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Ganguly A, Garza R, Jain V, Narmala S. Osteosarcoma of the Larynx: A Case Report and Review of Literature. Cureus 2023; 15:e39307. [PMID: 37378237 PMCID: PMC10292173 DOI: 10.7759/cureus.39307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2023] [Indexed: 06/29/2023] Open
Abstract
The most common malignant laryngeal tumors are squamous cell carcinomas (SCCs), and other types such as sarcomas are rare. Osteosarcomas of the larynx are extremely rare within the subset of sarcomas, with very few cases reported in the literature. This cancer has a predilection for elderly males, in the sixth to eighth decades of life. Associated symptoms include hoarseness, stridor, and dyspnea. It is known to spread early and has a high rate of recurrence. We present the case of a 73-year-old male, a former smoker, who presented to the clinic with severe dyspnea and progressive hoarseness and was found to have a large exophytic mass arising from the epiglottis. A biopsy of the mass showed a poorly differentiated cancer with osteoid and new bone formation. He then underwent surgical removal of the mass, followed by radiation, and achieved clinical remission. However, a surveillance positron emission tomography (PET) scan 14 months later showed a hypermetabolic lesion in the left lung. Biopsy revealed metastatic osteosarcoma, and unfortunately, this cancer also spread to the brain. In this report, we will focus on the histological features of this rare malignancy and treatment options.
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Affiliation(s)
- Arup Ganguly
- Internal Medicine, Doctors Hospital at Renaissance/University of Texas Rio Grande Valley, Edinburg, USA
| | - Rodolfo Garza
- Internal Medicine, Doctors Hospital at Renaissance/University of Texas Rio Grande Valley, Edinburg, USA
| | - Vinayak Jain
- Internal Medicine, MedStar Washington Hospital Center, Washington, DC, USA
| | - Shravan Narmala
- Hematology and Medical Oncology, Doctors Hospital at Renaissance, Edinburg, USA
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2
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Kumbul YÇ, Akın V, Yasan H, Özdoğan Yılmaz G, Ayyıldız VA. A Rare Case of Laryngeal Osteosarcoma Causing Diagnostic Challenges. Cureus 2023; 15:e37393. [PMID: 37182021 PMCID: PMC10171873 DOI: 10.7759/cureus.37393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2023] [Indexed: 05/16/2023] Open
Abstract
Laryngeal osteosarcomas are extremely rare. They cause diagnostic difficulty for the otolaryngologist and pathologist. Differentiation from sarcomatoid carcinoma is challenging but important, as clinical features and treatment strategies are different. Total laryngectomy is generally the preferred surgical approach for laryngeal osteosarcomas. Since lymph node metastasis is not expected, neck dissection is not needed. In this report, we present a case diagnosed with laryngeal osteosarcoma post the examination of the total laryngectomy specimen of a laryngeal tumor that could not be histopathologically differentiated by punch biopsy.
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Affiliation(s)
- Yusuf Ç Kumbul
- Otorhinolaryngology and Head and Neck Surgery, Suleyman Demirel University, Isparta, TUR
| | - Vural Akın
- Otorhinolaryngology and Head and Neck Surgery, Suleyman Demirel University, Isparta, TUR
| | - Hasan Yasan
- Otorhinolaryngology and Head and Neck Surgery, Suleyman Demirel University, Isparta, TUR
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3
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Mäkitie AA, Devaney KO, Baujat B, Almangush A, Ferlito A. Characteristics of Laryngeal Osteosarcoma: A Critical Review. Oncol Ther 2020; 8:33-44. [PMID: 32700074 PMCID: PMC7359981 DOI: 10.1007/s40487-020-00110-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Indexed: 12/14/2022] Open
Abstract
Laryngeal sarcomas constitute an extremely rare entity among head and neck malignancies. Furthermore, most of them are chondrosarcomas, and the osteogenic form remains a true rarity. In general, there is a lack of information on the characteristics of laryngeal osteosarcoma. Thus, we sought to critically review the existing world literature on laryngeal osteosarcoma in order to develop a more accurate clinicopathological profile of this malignancy. Laryngeal osteosarcoma has a predilection for elderly male patients, as 87% were male in the present series and the mean age was 62 years (range 32-80), and without a direct association with tobacco exposure. Osteosarcoma of the larynx is typically a highly malignant neoplasm that metastasizes early, has a propensity for hematogenous spread and also has a marked tendency to recur. Twelve (41%) out of the 29 cases in the present review with follow-up data had metastatic disease. The aspects that distinguish osteosarcoma from its differential diagnostic alternatives are discussed in this review.
