The clinical consequences of the COVID-19 lockdown: A report from an Italian referral ENT department.

Objectives: To evaluate the clinical effects of health care reorganization because of COVID-19, in a non-red zone Italian referral department of Otorhinolaryngology. Materials and Methods: We retrospectively reviewed the statistics of admissions to the Emergency Department (ED) of the Careggi University Hospital, Florence, from January 1, 2020, to May 17, 2020. Data regarding elective and urgent head and neck disorders were reviewed and the most challenging cases were discussed. Results: During the lockdown period, outpatient otolaryngological consultations and elective procedures decreased by 78% and 75% respectively, while emergency/urgency surgery increased by 128%. The five most emblematic clinical cases were thoroughly analyzed. Conclusion: Our analysis shows how the profound rearrangement of clinical and surgical activities, along with the citizens' fear to seek medical care has probably exacerbated the management of many routine head and neck conditions. Level of Evidence: 4.

Endoscopic nasal versus open approach for the management of sinonasal adenocarcinoma: A pooled-analysis of 1826 patients.

BACKGROUND: Surgical resection represents the gold standard for the treatment of sinonasal malignancies. This study reviewed the published outcomes on endoscopic surgery or endoscopic-assisted surgery versus open approach for the management of sinonasal adenocarcinomas. METHODS: PubMed, EMBASE, the Cochrane Library, and CENTRAL electronic databases were searched for English language articles on endoscopic surgery, endoscopic-assisted surgery, and open approach for sinonasal adenocarcinomas. Each article was examined for patient data and outcomes for analysis. RESULTS: Thirty-nine articles including 1826 patients were used for the analysis. The endoscopic surgery and endoscopic-assisted surgery showed low rates of major complications (6.6% and 25.9%, respectively) compared to open approaches (36.4%; p < .01). The incidence of local failure was lower in the endoscopic surgery group as compared with open approach patients (17.8% vs 38.5%; p < .01, respectively). The multivariate Cox regression model showed a worst overall survival related to advanced T classification and open approach. CONCLUSION: From the existing body of data, there is growing evidence that endoscopic nasal resection is a safe surgical option in the management of sinonasal adenocarcinomas. © 2015 Wiley Periodicals, Head Neck 38: E2267-E2274, 2016.