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Verro B, Saraniti G, Fiumara S, Ottoveggio G, Saraniti C. Smoking and alcohol habits in head and neck cancers: How many patients stop after diagnosis? J Cancer Policy 2024; 41:100498. [PMID: 39059763 DOI: 10.1016/j.jcpo.2024.100498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 06/09/2024] [Accepted: 07/14/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Smoking and alcohol are the main risk factors for head and neck cancer. Despite the significant psychological impact, many patients continue to smoke and drink alcohol after diagnosis of cancer. This study aims to analyze the patients' behavior post diagnosis and treatment of head and neck cancer. METHODS An observational retrospective study was conducted on patients suffering from head and neck cancer. Their smoking and alcohol habits before and after diagnosis of cancer were studied. RESULTS A total of 85 patients were recruited: 80 % males, mean age 61.77±9.30 years. Among smokers, 35.80 % continued smoking post-diagnosis. A statistically significant correlation was found between smoking habit after diagnosis of cancer and type of treatment and tracheostomy. Among drinkers, 65.52 % continued to consume alcohol after diagnosis of cancer. A statistically significant correlation was found between alcohol consumption post-diagnosis and sex. CONCLUSIONS Patients undergoing more invasive treatments are more likely to quit smoking and/or drinking alcohol, suggesting the strong psychological impact of cancer and its therapy. Many patients continue smoking and consuming alcohol due to unawareness, depression, or addiction. However, most patients reduced cigarette smoking and alcohol consumption. Comprehensive care, including psychological support, is essential for these patients.
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Affiliation(s)
- Barbara Verro
- Division of Otorhinolaryngology, Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, Palermo 90127, Italy.
| | - Giuseppe Saraniti
- Division of Otorhinolaryngology, Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, Palermo 90127, Italy
| | - Simona Fiumara
- Division of Otorhinolaryngology, Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, Palermo 90127, Italy
| | - Gaetano Ottoveggio
- Unit of Anesthesia, Intensive Care, and Emergency, Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Italy.
| | - Carmelo Saraniti
- Division of Otorhinolaryngology, Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, Palermo 90127, Italy.
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Ottoveggio G, Verro B, Lapi M, Tarantino F, Beccia G, Saraniti C. Difficult intubation in ENT patient: Simultaneous videolaryngoscopy with flexible bronchoscopy. A combined approach. Case report. Int J Surg Case Rep 2024; 116:109345. [PMID: 38320417 PMCID: PMC10850949 DOI: 10.1016/j.ijscr.2024.109345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/01/2024] [Indexed: 02/08/2024] Open
Abstract
INTRODUCTION Difficult intubation is the situation when a skilled anesthetist has difficulties to manage airway using face mask, laryngoscopy, supraglottic device, tracheal intubation, surgery. Videolaryngoscope and flexible fibroscope (FFS) represent valid alternatives for difficult airway management, with some limitations. However, literature lacks of studies about the efficacy of the combined use of videolaryngoscope and FFS. CASE REPORT We report a case of a man, with glottic lesion, who needs surgery under general anesthesia. Anesthesiologic pre-operative evaluation revealed that he's a difficult intubation case. So, in a supine position, intubation was performed on first attempt by videolaryngoscope combined with FFS. On post-op, no signs of injuries due to intubation have been found. DISCUSSION In 2022, the American Society of Anesthesiologists defined the guidelines to manage difficult intubation: based on patient' anatomical and clinical feature and anesthetist' skills, several intubation procedures could be used. Each procedure has pros and cons. CONCLUSION It's the first case of anticipated difficult intubation in adult man that was intubated under general anesthesia by using videolaryngoscope combined with FFS. We demonstrated that this procedure is safe and useful in case of difficult airway and recommended in case of laryngeal lesions that hinder the visualization of glottic plane.
