Hasil untuk "Otorhinolaryngology"

Rohit Gulati, Neethu Venkitakrishnan, Tamer M. Attia et al.

Abstract Background Dermoid cysts involving the maxillofacial region are uncommon with primary involvement of the maxilla being exceptionally rare. To date, only three cases of maxillary dermoid cysts have been reported in the literature. To the best of our knowledge, this represents the first reported case of an extraosseous maxillary dermoid cyst, underscoring the exceptional rarity and uniqueness of this entity. The case posed significant diagnostic challenges, particularly in accurately delineating the precise anatomical plane of origin and characterizing the lesion’s internal contents on radiologic evaluation. Also, an updated review of dermoid cysts arising in deep facial spaces, skull base, and bony compartments of the maxillofacial region, highlighting their varied clinical presentations and management strategies, is included. Case presentation A 28-year-old male presented with chronic right-sided facial pain. He was previously diagnosed and treated outside for chronic rhinosinusitis. With computed tomography (CT) and magnetic resonance imaging (MRI), a benign cyst with punctate calcifications with fat-predominant contents in the subperiosteal plane protruding into the pterygopalatine fossa (PPF) was identified. An endonasal endoscopic surgery was performed and a cyst with cheesy keratinous material was removed completely. A histopathology confirmed the diagnosis of a dermoid cyst. Conclusions Both CT and MRI are indispensable modalities for accurate localization and characterization of cystic lesions arising in the deep spaces of maxillofacial region. Subtle imaging findings, particularly the presence of hypointense rim on T1-weighted images (T1WI), were instrumental in suggesting a posterior-maxillary origin rather than a true PPF lesion. The fat-suppression MRI sequence (FS-T2WI) being able to demonstrate the co-existence of lipid content and punctate calcifications was the decisive imaging sequence that helped us narrow the diagnosis in favor of a dermoid cyst. Nevertheless, histopathological examination was essential for establishing a definitive diagnosis. Histopathological examination was essential for a definitive diagnosis. Surgically, the endoscopic endonasal approach provided excellent access with minimal morbidity, enabling superior visualization, complete excision, rapid postoperative recovery, and effective postoperative surveillance.

Lavinia Ghiani, Simona Citro, Alessandro Medda et al.

Abstract Background Head and Neck Squamous Cell Carcinoma (HNSCC) are classified in two main subtypes: HPV-positive (HPV+), driven by human papillomavirus (HPV) infections, and HPV-negative (HPV-), associated with environmental risk factors. Despite molecular and clinicopathological differences, neither subtype has effective tailored therapies. Since high-risk HPV oncoproteins E6/E7 affect several epigenetic regulators, characterizing the epigenetic landscape of HPV+ and HPV- HNSCC may uncover novel subtype-specific biomarkers and therapeutic targets. Methods Histone post-translational modifications were profiled in HPV+ and HPV- HNSCC tissues and cell lines using super-SILAC mass spectrometry. The same analysis was performed and combined with RNA-sequencing on E6/E7-transduced human primary keratinocytes (HKs) to identify relevant histone modifiers affected by HPV oncoproteins. Candidate gene was validated via E6/E7-mediated-siRNA knockdown in HPV + cell lines. Western Blot, RT-qPCR and Immunohistochemistry assessed gene expression. NSD2 expression was examined in patients’ tissue samples, TCGA data and 14 HNSCC cell lines. shRNA-mediated NSD2 knockdown followed by RNA-seq, cell proliferation and migration assays evaluated its oncogenic role in HNSCC. CaCl2 treatments were used to investigate NSD2’s role in epithelial differentiation, while ALDH-positive cells were quantified by flow-cytometry. NSD2 overexpression was used to confirm results. Results HPV+ HNSCC exhibited elevated H3K36me2 levels, compared to HPV-. This alteration is driven by E6/E7-induced NSD2 upregulation. NSD2, a histone methyltransferase specific for H3K36 di-methylation is overexpressed in HPV+ relative to HPV- HNSCC and in both subtypes compared to normal tissue, suggesting crucial implications in HNSCC. Functional assays revealed that NSD2 promotes cell proliferation and migration in both the subtypes. Notably, we identified a novel role for NSD2 in inhibiting epithelial cell differentiation, particularly in HPV+ HNSCC, where its upregulation mediates the E6/E7-induced differentiation blockade. Conclusions We identified a novel HPV-driven epigenetic signature in HNSCC marked by increased H3K36me2 and its writer, NSD2. Our study highlights H3K36me2 as a potential biomarker for patient stratification and positions NSD2 as a promising therapeutic target across HNSCC subtypes, modulating both common and subtype-specific oncogenic pathways. Specifically, NSD2 inhibition in HPV+ tumors restores epithelial differentiation, offering a potential strategy to arrest tumor progression.

