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Pleomorphic adenoma is a non-cancerous neoplasm that develops in the salivary glands. Originating from minor salivary glands, it is extremely uncommon and primarily affects females. The peak incidence is observed between 40 and 60 years of age. It usually presents as a slowly growing, painless, solid tumor that does not cause ulcers on the overlying mucosa. Here, a 47-year-old woman experienced repeated swelling on the buccal mucosa following surgical extraction of a pleomorphic adenoma three years ago. The swelling was solid with clearly defined boundaries. An excisional biopsy was conducted under general anesthesia, resulting in total mass removal. The histological evaluation revealed the existence of a recurring pleomorphic adenoma. This instance emphasizes the significance of addressing this entity as a potential etiology for persistent painless and intraoral swellings.

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Background: We present the case of a patient with solitary fibrous tumor of the masticator space with unusual extension. Case presentation: A 43-year-old woman presented with a painless mass with intraoral extension on the right cheek. The B-scan sonograph and magnetic resonance imaging revealed the extension of the tumor. The biopsy performed under local anesthesia raised the suspicion of a solitary fibrous tumor. Tumor excision included a preoperative tumor embolization. The surgical removal of the tumor included a partial parotidectomy on the right side, insertion of masseteric and temporalis muscle, resection of the middle part of the zygomatic bone and stabilization of the bone with a plate, mobilization of the tumor from the maxillary sinus and the pterygopalatine fossa through an endoscopic approach and an approach via partial resection of the anterior wall of the maxillary sinus after identifying and sparing the infraorbital nerve. Ôhe histological findings confirmed the diagnosis of solitary fibrous tumor. The patient's treatment completed with radiation therapy, and 2.5 years later, there was recurrence in the right temporal area. Conclusion:To our knowledge, this is the second reported case of solitary fibrous tumor arising in the masticator space and the only case with extension intraorally and in the paranasal sinuses. Tumor embolization and complete surgical excision are the most frequently recommended treatments.

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BACKGROUND: A link between inflammation and venous thromboembolism (VTE) in COVID-19 disease has been suggested pathophysiologically and clinically. The aim of this study was to investigate the association between inflammation and disease outcomes in adult hospitalized COVID-19 patients with VTE. METHODS: This was a retrospective observational study, including quantitative and qualitative data collected from COVID-19 patients hospitalized at the Infectious Diseases Unit (IDU) of the University Hospital of Ioannina, from 1 March 2020 to 31 May 2022. Venous thromboembolism was defined as a diagnosis of pulmonary embolism (PE) and/or vascular tree-in-bud in the lungs. The burden of disease, assessed by computed tomography of the lungs (CTBoD), was quantified as the percentage (%) of the affected lung parenchyma. The study outcomes were defined as death, intubation, and length of hospital stay (LoS). A chi-squared test and univariate logistic regression analyses were performed in IBM SPSS 28.0. RESULTS: After propensity score matching, the final study cohort included 532 patients. VTE was found in 11.2% of the total population. In patients with VTE, we found that lymphocytopenia and a high neutrophil/lymphocyte ratio were associated with an increased risk of intubation and death, respectively. Similarly, CTBoD > 50% was associated with a higher risk of intubation and death in this group of patients. The triglyceride-glucose (TyG) index was also linked to worse outcomes. CONCLUSIONS: Inflammatory indices were associated with VTE. Lymphocytopenia and an increased neutrophil-to-lymphocyte ratio negatively impacted the disease's prognosis and outcomes. Whether these indices unfavorably affect outcomes in COVID-19-associated VTE must be further evaluated.

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Purpose: The present study aims to provide a comprehensive analysis of the use of stroboscopy as an assessment tool for patients with benign lesions of the vocal folds. Methods: The current study was based on an extensive review of the international bibliography regarding the evaluation of voice in patients with benign lesions of the vocal cords using videostroboscopy. Results: Stroboscopy is a convenient technique used by otolaryngologists that has been established as a valuable diagnostic tool for assessing patients with dysphonia and benign vocal cords lesions. Conclusions: Stroboscopy is recommended in the literature as the preferred method for assessing vocal cord vibratory function. The future poses challenges in standardizing guidelines and quantifying measurements of stroboscopic findings.