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Affiliation(s)
- Gaetano Ottoveggio
- Unit of Anesthesia, Intensive Care, and Emergency, Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Italy
| | - Barbara Verro
- Unit of Otorhinolaryngology, Department of Biomedicine, Neuroscience and Advanced Diagnostic (BIND), University of Palermo, Palermo, Italy.
| | - Maria Lapi
- Unit of Anesthesia, Intensive Care, and Emergency, Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Italy
| | - Francesco Tarantino
- Unit of Anesthesia, Intensive Care, and Emergency, Department of Emergency and Neuroscience, Trauma Center, Villa Sofia Cervello United Hospitals, Palermo, Italy
| | - Giovanna Beccia
- Unit of General Surgery and Transplant Anesthesia, IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy
| | - Carmelo Saraniti
- Unit of Otorhinolaryngology, Department of Biomedicine, Neuroscience and Advanced Diagnostic (BIND), University of Palermo, Palermo, Italy
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Filipovsky T, Kalfert D, Lukavcova E, Zavazalova S, Hlozek J, Kovar D, Astl J, Holy R. The importance of preoperative and perioperative Narrow Band Imaging endoscopy in the diagnosis of pre-tumor and tumor lesions of the larynx. J Appl Biomed 2023; 21:107-112. [PMID: 37747310 DOI: 10.32725/jab.2023.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 09/13/2023] [Indexed: 09/26/2023] Open
Abstract
INTRODUCTION Narrow band imaging (NBI) is an endoscopic imaging method intended for the diagnosis of mucosal lesions of the larynx that are not visible in white-light endoscopy, but are typical of pre-tumor and tumor lesions of the larynx. THE PURPOSE OF THE STUDY To compare preoperative/perioperative white light endoscopy and NBI endoscopy with the results of histopathological examinations in pre-tumor and tumor lesions of the larynx. METHODS A prospective study, over a period of five years (5/2018-5/2023), included 87 patients with laryngeal lesions aged 24-80 years. We evaluated preoperative/ perioperative white light and NBI endoscopy, established a working prehistological diagnosis, and compared this with the definitive histopathological results of laryngeal biopsies. RESULTS In relation to the definitive histology score, a statistically significant correlation was found between the evaluation of the finding and the definitive histology for preoperative and perioperative white light endoscopy and NBI endoscopy (p < 0.001). Both methods showed higher precision when used perioperatively. CONCLUSION NBI endoscopy is an optical method that allows us to improve the diagnosis of laryngeal lesions, perform a controlled perioperative biopsy, and refine the surgical scope. The NBI endoscopy is a suitable method for the diagnosis of early cancerous lesions of the larynx. The use of preoperative/perioperative NBI endoscopy allowed us to achieve a high level of agreement correlation (p < 0.001) between the prehistological working diagnosis and the final histopathological result. The NBI method proves its application in the diagnosis of pre-tumor and tumor lesions of the larynx.
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Affiliation(s)
- Tomas Filipovsky
- Military University Hospital Prague, Department of Otorhinolaryngology and Maxillofacial Surgery, Prague, Czech Republic
- Charles University, Third Faculty of Medicine, Prague, Czech Republic
| | - David Kalfert
- Motol University Hospital, Department of Otorhinolaryngology and Head and Neck Surgery, Prague, Czech Republic
- Charles University, First Faculty of Medicine, Prague, Czech Republic
| | - Eva Lukavcova
- Military University Hospital Prague, Department of Otorhinolaryngology and Maxillofacial Surgery, Prague, Czech Republic
| | - Sarka Zavazalova
- Military University Hospital Prague, Department of Otorhinolaryngology and Maxillofacial Surgery, Prague, Czech Republic
- Charles University, Third Faculty of Medicine, Prague, Czech Republic
| | - Jiri Hlozek
- Military University Hospital Prague, Department of Otorhinolaryngology and Maxillofacial Surgery, Prague, Czech Republic
- Charles University, Third Faculty of Medicine, Prague, Czech Republic
| | - Daniel Kovar
- Military University Hospital Prague, Department of Otorhinolaryngology and Maxillofacial Surgery, Prague, Czech Republic
- Charles University, Third Faculty of Medicine, Prague, Czech Republic
| | - Jaromir Astl
- Military University Hospital Prague, Department of Otorhinolaryngology and Maxillofacial Surgery, Prague, Czech Republic