Li Zhou, Qing Liu, Zehui Fang et al.

The single-function agents with wide-spectrum activity which tend to disturb the ecological balance of oral cavity cannot satisfy dental treatment need. A multi-functional agent with specifically targeted killing property and in situ remineralization is warranted for caries management. A novel multi-functional agent (8DSS-C8-P-113) consisting of three domains, i.e., a non-specific antimicrobial peptide (AMP) (P-113), a competence stimulating peptide (C8), and an enhancing remineralization domain (8DSS), is fabricated and evaluated in this study. The findings demonstrates that 2 μM mL−1 of 8DSS-C8-P-113 eliminates planktonic Streptococcus mutans (S. mutans) without disrupting the oral normal flora. At a concentration of 8 μM mL−1, it exhibits the ability to prevent S. mutans' adhesion. Furthermore, 8DSS-C8-P-113 self-assembles a hydrogel state at the higher concentration of 16 μM mL−1. This hydrogel self-adheres on the tooth surface, resisting acid attack, eradicating S. mutans’ biofilm, and inducing mineralization in order to facilitate the repair of demineralized dental hard tissue. Its significant effectiveness in reducing the severity of dental caries is also demonstrated in vivo in a rat model. This study suggests that the multi-functional bioactive AMP 8DSS-C8-P-113 is a promising agent to specifically target pathogen, prevent tooth demineralization, and effectively induce in situ bio-mimic remineralization for the management of dental caries.

Gül Özbilen Acar, Filiz Özen, Halil İbrahim Yıldırım et al.

Objective: The goal of this study was to investigate the expression patterns and potential relationship of the Kirsten rat sarcoma viral oncogene homolog (KRAS) and B-raf proto-oncogene (BRAF) genes in nasal polyposis (NP). Methods: Twenty-nine patients were included in the study. Small punch biopsies were collected from nasal polyps during each operation and immediately frozen in liquid nitrogen. Punch biopsies were also taken during surgery from the inferior turbinate or the septum mucosa of the patients as a control group, and these samples were also frozen. Total ribonucleic acid (RNA) was isolated using TRIzol reagent. The gene expression analyses of the KRAS and BRAF genes were performed by the real-time polymerase chain reaction method. Results: When compared to control subjects, KRAS nasal polyp gene expression increased in 21, but decreased in eight of the 29 patients. This statistical analysis revealed a statistically significant difference between the nasal polyp group and the controls (p=0.023). Like KRAS, a decrease was observed in BRAF gene expression in six, and an increase in 23 patients (p=0.011). Conclusion: Our findings suggest a potential association between BRAF and KRAS genes expression and NP, but further studies are needed to confirm this relationship. This finding suggests that the genetic background of NP could be a contributing factor, with the BRAF and KRAS mutations playing a role.

Zhang Y, Wang H, Yang J et al.