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Affiliation(s)
- Antti A Mäkitie
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. .,Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland. .,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden. .,Sorbonne université, Service d'oto-rhino-laryngologie et de chirurgie cervicofaciale, DMU CHIR, Hôpital Tenon, Assistance-Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020, Paris, France.
| | | | - Bertrand Baujat
- Sorbonne université, Service d'oto-rhino-laryngologie et de chirurgie cervicofaciale, DMU CHIR, Hôpital Tenon, Assistance-Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020, Paris, France.,EURACAN (European Rare Cancer Network) Group 7 Head and Neck rare tumours, Paris, France.,REFCOR (Réseau d'Expertise Français sur les cancers ORL Rares), Paris, France
| | - Alhadi Almangush
- Department of Pathology, University of Helsinki, Helsinki, Finland.,Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Institute of Dentistry, University of Misurata, Misurata, Libya
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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4
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Escher P, Bu L, Cayci Z, Yueh B, Li F. Laryngeal Squamous Cell Carcinoma with Osteosarcomatous Differentiation and Involvement of Thyroid Cartilage Mimicking Sarcoma Arising from Thyroid Cartilage. Head Neck Pathol 2019; 14:771-777. [PMID: 31873935 PMCID: PMC7413955 DOI: 10.1007/s12105-019-01119-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 12/18/2019] [Indexed: 11/29/2022]
Abstract
Basaloid squamous cell carcinoma (BSCC) with a spindle cell component of the head and neck is an uncommon entity. In this case, we present a radiology-pathology correlation of a rare laryngeal BSCC with sarcomatous transformation and osteosarcomatous differentiation involving the laryngeal cartilage, which thus mimicked clinically and radiographically osteosarcoma or chondrosarcoma with calcification. Microscopic examination revealed predominantly BSCC with extensive osseous metaplasia among sheets and nests of basaloid tumor cells. There were also small foci of osteosarcoma, undifferentiated pleomorphic sarcoma, and spindle cell carcinoma. The presence of squamous cell carcinoma (SCC) in-situ, small areas of conventional SCC and diffuse positivity of p40 in conventional and basaloid squamous components confirmed that this tumor was indeed derived from surface squamous epithelium. Awareness of the broad differentiation potentials of SCC can avoid misdiagnosis of SCCs as sarcoma. This case emphasizes the importance of radiologic-pathologic correlation in definitive diagnosis and clinical management of laryngeal malignancies.
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Affiliation(s)
- Paul Escher
- University of Minnesota Medical School, Minneapolis, MN USA
| | - Lihong Bu
- Department of Laboratory Medicine and Pathology, University of Minnesota, MMC 76, C476 Mayo Building, 420 Delaware St. SE, Minneapolis, MN 55455 USA
| | - Zuzan Cayci
- Department of Radiology, University of Minnesota, Minneapolis, MN USA
| | - Bevan Yueh
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, MN USA
| | - Faqian Li
- Department of Laboratory Medicine and Pathology, University of Minnesota, MMC 76, C476 Mayo Building, 420 Delaware St. SE, Minneapolis, MN 55455 USA
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Bennion NR, Baine MJ, Malouff T, Zhen W. Osteosarcoma of the Larynx: Treatment Outcomes and Patterns of Failure Analysis. Rare Tumors 2017; 9:6955. [PMID: 28458793 PMCID: PMC5379232 DOI: 10.4081/rt.2017.6955] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 01/11/2017] [Accepted: 02/14/2017] [Indexed: 11/23/2022] Open
Abstract
The incidence of laryngeal sarcoma is exceedingly low with osteosarcomas of the larynx being rarer still, comprising less than 1% of all associated malignancies. To date, only 32 cases have been reported since this pathologic entity was first described in 1942. In this article, we discuss the most recent case of laryngeal osteosarcoma in a patient presenting with respiratory distress found to be due to a tumor mass arising from her cricoid cartilage. We further summarize current knowledge regarding the epidemiology, presentation, and diagnosis of this uncommon disease. Lastly, we synthesize all available information regarding treatment and outcomes of the 32 previously described cases of osteosarcoma of the larynx as well as the presently described case in an attempt to offer some insight regarding optimal treatment in future cases.
