text/xml
1827-675X
2601
en
Marco  Benazzo
http://creativecommons.org/licenses/by-nc-nd/4.0
ACTA Otorhinolaryngologica Italica
Non-neoplastic recurrences in otorhinolaryngological diseases. Introduction
Text.Serial.Journal
https://www.actaitalica.it/
43
Annual congress report
2023-04-21
2023-04-19
2023-04-28
2023-04-28
S1-S2
1
Marco  Benazzo
2023/04/21
S1
Department of Otolaryngology Head and Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation piazzale Golgi, Pavia, Italy
1827-675X
S2
Non-neoplastic recurrences in otorhinolaryngological diseases. Introduction
https://www.actaitalica.it/article/download/2601/937
43
ACTA OTORHINOLARYNGOLOGICA ITALICA 2023;43(SUPPL.1):S1-S2




Non-neoplastic recurrences in otorhinolaryngological
diseases
Introduction
Le recidive non-neoplastiche nella patologia otorinolaringoiatrica
Introduzione

Otorhinolaryngology is a discipline that includes a wide variety of pathologies
affecting anatomical districts with critical vital functions. The Otorhinolaryn-
gologist is often called upon to provide complex therapeutical strategies for
challenging diseases whose aetiopathogenesis relies on complex mechanisms,
sometimes leading to disease chronicisation or relapses.
For disease relapse, it is intended the return of a disease or the signs and symp-
toms of a disease after a period of remission due to the persistence or re-
exposition to the same risk factors or pathogens.
Depending on the severity of the disease relapse, patients may be affected by
the same clinical signs and symptoms or, in some cases, present with more
severe symptoms due to disease progression or complications.
The term “relapse” is more commonly adopted in oncology, and refers to the
return of the tumour, loco-regionally or with distant metastasis, after it has
been successfully treated with surgical or non-surgical therapeutic protocols.
In the literature, many authors have widely investigated the aetiopathogenetic
                                                                                     Marco Benazzo
factors underlying cancer relapses, and even nowadays, there are several active      Department of Otolaryngology Head and Neck
protocols aimed at better defining such unknown phenomena.                           Surgery, University of Pavia, IRCCS Policlinico
Considering this massive attention directed to the head and neck oncology            San Matteo Foundation
                                                                                     piazzale Golgi 2, 27100 Pavia, Italy
field, we have decided to focus on the less investigated and still mysterious        E-mail: marben04@unipv.it
mechanisms underlying non-neoplastic disease relapses in otorhinolaryngol-
ogy.
The 2023 Official Report includes three segments focusing on the most rep-
resented non-oncologic pathologies in all three branches of otorhinolaryngol-
ogy:
• Rhinology
• Otology
• Head and Neck
The main aspect that defines an event as a relapse of disease is that it must
occur after a certain period of time without any disease-related sign, symptom
or alteration in the commonest blood chemistry analysis or diagnostic inves-
tigations. Although there is no general consensus about the definition of the
time interval between disease remission and relapse, it is believed to be at least
several weeks.
                                                                                     © Società Italiana di Otorinolaringoiatria
Another aspect that needs to be better specified is the distinction between dis-     e Chirurgia Cervico-Facciale
ease relapse and recurrence. The latter refers to a disease that has clinically
come back, usually after a period of time during which the disease itself could                     OPEN ACCESS

be undetectable.                                                                     This is an open access article distributed in accordance with
                                                                                     the CC-BY-NC-ND (Creative Commons Attribution-Non-
A representative example of recurrent disease is laryngeal papillomatosis,           Commercial-NoDerivatives 4.0 International) license. The
where the pathogen is the human Papillomavirus, and the clinical recurrences         article can be used by giving appropriate credit and mentio-
                                                                                     ning the license, but only for non-commercial purposes and
are due to multifactorial aetiopathogenesis (non-radical surgery, multifocal vi-     only in the original version. For further information: https://
ral infection, etc.).                                                                creativecommons.org/licenses/by-nc-nd/4.0/deed.en




                                                                                                                                               S1
M. Benazzo




In other cases, disease relapses are due to still unknown aetiopathogenetic factors, thus burdening treatment results and
surgical outcomes as for nasal polyposis or chronic otitis media with cholesteatoma.
Due to their complexity and multifactorial nature, some challenging chronic diseases are managed with a multidisciplinary
approach, both medical and surgical. For such chronic diseases, patients often suffer from unsatisfactory therapies and
frustration from non-resolutive surgeries. The role of the Otorhinolaryngologist is to guide the patient through long-lasting
therapeutic protocols, thus defining the best surgical timing, whether necessary and providing effective patient counselling
to preserve the doctor-patient relationship.
In several cases, it is essential to stress the role of some primary prevention measures, such as the HPV vaccination cam-
paign for laryngeal papillomatosis, or the importance of effective counselling about nasal hygiene in patients affected by
nasal polyposis, or, furtherly, the sensibilisation towards experimental medical therapies in patients affected by benign
positional parossistic vertigo.
In other cases, patients suffer from the consequences of inadequate primary surgery. Thus, the most effective strategy to
avoid disease relapses is to provide medical treatment or surgical protocols according to the current best standards of care.
Finally, from a comparative reading of the manuscripts included in the 2023 Official Report, it should be highlighted that
most authors summarise the conclusions of their scientific contributions in the form of algorithms or flowcharts, thus sug-
gesting the emerging role of artificial intelligence in Otorhinolaryngologist practice.
The 2023 Official Report aims to unravel the most significant problems related to the diagnosis and treatment of non-
neoplastic disease recurrences in the otorhinolaryngological field and includes the contribution of the most representative
Italian Tertiary Centres. It is intended to stimulate the attention of specialists on an important topic which, at times, also
exposes us to important medico-legal problems.

                                                                                                             Marco Benazzo




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