<abstract><title style='display:none'>Abstract</title> Cystic lesions of the maxilla are benign entities with both odontogenic and non-odontogenic origins. The maxillary cyst is a benign tumor of the bones of the jaw, which has a membrane and contains a fluid, semi-solid or mixed (liquid / semi-gaseous) material. These often lead to deformities in the jaw area. Cases are specific by framing pathological rarity, etiology, pathogenesis and clinical symptoms.Considering the large entity of cystic formations that can be found in the maxilla region, we selected two patients with cystic formations of the upper jaw, which were part of different pathological etiology categories, with special rarity occurring, evolutionary appearance and difficult to classify in terms of pathognomonic signs.</abstract>

ENT Department, Braila Emergency County Hospital, Braila,

Department of Oral and Maxillofacial Surgery, Braila Emergency County Hospital, Braila,

Case report. Cystic lesions of the maxilla – clinical considerations and differential diagnosis

<abstract><title style='display:none'>Abstract</title>Surgical treatment of chronic rhinosinusitis is indicated after failure of correctly conducted maximal drug therapy or the occurrence of complications. Radical maxillary sinus surgery has been abandoned nowadays, to the detriment of endoscopic sinus surgery, for several reasons, such as: increased incidence of complications, decreased healing rate compared to the endoscopic technique. The literature cites many situations in which the Caldwell-Luc procedure is used as a first-line surgical technique: recurrent chronic rhinosinusitis, malignant tumors of the maxillary sinus extending to the lateral wall of the nasal fossa and the pterygomaxillary space, the cases where an extensive approach to the pterygopalatine fossa is required – for ligation of the internal maxillary artery or the approach of the vidian canal in vidian neurectomy.The authors highlight the use of Caldwell-Luc procedure in endoscopic sinus surgery era, by reviewing the complications rates, indications and long-term effectiveness of the two surgical techniques.</abstract>

Indications of the Caldwell-Luc procedure in the era of endoscopic sinus surgery

<abstract><title style='display:none'>Abstract</title>The facial nerve, the seventh pair of cranial nerves, has an essential role in non-verbal communication through facial expression. Besides innervating the muscles involved in facial expression, the complex structure of the facial nerve contains sensory fibres involved in the perception of taste and parasympathetic fibres involved in the salivation and tearing processes. Damage to the facial nerve manifested by facial paralysis translates into a decrease or disappearance of mobility of normal facial expression.Facial nerve palsy is one of the common causes of presenting to the Emergency Room. Most facial paralysis are idiopathic, followed by traumatic, infectious, tumor causes. A special place is occupied by the child’s facial paralysis. Due to the multitude of factors that can determine or favour its appearance, it requires a multidisciplinary evaluation consisting of otorhinolaryngologist, neurologist, ophthalmologist, internist.Early presentation to the doctor, accurate determination of the cause, correctly performed topographic diagnosis is the key to proper treatment and complete functional recovery.</abstract>

Facial nerve paralysis

<abstract>
<title style='display:none'>Abstract</title>
Squamous cell carcinoma (SCC) has several variants based on its histopathological features. Nuclear protein in testis (NUT) carcinoma (NC) is a rare and aggressive variant of SCC, previously described exclusively in midline sites. The histopathological features of NC are similar to poorly differentiated carcinoma or undifferentiated carcinoma. Abrupt keratinization in an otherwise undifferentiated carcinoma is an important diagnostic clue. The confirmatory diagnosis is dependent on molecular techniques such as Immunohistochemistry, Fluorescent in situ hybridization technique or RT-PCR to detect mutations in NUT gene. It is most commonly found in middle aged, in lungs and head and neck regions. Since NC features overlap with poorly differentiated and undifferentiated carcinomas, these cases need to be suspected and evaluated for NUT gene mutations thoroughly. Due to their rarity and less known facts, NC cases are required to be reported on large scale.
Here, we report a middle-aged woman with a mass on the forehead diagnosed as NC based on molecular evaluation, with a review of the literature emphasizing the rarity of NUT carcinoma and the importance of careful histopathology as well as immunohistochemistry evaluation.
</abstract>

NUT carcinoma in head and neck region: Case report with literature review

<abstract><title style='display:none'>Abstract</title>Whiplash syndrome is a quite common pathology and can be defined as a neck injury produced by a sudden acceleration-deceleration, the consequence of which is a sudden forward and backward movement of the head and neck. The main production mechanism is a sudden acceleration-deceleration process that has as a consequence the sudden extension/flexion of the neck. Starting from the many structures involved, the whiplash syndrome is an interdisciplinary challenge (ENT specialist, neurologist, orthopedist, ophthalmologist, psychologist) and can be described by multiple signs and symptoms.Whiplash syndrome is a complex pathology both through the mechanism of production and symptoms, and through the forensic implications that it has. The interdisciplinary medical collaboration, the implementation of stricter rules on wearing the seat belt and the development by car manufacturers of chairs and head restraints that protect the head and neck of passengers, would be the preventive step in the occurrence and especially the chronicization of these lesions.</abstract>