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Affiliation(s)
- Nathan R Bennion
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE
| | - Michael J Baine
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE
| | | | - Weining Zhen
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE
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6
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Osteosarcoma of the larynx. Contemp Oncol (Pozn) 2015; 19:246-9. [PMID: 26557767 PMCID: PMC4631292 DOI: 10.5114/wo.2015.52659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 06/15/2013] [Accepted: 11/13/2013] [Indexed: 11/17/2022] Open
Abstract
Malignant neoplasms of the larynx are divided into epithelial and non-epithelial. Non-epithelial neoplasms include, among others, mesenchymal chondrosarcomas and osteosarcomas. Few cases of laryngeal osteosarcomas described in the literature were usually treated by surgery without the need to use adjuvant radio- or chemotherapy. Few authors propose the initial application of radiotherapy or high-dose chemotherapy. Our study presents a very rare case of a woman treated due to laryngeal osteosarcoma. We have also presented diagnostic difficulties preceding a decision to perform radical surgery. The patient had been eligible for radical surgical treatment, even though there were no features of malignancy in a histopathological examination of the biopsy material. Complete laryngectomy was carried out without the surgery of the cervical lymphatic system. Laryngeal osteosarcoma was diagnosed based on the postoperative histopathological examination using vimentin and Ki67. The patient remains under the care of the Otolaryngology and Laryngological Oncology Department and Oncology Centre in Bydgoszcz. There were no reports on local recurrence or distant metastases during regular check-ups.
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Bhatt NR, Kakked GA, Merchant R, Bhatt R. Extraskeletal osteosarcoma of the larynx: an extremely unusual tumour. BMJ Case Rep 2014; 2014:bcr-2014-206759. [PMID: 25323286 DOI: 10.1136/bcr-2014-206759] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Osteosarcoma of the larynx is probably the rarest mesenchymal tumour of the larynx, with only 16 cases reported so far. The majority of them occur in males between the sixth and eighth decades of life. Patients usually present with non-specific symptoms such as dysphonia and upper airway compromise. The most common site of distant metastasis is the lung. Clinically, the tumour follows an aggressive course and is associated with high mortality. The case we present is unusual as it occurred at a young age (38 years) as compared with the norm and it did not arise from the endolarynx, unlike many of the other cases. This was the only known case where a Pearson near-total laryngectomy was performed whereby the patient's natural speech mechanism was preserved. This surgery was possible because the contralateral half of the larynx was clearly disease free and the interarytenoid region was uninvolved. The patient underwent postoperative adjuvant external beam radiotherapy beginning 4 weeks after surgery. The patient is doing well after 15 months of follow-up and shows no signs of recurrence.
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Affiliation(s)
- Nikita R Bhatt
- Department of Surgery, SSG Hospital, Baroda, Gujarat, India
| | | | - Rajiv Merchant
- Department of Orthopedics, Vincent's University Hospital, Dublin, Ireland
| | - Rajiv Bhatt
- Department of Oncosurgery, Shubhechha Multispecialty Hospital, Vadodara, Gujarat, India
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8
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Kuba K, Inoue H, Hayashi T, Matsumura S, Minami K, Takajo H, Morita K, Nakahira M, Sugasawa M. Laryngeal osteosarcoma: case report and literature review. Head Neck 2014; 37:E26-9. [PMID: 24824784 DOI: 10.1002/hed.23767] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2014] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Sarcomas of the larynx are uncommon tumors, and osteosarcoma is the rarest. Only 24 cases of osteosarcoma of the larynx have been reported. The only case reported in Asia was from Thailand in 1981. METHODS A 55-year-old male patient was referred to our hospital because of an 8-month history of odynophagia and a gradually enlarging left neck mass. A neck CT scan was performed. A literature review was also performed for this report. RESULTS The CT scan revealed extensive calcification with enlargement of the thyroid cartilage. The patient was diagnosed with osteosarcoma and was successfully treated by surgery alone. CONCLUSION Adequate surgical resection is required for successful treatment of laryngeal sarcomas. Adjuvant therapy is not contraindicated, but chemotherapy may improve the prognosis in patients with high-grade tumors or metastatic disease.
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Affiliation(s)
- Kiyomi Kuba
- Department of Head and Neck Surgery and Otolaryngology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
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9
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A review of primary osteosarcoma of the larynx and case report. Head Neck Pathol 2014; 9:158-64. [PMID: 24947052 PMCID: PMC4382484 DOI: 10.1007/s12105-014-0550-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 06/07/2014] [Indexed: 10/25/2022]
Abstract
Sarcomas of the larynx are exceedingly uncommon, of which primary laryngeal osteosarcomas are the rarest. To date, 25 cases of primary laryngeal osteosarcomas have been reported in the literature. Laryngeal osteosarcomas may closely simulate sarcomatoid carcinomas, since both entities share clinical, histological and immunohistochemical features. Herein, we report a case of primary laryngeal osteosarcoma in a 55 year old male, focusing on the importance of light microscopic, immunohistochemical and ultrastructural features in accurately establishing the diagnosis. In addition, the current paper provides a review of the English language literature on the subject. Laryngeal osteosarcomas usually carry a dismal prognosis with no general consensus on the most effective mode of therapy. Similarly, the current patient developed bilateral lung metastases 8 months after the initial surgery.
