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Article: Epistaxis Treatment Options: Literature Review.

Mylonas, Stylianos / Skoulakis, Charalampos / Nikolaidis, Vasileios / Hajiioannou, Jiannis

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India

2023 Volume 75, Issue 3, Page(s) 2235–2244

Abstract: Epistaxis means bleeding from nostrils, nasal cavity or nasopharynx. To summarize the available epistaxis treatment options. Methods: 61 articles published in the last 20 years were included. Duplicate records, irrelevant and inaccessible ones were ... ...

Abstract	Epistaxis means bleeding from nostrils, nasal cavity or nasopharynx. To summarize the available epistaxis treatment options. Methods: 61 articles published in the last 20 years were included. Duplicate records, irrelevant and inaccessible ones were excluded. Epistaxis can be treated with first aid measures such as external pressure and ice packing and applying topical agents, e.g. oxymetazoline that stops 65-75% of nosebleeds in A&E. Also, with electrocautery which is more effective and has fewer recurrences (14.5% vs. 35.1%) than chemical cauterization and applying tranexamic acid that promotes hemostasis in 78% of patients, versus 35% and 31% respectively in patients treated with oxymetazoline and nasal packing. Furthermore, nasal packing can be applied with non-absorbable materials, e.g. petroleum jelly, BIPP gauze, PVA nasal tampons (Merocel), Foley catheter, balloons (Rapid-Rhino), absorbable materials, e.g. nasal tampon (Nasopore), and with newer hemostatic materials which are more effective and with fewer complications, e.g. hemostatic gauzes (Surgicel), thrombin matrix (Floseal), gelatin sponge (Spongostan) and fibrin glue. Moreover, epistaxis can be achieved with endoscopic ligation of arteries, mainly SPA, which is more effective than conventional nasal packing (97% vs. 62%), and with endoscopic cauterization which is more effective than ligation. Finally, for intractable cases embolization can be applied using gelatin sponge, foam, PVA and coils with 80% success rate and comparable efficacy and complications to surgical methods. Epistaxis can be dealt with various methods depending on patient's history and available resources. Newer hemostatic agents in combination with endoscopic methods have advantages over traditional methods.
Language	English
Publishing date	2023-05-08
Publishing country	India
Document type	Journal Article
ZDB-ID	1471137-0
ISSN	0973-7707 ; 2231-3796 ; 0019-5421
ISSN (online)	0973-7707
ISSN	2231-3796 ; 0019-5421
DOI	10.1007/s12070-023-03824-z
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Article: Otitis media with effusion prevalence in mountainous/rural and urban environment in Greece.

Tsitiridis, I / Skoulakis, C / Hajiioannou, J

Hippokratia

2020 Volume 24, Issue 1, Page(s) 45

Language	English
Publishing date	2020-05-20
Publishing country	Greece
Document type	Journal Article
ZDB-ID	2491943-3
ISSN	1790-8019 ; 1108-4189
ISSN (online)	1790-8019
ISSN	1108-4189
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Article: Vitamin D Levels in Chronic Rhinosinusitis in Patients With or Without Nasal Polyposis: A Systematic Review.

Pantazidou, Georgia / Papaioannou, Ioannis / Skoulakis, Charalampos / Petinaki, Efthimia / Hajiioannou, Jiannis

Cureus

2023 Volume 15, Issue 9, Page(s) e46275

Abstract: Chronic rhinosinusitis (CRS) is a large group of heterogeneous diseases characterized by extensive inflammation of the nasal mucosa and sinuses. Vitamin D (VD), as an immunoregulatory hormone, may play an important role in the pathophysiology of CRS. The ...

Abstract	Chronic rhinosinusitis (CRS) is a large group of heterogeneous diseases characterized by extensive inflammation of the nasal mucosa and sinuses. Vitamin D (VD), as an immunoregulatory hormone, may play an important role in the pathophysiology of CRS. The purpose of this study is to review the existing literature that correlates VD levels with CRS with or without nasal polyps. A systematic manual search was conducted in the PubMed and Google Scholar databases up to July 2023. Articles from PubMed and the first 100 articles from Google Scholar were recorded for our research. Keywords used were the following: vitamin D, chronic rhinosinusitis, and nasal polyps. Among the 134 articles retrieved, only 18 were eligible. The other 116 studies were excluded as they related VD levels with other conditions (e.g., allergic rhinitis) and for other reasons. However, we identified two more eligible records through the manual research of the above-mentioned 132 studies, and finally, 20 records were included in the current review. The review concerned case-control studies, prospective, retrospective, and cross-sectional studies. Based on our review, we concluded that CRS patients are correlated with the lowest VD levels, accompanied by increased severity of the disease, especially in those with nasal polyposis. Patients can benefit from appropriate VD supplementation, and serum VD levels should be included in the laboratory assessment of CRS. However, due to the heterogeneity of the individuals involved, more well-designed clinical trials as well as randomized clinical trials should be conducted for further validation of the above findings in the general population in the future.
Language	English
Publishing date	2023-09-30
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.46275
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Article ; Online: Current Treatment Options for Patulous Eustachian Tube: A Review of the Literature.

