The Journal of International Advanced Otology (J Int Adv Otol) is an international, peer reviewed, open access publication that is fully sponsored and owned by the European Academy of Otology and Neurotology and the Politzer Society. The journal is published triannually in April, August, and December and its publication language is English.The scope of the Journal is limited with otology, neurotology, audiology (excluding linguistics) and skull base medicine.The Journal of International Advanced Otology aims to publish manuscripts at the highest clinical and scientific level. J Int Adv Otol publishes original articles in the form of clinical and basic research, review articles, short reports and a limited number of case reports. Controversial patient discussions, communications on emerging technology, and historical issues will also be considered for publication.Target audience of J Int Adv Otol includes physicians and academics who work in the fields of otology, neurotology, audiology and skull base medicine.

Introduction. Migraine vertigo (MV) and Ménière's disease (MD) share several signs and symptoms such as tinnitus, fullness, photophobia, phonophobia, headache and vertigo spells lasting hours. Objective. The aim of the present study was to prospectively observe patients with MV with a sporadic audiological symptom evaluated with clinical examination, Vestibular Evoked Myogenic Potentials (VEMPs), ECochG and v-HIT. Results. The finding of VEMP asymmetry, according to our cut-off of 33% of difference between sides, resulted in 20 cases, of which 6 had asymmetry of both c-VEMPs and o-VEMPS, all with development of fluctuating hearing during follow-up. ECochG was positive for endolymphatic hydrops in 12 patients. Conclusions. The evolution of MV may have a variable course in which some patients may develop symptoms typical of MD. The two diseases may be contextually present at the same time configuring an overlapping syndrome, and asymmetric VEMPs might predict development of fluctuating hearing.

Madelung’s Disease (MD), also known as benign multiple symmetric lipomatosis or Launois-Bensaude syndrome, is a rare condition. The characteristic feature is the presence of numerous diffuse lipomas at the level of the neck or upper limbs. The etiology is unknown, but a close association with ethyl abuse has been observed. The use of radiological examinations such as ultrasound, computed tomography and magnetic resonance imaging is helpful for the differential diagnosis. There are two classifications mainly used: The Enzi classification and the Donhauser classification. In this article we present a case of MD with laryngeal localization. A 50-year-old man was referred to our department complaining of dysphonia for about 6 months. An abnormal and diffuse enlargement of the anterior part of the neck was noticed, compatible with “Madelung’s Collar”. Fiberoptic examination of the larynx revealed the presence of a lipomatous-like neoformation of the left false vocal cord. The patient underwent surgical removal of the laryngeal neoformation with transoral laser microsurgery. With this article we suggest a possible diagnostic and therapeutic procedure for the treatment of laryngeal lipomatosis. Keywords: Lipoma; TML; Larynx; Dysphonia; ENT

Centrifuged autologous fat injection is a safe, feasible and effective phonosurgical technique for the treatment of chordal paralysis and its use dates back to 1991. This procedure allows to correct glottic incompetence by medialization of one or both vocal cords. Expecting fat resorption, which occurs postoperatively, the surgeon injects at least 30-40% more fat than needed to achieve glottic closure. The procedure is minimally invasive, with minimal morbidity and complications. In this article, we present a rare case of iatrogenic lipoma secondary to excessive lipoinjection due to the increase of the vocal cords, causing severe dysphonia.

The purpose of this study is to verify whether the performance of ultrasound-guided quadrantectomy (USGQ) versus palpation-guided quadrantectomy (PGQ) can reduce the incidence of positive margins and if it can change the attitude of the surgeon. A retrospective study was conducted on 842 patients underwent quadrantectomy for breast cancer, 332 of them underwent USGQ, whereas 550 underwent PGQ. The histological type of the tumors and the margin status obtained with the histological examination were compared. The histological examination of the surgical specimen showed involvement of the margins in 24/842 patients (2.85%), 22 (2.61%) of them belonged to the PGQ group, and two to the USGQ group (P = 0.0011). The highest rate of microscopically positive margins was, statistically significant, for carcinoma in situ, when compared with patients with invasive carcinoma (0.0001). USGQ technique showed several advantages compared with PGQ. In fact, the former notes a lower positive margin rate and, consequently, a lower rate of reintervention. In addition, it may change the surgeon's attitude by causing him to remove another slice of margin to ensure more histological negativity. It should be the gold standard technique for breast-conservative surgery of palpable tumors.