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Background The visual analogue scale (VAS) has been used as a diagnostic tool for the evaluation of the severity of olfactory and gustatory dysfunction (OGD) caused by SARS-CoV2 infection. The main objective of the present study was the evaluation of OGD with VAS in COVID-19-positive patients in Northwestern Greece and its possible association with the patients' self-reported symptoms of olfactory and gustatory dysfunction. Methods The presence of olfactory and gustatory symptoms and their severity were assessed by questionnaire along with the use of specific odorants and tastant ingredients, in three time periods: prior to COVID-19, during COVID-19 (initial diagnosis) and post-COVID-19 disease (at four weeks from disease onset). Three hundred COVID-19-positive patients (home-quarantined and hospitalized) tested with RT-PCR test in the University Hospital of Ioannina Greece were included in this study. Statistical analysis was performed on SPSS Statistics 26.0 (IBM Corp., Armonk, NY) Results Out of a total of 300 patients, 146 and 190 patients had mild hyposmia and hypogeusia respectively, followed by patients with severe hyposmia or hypogeusia (118 and 88 respectively), at the time of COVID-19 onset (initial diagnosis). An increase in the number of patients with recovery of symptoms was observed during the follow-up period, during which only eight patients had non-resolving severe symptoms (six patients with hyposmia and two with hypogeusia). On further analysis, a statistically significant association was found between the severity of symptoms (assessed by VAS score) and the self-reported symptoms of sensory dysfunction by the patients. There was a significant association between the groups of patients with mild hyposmia and patients that reported no loss of smell; between the patients with moderate hyposmia and the patients who reported "loss of smell"; and between the patients with severe hyposmia and the group of patients who reported a loss of smell, at the COVID-19 onset period. Similarly, patients with mild hyposmia were associated with those that reported a loss of smell at the same time. The severity of hyposmia was also associated with the reported symptom of "loss of taste" at the time of COVID-19 diagnosis. Similar findings were observed regarding the severity of hypogeusia and the reported symptom of "loss of taste" among the groups of patients. Finally, the severity of hypogeusia was associated with smell loss at the time of initial diagnosis of the infection. Conclusion Similar to the literature data, our findings indicate that hyposmia and hypogeusia are common symptoms of COVID-19 disease with varying severity. In our study, most of the patients exerted a complete recovery of these OGD symptoms. In addition, we found an association between olfactory dysfunction and self-reported sensory of taste as well as gustatory dysfunction and sensory of smell. Finally, we found that the VAS score was a reliable diagnostic tool in the estimation of OGD in this cohort of patients. However, our results need to be confirmed by larger-scale trials.

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Nasal masses are a clinical entity with great diversity. They present with various symptoms such as nasal obstruction, facial pain, discomfort, epistaxis, headache, anosmia and visual disturbances. Especially unilateral nasal masses are very suspicious and must be differentiated between benign and malignant lesions. Nasal endoscopy is a weapon in the quiver of otorhinolaryngologists. It is an innovative, quick, direct and inexpensive examination that can be performed even at the otorhinolaryngologist's office. Immediate imaging of lesions within the nasal cavity allows rapid initiation of treatment. This article highlights the importance of correct differential diagnosis of a unilateral nasal mass in a 37-year-old female patient.

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Autoimmune hepatitis (AIH) is characterized by elevated serum transaminase, increased immunoglobulin G levels, presence of autoantibodies, and hepatocellular damage. Coexistence with other autoimmune diseases has been reported in almost half of patients with AIH. Here, we report a 60-year-old man who developed rapidly progressive, bilateral, asymmetrical, and asynchronous sensorineural hearing loss that was consistent with immune-mediated inner ear disease (IMIED). This devastating presentation evolved as a late manifestation in the context of a six-month systemic illness that had previously resulted in type 1 AIH. A biochemical remission with normalization of aminotransferases achieved within two months after the initiation of corticosteroids with azathioprine. Further, an acceptable response has also been achieved at the patient regarding the right ear-hearing impairment; though, treatment could not reverse the substantial decrement in hearing capability of the left ear. To our knowledge, this is the first case report of the concurrent development of type 1 AIH and IMIED.

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Background: We present the case of a patient with a Merkel cell carcinoma (MCC) of the left preauricular area. Case presentation:A 84-year-old Greek man was examined at the outpatient ENT Department of our clinic with a lesion in the preauricular area that had appeared four months ago. The patient history included antihypertensive and antihyperlipidemic therapy as well as treatment for dementia. The excision of the skin lesion was performed under local anesthesia. The histological examination revealed a Merkel cell carcinoma. The patient underwent a computed tomography (CT) scan that showed a lesion with clear limits in the left parotid gland and lymph nodes. Under general anesthesia, he underwent a left superficial parotidectomy, left submandibular gland excision and radical neck dissection. Histological preparations were analyzed using an intraoperative flow cytometry (iFC) protocol. A radiation therapy concluded the patient's treatment. Conclusion:Even if MCC appears as a less common and more aggressive skin cancer type, a clinician always has to include it in the differential diagnosis of a skin lesion. We found the use of iFC very useful for the diagnosis of this skin cancer.

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Fibrous dysplasia (FD) is a rare, benign, chronic, slowly progressive bone disorder characterized by the replacement of normal bone and bone marrow by fibrous tissue, leading to deformity, pain and functional impairment. It was considered a disease of unknown etiology, uncertain pathogenesis and diverse histopathology. It was later discovered that was caused by a non-heritable activating mutation in the á-subunit gene of the stimulatory G-protein coding gene. Temporal bone involvement is the least frequently reported type, especially in children. The purpose of the current manuscript was to report a rare case of fibrous dysplasia of the left temporal bone of a 17-year-old child who came to the emergency room of our hospital with otalgia and progressive hearing loss on the left ear.

