<abstract xmlns="http://www.w3.org/1999/xhtml"> Hereditary angioedema (HAE) is a rare autosomal dominant disease consisting of recurrent angioedema attacks, varying in severity, possibly life-threatening and with frequent involvement of the head and neck areas. The patophysiology of HAE differs from histamine-mediated allergic angioedema. Three types of reduced quality or quantity in various complement or coagulation factors, leading to massive release of bradykinin, increase vascular permeability and produce capilary leakage. Clinical manifestations of HAE include swelling located predominantly in the head and neck area, hands, feet and urogenital area and abdominal pain caused by edema of the gastrointestinal tract mucosa. Diagnosis requires laboratory tests for complement components and genetic tests. A timely and correct diagnosis in the emergency room is of utmost importance, the medical treatment of HAE being substantially different from that of allergic angioedema. Although new therapies are available and in development, airway intervention and surgery are still life-saving procedures and the ENT surgeon is an important part of the multidisciplinary team managing an HAE attack.</abstract>

ENT&HNS Department, “Sfanta Maria” Hospital, 37-39 Ion Mihalache Blvd., District 1, Bucharest, Romania

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

Hereditary angioedema - an otolaryngologist’s perspective

<abstract xmlns="http://www.w3.org/1999/xhtml"> Frequently encountered in medical practice, the gastroesophageal reflux (GER) is a chronic condition characterized by the passage of gastric acid or gastric contents into the esophagus. In otorhinolaryngology, the diagnosis of pharyngo-laryngeal or rhinosinusal inflammatory conditions secondary to GER is one of exclusion and it is based on a detailed anamnesis in which we are interested in symptoms, behavioural and medical risk factors, on the ENT clinical examination, the laryngo-fibroscopical assessment, the phoniatric examination, the barite pharyngo-esogastric exam, the upper gastrointestinal endoscopy and the esophageal manometry.The authors are making a systematization of the contribution of the gastroesophageal reflux has in the ENT pathology, emphasising the sympytoms and the most frequent associated pathological entities.</abstract>

CESITO Centre, “Sfanta Maria” Hospital, Bucharest, Romania

The impact of gastroesophageal reflux in the ENT pathology

<abstract xmlns="http://www.w3.org/1999/xhtml"> BACKGROUND. The measurement of the total nasal resistance by rhinomanometry is of special interest in the functional diagnosis of the nasopharynx and retropalatal space. It can be measured by posterior rhinomanometry or estimated by calculating the total resistance from measurements of both sides. Because the standard parameters of the classic rhinomanometry have to be considered as obsolete, Vertex Resistance and Effective Resistance and their logarithmic derivations have been introduced with 4-phase-rhinomanometry.MATERIAL AND METHODS. In the first part, posterior and anterior rhinomanometry have been compared in a study of 32 volunteers. The disadvantages of posterior rhinomanometry have been apparent because of inconsistent statistic results. To compare both methods is useful in cooperative patients for the diagnosis of postnasal pathological alterations. By analyzing the rhinomanometric databases of 5 hospitals in 10,033 untreated patients and in 8,246 patients after decongestion, the total nasal resistance could be determined.RESULTS. Because only the logarithmic values for effective and vertex resistances are correlated with the sensing of obstruction, these values have been used to classify the total obstruction in 5 classes. The descriptive data of every class are given. The here-described classes are valid for Caucasian noses. The calculated data can be delivered on request by the authors.CONCLUSION. The here-presented parameters for measuring the resistance of the nasal airway and the classification of the obstruction from a statistically representative material can be recommended for the daily practice in rhinology and rhinosurgery.</abstract>

University of Latvia, Riga /Latvia, Faculty of Medicine, Center of Experimental Medicine, Mailing address: Schwarzer Weg 3 B, D-18292 Krakow am See/Germany

University of Latvia, Riga /Latvia, Faculty of Medicine, Center of Experimental Medicine, Riga, Latvia

Classification of total nasal obstruction in 10,033 cases by 4-phase –rhinomanometry