Yating Zhang,1 Hongyan Wang,1 Jie Yang,2 Sanchun Wang,1 Weifang Tong,1 Bo Teng1 1Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University, Changchun, Jilin Province, People’s Republic of China; 2Department of Neurology, the First Hospital of Jilin University, Changchun, Jilin Province, People’s Republic of ChinaCorrespondence: Bo Teng, Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University, No. 218 Ziqiang Street, Nanguan District, Changchun, Jilin Province, 130000, People’s Republic of China, Email tengbo1975@163.comPurpose: This investigation sought to elucidate the genetic underpinnings that connect obesity indicators, circulating blood lipid levels, adipokines levels and obstructive sleep apnea syndrome (OSAS), employing a bidirectional two-sample Mendelian randomization (MR) analysis that utilizes data derived from extensive genome-wide association studies (GWAS).Methods: We harnessed genetic datasets of OSAS available from the FinnGen consortium and summary data of four obesity indices (including neck circumference), seven blood lipid (including triglycerides) and eleven adipokines (including leptin) from the IEU OpenGWAS database. We primarily utilized inverse variance weighted (IVW), weighted median, and MR-Egger methods, alongside MR-PRESSO and Cochran’s Q tests, to validate and assess the diversity and heterogeneity of our findings.Results: After applying the Bonferroni correction, we identified significant correlations between OSAS and increased neck circumference (Odds Ratio [OR]: 3.472, 95% Confidence Interval [CI]: 1.954– 6.169, P= 2.201E-05) and decreased high-density lipoprotein (HDL) cholesterol levels (OR: 0.904, 95% CI: 0.858– 0.952, P= 1.251E-04). Concurrently, OSAS was linked to lower leptin levels (OR: 1.355, 95% CI: 1.069– 1.718, P= 0.012) and leptin receptor levels (OR: 0.722, 95% CI: 0.530– 0.996, P= 0.047). Sensitivity analyses revealed heterogeneity in HDL cholesterol and leptin indicators, but further multiplicative random effects IVW method analysis confirmed these correlations as significant (P< 0.05) without notable heterogeneity or horizontal pleiotropy in other instrumental variables.Conclusion: This investigation compellingly supports the hypothesis that OSAS could be a genetic predisposition for elevated neck circumference, dyslipidemia, and adipokine imbalance. These findings unveil potential genetic interactions between OSAS and metabolic syndrome, providing new pathways for research in this domain. Future investigations should aim to delineate the specific biological pathways by which OSAS impacts metabolic syndrome. Understanding these mechanisms is critical for developing targeted prevention and therapeutic strategies.Keywords: sleep disorders, metabolic syndrome, causal inference, GWAS

Justus Kaufmann, Maximilian Haist, Ivan-Maximiliano Kur et al.

The growth pattern of oropharyngeal squamous cell carcinomas (OPSCC) varies from compact tumor cell aggregates to diffusely infiltrating tumor cell-clusters. The influence of the growth pattern on local tumor control and survival has been studied mainly for surgically treated oral cavity carcinomas on a visual basis. In this study, we used multiplex immunofluorescence staining (mIF) to examine the antigens pan-cytokeratin, p16INK4a, Ki67, CD271, PD-L1, and CD8 in pretherapeutic biopsies from 86 OPSCC. We introduce Tumor-stroma contact ratio (TSC), a novel parameter, to quantify the relationship between tumor cells in contact with the stromal surface and the total number of epithelial tumor cells. mIF tumor cores were analyzed at the single-cell level, and tumor-stromal contact area was quantified using the R package ''Spatstat''. TSC was correlated with the visually assessed invasion pattern by two independent investigators. Furthermore, TSC was analyzed in relation to clinical parameters and patient survival data to evaluate its potential prognostic significance.Higher TSC correlated with poor response to (chemo-)radiotherapy (r = 0.3, p < 0.01), and shorter overall (OS) and progression-free (PFS) survival (median OS: 13 vs 136 months, p < 0.0001; median PFS: 5 vs 85 months, p < 0.0001). Visual categorization of growth pattern according to established criteria of tumor aggressiveness showed interobserver variability increasing with more nuanced categories (2 categories: k = 0.7, 95 %-CI: 0.55 - 0.85; 4 categories k = 0.48, 95 %-CI: 0.35 - 0.61).In conclusion, TSC is an objective and reproducible computer-based parameter to quantify tumor-stroma contact area. We demonstrate its relevance for the response of oropharyngeal carcinomas to primary (chemo-)radiotherapy.

Natalia Smith-Cortinez, Natalia Smith-Cortinez, Ferry G. J. Hendriksen et al.

