Laser microsurgery in the therapeutic management of atypical laryngeal papilloma – comments on a clinical case

Papillomas are some of the most common injuries found in the larynx and belong to the category of precancerous, progressive, recurrent conditions, with a high severity potential. They take two clinical forms: recurrent respiratory papillomatosis and keratinised squamous papilloma. In this article, the authors present the main elements of therapeutic conduct applied to a patient diagnosed with keratinised squamous papilloma. This case highlights peculiarities related to the atypical location of the tumor, the patient’s personal history, the surgical approach difficulties encountered in this case and the advantages conferred by laser technology in successfully solving such a pathology.

Rolul medicului otorinolaringolog în îmbunătăţirea declinului cognitiv

Longevity is expected to rise in the following years, therefore neurological problems become a global health concern. Dementia and hearing loss are highly prevalent pathologies in the older population, and a possible association be­t­ween them was studied in recent years. Dementia is still con­si­dered an incurable disease, but the evolution of the symp­toms is considered manageable by addressing the risk factors. In the latest studies, hearing loss has been con­sidered a modifiable risk factor for cognitive decline, along with obesity, smoking, hypertension, depression and physical inactivity. This paper presents the potentially pi­vo­tal role hearing loss might have in the evolution of cog­ni­tive decline and a summary of studied theories regarding the relationship between these pathologies. The recent guide­line of the World Health Organization regarding cognitive de­cline management involves otolaryngologists in the ef­fort of improving outcomes.

Tinnitus pathophysiology – still a puzzle for medicine

Tinnitus is an auditory sensation perceived by the patient without a corresponding external sound source, which in some cases can profoundly affect the quality of life, causing anxiety or even depression. One of the most demanding areas for tinnitus research is comprehending the underlying pathophysiological mechanisms, particularly for subjective chronic tinnitus. This review provides an update on the main mechanisms involved in the genesis of tinnitus. Coch­lear impairment remains an important cause in the onset of tinnitus, especially as it may be present in in­di­vi­duals considered to have normal hearing. These people have alterations on the audiogram that can be seen only at high frequencies, above 8 kHz, undetectable by standard au­dio­metric measurements. Other triggers in­volved are emo­tio­nal trauma or neurosensory factors. The feeling of tinnitus reflects a complex interaction bet­ween peri­phe­ral and central mechanisms at the level of the au­di­tory pathway, but also the involvement of non-auditory central areas, including frontal and parietal lobe or limbic level regions. Considering these aspects, tin­nitus can be considered a result of neuroplastic response to sensory deprivation. The knowledge of the complex and mul­ti­fac­torial mechanisms involved in the genesis of tinnitus can guide clinicians to make a correct diagnosis and recommend appropriate therapy in daily medical practice.

Burning mouth syndrome (BMS) – clinical symptoms

The scientific news and the importance for medical practice of approaching this oro-dental disease is supported not only by the patient’s persistent long-term suffering, but also by the concern to know how to identify the possible etiopathogenesis, especially in the secondary form, which once identified and sanctioned therapeutically is successful for both the attending physician and the patient.