues exhibited varying histopathologic features were compared using logistic regression models. RESULTS Data from 291 CRS patients were analyzed. Higher degree of inflammation was significantly associated with increased ozone exposure (p = 0.031). Amongst the patients with CRSwNP (n=131), presence of eosinophilic aggregates (p = 0.018) and Charcot-Leyden crystals (p = 0.036) was associated with increased ozone exposure. CONCLUSION Exposure to ambient air pollutants may contribute to pathogenesis of CRS. Increasing ozone exposure was linked to both higher tissue inflammation and presence of eosinophilic aggregates and Charcot-Leyden crystals in CRSwNP patients.
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Affiliation(s)
- Tirth R Patel
- Department of Otolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois
| | - Bobby A Tajudeen
- Department of Otolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois.,Rush Sinus, Allergy, and Asthma Center, Rush University Medical Center, Chicago, Illinois
| | | | - Paolo Gattuso
- Department of Pathology, Rush University Medical Center, Chicago, Illinois
| | - Phillip LoSavio
- Department of Otolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois.,Rush Sinus, Allergy, and Asthma Center, Rush University Medical Center, Chicago, Illinois
| | - Peter Papagiannopoulos
- Department of Otolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois.,Rush Sinus, Allergy, and Asthma Center, Rush University Medical Center, Chicago, Illinois
| | - Pete S Batra
- Department of Otolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois.,Rush Sinus, Allergy, and Asthma Center, Rush University Medical Center, Chicago, Illinois
| | - Mahboobeh Mahdavinia
- Rush Sinus, Allergy, and Asthma Center, Rush University Medical Center, Chicago, Illinois.,Division of Allergy and Immunology, Rush University Medical Center, Chicago, Illinois
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Workman AD, Nocera AL, Mueller SK, Otu HH, Libermann TA, Bleier BS. Translating transcription: proteomics in chronic rhinosinusitis with nasal polyps reveals significant discordance with messenger RNA expression. Int Forum Allergy Rhinol 2019; 9:776-786. [PMID: 30775848 DOI: 10.1002/alr.22315] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 09/02/2018] [Revised: 12/28/2018] [Accepted: 01/22/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Much of the literature examining chronic rhinosinusitis with nasal polyps (CRSwNP) immunopathology has been predicated on messenger RNA (mRNA) analysis with the assumption that transcriptional changes would reflect end-effector protein expression. The purpose of this study was to test this hypothesis using matched transcriptomic and proteomic data sets. METHODS Matched tissue proteomic and transcriptomic arrays were quantified in CRSwNP polyp tissue and control inferior turbinate tissue (n = 10/group). Mucus samples were additionally collected in 6 subjects from each group. Proteins were grouped into functional categories by bioinformatics and differential expression analyses. Log-log regression and Pearson correlations were performed to determine the level of agreement between data sets. RESULTS Of the 1310 proteins examined, 393 were significantly differentially expressed in CRSwNP. On regression analysis, differences in protein expression were poorly predicted by differences in mRNA expression (R2 = 0.020, p < 0.05). Several genes canonically thought to be overexpressed in CRSwNP, including IL-5, IL-13, TSLP, CCL13, and CCL26, showed substantial increases in mRNA transcription, but had minimally or unchanged protein expression. Others, including IgE, periostin, CCL18, and CST1/2, were increased at both the transcriptomic and proteomic levels. Among differentially regulated proteins, tissue and mucus protein levels showed weak correlation (r = 0.26, p < 0.0001). CONCLUSION Proteomic analysis in CRSwNP has revealed novel disease-associated proteins and pathways, yet correlates poorly with transcriptomic data. The increasing availability of proteomic arrays opens the door to new potential explanatory mechanisms in CRSwNP and suggests that mRNA based studies should be validated with protein analysis.