IntroductionThe leucine-rich repeat-containing G-protein coupled receptor 5 (LGR5) is a tissue resident stem cell marker, which it is expressed in supporting cells (SCs) in the organ of Corti in the mammalian inner ear. These LGR5+ SCs can be used as an endogenous source of progenitor cells for regeneration of hair cells (HCs) to treat hearing loss and deafness. We have recently reported that LGR5+ SCs survive 1 week after ototoxic trauma. Here, we evaluated Lgr5 expression in the adult cochlea and long-term survival of LGR5+ SCs following severe hearing loss.MethodsLgr5GFP transgenic mice and wild type mice aged postnatal day 30 (P30) and P200 were used. P30 animals were deafened with a single dose of furosemide and kanamycin. Seven and 28 days after deafening, auditory brainstem responses (ABRs) were recorded. Cochleas were harvested to characterize mature HCs and LGR5+ SCs by immunofluorescence microscopy and quantitative reverse transcription PCR (q-RT-PCR).ResultsThere were no significant age-related changes in Lgr5 expression when comparing normal-hearing (NH) mice aged P200 with P30. Seven and 28 days after ototoxic trauma, there was severe outer HC loss and LGR5 was expressed in the third row of Deiters’ cells and in inner pillar cells. Seven days after induction of ototoxic trauma there was an up-regulation of the mRNA expression of Lgr5 compared to the NH condition; 28 days after ototoxic trauma Lgr5 expression was similar to NH levels.DiscussionThe presence of LGR5+ SCs in the adult mouse cochlea, which persists after severe HC loss, suggests potential regenerative capacity of endogenous cochlear progenitor cells in adulthood. To our knowledge, this is the first study showing not only long-term survival of LGR5+ SCs in the normal and ototoxically damaged cochlea, but also increased Lgr5 expression in the adult mouse cochlea after deafening, suggesting long-term availability of potential target cells for future regenerative therapies.

Sabri Abus, Mehtap koparal, Hakan Kaya et al.

Abstract Background Chronic Rhinosinusitis (CRS) refers to inflammation of the paranasal sinuses and nasal mucosa. Electrocardiographic indicators of ventricular repolarization have been shown to correlate with systemic inflammation parameters. Recently, the frontal QRS-T (fQRS-T) angle has been accepted as a new indicator of ventricular depolarization and repolarization heterogeneity. The (fQRS-T) angle is recommended in predicting the risk of malignant ventricular arrhythmia. In this study, we aimed to evaluate the ventricular arrhythmia potential in patients with chronic rhinosinusitis by examining the relationship between fQRS-T angle on ECG and inflammation markers. Methods Inflammatory markers as well as electrocardiographc (ECG) f(QRS-T) angle, QRS duration, QT interval and corrected QT interval were examined in 54 patients with CRS versus 56 healthy control subjects. Results The f(QRS-T) angle was significantly higher in CRS patients than in healthy controls (p < .001). The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and monocyte-to-lymphocyte ratio (MLR) were significantly higher in CRS patients compared to healthy controls (p < .001, for all). Based on correlation analysis, NLR and f(QRS-T) angles were highly correlated (r = .845, p < .001), and according to the results of linear regression analysis, NLR was independently associated with the f(QRS-T) angle (t = 5.149, Beta = 0.595, p = < 0.001). Conclusion Both f(QRS-T) angle and NLR are significantly increased in CRS patients compared to healthy controls, with increases in NLR also independently associating with increases in f(QRS-T) angle. While the increases in f(QRS-T) angle did not result in clinically alarming absolute values for f(QRS-T), CRS patients might nonetheless be at relatively higher risk for malignant cardiac arrhythmias.

Xin Wang, Xiaoping Qiu

Mingzhu Zhou, Mingyu Mao, Fan Yang et al.

