The objective was to assess the local oncological outcomes of endoscopic versus external surgical treatment of sinonasal intestinal-type adenocarcinomas (ITAC) and the factors of recurrence.
a retrospective non-randomized case-control multicenter study was carried out, including 452 untreated sinonasal ITACs recruited from 10 tertiary referral centers. The tumors were re-classified according to the UICC 2017 (pT). Survival curves were obtained using the Kaplan-Meier method. Univariate analysis was done with the log-rank test. Multivariate analysis was performed with a Cox model adjusted for age, T stage, and radiotherapy. A binary logistic regression compared surgical complications and performed two supplementary analyses on positive margins.
We compared 195 and 257 patients operated by the external and endoscopic approach, respectively. The mean follow-up was 59.2 ± 48.7 months. Post-operative margins were invaded in 30.6 versus 18.9% of patients, respectively (p = 0.007). The overall recurrence rate was 33.8 versus 24.6%, respectively (p = 0.034). There was a significant difference in favor of the endoscopic approach regarding local recurrence-free survival thanks to better surgical margins in univariate and multivariate analysis (Odd Ratio = 2.01 (1.2-3.36) p = 0.0087). The complication rate (Odds Ratio = 3.4 (1.79-6.32) p < 0.001) was significantly lower in the endoscopic group. The histological positivity of signet-ring cells shows a statistically significant difference in recurrence-free survival (p = 0.0028).
the oncological control of ITAC is better through the endoscopic approach, with negative margins and the absence of signet-ring-cells, two independent factors of recurrence.

BACKGROUND: Effective nasal reconstruction requires skin and soft tissue cover, cartilage or bone structure, and mucosal lining. Ideal lining is thin, pliable and vascularised, making reconstruction challenging. This paper presents the first case series with long-term outcomes of pericranial flaps used as inner lining for nasal reconstruction.
METHODS: Patients undergoing paramedial forehead flaps from 2007 to 2019 were identified using second-stage nasal reconstruction billing codes. Patients with pericranial flaps for lining, for whom there were data on resulting outcomes and complications, were identified.
RESULTS: Sixty-six patients underwent second-stage nasal reconstruction. Eighteen patients had paramedian forehead and pericranial flaps for inner lining reconstruction. The flap lining had no immediate post-operative complications. Three patients suffered partial to major reconstructive failure post radiotherapy. Other complications included nasal stenosis and orocutaneous fistula.
CONCLUSIONS: Combined with paramedian forehead flaps, the pericranial flap is reliable as inner lining for nasal reconstruction. It is easily accessible and useful in resections with limited mucosal options.

Epistaxis or nosebleeds (NB) are the most common emergency pathology that otorhinolaryngologists have to deal with. Purpose of the work: to study the prevalence of patients with NB in the otorhinolaryngological departments of hospitals in Moscow from 2003 to 2019. The reports of the heads of the ENT departments of the city clinical hospitals in Moscow were studied. Inclusion criteria were hospitals working with an adult contingent of patients. An approximation analysis was carried out and trend indicators of the prevalence of NB were studied.
RESULTS: 2003 to 2019 the total number of patients treated in ENT hospitals was 563 189 people, 20 623 (3.7%) patients were treated with NB, of which 52 (0.25%) died. The average age of the deceased was 64.7 years, men are 73.7% more prevalent than women. In 96.2% of patients, epistaxis was a complication of the underlying disease, and in 3.8%, it was regarded as a concomitant condition. In 30.8% of the deceased, NB recurred with the background of malignant lesions of the nose and nasopharynx, in 69.2% - posthemorrhagic anemia aggravated diseases of other organs and systems. Over the past 17 years, there has been a tendency for the growth of treated patients with diseases of ENT organs and patients with nosebleeds by 58.5% and 51.1%, respectively. The studied approximation of the relative prevalence and mortality rates in patients with NB showed that for the period from 2003 to 2019. trend values are practically at the same level with the minimum multidirectional linear dynamics - -0.24% and +0.04%, respectively.
Носовые кровотечения (НК) являются наиболее частой экстренной патологией, с которой приходится сталкиваться оториноларингологам.
UNASSIGNED: Изучить распространенность больных с НК в структуре оториноларингологических отделений стационаров Москвы за длительный период времени и на основании полученных данных построить математическую модель данного эпидемиологического процесса с трендовым анализом установленных показателей.
UNASSIGNED: Изучены отчеты заведующих отделений оториноларингологии городских клинических больниц Москвы. Критерием включения были стационары, работающие со взрослым контингентом больных. Проведен аппроксимационный анализ и изучены трендовые показатели распространенности НК.
UNASSIGNED: С 2003 по 2019 г. общее число больных, пролеченных в отделениях оториноларингологии, составило 563 189 человек, 20 623 (3,7%) пациента находились на лечении с НК, из них 52 (0,25%) скончались. Средний возраст умерших составил 64,7 года, мужчин на 73,7% больше, чем женщин. У 96,2% больных НК представляло осложнение основного заболевания, а у 3,8% — расценено как сопутствующее состояние. У 30,8% умерших НК рецидивировало на фоне злокачественного поражения носа и носоглотки, у 69,2% — постгеморрагическая анемия усугубила заболевания других органов и систем. За последние 17 лет зафиксирована тенденция увеличения пролеченных больных с заболеваниями уха, горла, носа и пациентов с НК на 58,5 и 51,1% соответственно. Изученная аппроксимация относительных показателей распространенности и летальности больных с НК показала, что за период с 2003 по 2019 г. трендовые значения находятся практически на одном уровне с минимальной разнонаправленной линейной динамикой — –0,24% и +0,04% соответственно.
UNASSIGNED: Полученные данные свидетельствуют о том, что оториноларингологическая служба стационаров Москвы на сегодняшний день обладает достаточным «запасом прочности» в возможности оказания экстренной помощи больным с носовыми кровотечениями.

The current study aims to provide stronger evidence to aid in our understanding of the role of cumulative occupational exposure to (softwood-dominated) mixed wood dust in aetiology of nasal cancer. We included broad exposure occurred in a range of wood-processing occupation across varied industries in four Nordic countries. A population-based case-control study was conducted on all male cases with nasal adenocarcinoma (393 cases), other types of nasal cancer (2,446) and nasopharyngeal cancer (1,747) diagnosed in Finland, Sweden, Norway and Iceland between 1961 and 2005. For each case, five male controls, who were alive at the time of diagnosis of the case (index date), were randomly selected, matched by birth-year and country. Cumulative exposures (CE)s to wood dust and formaldehyde before the index date were quantified based on a job-exposure matrix linked to occupational titles derived from population censuses. Hazard ratios (HRs) for the CE of wood dust were estimated by conditional logistic regression, adjusted for CE to formaldehyde and 95% confidence intervals (CIs) were calculated. There was an increasing risk of nasal adenocarcinoma related to wood dust exposure. The HR in the highest CE category of wood dust (≥ 28.82 mg/m3 -years) was 16.5 (95% CI 5.05-54.1). Neither nonadenocarcinoma of the nose nor nasopharyngeal cancer could be linked to wood dust exposure. CE to softwood-dominated mixed wood dusts is strongly linked with elevated risk in nasal adenocarcinoma but not with other types of nasal or nasopharyngeal cancer.