No abstract

Deep neck infections are less and less frequent today than in the past. Nevertheless, their complications are often life-threatening. The present study reviews the experience of the Department of Otolaryngology and Head and Neck Surgery of Padua with deep neck infections during the period from 1998 to 2001. Eighty-three patients (55 males and 28 females) were retrospectively considered. The site of origin of deep neck infection was identified in 76 patients (91%). The most common cause was dental infection, occurring in 35 cases (42%). In 12 cases (14%) deep neck infection was a complication of oropharyngeal infection. The relatively high incidence of Peptostreptococcus sp, Streptococcus viridans, Streptococcus intermedius and constellatus isolation was consistent with the high rate of odontogenic cases. Surgery was advocated as the treatment for any infection of the deep neck spaces. The recent series has demonstrated that medical treatment did not seem to increase complication rates or mortality. Our tailored approach (medical or medical and surgical) based on clinical and radiological evidence was successful in 97% of the patients.

Dear Editor, A novel member of human RNA coronavirus was newly identified in Wuhan, China. International Committee on Taxonomy of Viruses (ICTV) officially named it as Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) [1]. World Health Organization (WHO) recently named the disease caused by SARS-CoV-2, as Coronavirus Disease 2019 (COVID-19). Clinical evidence has demonstrated that this virus was transmissible from person to person [2]. SARS-CoV-2 cases increased rapidly in Wuhan and Hubei Province and extended with transmission chains throughout China. Outside China, imported cases and secondary cases have been reported in many countries and territories, and WHO declared COVID-19 outbreak a pandemic on March 11th, 2020 [3]. In Italy, we are experiencing a constant increase of infected patients and there is now concern regarding the Italian national health system's capacity to effectively respond to the needs of patients who are infected and require intensive care for SARS-CoV-2 pneumonia [4]. On March 27th, 2020 in Italy, 66,414 patients tested positive to the virus, 36,653 (55.2%) were isolated at home, 26,029 (39.2%) were hospitalized and 3732 (5.6%) were admitted to intensive care unit [5]. Very recently, Sky News reported that two National Health Service ENT consultants were receiving critical care after contracting SARS-CoV-2 [6]. These colleagues most likely acquired the infection from exanimated patients during their daily clinical work [6]. Considering that the most likely route of transmission of SARS-CoV-2 is by contact and respiratory droplets (aerosols), over short distances (1.5 m) [7], ENT examination stands at high risk for transmission of the virus to healthcare providers. Otolaryngologists should be accurately informed on COVID-19 in order to identify suspected cases. According to a very large case series from the Chinese Center for Disease Control and Prevention (72,314 cases, updated through February 11, 2020), more than 80% of COVID-19 cases presented mild symptoms [1]. In this report, the authors stated that cough and fever were very frequent but did not describe all presenting complaints [1]. COVID-19 commonly presented with fever, cough, and fatigue [2]; at now, little attention has been paid to upper airway symptoms. Considering case series of less than 150 patients, sore throat was reported in 5% [8], 11% [9], or 17.4% [10] of COVID-19 patients. In a larger series of 1099 COVID-19 patients, Guan et al. [2] found pharyngodynia in 13.9% of cases. In the same report, nasal congestion was present in 4.8% of COVID-19 patients [2], similarly to what it was found by Chen et al. (4% of cases) [8]. It is rational that COVID-19 entails pharyngeal and nasal complaints, including rhinorrhea [8]. In fact, the standard for detection of SARS-CoV-2 are real-time reverse-transcriptase polymerase-chain-reaction (RT-PCR) assays collected by nasal and oropharyngeal swabs, meaning that virus load in these sites should be high [7]. Olfaction alterations remain an open issue. One of the first warning...

Recurrences occurred despite obtaining block resections according to the tumor's clinical stage and pathologically free margins in all cases. Further analyses are mandatory to investigate hidden microscopic pathways of tumor diffusion, particularly in bone. Multi-institutional protocols are needed to facilitate comparisons between studies and enable meaningful meta-analyses.

Temporal bone carcinoma is an uncommon aggressive malignancy. Its low incidence and the absence of a globally accepted staging system still make it difficult to compare different centers' approaches and results. In this review of the main available studies dealing with temporal bone carcinoma since 1995, we consider its rational preoperative staging and assessment, compare the effectiveness of different treatments by tumor stage, and outline the main actuarial prognostic factors.