Purpose To compare and analyze the incidence of otitis media with effusion (OME), before and during the COVID-19-related pandemic period, to evaluate the effects of the social changes (lockdown, continuous use of facial masks, social distancing, reduction of social activities) in the OME incidence in children and adults. Methods The number of diagnosed OME in e five referral centers, between 1 March 2018 and 1 March 2021, has been reviewed and collected. To estimate the reduction of OME incidence in children and adults during the COVID-19 pandemic period the OME incidence in three period of time were evaluated and compared: group 1—patients with OME diagnosis achieved between 1/03/2018 and 01/03/2019 (not pandemic period). Group 2—patients with OME diagnosis achieved between 1/03/2019 and 1/03/2020 (not pandemic period). Group 3—patients with OME diagnosis achieved between 1/03/2020 and 1/03/2021 (COVID-19 pandemic period). Results In the non-pandemic periods (group 1 and 2), the incidence of OME in the five referral centers considered was similar, with 482 and 555 diagnosed cases, respectively. In contrast, the OME incidence in the same centers, during the pandemic period (group 3) was clearly reduced with a lower total number of 177 cases of OME estimated. Percentage variation in OME incidence between the first non-pandemic year considered (group 1) and the pandemic period (group 3) was—63, 3%, with an absolute value decrease value of—305 cases. Similarly, comparing the second non-pandemic year (group 2) and the pandemic year (group 3) the percentage variation of OME incidence was—68, 1% with an absolute value of—305 cases decreased. Conclusions Our findings showed a lower incidence of OME during the pandemic period compared with 2 previous non pandemic years. The drastic restrictive anti-contagion measures taken by the Italian government to contain the spread of COVID-19 could have had a positive impact on the lower OME incidence during the last pandemic year.

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Obstructive Sleep Apnea (OSA) syndrome is a respiratory sleep disorder characterized by a reduction (hypopnea) in or a complete cessation (apnea) of airflow in the upper airways at night, in the presence of breathing effort. The gold standard treatment for OSA is ventilation through continuous positive airway pressure (CPAP), although this often shows poor patient compliance. In recent years, transoral robotic surgery (TORS) has been proposed as a valid surgical treatment for patients suffering from OSA in a multilevel surgical setting. The aim of this study is to analyze the effects on QoL and daytime sleepiness of multilevel surgery for OSA (barbed pharyngoplasty + transoral robotic surgery). Furthermore, we compared the impact on QoL and daytime sleepiness of two different treatments for patients with moderate to severe OSA, such as CPAP and TORS. Sixty-seven OSA patients who underwent multilevel robotic surgery and sixty-seven OSA patients treated with CPAP were enrolled, defined as Group 1 and Group 2, respectively. The Glasgow Benefit Inventory (GBI) questionnaire was administrated to evaluate the changes in the QoL. Respiratory outcomes were evaluated and compared. Group 1 showed a GBI total average value of +30.4, whereas Group 2, a value of +33.2 (p = 0.4). General benefit score showed no difference between groups (p = 0.1). Better values of social status benefit (p = 0.0006) emerged in the CPAP Group, whereas greater physical status benefit (p = 0.04) was shown in the TORS Group. Delta-AHI (−23.7 ± 14.3 vs. −31.7 ± 15.6; p = 0.001) and Delta-ODI (−24.5 ± 9.5 vs. −29.4 ± 10.5; p = 0.001) showed better values in the CPAP group. Therapeutic success rate of the Multilevel TORS Group was 73.1% and 91% in the CPAP group (p = 0.01), respectively. Multilevel TORS and CPAP have a positive effect on the quality of life of OSA patients. Greater social support has been reported in the CPAP group and better physical health status in the TORS group. No statistical difference emerged in the reduction in daytime sleepiness between both groups.

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Objectives: The aim of this study has been to analyze effects on Quality of Life (QoL) of the multilevel surgery for Obstructive Sleep Apnea (OSA). Also, we have compared the impact on QoL of two different treatments for patients with moderate to severe OSA such as CPAP and transoral robotic surgery (TORS). Design: 67 OSA patients who underwent multilevel robotic surgery and 67 OSA patients treated with CPAP were enrolled in a Group 1 and Group 2 respectively. The Glasgow Benefit Inventory (GBI) questionnaire has been administrated to all patients to evaluate the changes in the QoL after the different OSA treatment. Respiratory outcomes pre and post treatment were evaluated and compared. Results: Group 1 showed a GBI total average value of +30.4, whereas the group 2 a value of +33.2 . No statistical difference emerged (p=0.4). General benefit score showed no difference between groups (p = 0.1). Better values of social status benefit (p= 0.0006) emerged in CPAP Group, whereas greater physical status benefit (p=0.04) was showed in TORS Group. Delta-AHI (-23.7 ± 14.3 vs -31.7 ± 15.6; p = 0.001), Delta-ODI (-24.5 ± 9.5 vs. -29.4 ±10.5; p = 0.001) showed better values in CPAP group. Therapeutic success rate of Multilevel TORS Group was 73.1% and 91% in CPAP group (p = 0.01) respectively. Conclusion: Multilevel TORS and CPAP have a positive effect in quality of life of OSA patients. Greater social support has been reported in CPAP group and better physical health status in TORS group.

Objective: The objective of this article is to define a correct diagnostic pathway for oropharyngeal cancer of unknown primary (OPCUP) identification. Background: OPCUP represents one of the most frequent causes of neck metastases onset without the identification of the primary tumor. Therefore, there is a high percentage of late or missing diagnoses, resulting in treatment delay or in a wrong therapeutic process. The up-to-date diagnostic procedures can help us to begin therapies at the right time. Methods: This is a review of the latest articles about diagnostic pathways in the OPCUP. A selection of the references was carried out in PubMed, EMBASE, Cochrane, and CENTRAL electronic databases. Conclusion: The oropharynx represents the most common site of primary unknown head and neck cancer (HNCUP). Recent epidemiologic data reported an increasing incidence of HNCUP related to human papilloma virus positive squamous cell carcinoma. Positron emission tomography combined with computerized tomography scanning or magnetic resonance imaging allows for improving the detection of primary unknown tumors and distant and locoregional metastases. Finally, the introduction of the trans-oral robotic surgical approach has introduced a new role of surgery in the HNCUP diagnosis and treatment. Hence, the new technological improvement allows reaching in most HNCUP patients an early diagnosis, achieving targeted management and better treatment outcomes, as well as decreasing toxicity and the side effects of treatment options.

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