Background A significant proportion of spontaneous cerebrospinal fluid sCSF leaks are associated with idiopathic intracranial hypertension IIH The aim of this study was to assess the association between sCSF rhinorrhea and transverse venous sinus stenosis VSS a feature commonly observed in IIH with a proposed role in its pathophysiology Methods In this single-center retrospective matched case-control study venous and pituitary imaging data of consecutive patients undergoing endoscopic surgery for sCSF rhinorrhea over the last years were retrospectively reviewed Measurement of the height of the pituitary gland was used to assess empty sella and VSS was quantified as the ratio between the minimal area of the transverse sinus and the cross-sectional area of the sigmoid sinus VSS was considered significant when it was ≥ and bilateral Cases were compared with age-and sex-adjusted controls explored for causes other than IIH intracranial mass effect or venous thrombosis Results Twenty-nine patients were included median age years females body mass index BMI kg/m Cases had a significantly lower height of the pituitary gland than controls mm vs mm p < Bilateral VSS was found in of cases confidence interval CI to vs of controls CI to with p < Conclusion In this retrospective study sCSF leaks were strongly associated with VSS This novel finding provides a rationale for further investigation of the role of VSS in the onset of sCSF leaks and of the potential interest in venous stenting a er the surgical repair of leaks © 2020 ARS-AAOA, LLC.

Background: Parotid spread tumor may occasion wide defect with facial nerve sacrifice. We report our one time reconstruction experience of this defect using a thoracodorsal artery perforator and nerve flap (TAPN).

Surgery plays an important role in the treatment of sinonasal cancer. Many surgical approaches have been described, including open, endoscopic, or combined approaches. The choice is based on several criteria: general criteria related to the oncological results and morbidity of each technique, specific criteria related to the tumor (tumor extensions, tumor pathology), the patient, or the surgeon himself. The aims of this review are (i) to provide a complete overview of the surgical techniques available for the management of sinonasal malignant tumors, with a special focus on recent developments in the field of transnasal endoscopic surgery; (ii) to summarize the criteria that lead to the choice of one technique over another. In particular, the oncological outcomes, the morbidity of the different techniques, and the specificities of each histologic subtype will be discussed based on a comprehensive literature review.

Invasive fungal diseases (IFD) still cause substantial morbidity and mortality, and new therapeutic approaches are urgently needed. Recent data suggest a benefit of checkpoint inhibitors (ICI). We report the case of a diabetic patient with refractory IFD following a SARSCoV-2 infection treated by ICI and interferon-gamma associated with antifungal treatment.

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We have read with great interest Dr Onder's correspondence 1 regarding our article. 2 In our study, we reported a higher incidence of transverse venous sinus stenosis (TSS) in a group of patients operated on for a spontaneous cerebrospinal fluid (sCSF) leak than in a control group of patients adjusted for age and sex. Dr Onder's comments focus on 3 main points. The first question that needs to be addressed is whether the diagnostic criteria for intracranial idiopathic hypertension (IIH) are appropriate for sCSF leak patients. Indeed, the diagnostic features described by Dandy in 1937, and later formulated into a set of diagnostic criteria by Smith in 1985, notably include signs and symptoms of increased intracranial pressure (headaches, nausea, vomiting, transient visual obscurations, or papilledema) and increased CSF pressure. 3 Fundoscopy or lumbar puncture opening pressure measurements were performed in only 11 of 29 patients (38%) in our series. Five of these 11 patients had clinical signs of IIH. As pointed by Dr Onder, it is therefore not possible to conclude that there was a high prevalence of IIH among the patients of our series. However, it has been clearly shown that IIH in sCSF leak patients is not systematically associated with papilledema. 4 Moreover, all of our patients had an empty sella. Given the fact that empty sella has a 90.7% specificity for the diagnosis of IIH, 5 we hypothesized that this radiologic sign favored IIH in our patients. We were able to compare pre-and postoperative magnetic resonance images (MRIs) in a subset of the patients (n = 12): the height of pituitary gland was lower after than before surgery (1.9 mm [1.7-3.2] vs 2.2 mm [1.7-3.4]; p = 0.05). This further supports the fact that empty sella is a reflection of elevated intracranial pressure.

(1) Background: In head and neck squamous cell carcinoma, tumor hypoxia has been associated with radio/chemoresistance and poor prognosis, whereas human papillomavirus (HPV)-positive status has a positive impact on treatment response and survival outcomes. The aim of this study was to evaluate the expression and the potential prognostic value of hypoxia-induced endogenous markers in patients treated for squamous cell carcinoma of the nasal cavity and paranasal sinuses (SNSCC), and their correlation with HPV status. (2) Methods: In this monocentric study, patients treated in a curative intent for a SNSCC were screened retrospectively. Protein expression of CA-IX, GLUT-1, VEGF, VEGF-R1, and HIF-1α was determined by immunohistochemical staining, scored, and then correlated with overall survival (OS) and locoregional recurrence free survival (LRRFS). HPV status was assessed and correlated with hypoxic markers. (3) Results: 40 patients were included. A strong expression of CA-IX, GLUT-1, VEGF, and VEGF-R1 was detected in 30%, 32.5%, 50%, and 37.5% of cases, respectively. HIF-1α was detected in 27.5% of cases. High CA-IX expression was associated in univariate analysis with poor OS (p = 0.035), but there was no significant association between GLUT-1, VEGF, VEGF-R1, and HIF-1α expression, and OS/LRRFS. There was no correlation found between HPV status and hypoxia-induced endogenous markers (all p > 0.05). (4) Conclusions: This study provides data on the expression of hypoxia-induced endogenous markers in patients treated for SNSCC and underlines the potential role of CA-IX as a prognostic biomarker for SNSCC.