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Background Interventional radiotherapy (brachytherapy; IRT) reemerged in the last decades as a potentially useful tool in head and neck oncology after a set of clear technical improvements were developed. Methods Sixty‐one high dose ratio (HDR) IRT treatments were recommended and performed on 58 patients. We classified the cases into four relatively homogeneous groups based on the clinical needs that led to the recommended IRT. Also, we separately evaluated primary and recurrent cases. Results Disease‐specific survival was significantly different among the four treatment groups. The group with the best prognosis was the cohort treated locally by exclusive interstitial IRT for resectable midface malignancies (2‐year relapse‐free survival = 82%, disease‐specific survival = 89%). Conclusion HDR IRT is a valuable tool in well‐defined clinical situations and, in particular, in recurrences. In midface malignancies, it could become the preferred primary treatment.

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ObjectiveTo report on the results of intracanalicular vestibular schwannomas (ICVS) that were managed by wait and scan and to analyze the possible predictors of tumor growth and hearing deterioration throughout the observation period.Study DesignA retrospective case series.SettingQuaternary referral center for skull base pathologies.PatientsPatients with sporadic ICVS managed by wait and scan.InterventionSerial resonance imaging (MRI) with size measurement and serial audiological evaluation.Main Outcome MeasureTumor growth defined as 2 mm increase of maximal tumor diameter, further treatment, and hearing preservation either maintain initial modified Sanna hearing class, or maintain initial serviceable hearing (class A/B).Results339 patients were enrolled. The mean follow-up was 36.5±31.7 months with a median of 24 months. Tumor growth occurred in 141 patients (40.6%) either as slow growth (SG) in 26.3% of cases or fast growth (FG) in 15.3% of cases. Intervention was performed in only 64 cases (18.8%). Out of 271 patients who underwent hearing analysis, 86 patients (33.5%) showed hearing deterioration to a lower hearing class of the modified Sanna classification. Tumor growth and older age were predictors of hearing deterioration. Of the 125 cases with initial serviceable hearing (Class A/B), 91 cases (72.8%) maintained serviceable hearing at last follow-up. Tumor growth and a worse initial pure tone average (PTA) were predictors of hearing deterioration.ConclusionsWait and scan management of ICVS is a viable option and only 18.8% of patients needed further treatment. Hearing tends to deteriorate over time.

Introduction: This study aims at defining through a retrospective evaluation, the clinical parameters affecting the clinical course and consequently the management of patients presenting with cervicofacial abscesses. Methodology: A total of 394 patients diagnosed with abscess at the University of Sassari Otorhinolaryngology Division between 2009 and 2017 were included; among these, eleven patients were diagnosed with necrotizing fasciitis. Personal and clinical parameters including the LRINEC score and the medical and/or surgical treatment used were analyzed for each patient. The most frequently affected site was the peritonsillar space (76.9%), followed by the parapharyngeal space. Results: Mean age was 41(±17) years, the male population was slightly overrepresented (68%). An average of 6 (±7) days of hospitalization duration was recorded. The mortality rate was confirmed to be relatively low (1/349 patients) and was reported only in one patient diagnosed with necrotizing fasciitis (1/11). Conclusion: Diagnosis, correct clinical definition and early medical-surgical treatment of neck abscesses were crucial to reduce complications; LRNEC score, C-reactive protein, glycemia and creatininemia proved to be reliable prognostic indicators of difficult patient management and risk of complications.