Whiplash Syndrome

<abstract>
<title style='display:none'>Abstract</title>
Synovial sarcoma is a rare and high-grade soft tissue tumour that rarely affects the head and neck region. Approximately 90% of synovial sarcomas are seen in the extremities. About 5 to 10% occur in the head and neck region with high incidences in the parapharyngeal space and hypopharynx. In the oral cavity, synovial sarcoma has been reported in the buccal mucosa, tongue, floor of the mouth, the retromolar region, hard and soft palates, the gingivobuccal sulcus and the mandible. In this paper, we report 4 very rare cases of monophasic synovial sarcoma of the oral cavity and highlight the need for proper diagnosis and treatment plan in the cases of synovial sarcoma. So far, around 250 cases of synovial sarcoma of head and neck have been reported in the literature. In India, on extensive literature search we could retrieve 18 cases of synovial sarcoma involving the head and neck region, of these 11 cases of primary synovial sarcoma involving the oral cavity have been reported previously. To our knowledge, this is the first series of primary synovial sarcoma of the oral cavity in the Indian literature.
</abstract>

Synovial sarcoma of the oral cavity: Report of 4 cases and review of the literature

<abstract>
<title style='display:none'>Abstract</title>
<bold>OBJECTIVES.</bold> Hyperostosis frontalis interna (HFI) is a condition that involves the non-cancerous growth of the inner part of the frontal bone. We investigated diffuse HFI in cranial CT in terms of bone thickness and density.
<bold>MATERIAL AND METHODS.</bold> The cranial CT images of 154 adult patients with diffuse HFI and 151 adult patients without HFI were included in the study. Bone thickness measurements were performed at vertex, frontal tuberosity and frontal sinus levels in the midline, right and left lateral parts. Density measurements were also performed in the same areas. In the HFI group, measurements were performed at the HFI and non-HFI regions. In the control group, density measurements were also performed.
<bold>RESULTS.</bold> HFI was detected more in females (96.1%). In diffuse HFI patients, bone thickness values increased at the vertex, frontal tuberosity and frontal sinus levels (p&lt;0.05). Bone densities of the HFI parts increased at vertex and frontal tuberosity levels (p&lt;0.05). In the HFI group, there were positive correlations between bone thicknesses (p&lt;0.05). As bone thicknesses increased, bone density values decreased (p&lt;0.05). In older patients, frontal tuberosity and frontal sinus bone densities decreased (p&lt;0.05).
<bold>CONCLUSION.</bold> HFI may be one of the reasons for headaches in females. In the future, it would be better to investigate the relationship between HFI and headaches. The physicians should notice that increased bone thickness may be the sign of the HFI and they should consult with the Radiology Department. When HFI is detected, an endocrinological assessments will also be performed.
</abstract>

The multidetector CT evaluation of diffuse hyperostosis frontalis interna

<abstract>
<title style='display:none'>Abstract</title>
<bold>BACKGROUND.</bold> Antrochoanal polyps (ACP) were originally reported by Gustav Killian in 1906. Antrochoanal polyps (ACPs) are benign polypoid lesions that begin in the maxillary antrum and extend into the choana. Although there have been recorded occurrences of bilateral ACPs in the literature, ACPs are mostly unilateral. They typically have an impact on youth and youngsters.
<bold>MATERIAL AND METHODS.</bold> In a trial of 15 cases treated and admitted to our ENT Pediatric Department at the Emergency County Hospital Timisoara over the previous four years, the pathology, differential diagnosis, treatment, complications, etiopathogenesis, clinical features, positive and differential diagnosis, preoperative evaluation, pathology, and treatment of ACPs were reviewed in this study.
<bold>RESULTS.</bold> The patients age group comprised five females (33.33%) and ten boys (66.67%), ranging in age from 7 to 16 years. The most common presenting symptoms were unilateral nasal obstruction (100%), purulent rhinorrhea (66.67%), olfactory impairment (53.33%), and mouth breathing (46.67%). A nasal endoscopy and a craniofacial CT scan were the gold standards for diagnosing ACP. The chosen course of treatment for all pediatric patients included in the study was surgery: 12 patients (80%) underwent transnasal endoscopic polypectomy, and 3 patients (20%) underwent both transnasal polypectomy and transcanine fossa approach. The success rate of the combined endoscopic and transcanine fossa approach was 100%, whereas the transnasal endoscopic surgery (polypectomy) had an 80% success rate.
<bold>CONCLUSION.</bold> Polypectomy combined with a transcanine fossa approach technique and transnasal polypectomy is the optimal course of treatment.
</abstract>