<abstract xmlns="http://www.w3.org/1999/xhtml"> BACKGROUND. Intraoperative neural monitoring (IONM) has begun to be studied in detail by surgeons around the world since several decades ago from the need to verify functional integrity of the neural elements. Parotid gland surgery requires a thorough knowledge of the anatomy of this region by ENT surgeons. Also, the surgeons performing parotid surgery need to have important strategies of management which include: handiness to identify facial nerve, dissection nerve branches and application of neuromonitoring in order to preserve nerve functions.OBJECTIVE. This study has analysed the usefulness of intraoperative continuous monitoring in superficial or in total parotidectomy. It identifies the facial nerve and reduces the risk of postoperative facial palsy. We have been using intraoperative continuous monitoring - evoked facial nerve electromyograms (EMG).MATERIAL AND METHODS. Continuous intraoperative facial nerve monitoring was prospectively achieved in the case of three patients diagnosed with benign tumors, on which parotidectomy with the preservation of the nerve was carried out in order to highlight the value and efficacy of this method.RESULTS. In our country, continuous intraoperative facial nerve monitoring performance is still not a common practice in ENT Departments. It revealed postoperatively that the incidence of temporary or permanent facial palsy was 0% and the minimal stimulation was obtained at levels equal to 0,5 mA, which implies integral functioning of the facial nerve.CONCLUSION. In parotid surgery, facial nerve IONM represents the gold standard in recognition of real-time electrophysiological signals, electromyography waves and auditory signals to enable the correct approach wherever possible, avoiding extensive nerve damage. It is known the importance of continuous IONM in postoperative prognosis of the neural function and intraoperative decision making regarding the technical surgery.</abstract>

ENT&HNS Department, “Sfanta Maria” Hospital, 37-39 Ion Mihalache Blvd, District 1, Bucharest, Romania

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

The role of continuous intraoperative neuromonitoring followed by facial nerve stimulation during parotidectomy

<abstract xmlns="http://www.w3.org/1999/xhtml"> 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

ENT Department, Clinical Hospital Center Zagreb, Croatia

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

<abstract xmlns="http://www.w3.org/1999/xhtml"> The pterygopalatine fossa is an inverted pyramid-shaped space of the viscerocranium, protected by bony structures. Surgical access to this anatomical space is difficult, especially for tumor resection. There are numerous open surgical techniques for accessing this space, but nowadays, minimally-invasive endoscopic approaches are preferred in order to increase postoperative quality of life and reduce postoperative morbidities.The tumors of the pterygopalatine fossa can be benign or malignant, and can occur primarily in the fossa or as secondary extensions from the surrounding regions through the multiple canals and foramina in its walls. Squamous cell carcinomas of this space have been described to appear as extensions from the nasopharynx, the paranasal sinuses or through perineural extension from the cutaneous branches of the maxillary nerve.In this paper the authors present a rare case of squamous cell carcinoma of the pterygopalatine fossa, which was excised in an endoscopic transnasal approach after preoperative selective embolization.</abstract>

“Prof. Dr. Dorin Hociota” Institute of Phono-Audiology and Functional ENT Surgery, 21 Mihai Cioranu Street, District 5, Bucharest, Romania

Department of Morphological Sciences, Anatomy Discipline, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

Squamous cell carcinoma of the pterygopalatine fossa - A case report

<abstract xmlns="http://www.w3.org/1999/xhtml"> The terminal nerve (cranial nerve zero, cranial nerve XIII, the nerve “N”) was discovered in fish in 1894. In the early 90’s, it was found in human embryos and human adults. In the anterior fossa, it courses on the inner side of the olfactory tract and bulb; it then spreads fibers through the cribriform plate to distribute beneath the nasal septum mucosa. Being provided with intrinsic ganglion cells, its functions are weakly suggested by studies in different species. It may be connected with the visual system, it could act upon the intracranial vascular system, or it could ensure the pathway for pheromone-mediated behaviours. The cranial nerve zero deserves a better attention equally from anatomists and ENT specialists.</abstract>

The cranial nerve zero – mini review

<abstract xmlns="http://www.w3.org/1999/xhtml"> Medicine is in an era of technical development and innovation. Creating a tympanic membrane by using a 3D printer can exceed the disadvantages that classic graft materials have. The field of otolaryngology can be experiencing a paradigm shift towards the use of 3D-printer.</abstract>

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

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

What is new in tympanoplasty?