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10
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Dellmann A, Schroeder HG, Donhuijsen K. Destructive tumours of the larynx mimicking osteosarcoma: two cases of osteoblastoma with organ-saving resection and follow-up. Eur Arch Otorhinolaryngol 2009; 267:151-4. [DOI: 10.1007/s00405-009-1091-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2009] [Accepted: 08/31/2009] [Indexed: 10/20/2022]
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Angelillo M, Mazzone S, Costa G, Mazzone A, Barillari U. The first case of osteoma in the false vocal fold. Auris Nasus Larynx 2009; 36:235-8. [PMID: 18644689 PMCID: PMC2716545 DOI: 10.1016/j.anl.2008.04.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2008] [Revised: 04/10/2008] [Accepted: 04/18/2008] [Indexed: 11/19/2022]
Abstract
OBJECTIVES This article reports the first evidence of a larynx osteoma of the false vocal fold. STUDY DESIGN Case report and literature review. METHODS Case report and review of previously published cases of larynx osteomas. RESULTS A 79-year-old patient was referred to our institution for dysphagia and hoarseness. Fibrolaryngoscopy showed a regular surface tumefaction of the false fold and the left ventricle, with preserved cordal motility. Patient underwent direct laryngoscopy with CO(2) laser excision of the lesion. Pathologic examination of the lesion (1.6cmx1cm) showed features consistent with an osteoma. Complete regression of symptoms was observed after surgery, with no lesions found on routine 1-year follow-up. CONCLUSIONS Osteomas are benign, slow growing tumors of the craniofacial bone area, very rarely located in the larynx. Although the etiology is unknown, accepted theories point to embryologic, post-traumatic and infectious causes. Surgical excision is indicated only in symptomatic cases. This case report is the fourth evidence of laryngeal osteoma and, to our knowledge, the first finding of a false vocal fold osteoma.
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Affiliation(s)
- M Angelillo
- Department of Audiology and Phoniatry of Second University of Naples, Italy.
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Fernández-Aceñero >MJ, Larach F, Ortega-Fernández C. Non-epithelial lesions of the larynx: review of the 10-year experience in a tertiary Spanish hospital. Acta Otolaryngol 2009; 129:108-12. [PMID: 18607979 DOI: 10.1080/00016480802008207] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
CONCLUSION In this report we review the diagnosis, therapy, and outcome of laryngeal non-epithelial tumors and comment on the literature on these rare lesions. OBJECTIVES Non-epithelial tumors of the larynx are rather rare and most cases have been reported as isolated or short series of cases from different centers all over the world. The aim of the present study was to review the 10-year experience with non-epithelial lesions in a 400-bed tertiary hospital covering a population of almost 250 000 people in Madrid, Spain. PATIENTS AND METHODS We reviewed 2631 laryngeal samples corresponding to this time period. RESULTS In all, 737 corresponded to carcinomas (726 squamous cell carcinomas). We had two cases of chondrosarcoma, one case of liposarcoma, one case of synovial sarcoma, and one neural benign tumor, suggestive of neurinoma. In this period we also had an inflammatory pseudotumor affecting the vocal cord, a case of primary laryngeal extramedullary plasmocytoma, and one case of high grade diffuse malignant lymphoma with exclusive involvement of the larynx. In our series most patients were women (five vs three patients) and ages ranged between 12 and 92 years.
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Mottola G, Cascone AM, Cavaliere M, Angrisani B, Fiorillo G, Parente G, Volino F, Iemma M. Osteosarcoma of the larynx: a case report. CASES JOURNAL 2008; 1:365. [PMID: 19046454 PMCID: PMC2621131 DOI: 10.1186/1757-1626-1-365] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2008] [Accepted: 12/01/2008] [Indexed: 11/10/2022]
Abstract
BACKGROUND We add a new rare illustrative case of osteosarcoma of the larynx to the literature. CASE PRESENTATION The patient (man; 56 years old) first underwent several biopsies, followed in the end by a total laryngectomy. Diagnosis was histological. The patient developed regional and distant metastases and died of disease after 3 months from surgery. CONCLUSION Osteosarcoma of the larynx is a rare and aggressive tumour with a poor long-term prognosis. The preferred treatment for this tumour is aggressive surgery.To perform a diagnosis we must be in presence of osteoid or of neoplastic osseous tissue directly produced by the neoplastic cells.
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Affiliation(s)
- Giampiero Mottola
- Department of Otolaryngology, Hospital "San Giovanni di Dio e Ruggi d'Aragona", Via San Leonardo, Salerno, Italy.
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