Natural killer (NK) cells are emerging as unique players in the immune response against cancer; however, only limited data are available on tumor infiltrating NK cells in head and neck squamous cell carcinoma (HNSCC), one of the most common cancer. Occurrence of HNSCC is closely related to the immune microenvironment, and immunotherapy is increasingly being applied to this setting. However, the limited success of this type of treatment in this tumor calls for further investigation in the field.Surgical HNSSC specimens of 32 consecutive patients were mechanically and enzymatically dissociated. Tumor cells were separated from infiltrating cells by short centrifugation and infiltrating NK cells were phenotypically and functionally characterized by multiple antibody staining and flow cytometry. Tumor infiltrating NK cells in HNSCC showed a peculiar phenotype predominantly characterized by increased NKG2A and reduced Siglec-7, NKG2D, NKp30 and CD16 expression. This phenotype was associated with a decreased ability to perform antibody-dependent cellular cytotoxicity (ADCC). However, NK, CD4 and CD8 shared an increment of glucocorticoid-induced tumor necrosis factor-related (GITR) costimulatory receptor which could be exploited for immunotherapy with agonistic anti-GITR antibodies combined with checkpoint inhibitors.

Adenoid tissue diseases (acute adenoiditis, adenoid hypertrophy and chronic adenoiditis) typically occur in the childhood. Adenoid hypertrophy seems to be related to many factors, such as infections, passive smoking, low vitamin D levels, while the role of allergy still remains controversial. Chronic adenoiditis incidence has increased in recent years, as a result of higher rates of upper airway infections and biofilm formation, with multiple potential clinical complications. Diagnosis is typically clinical, with physical examination and nasal endoscopy. The treatment can be medical or surgical. Non-surgical treatment of chronic adenoiditis with intranasal steroids and leukotriene inhibitors have proven to be effective, reducing the size of the adenoid tissue and symptoms. On the other hand adenoidectomy is one of the commonest ENT surgical procedures with excellent outcomes and rare adverse events. Curettage adenoidectomy is widely used by many ENT surgeon, but presents risk of residual adenoidal tissue, especially in peritubaric and superior nasopharynx regions. In the last years different surgical techniques have been proposed to reduce surgical risk and morbidity, such as electrocautery adenoidectomy, microdebrider adenoidectomy and coblation adenoidectomy. Intranasal or transoral endoscopes enabled a great control of surgical field and a complete removal of adenoid tissue.