Editorial: The impact of tracheostomy on spoken language in children: a narrative review

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<bold>BACKGROUND.</bold> Endoscopic sinus surgery (ESS) has revolutionized the treatment of nasal and paranasal sinus conditions, offering minimally invasive techniques with improved patient outcomes. However, ESS can be challenging, lengthy, and physically demanding. This article presents a comprehensive overview of factors to consider before and during ESS to enhance surgical ease and patient comfort.
<bold>MATERIAL AND METHODS.</bold> The paper is a literature review sustaining a point of view on the factors influencing the outcome of endoscopic sinus surgery.
<bold>RESULTS.</bold> Preoperative considerations encompass a thorough assessment of surgical indications, weighing against medical alternatives as per guidelines. Attention to patient comorbidities, medication management and infection control are paramount. Intraoperatively, collaboration with anesthesiologists is crucial for optimizing patient stability and minimizing complications. Ergonomic considerations, patient positioning and surgical environment optimization contribute to surgeon comfort and procedural efficiency. The surgical procedure entails meticulous preparation of the nasal cavity, preservation of anatomical structures, and adherence to standardized techniques. The sphenoethmoidectomy is described as a sequential five-door procedure, emphasizing anatomical landmarks and meticulous dissection techniques. Hemostasis and the judicious use of powered shavers play pivotal roles in minimizing bleeding and optimizing tissue removal. Navigation systems offer additional support, particularly in complex cases or revision surgeries.
<bold>CONCLUSION.</bold> ESS requires meticulous planning, technical proficiency, and interdisciplinary collaboration to optimize outcomes. Anticipation and adherence to standardized protocols are paramount in navigating the challenges of ESS, ultimately enhancing surgical ease and patient comfort.
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“Carol Davila” University of Medicine and Pharmacy

How to make your sinus surgery more comfortable: our point of view

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<bold>BACKGROUND.</bold> Children’s communication with the family and the environmental surroundings begins immediately after birth and development continues throughout life. Impairment of hearing due to the presence of congenital hypoacusis results in severe language development disorders. The purpose of the study was to identify the main factors involved in the auditory-verbal rehabilitation process of children with hearing impairment.
<bold>MATERIAL AND METHODS.</bold> A descriptive, observational study was conducted on a group of 35 carers of hearing-impaired children proposed for auditory-verbal rehabilitation through cochlear implantation. The study carried out was based on the parents’ statements, analyzing the essential factors that can influence the quality of life of parents with hearing-impaired children: the child’s age at the time of the positive diagnosis, the child’s communication skills before implantation, the time elapsed from the intervention to implant activation, participation in auditory-verbal rehabilitation sessions with a speech therapist, parental commitment during the immediate pre- and post-implant period, the parent’s level of education.
<bold>RESULTS.</bold> The dominance of the female gender can be noted - 91.43%. 60% of adult participants were college graduates, 20% discontinued their education after completing high school, 17.14% graduated from a post-secondary school. 57.14% of the parents reported being employed in some form of work during the period before and immediately after the cochlear implantation of their children. 82.85% reported the diagnosis of their child’s hypoacusis in the pre-kindergarten group. Out of the total number of children, 68.57% were recipients of bilateral cochlear implants, 31.43% had unilateral implants. The periods during which children benefited from post-implantation speech therapy were between 1 and 6 months (5.71%), 1 and 2 years (2.86%), >2 years (17.14%). In 71.43% of cases, families were in the rehabilitation phase with speech therapy at the time of filling out the form.
<bold>CONCLUSION.</bold> In the auditory-verbal rehabilitation process of a hearing-impaired child, there are a number of factors and conditions that must be considered in a specific manner for each individual patient.
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“George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology

Assessment of the main factors involved in the auditory-verbal rehabilitation process in children with cochlear implants

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<bold>BACKGROUND.</bold> Extramedullary plasmacytoma is an extremely rare solitary plasma cell neoplasm that occurs in locations other than bone, without involving the bone marrow. It is commonly located in the upper aerodigestive tract. In the head and neck region, the most frequent location is the sinonasal region.
<bold>MATERIAL AND METHODS.</bold> A systemic review in accordance with the PRISMA guidelines was done with research works in PubMed, Elsevier database, Cochrane library, Web of Science, Scopus, Crossref and Google Scholar. The search was carried out using the keywords “plasmacytoma and nose”, “extramedullary plasmacytoma”, “extramedullary plasmacytoma of nose”, “plasmacytoma and nasal cavity”, and “extramedullary plasmacytoma of nasal cavity”.
<bold>RESULTS.</bold> We analysed 27 research works with a total number of 32 cases. The most common presenting symptoms were nasal cavity bleeding. The disease showed a male preponderance (78.1%). Bone erosion was seen in 7 cases. The histopathological examination showed plasma cells arranged predominantly as a uniform population or sheet-like appearance. A common immunohistochemical marker was CD138 (11 cases). Treatment was primarily radiotherapy (43.7%). We are also reporting a case of a 53-year-old male with plasmacytoma of the middle turbinate managed by wide resection and postoperative radiotherapy.
<bold>CONCLUSION.</bold> Though a less common condition, in a case of polypoidal-like lesion with bleeding tendency, the clinician should keep in mind the possibility of extramedullary plasmacytoma. The diagnosis is made with histopathological examination and immunohisto-chemistry of the tissue involved. Treatment can be radiotherapy, surgery, or a combination of modalities.
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Department of Otolaryngology and Head and Neck Surgery