Evaluation and management of antrochoanal polyps in children

<abstract>
<title style='display:none'>Abstract</title>
<bold>OBJECTIVES.</bold> We investigated whether there were atrophic changes in grey matter (pons, midbrain, and thalamus) in migraine patients. Vertebral artery diameters were also evaluated.
<bold>MATERIAL AND METHODS.</bold> The cranial MRI images of 49 adult migraine-diagnosed patients and 49 adult subjects with normal cranial MRI results were included in the study. In both groups, pons, midbrain, and thalamus volumes, as well as vertebral artery diameters were measured.
<bold>RESULTS.</bold> There were no significant differences between pons, midbrain, bilateral thalamus volumes and vertebral artery diameters of the migraine and control groups (p&gt;0.05). In the right-sided migraine group, the right thalamus volume was significantly lower than the contralateral side (p&lt;0.05). In the left-sided migraine group, the left thalamus volume was non-significantly lower than the contra-lateral side (p&gt;0.05). In the right-sided and left-sided migraine groups, left vertebral artery diameters were significantly higher than those on the right side (p&lt;0.05). In older migraine patients, pons and midbrain volumes decreased (p&lt;0.05). In longer migraine duration, pons volume decreased (p&lt;0.05). In aura-present migraine patients, right vertebral artery diameters decreased (p&lt;0.05).
<bold>CONCLUSION.</bold> We concluded that migraine is related to grey matter atrophy in terms of thalamus atrophy on the migraine side. Pons atrophy in longer migraine, and pons and midbrain atrophy in older migraine patients were also detected. Therefore, during the follow-up of the migraine patients, grey matter atrophy should be examined by MRI, and treatment to prevent migraine attacks should be planned.
</abstract>

Volumetric analysis of pons, middle brain and thalamus by MRI in migraine patients; and evaluation of vertebral artery diameter

<abstract>
<title style='display:none'>Abstract</title>
<bold>OBJECTIVES.</bold> In this paper, we reviewed cough and herbal therapies.
<bold>MATERIAL AND METHODS.</bold> Research methods included searching online databases such as Google, Google Scholar, ProQuest Central, and PubMed at Kirikkale University. We used terms like “cough”, “herbal”, “reflex”, “Primula veris”, “Primula elatior”, “Thymus vulgaris”, “Althea Officinalis”, and “Mentha piperita” to find related articles.
<bold>RESULTS.</bold> Coughing is a reflex that serves a legitimate physiological purpose by expelling fluids and debris from the lungs. Herbal teas and preparations with antioxidant and expectorant properties are made from medicinal herbs like Primula veris and Primula elatior. The phenolic monoterpene thymol, one of the primary components of thyme oil, is found primarily in thyme plants. Both thymol and thyme essential oil have lengthy histories of usage in conventional medicine, particularly for their upper respiratory system-targeted expectorant, anti-inflammatory, antiviral, antibacterial, and antiseptic properties. Historically, people have turned to the plant Althaea officinalis for help with treating respiratory issues, like cough. Officinalis extracts alone for dry cough therapy, while A. officinalis was more effective when combined with Zataria multiflora, Zingiber officinale, or Helix hedera. Furthermore, all types of coughs benefited from officinalis. One of the most popular types of herbal tea, known as a tisane, is peppermint, or Mentha piperita. Peppermint essential oil and tea made from the plant’s leaves have long histories of usage in alternative medicine. Some studies have found that peppermint may have antiallergenic properties in addition to its antibacterial, antiviral, antioxidant, and anticancer properties.
<bold>CONCLUSION.</bold> Cough is a persistent symptom of many acute and chronic illnesses. Primula veris, Thymus vulgaris, Althaea Officinalis, and Mentha piperita are some herbs used to treat cough. Cough patients can supplement their standard medical care with herbal remedies that contain these compounds.
</abstract>

Cough: A protective reflex and herbal therapies

Editorial: The present and future in rhinology

<abstract>
<title style='display:none'>Abstract</title>
Digital planning and 3D printing have seen a significant impact in personalised presurgical planning in ENT pathology. However, segmentation and 3D printing of the cranium and especially the sinuses in ENT sinonasal pathologies are still fraught with challenges. This article will provide a comprehensive analysis, from segmentation to 3D printing, to provide insights into the future directions of 3D printing in sinonasal pathology and its implications for patient care.
</abstract>