BackgroundLong non-coding RNAs (lncRNAs) are increasingly recognized as essential players in various biological processes due to their interactions with DNA, RNA, and protein. Emerging studies have demonstrated lncRNAs as prognostic biomarkers in multiple cancers. However, the prognostic effect of lncRNA AL161431.1 in head and neck squamous cell carcinoma (HNSCC) patients has not been reported.MethodsIn the present study, we conducted a series of analyses to identify and validate the prognostic value of lncRNA AL161431.1 in HNSCC, which included differential lncRNAs screening, survival analysis, Cox regression analysis, time ROCanalysis, nomogram prediction, enrichment analysis, tumor infiltration of immune cells, drug sensitivity analysis, and quantitative real-time polymerase chain reaction (qRT-PCR).ResultsIn this study, we performed a comprehensive survival and predictive analysis and demonstrated that AL161431.1 was an independent prognostic factor of HNSCC, for which a high AL161431.1 level indicated poor survival in HNSCC. Functional enrichment analyses found that cell growth and immune-related pathways were significantly enriched in HNSCC, suggesting that AL161431.1 may play a role in tumor development and tumor microenvironment (TME). AL161431.1-related immune cells infiltration analysis demonstrated that AL161431.1 expression is significantly positively associated with M0 macrophages in HNSCC (P&lt;0.001). Using "OncoPredict", we recognized chemotherapy drugs sensitive to the high expression group. Quantitative real-time polymerase chain reaction (qRT-PCR) was performed to identify the expression level of AL161431.1 in HNSCC, and the results further validated our findings.ConclusionsOur findings suggest that AL161431.1 is a reliable prognostic marker for HNSCC and can potentially be an effective therapeutic target.

E. de Corso, G. Bellocchi, M. De Benedetto et al.

SUMMARY Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous inflammatory condition of nasal mucosa and paranasal sinuses, predominantly mediated by type 2 inflammation and often associated with comorbid asthma and/or Exacerbated Respiratory Disease (N-ERD). The standard of care involves local and systemic corticosteroids and/or sinonasal surgery, although these options may be associated with recurrences and patients may require revision surgery. Difficult-to-treat patients, in fact, have a more severe disease requiring high systemic corticosteroid use and/or multiple sinonasal surgeries. Literature data suggests that biologic agents targeting specific key effectors of type 2 inflammation may offer supplemental therapy for patients with severe and uncontrolled CRSwNP, leading to significant improvement in several outcomes. For these reasons, over the years the endotyping of the disease has become increasingly important. Herein, we provide not only an update on the existing studies about the most promising biologics in CRSwNP, but also critical discussion on controversies about the use of biologics in severe uncontrolled CRSwNP. We finally provide consensus on strategic issues gathered among experts of the Joint Committee of Italian Society of Otorhinolaryngology on biologics in order to offer the best care for difficult to treat patients.

O. Laccourreye, R. Jankowski, Q. Lisan

As a key player in modern scientific methodology, statistics, the science of collecting, processing and analyzing data from observation of random phenomena (i.e., in which chance is a factor), is an essential part of the process of formulating a research hypothesis, choosing the study variables and research method, analyzing the results and drawing conclusions. In this technical note, the authors touch on the main notions to be mastered for optimal use of descriptive statistics in this process, facilitating publication of articles submitted to the European Annals of Otorhinolaryngology, Head and Neck Diseases.

O. Laccourreye

O. Laccourreye, O. Laccourreye, N. Fakhry et al.

OBJECTIVES To evaluate biostatistics in scientific articles published in the European Annals of Otorhinolaryngology Head & Neck Diseases. MATERIALS AND METHODS Retrospective analysis of 76 scientific articles published in 2018 and 2019. The main goal was to describe the percentage of articles using biostatistics and to explore for potential associations with the article's main characteristics. Secondary goals were, within the group of articles using statistical tests, to describe the type of statistics used, the assessment of normality in case of comparison of mean values, the p-value threshold for significance, the use of confidence intervals, and power analysis. RESULTS Statistics were used in 73.7% of articles, without any significant association with main characteristics. Within the group of articles using statistics, the tests used were parametric, non-parametric and not specified in 77.7%, 51.4% and 1.8% of cases, respectively. Normality was checked in 14.2% of article using parametric tests to evaluate mean values. The p-value significance threshold was set at .05, .01, .005 levels and not defined in 60.7%, 1.8%, 1.8% and 35.7% of articles, respectively, while confidence intervals and power analyses were documented in 10.7% and 5.3%, respectively. CONCLUSION This article underlines the need for better use of statistics in the European Annals of Otorhinolaryngology Head & Neck Diseases, to improve the quality of scientific articles published in the organ of written expression of the French and International French-speaking Societies of Otorhinolaryngology, and to support the ongoing move toward better medical science.