Koltsidopoulos, Petros / Skoulakis, Charalampos

Ear, nose, & throat journal

2020 , Page(s) 145561320932807

Abstract: Objective: Patulous Eustachian tube (PET) is a clinical condition that is associated with troublesome aural symptoms and is difficult to be treated successfully. The purpose of this review is to examine the published literature regarding the therapeutic ...

Abstract	Objective: Patulous Eustachian tube (PET) is a clinical condition that is associated with troublesome aural symptoms and is difficult to be treated successfully. The purpose of this review is to examine the published literature regarding the therapeutic value of the current treatment options for PET. Methods: We searched Web of Science, PubMed and Medline from 1999 to 2019. The search focused on papers concerning the clinical evaluation of treatment methods in PET patients. Statistical techniques were not used. Results: Prospective and retrospective case series were the types of trials available for review. We included 28 articles that evaluated the efficacy of various conservative and surgical therapeutic options. The recovery rates ranged from 50% to 100%. In most studies the assessment of efficacy was based on the subjective improvement of patient symptoms as there is no validated outcome tool available. No severe adverse events were observed in any study. Conclusion: On the basis of the available literature, it seems that conservative treatments can be considered as a primary therapeutic option for PET. Concerning the surgical interventions they seem to be a safe and valuable solution in patients with refractory disease. Finally, given the low level of evidence, prospective case-control studies with long follow-up and robust setting looking into the therapeutic approach of PET are required. The need for establishment of standard criteria of PET recovery should be underlined.
Language	English
Publishing date	2020-06-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	750153-5
ISSN	1942-7522 ; 0145-5613
ISSN (online)	1942-7522
ISSN	0145-5613
DOI	10.1177/0145561320932807
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Article ; Online: Laminin Immunostaining in Biopsies as a Useful Biomarker of Early Invasion in Actinic Cheilitis and Differential Diagnosis Between Actinic Cheilitis and Lip Cancer: New Insights.

Vageli, D / Doukas, P G / Zacharouli, K / Kakanis, V / Strataki, M / Zioga, A / Skoulakis, C / Koukoulis, G / Ioannou, M

Head and neck pathology

2022 Volume 17, Issue 2, Page(s) 331–338

Abstract: Background: Squamous cell carcinoma of the lip (LSCC) and oral cavity can be life-threatening if not diagnosed early. Precancerous lesions like actinic cheilitis (AC), can transform into LSCC. Laminin is a fundamental component for basement membrane (BM) ...

Abstract	Background: Squamous cell carcinoma of the lip (LSCC) and oral cavity can be life-threatening if not diagnosed early. Precancerous lesions like actinic cheilitis (AC), can transform into LSCC. Laminin is a fundamental component for basement membrane (BM) and its integrity may prevent neoplastic invasion. Therefore, laminin immunostaining of BM may be useful in identifying early invasion in actinic cheilitis and thus in the differential diagnosis between AC and invasive LSCC or high-grade epithelial dysplasia (ED). Materials and methods: Biopsies from 46 patients with oral lesions were histologically analyzed and immunohistochemically stained for laminin-1. Results: AC was diagnosed in 34 patients and LSCC in 12 patients, including 3 patients with AC and concomitant high-grade ED/in situ carcinoma. Laminin-1 immunostaining revealed intense and linear expression of the BM in AC with low-grade ED. Loss of laminin expression was observed in LSCC. Intracellular laminin expression in parabasal cells was noted in AC with high-grade ED/in situ carcinoma. Conclusion: Laminin immunostaining could be useful in identifying AC cases suspected of early invasion. It could also contribute to the histopathological differential diagnosis between AC with low- and high-grade ED and between AC and invasive LSCC. The findings of this study provide new insights into the mechanism involved in the progression process of AC into LSCC, encouraging preclinical studies that may document the stochastic role of laminin in this process.
MeSH term(s)	Humans ; Lip Neoplasms/diagnosis ; Lip Neoplasms/pathology ; Laminin ; Diagnosis, Differential ; Cheilitis/diagnosis ; Cheilitis/pathology ; Carcinoma, Squamous Cell/pathology ; Biomarkers ; Biopsy ; Carcinoma in Situ
Chemical Substances	Laminin ; Biomarkers
Language	English
Publishing date	2022-10-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2407834-7
ISSN	1936-0568 ; 1936-055X
ISSN (online)	1936-0568
ISSN	1936-055X
DOI	10.1007/s12105-022-01504-y
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Article: Diagnostic accuracy of fine needle aspiration cytology in parotid gland lesions.