3D segmentation and 3D printing in presurgical planning and patient education in sinonasal tumoral pathologies

<abstract><title style='display:none'>Abstract</title> BACKGROUND. Crista galli is an anatomical structure localized in the midline, that derives from the ethmoid bone, with a compact bone structure, sometimes pneumatized. The connection between the pneumatized crista galli and the adjacent paranasal structures is usually performed through an opening similar with a sinusal ostium.MATERIAL AND METHODS. We performed a retrospective clinical study about the incidence of the pneumatization of crista galli in 196 patients with chronic sinusitis. We evaluated the degree of pneumatization and the drainage pathways of crista galli, trying to correlate the radiological findings with the symptomatology of the patients with crista galli “sinusitis”.RESULTS. Pneumatization of crista galli was found in 30.1% of cases. From 59 patients with chronic rhinosinusitis and pneumatized crista galli, 66.4% had no opacification, 23.7% various degrees of opacification and 11.9% showed complete opacification. The presence of an opening of the pneumatized crista galli into surrounding air-cells was found in 16.98% of the patients. Headache was encountered in 76.2% of the patients with CRS and pneumatized crista galli sinusitis.CONCLUSION. When analyzing a CT scan of a patient with CRS, we should also take into consideration the pneumatization of crista galli, which has a high variability. Most of the patients included in our study had also a certain degree of opacification of the pneumatized crista galli. Headache had a higher incidence in patients with crista galli inflammation than in CRS patients who showed no pneumatization or opacification of the crista galli (76.2% versus 60.5% in “simple” CRS patients).</abstract>

CESITO Centre, “Sfanta Maria” Hospital, 37-39 Ion Mihalache Blvd., District, Bucharest, Romania

“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

ENT Department, Clinical Hospital Center Zagreb, Croatia

Crista galli sinusitis – a radiological impression or a real clinical entity

<abstract><title style='display:none'>Abstract</title>The current study aims to investigate the effect of smartphone usage on the upper extremity performance among Saudi youth. A goniometer to measure the Range of Motion (ROM), the Smartphone Addiction Scale (SAS), McGill Pain scale and Chattanooga stabilizer were used to perform the current study on a sample of 300 university students from Al-Imam Mohammed Bin Saud University. The results have shown that smartphone addiction is negatively correlated to the elbow flexion, shoulder flexion, shoulder extension, shoulder abduction, shoulder adduction, and both shoulder internal and external rotation. Furthermore, the results have shown that McGill pain scores were positively correlated to elbow flexion, shoulder flexion, shoulder extension, shoulder abduction, shoulder adduction, and both shoulder internal and external rotation. The study has concluded that smartphone usage among Saudi youth negatively affects the upper extremity and causes a significant increase in the pain intensity. The study has recommended that there is an urgent need for a significant awareness campaign to warn the community regarding the impact of using smartphones for long periods of time.</abstract>

The effect of smartphone usage on the upper extremity performance among Saudi Youth, KSA

<abstract><title style='display:none'>Abstract</title>Fungal rhinosinusitis is an important pathological entity, a highly controversial topic in the medical world today, by the various research directions it offers. In order to be able to predict a patient’s prognosis and his response to treatment, first we must have a classification of fungal rhinosinusitis. The authors considered it is important to make a distinction between invasive and noninvasive forms of fungal rhinosinusitis. The most important step in the management of fungal rhinosinusitis is to have a correct diagnosis, based on strong criteria, which will lead to a better prognosis of this disease. Because of its invasiveness potential, especially in patients at risk, it is essential to have a correct and fast diagnosis in case of fungal rhinosinusitis, in order to begin the treatment as fast as possible, for a favourable prognosis. The only way to establish diagnosis in a reliable way is to make a detailed clinical examination and to take biopsy samples.</abstract>