A. M. Sharaf, Isra H. Abdulla, Abdullah M Alnatheer et al.

Background Burnout syndrome is common among surgical residents, negatively affecting their mental health, physical wellbeing, and work performance. We investigated the relationship between emotional intelligence (EI) and burnout among Otorhinolaryngology–Head and Neck surgery residents. Methods This cross-sectional study examined 51 residents across different Otorhinolaryngology-Head and Neck surgery programs at various hospitals in Saudi Arabia using a survey conducted between January 2021 and March 2021. The questionnaire had different validated measurements of burnout and included the Trait EI Questionnaire–Short Form, Maslach Burnout Inventory–Human Services survey, and questions regarding demographics and job satisfaction. Results Of all the residents, 17.6% had a high risk of burnout, 39.2% had emotional exhaustion (EE), 29.4% had depersonalization (DP), and 43.1% had a low sense of personal accomplishment (PA). A statistically significant negative association was observed between the total EI score and EE (r = −0.577, p < 0.001) and DP (r = −0.765, p < 0.001), indicating that higher total EI scores were associated with lower EE levels. Conclusions Positive associations existed between high levels of EI, PA, and satisfaction with both surgical skills and specialty choice. Therefore, residency programs should use EI modifiers as tools to reduce the risk of burnout.

Ji Wang, Sai Liang, Ming Yu et al.

Background Since it began in December 2019, the coronavirus disease 2019 (COVID-19) outbreak has not been completely contained. COVID-19 has attracted the interest of nations throughout the globe. The global coronavirus outbreak has had an especially devastating effect on otolaryngology. The virus is commonly associated with otorhinolaryngological symptoms. COVID-19 research is becoming more common in otorhinolaryngology. Although various studies on covid-19-related Otorhinolaryngology manifestations have been published, there has been no bibliometric analysis of these articles concentrating on COVID-19-related Otorhinolaryngology research. Methods Original publications on Otolaryngological symptoms on COVID-19 were extracted from the Social Sciences Citation Index (SSCI) and the Science Citation Index-Expanded (SCI-E) databases in Clarivate Analytics' Web of Science Core Collection (WoSCC) between January 2020 and May 2022. CiteSpace and VOSviewer were utilized to detect and assess the research focus and trends in this field by extracting the country/region, institution, author, journal, references, and keywords related to this topic. Results A total of 631 journals from 97 countries were included in the total of 1,528 articles. Most of the articles on this topic were published in the United States, which had the most citations and the highest H-index. Huazhong University of Science and Technology is the institution with the largest number of articles in the research of COVID-19-related Otorhinolaryngology diseases. Claire Hopkins was the most prolific author belonging to Guy's and St. Thomas' NHS Foundation Trust. Huang CL from Jin Yin-tan Hospital received the most citations among all authors. The most cited article was Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, which was created by Huang CL. Most of the studies relating to COVID-19 and Otorhinolaryngology diseases were published in the European Archives of Oto-Rhino-Laryngology. Conclusion COVID-related research in the field of otorhinolaryngology has been studied in terms of descriptive quantitative metrics, which show that academics from around the world are working together to combat this pandemic.

Min-Jong Kim, Jin-A Park, H. Cha et al.

Since December 2019, COVID-19 has greatly influenced public healthcare systems around the globe in various aspects, including limitation of healthcare accessibility due to lack of both human and financial resources, suspension of clinics, and fear of infection causing healthcare avoidance. The aim of this study was to investigate the impact of COVID-19 on access to healthcare for otorhinolaryngology patients from different socioeconomic status (SES) groups. Otorhinolaryngology patients’ disease severity status, diagnosed at the first hospital visit, was investigated during the pre -and post-COVID-19 pandemic era in a single medical center located in Seoul, Korea. An ordinal regression model was used to assess the impact of both SES and the COVID-19 pandemic on otorhinolaryngology diseases. Within the chronic rhinosinusitis group, lower SES was associated with a higher disease severity at the first visit compared to higher SES (OR = 3.25). During the COVID-19 pandemic, while the total number of outpatients was reduced, the severity of these ENT diseases seemed to increase compared to the pre-pandemic severity in every SES group. Our study demonstrates the negative impact a worldwide pandemic can have on healthcare inequity and disease severity, and highlights the importance of re-allocating fundamental resources for those in need during periods of public health crisis.