Nasal cavity extramedullary plasmacytoma: literature review and clinical experience

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<bold>BACKGROUND.</bold> Patients were likely hesitant to communicate with physicians during the pandemic, when everyone saw others as potentially infectious. Every other was seen as the most likely to be infected as they were in close contact with infected persons. Likewise, physicians might have been wary of communicating with their patients, who might have been virus carriers. In our study, the communication between physicians (particularly pulmonologists) and geriatric patients was evaluated to develop recommendations for improvement if necessary.
<bold>MATERIAL AND METHODS.</bold> The study was conducted as an online evaluation questionnaire via e-mail or WhatsApp. The evaluation form, the Social Communication Skills Rating Scale, collected data regarding the respondents’ demographic characteristics, whose reliability and validity have been proven in previous studies. The volunteer pulmonologists completed the questionnaire.
<bold>RESULTS.</bold> The research comprised 200 doctors; 111 (55.5%) were women and 89 (44.5%) were men. Of the doctors who participated in the study, over 40% were in their forties. Pulmonologists’ communication skills with their geriatric patients were deemed adequate, and their interactions were evaluated as successful, despite the high risk of infection during the pandemic, the difficulty of examining patients while wearing protective clothing, and the typical communication difficulties of geriatric patients. This has been a crucial advantage for the senior patient group, as, throughout the COVID-19 pandemic, this group has communicated with pulmonologists predominantly owing to medical needs.
<bold>CONCLUSION.</bold> The pulmonologists’ effective communication with their geriatric patients could have made them feel good during the difficult time of the past pandemic period. It could have also been a source of pride for physicians.
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Communication levels of pulmonologists with geriatric patients during the COVID-19 pandemic

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<bold>BACKGROUND.</bold> Obstructive sleep apnea (OSA) is characterized by frequent episodes of breathing cessation during sleep, resulting in low oxygen and high carbon dioxide levels, leading to daytime sleepnes, cognitive issues, and increased cardiovascular risk. The objective of this study was to assess the effectiveness of the anterior palatoplasty (AP) procedure in the treatment of patients with mild and moderate obstructive sleep apnea.
<bold>MATERIAL AND METHODS.</bold> Sixteen patients diagnosed with mild and moderate OSA underwent AP in our clinic between 2021-2023. All patients were > 18 years old, body mass index &lt; 30, with an apnea-hypopnea index (AHI) from 10 to 40 and disfunction of the velopharyngeal or of the retropalatal space. Patients underwent a one-night polysomnography examination prior to the surgical procedure, as well as six months after the procedure. Additionally, patients were asked to complete the Epworth Sleepiness Scale (ESS) both prior to and six months following the surgery. The procedure was done under general anaesthesia and involved AP surgery with or without reducing of the uvula.
<bold>RESULTS.</bold> The average of total AHI values decreased from 28.89 per hour prior to surgery to 11.14 per hour six months after surgery. The oxygen desaturation index decreased after surgery with 2.57%. ESS scores of patients also decreased from 10.40 to 7.80 and all patients felt less tired.
<bold>CONCLUSION.</bold> We believe that AP is an effective technique in the treatment of mild and moderate OSA caused by a disfunction of the velopharyngeal or retropalatal space. Additionally, we consider that AP is linked with a lower incidence of post-surgical complications compared to other surgical options.
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Anterior palatoplasty as a treatment for mild and moderate obstructive sleep apnea: our experience

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In this material, two clinical cases are described, regarding the use of CAD-CAM technology for producing the wax pattern of the metal substructure for a fixed prosthetic restoration. In fact, in these cases, it is about making a digital design and milling from a block of wax the patterns of future fixed metal-ceramic prosthetic restorations.
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Technological considerations regarding the use of CAD-CAM systems in the metal substructure design of some metal-ceramic prosthetic restoration

AHEAD OF PRINT

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Romanian Journal of Rhinology

