Objectives: To establish the efficacy of low-level laser therapy for tinnitus. Methods: We performed a prospective, randomized double-blind study on 60 outpatients with tinnitus presenting sensorineural hearing loss in the affected ear. They were randomly divided into two groups, the first performing active laser therapy 20 min a day for 3 months with a 650-nm, 5-mW soft laser (group L), the second using a dummy device which duplicated all aspects of active laser therapy except for the activation of the laser beam (group C). One subject in both groups dropped out due to an increase in tinnitus loudness. Two more patients in each group ceased to comply with the protocol due to familiar problems. Results: The Tinnitus Handicap Inventory (THI) was considered the main outcome measure; no statistical difference was detected between the 2 groups in the THI total score (p = 0.97), and its functional (p = 0.89), emotional (p = 0.89) and catastrophic (p = 0.89) subscales. Moreover, a visual analog scale for self-perceived loudness of the tinnitus showed no difference between the groups (p = 0.69). Regarding psychoacoustic parameters, the minimum masking level showed no difference (p = 0.42), while loudness expressed in sensation level exhibited lower values in group L (p = 0.0127). Group L subjects also presented a decreased rate of hyperacusis (p = 0.02). No changes were detected in the audiometric threshold in both groups. Conclusions: Soft laser therapy demonstrated no efficacy as a therapeutic measure for tinnitus.

The aim of this study was to evaluate the improvement of nasal flow and the fall of nasal resistance in 50 patients that underwent rhinoseptoplasty in our department and discuss the relative importance of valvular and septal deformities in nasal airway obstruction. Fifty consecutive patients underwent rhinoseptoplasty to improve nasal obstruction caused by severe septal deviation, external or internal valvular incompetence, or any combination of the three. We excluded patients with minor septal curvatures, septal perforations, or turbinate hypertrophy. Preoperative and postoperative rhinomanometry was performed on all 50 patients. In all 50 patients, septal and/or valvular surgery lowered nasal resistance in 90% of cases. Septoplasty alone with medial and basal osteotomies did not improve nasal flow (p < 0.4), whereas the correction of valvular obstruction alone increased nasal airflow in a statistically significant way (p < 0.0001). Moreover, patients with both valvular incompetence and septal deviation represented the group in which the greatest preoperative obstruction and the greatest postoperative improvement occurred. Nasal valvular function should be assessed with rhinomanometry in all preoperative rhinoplasty patients with airway obstruction. In many cases, valvular effects may surpass septal deviation as the primary cause of nasal airflow obstruction.

Objective/Hypothesis: The purpose of the study was to assess the satisfaction and quality of life in laryngectomees after vocal rehabilitation using voice prostheses. We evaluated the impact on quality of life between laryngectomees with voice prostheses, laryngectomees without them and healthy controls. Methods: This was a prospective study on a sample of laryngectomees in an Italian university hospital. Our study population was composed of 42 patients who had previously undergone a total laryngectomy; in 24 of them, voice rehabilitation was obtained with a voice prosthesis device (group A), while 18 of them learned oesophageal voice (group B). The results were compared with a group of 25 healthy controls (group C). In order to investigate the quality of life, we administered the Short Form 36-Item Health Survey (SF-36) to the 3 groups. Moreover, self-satisfaction of the subjects in group A was assessed by single questions regarding their use of the voice prosthesis. Results: A statistical difference in the SF-36 was detected for social functioning (SF) between groups A and B. Role physical, SF and role emotional were significantly better in group C than in group A. Group A stated they were very satisfied with voice quality while there were still some problems regarding prosthesis lifetime and communication at the telephone or in noisy environments. Conclusions: Voice prosthesis implantation in laryngectomees showed positive effects on patients’ quality of life; however, there are still some negative aspects. At present, an early diagnosis of larynx cancer with a partial laryngectomy in order to preserve phonatory function is the gold standard.

A rare case of cervicofacial actinomycosis arising primarily in the masseter muscle is described. The patient was a healthy 74-year-old woman who was not immunocompromised and had no other primary pathological finding in the oral cavity. The importance of the differential diagnosis for this unusual infection is demonstrated with tumoral pathological findings. Possible predisposing factors as well as diagnostic and therapeutic methods are discussed.

We report a case of glottic primary laryngeal lymphoma. Although the head and neck region is a frequent site of origin of extranodal non-Hodgkin's lymphomas, laryngeal involvement is exceptional. Including this case, about 90 primary laryngeal lymphomas have been reported in the literature. Microscopic study showed a diffuse malignant lymphoma of high-grade malignancy (WF sub-division H). A diffuse, large, B-cell-type NHL was diagnosed histopathologically. The patient was treated with combination chemotherapy, including cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP), which resulted in complete clinical remission after two courses. Four courses of combination chemotherapy were subsequently performed, making a total of six courses of combination chemotherapy. No recurrence has been observed during the 16-month follow-up period.