- Charles University, Third Faculty of Medicine, Prague, Czech Republic
| | - Richard Holy
- Military University Hospital Prague, Department of Otorhinolaryngology and Maxillofacial Surgery, Prague, Czech Republic
- Charles University, Third Faculty of Medicine, Prague, Czech Republic
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Saraniti C, Patti G, Verro B. Sulcus Vocalis and Benign Vocal Cord Lesions: Is There Any Relationship? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095654. [PMID: 37174173 PMCID: PMC10177882 DOI: 10.3390/ijerph20095654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/11/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Sulcus vocalis (SV) is a longitudinal groove in the free edge of the true vocal cord. It may impair phonation with incomplete glottic closure, phonasthenia and hoarseness. This study aims to detect a correlation between benign vocal cord lesions and the incidence of the SV. METHODS A retrospective study was carried out on patients who underwent transoral surgery due to benign vocal fold lesions and were selected according to strict criteria. Patients were divided into a group with sulcus vocalis (Group wSV) and a group without sulcus vocalis (Group w/oSV). The possible correlations between variables were assessed by the Pearson chi-square test (p < 0.05). RESULTS The study included 232 vocal cord lesions in 229 patients: 62.88% were females whose mean age was 46.61 ± 14.04. The most frequent diseases were polyps (37.94%), nodules (18.53%) and Reinke's edema (21.12%). Statistically significant relationships were found between age and SV (p-value 0.0005) and between mild dysplasia and SV (p-value 0.03). CONCLUSIONS This study did not detect a cause-effect relationship between SV and benign vocal fold lesions. SV within vocal fold lesions is more common in younger patients, suggesting a congenital nature of SV. In conclusion, in the case of a benign vocal fold lesion, a possible SV should be considered and researched to provide the patient the best healthcare.
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Affiliation(s)
- Carmelo Saraniti
- Division of Otorhinolaryngology, Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, 90127 Palermo, Italy
| | - Gaetano Patti
- Division of Otorhinolaryngology, Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, 90127 Palermo, Italy
| | - Barbara Verro
- Division of Otorhinolaryngology, Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, 90127 Palermo, Italy
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Bertino G, Pedretti F, Mauramati S, Filauro M, Vallin A, Mora F, Crosetti E, Succo G, Peretti G, Benazzo M. Recurrent laryngeal papillomatosis: multimodal therapeutic strategies. Literature review and multicentre retrospective study. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2023; 43:S111-S122. [PMID: 37698108 PMCID: PMC10159644 DOI: 10.14639/0392-100x-suppl.1-43-2023-14] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 01/19/2023] [Indexed: 09/13/2023]
Abstract
Objectives Recurrent respiratory papillomatosis (RRP) is a benign, rare disease caused by Human Papilloma Virus (HPV) that can be divided into juvenile and adult forms. The course of the disease is variable, but is usually more aggressive in the juvenile form. The standard surgical treatment is represented by CO2 laser resection, although photoangiolytic lasers represent a valid alternative. Adjuvant therapies have been proposed for disease control in case of frequent surgical resections or spreading into the lower airways. In recent years, the development of immunotherapy led to the use of bevacizumab either intratumorally or intravenously, but the most promising therapeutic development is represented by HPV vaccination. This paper aims to present a narrative review of the literature and the experience of three different University Centres in the treatment of RRP. Methods A retrospective analysis of the clinical charts of all patients affected by laryngeal papillomatosis and treated in three different University Centres between 2002 and 2022 was performed. The following parameters were collected: sex, age at first evaluation, sites of larynx involved, HPV type, type of first surgical treatment, presence and number of recurrences, surgical treatment of recurrences, adjuvant therapies, side effects and status at last follow-up. Results Seventy-eight patients were available for evaluation. Of these, 88% had adult onset RRP (Ao-RRP) and 12% juvenile onset RRP (Jo-RRP). The glottis was