AHEAD OF PRINT

Volume 14 (2024): Issue 54 (April 2024)

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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 the beneficiary of new technical means for accurate and effective investigation, treatment and research. The needs of modern medicine - over-specialization, interdisciplinary approach and evidence-based medicine, lead to the situation that the international rhinologic societies are the most dynamic and appreciated.  The Romanian Journal of Rhinology is the official scientific publication of the Romanian Rhinologic Society, and it is trying to fill the existing gap in the Romanian ENT literature, promoting modern publishing and criteria according to the international standards. Romanian Journal of Rhinology appears quarterly with the purpose to publish original articles, original clinical reports, clinically relevant experimental studies and short communications presenting new results of general interest. Its aim is to concentrate and provide information concerning care, cure and prevention of different rhinologic disorders and borderline pathology. With a peer review by an important national and international editorial board, the journal provides clinical and clinically related information written by authors from all over the world.  Journal’s business model  Romanian Journal of Rhinology is an Open Access journal. The submission and publication of the articles are free of charge, in both print and electronic publication. The publisher covers all costs – editing, printing, copyediting, typesetting, long-term archiving, journal management.  Romanian Journal of Rhinology is the journal of the Romanian Rhinologic Society; thus, one of the financial sources for publication is represented by the Society from the manuscript fees.  Advertisements represent another important founding source. The decision regarding the type of advertisements, acceptance/rejections, the price offering is made by the Publishing/technical Editor, the Editorial Board having no decision power on this aspect. Advertorials and publicity about pharmacological devices, drugs, supplements related to rhinologic and otolaryngologic pathologies can be taken into consideration. In case of Advertorials, with an important scientific content, the medical data presented will have the approval of the Journal’s Editors.  There is also available the annual subscription for individuals and companies. The contact person is also the Publishing/technical Editor.  Publication schedule  The Romanian Journal of Rhinology is published quarterly:   January-March (publication month: February)  April-June (publication month: April)  July-September (publication month: July)  October-December (publication month: October)  Editorial process  The Romanian Journal of Rhinology uses a standard scheme for the evaluation process of the submitted articles. All manuscripts are strictly reviewed for originality, correctness, methodology, quality of the medical information, suitability for the journal’s medical field, ethical nature.  The Editors reserve the right to refuse any manuscript which does not correspond to the submission guidelines.  Peer-review is the system used to assess the quality of a manuscript before it is published. Independent researchers in the otorhinolaryngology area assess the submitted manuscripts for originality, validity, and significance to help editors determine whether the manuscript should be published in their journal.  After submission:   All manuscript are treated as confidential documents, all being assigned with a registration number (for example, RJR010121 (day of submission)(month of submission) (the last two numbers of the year of submission)). All communications between the editors, the author(s), the reviewers are made by using this identification number.  Technical review performed by the editor-in-chief, associated editors, members of the editorial board analyses – the importance of the subject, presentation clarity, relevance, plagiarism index. Submissions that fail to fulfil all requirements are rejected. This process last for a few days after submission.  Review process. The Romanian Journal of Rhinology has a double-blind reviewing process, in which the reviewers do not know the names of the authors, and the authors do not know who reviewed their manuscript. Therefore, the authors are required to submit a blind manuscript without the authors’ names and affiliations on the title page or in the text and a separate title page with the names of the authors, affiliations, and information about the corresponding author. After the initial assessment for, submissions are sent to at least two experts in the field who are asked to evaluate whether the manuscript is scientifically coherent, easy to read, useful in the field, and whether the manuscript should be accepted, rejected or revised. The review process will take approximately 2 weeks. After the review process is completed, the corresponding author will receive an e- mail about the evaluation results of the submitted manuscript: accepted, revision or rejection. If the e-mail contains suggestions and comments for revising the manuscript, the authors should make the changes and return to the editor within 2 weeks; if not, the manuscript is considered rejected. If the manuscript is accepted for publication by the reviewers, it is forwarded to the Editor-in-Chief. The final decisions are made by the Editor-in-Chief based on the recommendations of reviewers reports and the journal’s editors. Where necessary, they will consult with members of the Editorial Board. The Editor-in-Chief may advice the corresponding author to make necessary revisions in order to publish the article. The final form of the article will be sent to the main author for the last approval from his/her part (if there are minor changes these should be send in no more than 1 week).  The publication process after the article’s submission may take 45 days, average. All accepted articles are assigned with a DOI number.  The Romanian Journal of Rhinology follows the International Committee of Medical Journal Editors (ICMJE) Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals and required ICMJSE to be listed as a journal that follows these recommendations.  Archiving  Sciendo archives the contents of this journal in Portico - digital long-term preservation service of scholarly books, journals and collections.  Plagiarism Policy  The editorial board is participating in a growing community of Similarity Check System's users in order to ensure that the content published is original and trustworthy. Similarity Check is a medium that allows for comprehensive manuscripts screening, aimed to eliminate plagiarism and provide a high standard and quality peer-review process. 