ENT&HNS Department, “Sfanta Maria” Clinical Hospital, Bucharest, Romania

Difficulties in the diagnosis of fungal rhinosinusitis – Literature review

<abstract><title style='display:none'>Abstract</title> BACKGROUND. Chronic rhinitis is a clinical condition affecting more than 20% of the world population. The standard treatment strategy is medical. Surgical management can be considered in patients with intractable rhinitis. Various surgical techniques have been documented with varying success rates, but none of them is considered as a gold standard. Hence, we are studying the effectiveness of posterior nasal neurectomy (PNN) in patients who have intractable rhinitis, refractory to maximum medical therapy.MATERIAL AND METHODS. A prospective study was conducted in the ENT Department, Padmavathy Medical Foundation, Kollam, Kerala, India, from January 2015 to February 2016. Adult patients, in the age group of 20 to 60 years, diagnosed with chronic rhinitis, presenting two or more symptoms of rhinitis, refractory to maximum medical therapy for a period of at least 3 or more years and whose quality of life was significantly affected were enrolled and PNN was done for them.RESULTS. We observed a statistically significant improvement in subjective symptoms and patient quality of life at the end of 6 months post-operatively.CONCLUSION. PNN is a safe and less invasive procedure, which can provide a significant relief in symptoms of intractable rhinitis. Fewer complications and better results make it superior over vidian neurectomy.</abstract>

Department of Otorhinolaryngology, Sri Siddhartha Medical College, Tumakuru, Karnataka,

Department of Dentistry, Padmavathy Medical Foundation, Kollam, Kerala,

Department of Anatomy, Sri Siddhartha Medical College, Tumakuru, Karnataka,

Original study. Effectiveness of endoscopic posterior nasal neurectomy for the treatment of intractable rhinitis

<abstract><title style='display:none'>Abstract</title> Fungus ball (FB) of the paranasal sinuses has a distinctive clinicopathological presentation. The disease occurs more frequently in elderly patients and has a female preponderance. Classically, it involves only one paranasal sinus in more than 90% of the cases, most commonly the maxillary sinus. Imaging characteristics (calcifications and / or erosion of the inner wall of the sinus visible on CT) and histopathological ones (luminal aggregation of fungal hyphae) confirm the diagnosis.Allergic fungal rhinosinusitis (AFRS) usually occurs in younger, immunocompetent patients, with a history of atopy, including allergic rhinitis and / or asthma, or a long clinical picture of chronic rhinosinusitis (CRS), refractory to antibiotic treatment. Nasal polyps (NP) are present in almost all patients, while extra-sinusal complications are described only in some of them. Usually, there is involvement of several sinuses, as well as bilateral damage. The definitive diagnosis is confirmed only by examining surgical specimens - the characteristic appearance of eosinophilic mucin is the most reliable indicator of AFRS.</abstract>

Department of Otorhinolaryngology, “Nicolae Testemitanu” State University of Medicine and Pharmacy, Chisinau, 165 Stefan Cel Mare si Sfant Blvd., MD-2004, Chisinau,

Department of Otorhinolaryngology, “Nicolae Testemitanu” State University of Medicine and Pharmacy, Chisinau, Republic of Moldova

Department of Otorhinolaryngology, Republican Clinical Hospital, Chisinau,

Literature review. Noninvasive fungal rhinosinusitis

<abstract><title style='display:none'>Abstract</title>Nasal reconstruction is challenging, considering surgical techniques complexity and difficulties in remodelling a tridimensional structure. Reconstructive requirements are: correct deformity evaluation, selecting the most suitable treatment option, respecting the principle of aesthetic subunit, appropriate reconstruction of each affected nasal layer, long-term stabile functional and aesthetic results. Reconstructive procedures range from simple to very complex. Conventional techniques can fail in restoring a satisfactory appearance in severely disfigured patients, for whom a new possibility arises: Vascularized Composite Allografts (VCA) transplantation.In this paper, we focus on nasal skeletal framework restoration. Structural defects may require a large amount of reconstructive material obtained usually from cartilage or bone autografts. Autologous cartilage is the gold standard in nasal architectural recovery, but in some cases, autologous graft sources are not available, imposing the necessity to use alternative solutions represented by the allografts or alloplastic materials. We analysed the specific features of skeletal allografts used in nasal reconstruction.With current clinical experience, the use of cartilage and bone allografts (especially irradiated cartilage homografts) shows a promising reconstructive option for nasal structural defects. For extensive facial defects, including midface deformities, impossible to restore with traditional surgical techniques, a new reconstructive era was open through the development of the VCA field.</abstract>

Department of Plastic Surgery, Aesthetic and Reconstructive Microsurgery, Emergency Clinical Hospital, Bucharest, Romania

ENT&HNS Department, “Sfanta Maria“ Hospital, Bucharest, Romania

The role of cartilage and bone allografts in nasal reconstruction

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Romanian Journal of Rhinology

Rhinology, as an important part of Otorhinolaryngology, addresses a very frequent and diverse pathology, with important interdisciplinary implications. In the last decades, this medical field was...

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Rhinology, as an important part of Otorhinolaryngology, addresses a very frequent and diverse pathology, with important interdisciplinary implications. In...

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