the most frequently involved subsite; all patients were submitted to surgical resection with CO2 laser under general anaesthesia. Recurrences appeared in 79% of the patients, the patients who did not recur were all adults. The mean number of recurrences was 9 (range 1-110). Recurrences were more frequent in children (M = 20; range 2-110) than adults (M = 5; range 1-21). Thirty-two (52%) of the 62 patients who recurred were re-treated with CO2 laser under general anaesthesia, while office-based treatment with a photoangiolytic laser was preferred in the remaining 30 (48%) patients. Adjuvant treatments were applied in 26 patients. The analysis of the course of the disease showed that in the 9 patients with Jo-RRP, 6 (67%) were free of lesions at the last follow-up, while the other 3 (33%) had papillomas. Of the 69 patients with Ao-RRP, 53 (77%) were alive and free of disease at the last visit, 14 (21%) were alive with disease, 1 (1%) was lost at follow-up and 1 (1%) died for other disease. Severe side effects were not observed except for 2 patients, who developed posterior glottic stenosis. Conclusions Our results confirmed the literature review. RRP is a potentially aggressive disease, especially in juvenile onset. Surgical resection is still first-line treatment, but in case of multiple recurrences the use of adjuvant therapies must be taken into consideration.
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Affiliation(s)
- Giulia Bertino
- Department of Otolaryngology Head and Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Fabio Pedretti
- Department of Otolaryngology Head and Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Simone Mauramati
- Department of Otolaryngology Head and Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Marta Filauro
- Unit of Otolaryngology Head and Neck Surgery, IRCCS Policlinico San Martino Hospital, Genoa, Italy
| | - Alberto Vallin
- Unit of Otolaryngology Head and Neck Surgery, IRCCS Policlinico San Martino Hospital, Genoa, Italy
- DISC, University of Genoa, Italy
| | - Francesco Mora
- Unit of Otolaryngology Head and Neck Surgery, IRCCS Policlinico San Martino Hospital, Genoa, Italy
- DISC, University of Genoa, Italy
| | - Erika Crosetti
- ENT Unit, Oncology Department, University of Turin, Orbassano (Turin), Italy
| | - Giovanni Succo
- ENT Department, San Giovanni Bosco Hospital, Turin, Italy
- Oncology Department, University of Turin, Turin, Italy
| | - Giorgio Peretti
- Unit of Otolaryngology Head and Neck Surgery, IRCCS Policlinico San Martino Hospital, Genoa, Italy
- DISC, University of Genoa, Italy
| | - Marco Benazzo
- Department of Otolaryngology Head and Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
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Verro B, Gallina S, Saraniti C. Papillomavirus Infection and Prevention: How Much Does the Sicilian Population Know? An Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11032. [PMID: 36078747 PMCID: PMC9518309 DOI: 10.3390/ijerph191711032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/11/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
Human papillomavirus is a sexually transmitted virus that is responsible not only for uterine cervical cancer, but also for the oral and oropharyngeal cancers. In this latter case, the virus indiscriminately affects both sexes at any age. Vaccination plays a key role in preventing infection and its possible consequences. Therefore, this study aimed to assess the degree of awareness of papillomavirus infection and its possible prevention in the Sicilian population. A prospective observational study was carried out on the Sicilian population through a self-administered questionnaire, consisting of 10 multiple-choice questions. The survey lasted from June 2021 to December 2021. A total of 844 respondents were included: 60.90% were female and 53.55% were aged between 21 and 30 years. Most of the surveyed population knew about the virus and the existence of the vaccine, however, many of them did not know about virus's effects on the oral and oropharyngeal sites (49.17%), or about the indication for vaccination for males (39.69%). Oral and oropharyngeal papillomavirus-related cancers are an increasingly frequent finding, especially in young adults. Therefore, it is necessary and quite mandatory to educate the population about the risks that certain voluptuous habits may cause, with the help of general practitioners, schools, social media, and social networks.
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