Rhinocerebral mucormycosis is an invasive infection caused by filamentous fungi of the Mucoraceae family. The rhinocerebral form of the disease represents the most common form and has two distinct clinical entities. The common presentation consists of a rapidly progressive infection with high mortality rate, while the other presentation is that of a chronic infection with lower mortality. In the present paper we report a rare case of chronic rhinocerebral mucormycosis. An 85-year-old male with a 6-month history of purulent and odorous nasal discharge, and sporadic episodes of epistaxis and anosmia, presented to the outpatient department of our clinic. Initial cultures were positive only for Pseudomonas aeruginosa. The patient was unresponsive to ciprofloxacin treatment, developing necrotic areas of the nasal septum suspicious for rhinocerebral mucormycosis. Admission to the ENT clinic followed, with histopathologic evaluation of the vomer bone confirming the diagnosis. The patient was treated with amphotericin B and was discharged 3 weeks later on oral posaconazole therapy. Chronic rhinocerebral mucormycosis may present with atypical symptoms or coinfection with another agent. A high degree of clinical suspicion is required for correct diagnosis and prompt initiation of appropriate treatment.

Survival trends in survival for laryngeal cancer in Europe are varied. Five-year survival varied around 60-64% but numbers below 50% have been commonly reported. The aim of this study was to assess the factors influencing survival in patients with laryngeal cancer in our region. A total of 128 male and 5 female patients with larynx cancer (91 glottic and 42 supraglottic) were treated at Patras University Hospital between March 1992 and August 2004. Except 3, all were smokers and 56 (41%) heavy alcohol users. Postsurgical staging showed that most had been classified at stages III (38%) and IV (49%). By histology, 31 tumors were classified as poorly differentiated, 78 as moderately differentiated and 23 as well differentiated. All patients underwent laryngectomy with extension of the procedure where appropriate. Also, a total of 45 patients received adjuvant therapy (either chemotherapy or radiotherapy). Farmers, construction workers, professional drivers and mechanics and coffee shop and bar employees account for more than 70% of patients. Results showed that 64 (48.1%) patients died during the follow-up, 58 (43.6%) of them died from cause related to their disease. With a median follow-up of 25 months, the 5-year disease-free survival (DFS) was 53% and the 5-year overall survival (OS) was 45%. Significant prognostic factors for OS included patient age, advanced staging, heavy alcohol use and poor tumor differentiation while for DFS affected mainly by poor tumor differentiation. We conclude that the disease stage at presentation, tumor grade and alcohol consumption prove to be important predictors for the OS as well as the DFS in our series.

Otitis media with effusion (OME) is a common condition affecting children and a well-known cause of conductive hearing loss that can potentially lead to speech development disorders. Recent studies, however, have demonstrated the influence of OME on development of attention disorders or social adaptation and acceptance. Hence, this study aimed to investigate the behavioral trends of children with OME based on the Achenbach test. A group of 117 patients with episodes of OME at the age of 4-5 was compared with a control group according to the Achenbach system of evaluation, by application of the Child Behavior Checklist questionnaire (CBCL). Patients suffering from OME had more anxiety/depression related disorders and attention disorders as compared with the control group. The psychological effect of OME in children of ages 6-8 is evident with anxiety and depression disorders being especially prominent among these patients.

Tonsillectomy is regarded as a safe procedure, with post-operative taste disturbances rarely reported. The aim of this study was to access taste function after tonsillectomy in a series of 60 patients. Sixty patients (age range 14-40 years; mean 24.4 years; median 21 years; STD 7.7 years), 24 males and 36 females, underwent bilateral tonsillectomy at the University Hospital of Patras, Greece. All patients were diagnosed with recurrent tonsillitis and randomly assigned to two groups. The first group consisted of 27 patients, who underwent tonsillectomy using scissors and raspatory with electrocautery for coagulation. The remaining 33 patients underwent tonsillectomy using pressure-assisted tissue-welding technology. Chemogustometry was used to evaluate the patients' taste function on the first postoperative day and succeedingly, 15 days and 1 month postoperatively. Three different quantities of tastant were used in each test. Taste recognition in posterior tongue regions proved to be more affected compared with anterior tongue regions in the first postoperative day. Bitter and sour tastes were more affected than those of sweet and salty. Succeeding tests yielded near normal results for all patients except two, with one patient achieving normal taste function 1 month postoperatively and the other still facing taste disorders 1 month after tonsillectomy. The results indicate that Tonsillectomy entails a temporary reduction in taste function. This finding should be attributed to direct or indirect intraoperative damage of the glossopharyngeal nerve or unintentional extension of the lingual nerve by application of the tongue retractor. No significant difference was noted between the two operative techniques evaluated in our study. In most cases taste function returns to preoperative levels within 2 weeks postoperatively. Post-tonsillectomy taste disturbances are uncommon, and patients should be informed of this possibility.

In order to evaluate the potential of matrix metalloproteinase 2 (MMP-2) as a prognostic factor for glottic laryngeal cancer. One hundred and two surgical specimens from patients with glottic laryngeal cancer who underwent laryngectomy for their disease in the University Hospital of Patras, Greece from 1998 to 2005 were reviewed retrospectively regarding MMP-2 expression via immunohistochemistry. Immunostaining was performed using a streptavidin-biotin peroxidase complex technique (LSAB). Results revealed that 54 of 102 patients (52.9%) had positive cytoplasmic staining for MMP-2. Kaplan-Meier analysis demonstrated statistically significant difference (p = 0.037) for the 5-year overall survival rate between the groups with positive and negative MMP-2 expression, and marginal statistical significance for the disease free survival rate (p = 0.048). The capsule rupture of metastatic lymph nodes and MMP-2 expression in primary tumor site also seems to be related (p = 0.047). Statistical significance could not be established between MMP-2 expression and the clinicopathological features of the disease (T stage, N stage, clinical stage, differentiation). In conclusion, MMP-2 expression was related with worse overall and disease-free survival and could be considered as a potential marker of poor prognosis.