Hajiioannou, J / Gkrinia, E / Brotis, G A / Saratziotis, A / Nepka, C / Korais, C / Skoulakis, C

Hippokratia

2022 Volume 26, Issue 1, Page(s) 25–31

Abstract: Background: This study aimed to estimate the fine needle aspiration cytology's (FNAC) diagnostic accuracy in differentiating neoplastic from inflammatory lesions (Q1) and malignant from their benign counterparts (Q2).: Methods: We present a ... ...

Abstract	Background: This study aimed to estimate the fine needle aspiration cytology's (FNAC) diagnostic accuracy in differentiating neoplastic from inflammatory lesions (Q1) and malignant from their benign counterparts (Q2). Methods: We present a retrospective case series covering a single University Hospital and six attending head and neck surgeons over eight years (January 2011 to July 2017). We concentrated on adults with clinically suspected parotid gland lesions. We offered all patients FNAC biopsy preoperatively, and the final diagnosis was established based on the findings of the final histology. The FNAC and histology results were cross-tabulated in a 2 x 2 contingency table, from which we calculated the diagnostic accuracy, sensitivity, specificity, and positive and negative predictive values. Results: From 212 consecutive patients reviewed, and after excluding thirteen cases (8 %) of valid but non-diagnostic FNAC, 161 cases (50 females and 111 males) fulfilled set eligibility criteria. The most common diagnosis was Warthin tumors (53 patients, 34 %), followed by pleomorphic adenomas (52 patients, 33.5 %). The sensitivity and specificity of FNAC in differentiating neoplastic from non-neoplastic lesions and in segregating malignant from benign conditions were estimated to be as high as 50 % and 97 %, and 98 % and 93 %, respectively. Conclusion: FNAC is moderately effective in differentiating non-neoplastic from neoplastic disease and highly accurate in selecting malignant lesions from benign ones. Although the lack of FNAC sensitivity can occasionally be problematic, it still comprises a valuable tool in salivary gland surgery. HIPPOKRATIA 2022, 26 (1):25-31.
Language	English
Publishing date	2022-04-04
Publishing country	Greece
Document type	Journal Article
ZDB-ID	2491943-3
ISSN	1790-8019 ; 1108-4189
ISSN (online)	1790-8019
ISSN	1108-4189
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Article ; Online: Anatomical variations of the recurrent laryngeal nerve according to the inferior thyroid artery and their clinical impact in patients undergoing thyroidectomy.

Gkrinia, E / Nana, P / Spanos, K / Fiska, A / Hajiioannou, J / Skoulakis, C / Zibis, A H

The Journal of laryngology and otology

2022 Volume 137, Issue 6, Page(s) 673–677

Abstract: Background: Recurrent laryngeal nerve identification is the 'gold standard' in thyroidectomy, to determine nerve function security and prevent severe complications. This study assessed the topographical relationship between the recurrent laryngeal nerve ...

Abstract	Background: Recurrent laryngeal nerve identification is the 'gold standard' in thyroidectomy, to determine nerve function security and prevent severe complications. This study assessed the topographical relationship between the recurrent laryngeal nerve and the inferior thyroid artery in patients undergoing total thyroidectomy, and determined its clinical impact. Methods: A retrospective study was performed of patients undergoing total thyroidectomy in a single tertiary centre over a six-month period. Results: Sixty-four patients were included. Among the 128 recurrent laryngeal nerve dissections, the nerve was identified traversing the inferior thyroid artery anteriorly in 27.3 per cent, with equal distribution between the two sides. No significant sex association was reported. One patient had transient vocal fold palsy, and hypocalcaemia was observed in 21.9 per cent, yet there was no statistical association with the topographical variation of the recurrent laryngeal nerve. Conclusion: Almost one-third of patients had an anatomical variation in which the recurrent laryngeal nerve ran superiorly to the inferior thyroid artery. Recurrent laryngeal nerve variation had no clinical impact on local complications or hypocalcaemia.
MeSH term(s)	Humans ; Thyroid Gland/surgery ; Thyroidectomy/adverse effects ; Recurrent Laryngeal Nerve ; Retrospective Studies ; Hypocalcemia ; Arteries/surgery
Language	English
Publishing date	2022-06-20
Publishing country	England
Document type	Journal Article
ZDB-ID	218299-3
ISSN	1748-5460 ; 0022-2151
ISSN (online)	1748-5460
ISSN	0022-2151
DOI	10.1017/S0022215122001360
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Article ; Online: Microscopic versus endoscopic stapes surgery: systematic review and meta-analysis.