A. Noto, C. Piras, L. Atzori et al.

Otorhinolaryngology (Ear, Nose and Throat-ENT) focuses on inflammatory, immunological, infectious, and neoplastic disorders of the head and neck and on their medical and surgical therapy. The fields of interest of this discipline are the ear, the nose and its paranasal sinuses, the oral cavity, the pharynx, the larynx, and the neck. Besides surgery, there are many other diagnostic aspects of ENT such as audiology and Vestibology, laryngology, phoniatrics, and rhinology. A new advanced technology, named metabolomics, is significantly impacting the field of ENT. All the “omics” sciences, such as genomics, transcriptomics, and proteomics, converge at the level of metabolomics, which is considered the integration of all “omics.” Its application will change the way several of ENT disorders are diagnosed and treated. This review highlights the power of metabolomics, including its pitfalls and promise, and several of its most relevant applications in ENT to provide a basic understanding of the metabolites associated with these districts. In particular, the attention has been focused on different heterogeneous diseases, from head and neck cancer to allergic rhinitis, hearing loss, obstructive sleep apnea, noise trauma, sinusitis, and Meniere’s disease. In conclusion, metabolomics study indicates a “fil rouge” that links these pathologies to improve three aspects of patient care: diagnostics, prognostics, and therapeutics, which in one word is defined as precision medicine.

O. Laccourreye, O. Laccourreye, Q. Lisan et al.

OBJECTIVES To evaluate the use of P-values and the terms "significant", "non-significant" and "suggestive" in Abstracts in the European Annals of Otorhinolaryngology, Head & Neck Diseases. MATERIALS AND METHODS Consecutive articles accepted for publication during the period January 2016 - February 2019 were systematically reviewed. Main goal: descriptive analysis of the citation of P-values and use of the terms "significant", "non-significant" and "suggestive" in Abstracts. Secondary goal: analytic study of: (i) correlations between citation of a P-value and the main characteristics of authors and topics; and (ii) misuse of the terms "significant", "non-significant" and "suggestive" with respect to cited P-values, and correlations with author and topic characteristics. RESULTS In all, 91 articles were included. P-values and the terms "significant", "non-significant" and "suggestive" were cited in 35.1%, 41.7%, 10.9% and 0% of Abstracts, respectively. Citing a P-value did not significantly correlate with author or topic characteristics. There were discrepancies between the terms "non-significant", "significant" and "suggestive" and P-values given in the body of the article in 57.1% of Abstracts, with 30.7% overestimation and 25.2% underestimation of results, without significant correlation with author or topic characteristics. CONCLUSION Authors, editors and reviewers must pay particular attention to the spin resulting from inappropriate use of the terms "significant", "non-significant" and "suggestive" in Abstracts of articles submitted to the European Annals of Otorhinolaryngology, Head & Neck Diseases, to improve the rigor, quality and value of the scientific message delivered to the reader.

Zheng Liu, Jianjun Chen, Lei Cheng et al.

The current document is based on a consensus reached by a panel of experts from the Chinese Society of Allergy and the Chinese Society of Otorhinolaryngology-Head and Neck Surgery, Rhinology Group. Chronic rhinosinusitis (CRS) affects approximately 8% of Chinese adults. The inflammatory and remodeling mechanisms of CRS in the Chinese population differ from those observed in the populations of European descent. Recently, precision medicine has been used to treat inflammation by targeting key biomarkers that are involved in the process. However, there are no CRS guidelines or a consensus available from China that can be shared with the international academia. The guidelines presented in this paper cover the epidemiology, economic burden, genetics and epigenetics, mechanisms, phenotypes and endotypes, diagnosis and differential diagnosis, management, and the current status of CRS in China. These guidelines—with a focus on China—will improve the abilities of clinical and medical staff during the treatment of CRS. Additionally, they will help international agencies in improving the verification of CRS endotypes, mapping of eosinophilic shifts, the identification of suitable biomarkers for endotyping, and predicting responses to therapies. In conclusion, these guidelines will help select therapies, such as pharmacotherapy, surgical approaches and innovative biotherapeutics, which are tailored to each of the individual CRS endotypes.