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Affiliation(s)
- Alan D Workman
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA.,Harvard Medical School, Boston, MA
| | - Angela L Nocera
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA.,Harvard Medical School, Boston, MA
| | - Sarina K Mueller
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA.,Harvard Medical School, Boston, MA.,Department of Otorhinolaryngology-Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Hasan H Otu
- Department of Electrical and Computer Engineering, University of Nebraska-Lincoln, Lincoln, NE
| | - Towia A Libermann
- Harvard Medical School, Boston, MA.,Department of Medicine, Beth Israel Deaconess Medical Center (BIDMC), Boston, MA.,Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center (BIDMC), Boston, MA.,BIDMC Genomics, Proteomics, Bioinformatics and Systems Biology Center, Beth Israel Deaconess Medical Center (BIDMC), Boston, MA
| | - Benjamin S Bleier
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA.,Harvard Medical School, Boston, MA
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7
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De Corso E, Baroni S, Lucidi D, Battista M, Romanello M, Autilio C, Morelli R, Di Nardo W, Passali GC, Sergi B, Bussu F, Fetoni AR, Zuppi C, Paludetti G. Nasal lavage levels of granulocyte-macrophage colony-stimulating factor and chronic nasal hypereosinophilia. Int Forum Allergy Rhinol 2015; 5:557-62. [PMID: 25821067 DOI: 10.1002/alr.21519] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [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: 12/01/2014] [Revised: 02/04/2015] [Accepted: 02/15/2015] [Indexed: 11/11/2022]
Abstract
BACKGROUND The aim of the present study was to measure levels of granulocyte-macrophage colony-stimulating factor (GM-CSF) in nasal lavage of patients affected by chronic eosinophilic sinonasal inflammation to clarify the relationship with eosinophilic tissue infiltration and clinical features. METHODS Between November 2012 and June 2013, we selected 70 patients with chronic eosinophilic inflammation (average age 41.8 years) who were classified into the following groups: persistent allergic rhinitis (group 1), noninfectious non-allergic rhinitis with eosinophilia syndrome (group 2) and chronic rhinosinusitis with polyps (group 3). Finally, we enrolled 20 healthy subjects as controls (group 4). All patients underwent symptoms score questionnaire based on a visual analogue scale, nasal endoscopy and/or computed tomography (CT) scan, and allergy testing. Nasal cytology by scraping of the mucosa and GM-CSF assays in nasal lavage were performed in all subjects. RESULTS Detectable levels of GM-CSF were found in 34 of 70 (48.57%) patients, with an average concentration of 2.67 ± 0.8 pg/mL, whereas in controls only 1 of 20 individuals showed detectable GM-CSF levels. Eosinophil infiltration was significantly higher in patients with detectable GM-CSF compared to those with undetectable levels (49.4% vs 39.2%, respectively; p < 0.05). Furthermore, significant weakly-moderate correlation was found between GM-CSF levels and percentage of eosinophil infiltration in tissue (p < 0.05). Correlation between symptom scores and GM-CSF levels was significant only in group 2, which showed higher average concentrations of GM-CSF compared to groups 1 and 3 (2.9 pg/mL vs 1.6 pg/mL and 1.8 pg/mL, respectively; p < 0.05). CONCLUSION Our data confirm that GM-CSF is more frequently detectable in nasal lavages of patients affected by chronic sinonasal eosinophilic inflammation than in controls. Statistical analyses revealed a significant weakly-moderate correlation between GM-CSF levels in nasal lavage of all patients and percentage of eosinophil infiltration of nasal mucosa.
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Affiliation(s)
- Eugenio De Corso
- Department of Head and Neck Surgery-Institute of Otorhinolaryngology, Catholic University School of Medicine and Surgery, Rome, Italy
| | - Silvia Baroni
- Department of Diagnostic and Laboratory Medicine-Institute of Biochemistry and Clinical Biochemistry, Catholic University School of Medicine and Surgery, Rome, Italy
| | - Daniela Lucidi
- Department of Head and Neck Surgery-Institute of Otorhinolaryngology, Catholic University School of Medicine and Surgery, Rome, Italy
| | - Mariapina Battista
- Department of Head and Neck Surgery-Institute of Otorhinolaryngology, Catholic University School of Medicine and Surgery, Rome, Italy
| | - Matteo Romanello
- Department of Head and Neck Surgery-Institute of Otorhinolaryngology, Catholic University School of Medicine and Surgery, Rome, Italy
| | - Chiara Autilio
- Department of Diagnostic and Laboratory Medicine-Institute of Biochemistry and Clinical Biochemistry, Catholic University School of Medicine and Surgery, Rome, Italy
| | - Renato Morelli
- Department of Diagnostic and Laboratory Medicine-Institute of Biochemistry and Clinical Biochemistry, Catholic University School of Medicine and Surgery, Rome, Italy
| | - Walter Di Nardo
- Department of Head and Neck Surgery-Institute of Otorhinolaryngology, Catholic University School of Medicine and Surgery, Rome, Italy
| | - Giulio Cesare Passali
- Department of Head and Neck Surgery-Institute of Otorhinolaryngology, Catholic University School of Medicine and Surgery, Rome, Italy
| | - Bruno Sergi
- Department of Head and Neck Surgery-Institute of Otorhinolaryngology, Catholic University School of Medicine and Surgery, Rome, Italy
| | - Francesco Bussu
- Department of Head and Neck Surgery-Institute of Otorhinolaryngology, Catholic University School of Medicine and Surgery, Rome, Italy
| | - Anna Rita Fetoni
- Department of Head and Neck Surgery-Institute of Otorhinolaryngology, Catholic University School of Medicine and Surgery, Rome, Italy
| | - Cecilia Zuppi
- Department of Diagnostic and Laboratory Medicine-Institute of Biochemistry and Clinical Biochemistry, Catholic University School of Medicine and Surgery, Rome, Italy
| | - Gaetano Paludetti
- Department of Head and Neck Surgery-Institute of Otorhinolaryngology, Catholic University School of Medicine and Surgery, Rome, Italy
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