Chronic rhinosinusitis (CRS) is a condition affecting as much as 16% of the adult population in developed countries with many factors attributed to its development, including the more recently proposed role of bacterial biofilm infections. Plenty of research has been conducted on biofilms in CRS and the causes behind the development of such an infection in the nasal cavity and sinuses. One such probable cause is the production of mucin glycoproteins by the mucosa of the nasal cavity. To investigate the possible link between biofilm formation and mucin expression levels and their relationship with CRS etiology, we examined samples from 85 patients by means of spinning disk confocal microscopy (SDCM) to establish their biofilm status and quantitative reverse transcription polymerase chain reaction (qRT-PCR) to determine MUC5AC and MUC5B expression levels. We observed a significantly higher prevalence of bacterial biofilms in the CRS patient group compared to the control group. In addition, we detected higher expression levels of MUC5B but not MUC5AC in the CRS group, which suggested a possible role for MUC5B in CRS development. Finally, we found no direct relationship between biofilm presence and mucin expression levels, thereby showing a multifaceted connection between these two major factors implicated in CRS etiology.

The common cause of metastatic cervical lymphadenopathy is the spread from primary tumours in the head and neck region. However, in unusual cases, a primary site in head and neck region cannot be located. This calls for a complete clinical and radiological examination, focusing on the organs or areas where there is a high chance of an existing primary tumour. Sometimes, lymphatic metastases do not first develop in the lymph nodes nearest to the tumour. This is known as skip metastases. Тhe careful evaluation of these metastatic regional nodes is essential for appropriate treatment and to achieve the best outcome for the patient.

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