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Backround: We aimed to assess the relation of chemosensory dysfunction with the reported symptoms in two subgroups of patients in Northwestern Greece: the first one included patients with moderate to severe symptomatology who needed hospitalization and the second one, patients with mild symptoms who recovered at home. Methods:We used a questionnaire to select information about patient demographics, medical history and reported symptoms during infection. Three hundred COVID-19 positive patients who were identified via RT-PCR test in the University Hospital of Ioannina, Greece, were included in the present study, of which 150 recovered at home and the remaining 150 needed hospitalization. Statistical analysis was based on IBM-SPSS Statistics 26.0. Results:The majority of patients had fever during infection, while o minor percentage of those who needed hospitalization (12.67%) suffered from sore throat. There was a statistically significant difference between the loss of smell and clinical symptoms including fatigue, nose congestion, body aches and headache, and loss of taste and reported symptoms including fatigue, body aches, runny nose, headache and sore throat. Conclusion: Fever was the symptom with the highest percentage rate, while sore throat was the symptom with the lowest percentage rate. There are reported clinical symptoms related with olfactory and gustatory dysfunction during COVID-19 infection.

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Background:Dizziness is a commonly referred symptom in emergency departments (EDs). The aim of this study is to describe the epidemiology of dizziness included acute vestibular syndrome (AVS) in the ED of the University Hospital of Ioannina, Grecce, during a six-month period. Methods:A total of 60 patients presenting with dizziness to the ED of our hospital during a short period of six months in 2021 were identified. Data were obtained through retrospective and prospective review of medical records. Statistical analysis was based on ÉBM-SPSS Statistics 26.0. Results:Among the 60 patients, 16.67% received the diagnosis of cerebellar stroke, 3.33% Meniere disease, 16.67% vestibular neuritis, 20% benign paroxysmal positional vertigo, 3.33% cardiovascular disease, and 1.67% had a neurological disease. Finally, 35% of patients left the ED undiagnosed. Conclusion:Benign paroxysmal positional vertigo was found to be the most common cause of dizziness in the ED, followed by cerebellar stroke and vestibular neuritis. A detailed neurological examination is recommended for the diagnosis of dizziness in the ED. Our data confirm the findings of previous studies in the GreeK population of patients presenting with dizziness to the ED of our hospital.

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Objective:Olfactory and gustatory dysfunction that relates with the infection from severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) has already improved. The relation between chemosensory dysfunction and age and gender in covid-19 positive patients is the main objective of the present study. Methods:We used a questionnaire to select information about medical history, patient demographics and reported symptoms during infection. Three hundred covid-19 positive patients, who underwent a RT-PCR test in the University Hospital of Ioannina, Grecce, were included in this study; 150 of them recovered at home and the remaining 150 were admitted to hospital. Statistical analysis based on ÉBM-SPSS Statistics 26.0 was done. Results:The total sample included 300 patients, of which 106 females and 194 males. There was a statistically significant difference between the subgroup of patients aged 21-25, 61-65 and 71-75 with loss of smell, that of hospitalized patients aged 41-45 with loss of smell and the subgroup of those aged 31-35 and 71-75 with loss of taste. Conclusion:There is a significant association between chemosensory dysfunction and younger age groups. Olfactory and gustatory dysfunction appears more frequently in women than men. Male gender relates with disease severity.

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Objectives: To provide a detailed description and evaluation of therapeutic techniques for the management of nasal valve in rhinoseptoplasty. Method:An extensive review of the international bibliography has been conducted to highlight published articles on nasal valve pathology and therapeutic measures to address it. Results:To date, many techniques have been described for increasing the cross-sectional area of the nasal valve. Selection of the appropriate technique poses a significant challenge to the nasal valve surgeon. Long-term correction of NVD requires surgical intervention. Correction typically involves the use of various grafts or suture techniques to enlarge and/or support the nasal valve. Selection of the appropriate technique depends on the location and type of dysfunction (dynamic/static). Conclusion:The nasal valve plays an important role in nasal airflow. It is important for the otolaryngologist not only consider, but also fully evaluate the nasal valve when seeing a patient with nasal obstruction. If it is not the primary cause of obstruction, it is often a contributing factor. If NVD is discovered, it should be addressed during surgical intervention (functional rhinoplasty) to avoid a suboptimal outcome.

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Diagnosis of odontogenic tumors can be challenging due to their rarity and diverse morphology, but when arising near the tooth, the diagnosis could be suspected. When their location is not typical, like inside the paranasal sinuses, the diagnosis is less easy. Maxillary ameloblastomas are exceedingly rare with only sparse information on their epidemiological, histological and genetic characteristics. The aim of this report is to thoroughly review the available literature in order to present the characteristics of this tumor. According to available data, maxillary ameloblastomas can occur in all ages but later than mandible ones, and everywhere within the maxillary region without necessarily having direct contact with the teeth. No sex preference has been shown. The most common histological patterns seen in this location are the follicular and plexiform ones. Maxillary ameloblastomas are locally aggressive neoplasms, thus therapy aims for excision including normal bone beyond the lesion. In contrast to mandible ameloblastomas, maxillary ones most commonly show mutations of the SMO gene. Furthermore, differential tumor diagnosis is thoroughly discussed in the present review.

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