Hajiioannou, J / Gkrinia, E / Tzimkas-Dakis, K / Palla, E / Brotis, A / Korais, C / Saratziotis, A / Lachanas, V / Skoulakis, C

The Journal of laryngology and otology

2022 Volume 136, Issue 11, Page(s) 1014–1022

Abstract: Objective: To compare the efficacy and safety characteristics of endoscopic and microscopic stapes surgery based on current evidence.: Methods: A systematic literature search was conducted of three medical databases, focusing on randomised, ... ...

Abstract	Objective: To compare the efficacy and safety characteristics of endoscopic and microscopic stapes surgery based on current evidence. Methods: A systematic literature search was conducted of three medical databases, focusing on randomised, controlled studies or observational studies. Data related to the efficacy and safety of each technique were extracted. Outcome data were summarised using the pooled mean differences or pooled odds ratios, along with their 95 per cent confidence intervals. Results: Thirteen studies were included in the meta-analysis. Success rate was evaluated by estimating air-bone gap improvement; this revealed comparable outcomes for the two techniques (mean difference = -0.20; 95 per cent confidence interval = -0.53, 0.14). No statistically significant difference was detected concerning post-operative complications, except for dysgeusia (odds ratio = -1.12; 95 per cent confidence interval = -1.97, -0.28) and pain (odds ratio = -2.00; 95 per cent confidence interval = -2.97, -1.04), which favoured the endoscopic approach. Conclusion: Though both techniques result in commensurate outcomes concerning success rate, post-operative pain and dysgeusia favour the endoscopic approach. Further high-quality studies are needed to adequately compare the two methods.
MeSH term(s)	Humans ; Dysgeusia ; Stapes Surgery/methods ; Stapes ; Endoscopy/adverse effects ; Endoscopy/methods ; Ossicular Prosthesis
Language	English
Publishing date	2022-01-11
Publishing country	England
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	218299-3
ISSN	1748-5460 ; 0022-2151
ISSN (online)	1748-5460
ISSN	0022-2151
DOI	10.1017/S0022215121004436
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Article ; Online: Otomycosis With Tympanic Membrane Perforation: A Review of the Literature.

Koltsidopoulos, Petros / Skoulakis, Charalampos

Ear, nose, & throat journal

2019 Volume 99, Issue 8, Page(s) 518–521

Abstract: Objective: The purpose of the present study was to assess the rate of tympanic membrane perforation in patients with otomycosis and to discuss the literature regarding the difficulties in managing this condition.: Data sources: Literature review from ...

Abstract	Objective: The purpose of the present study was to assess the rate of tympanic membrane perforation in patients with otomycosis and to discuss the literature regarding the difficulties in managing this condition. Data sources: Literature review from 1999 to 2019, Web of Science, PubMed, and Medline. Study selection: We searched for eligible articles concerning the clinical entity of tympanic membrane perforation secondary to otomycosis. Case series and clinical trials were the types of articles included for this review. Data extraction: All the articles described in the study selection were used for this review. Data synthesis: Statistical techniques were not used. Conclusion: Based on the available literature, it seems that tympanic membrane perforation secondary to otomycosis is not uncommon. The presence of this complication is associated with 2 problems: Antimycotic solutions are irritant to middle ear and may be ototoxic to the cochlea. Although most cases of fungus caused tympanic membrane (TM) perforation resolve with proper medical treatment, in a few patients a tympanoplasty may be required.
MeSH term(s)	Antifungal Agents/adverse effects ; Cochlea/drug effects ; Cochlea/microbiology ; Ear, Middle/drug effects ; Ear, Middle/microbiology ; Humans ; Otomycosis/complications ; Otomycosis/drug therapy ; Ototoxicity/epidemiology ; Ototoxicity/etiology ; Tympanic Membrane Perforation/epidemiology ; Tympanic Membrane Perforation/microbiology
Chemical Substances	Antifungal Agents
Language	English
Publishing date	2019-05-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	750153-5
ISSN	1942-7522 ; 0145-5613
ISSN (online)	1942-7522
ISSN	0145-5613
DOI	10.1177/0145561319851499
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Article ; Online: Hourglass neck mass.

Koltsidopoulos, Petros / Skoulakis, Charalampos

Archives of disease in childhood

2019 Volume 105, Issue 5, Page(s) 512

Language	English
Publishing date	2019-01-17
Publishing country	England
Document type	Journal Article
ZDB-ID	524-1
ISSN	1468-2044 ; 0003-9888 ; 1359-2998
ISSN (online)	1468-2044
ISSN	0003-9888 ; 1359-2998
DOI	10.1136/archdischild-2018-316433
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