Rhinology, as an important part of Otorhinolaryngology, addresses a very frequent and diverse pathology, with important interdisciplinary implications. In the last decades, this medical field was the beneficiary of new technical means for accurate and effective investigation, treatment and research. The needs of modern medicine - over-specialization, interdisciplinary approach and evidence-based medicine, lead to the situation that the international rhinologic societies are the most dynamic and appreciated.  The Romanian Journal of Rhinology is the official scientific publication of the Romanian Rhinologic Society, and it is trying to fill the existing gap in the Romanian ENT literature, promoting modern publishing and criteria according to the international standards. Romanian Journal of Rhinology appears quarterly with the purpose to publish original articles, original clinical reports, clinically relevant experimental studies and short communications presenting new results of general interest. Its aim is to concentrate and provide information concerning care, cure and prevention of different rhinologic disorders and borderline pathology. With a peer review by an important national and international editorial board, the journal provides clinical and clinically related information written by authors from all over the world.  Journal’s business model  Romanian Journal of Rhinology is an Open Access journal. The submission and publication of the articles are free of charge, in both print and electronic publication. The publisher covers all costs – editing, printing, copyediting, typesetting, long-term archiving, journal management.  Romanian Journal of Rhinology is the journal of the Romanian Rhinologic Society; thus, one of the financial sources for publication is represented by the Society from the manuscript fees.  Advertisements represent another important founding source. The decision regarding the type of advertisements, acceptance/rejections, the price offering is made by the Publishing/technical Editor, the Editorial Board having no decision power on this aspect. Advertorials and publicity about pharmacological devices, drugs, supplements related to rhinologic and otolaryngologic pathologies can be taken into consideration. In case of Advertorials, with an important scientific content, the medical data presented will have the approval of the Journal’s Editors.  There is also available the annual subscription for individuals and companies. The contact person is also the Publishing/technical Editor.  Publication schedule  The Romanian Journal of Rhinology is published quarterly:   January-March (publication month: February)  April-June (publication month: April)  July-September (publication month: July)  October-December (publication month: October)  Editorial process  The Romanian Journal of Rhinology uses a standard scheme for the evaluation process of the submitted articles. All manuscripts are strictly reviewed for originality, correctness, methodology, quality of the medical information, suitability for the journal’s medical field, ethical nature.  The Editors reserve the right to refuse any manuscript which does not correspond to the submission guidelines.  Peer-review is the system used to assess the quality of a manuscript before it is published. Independent researchers in the otorhinolaryngology area assess the submitted manuscripts for originality, validity, and significance to help editors determine whether the manuscript should be published in their journal.  After submission:   All manuscript are treated as confidential documents, all being assigned with a registration number (for example, RJR010121 (day of submission)(month of submission) (the last two numbers of the year of submission)). All communications between the editors, the author(s), the reviewers are made by using this identification number.  Technical review performed by the editor-in-chief, associated editors, members of the editorial board analyses – the importance of the subject, presentation clarity, relevance, plagiarism index. Submissions that fail to fulfil all requirements are rejected. This process last for a few days after submission.  Review process. The Romanian Journal of Rhinology has a double-blind reviewing process, in which the reviewers do not know the names of the authors, and the authors do not know who reviewed their manuscript. Therefore, the authors are required to submit a blind manuscript without the authors’ names and affiliations on the title page or in the text and a separate title page with the names of the authors, affiliations, and information about the corresponding author. After the initial assessment for, submissions are sent to at least two experts in the field who are asked to evaluate whether the manuscript is scientifically coherent, easy to read, useful in the field, and whether the manuscript should be accepted, rejected or revised. The review process will take approximately 2 weeks. After the review process is completed, the corresponding author will receive an e- mail about the evaluation results of the submitted manuscript: accepted, revision or rejection. If the e-mail contains suggestions and comments for revising the manuscript, the authors should make the changes and return to the editor within 2 weeks; if not, the manuscript is considered rejected. If the manuscript is accepted for publication by the reviewers, it is forwarded to the Editor-in-Chief. The final decisions are made by the Editor-in-Chief based on the recommendations of reviewers reports and the journal’s editors. Where necessary, they will consult with members of the Editorial Board. The Editor-in-Chief may advice the corresponding author to make necessary revisions in order to publish the article. The final form of the article will be sent to the main author for the last approval from his/her part (if there are minor changes these should be send in no more than 1 week).  The publication process after the article’s submission may take 45 days, average. All accepted articles are assigned with a DOI number.  The Romanian Journal of Rhinology follows the International Committee of Medical Journal Editors (ICMJE) Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals and required ICMJSE to be listed as a journal that follows these recommendations.  Archiving  Sciendo archives the contents of this journal in Portico - digital long-term preservation service of scholarly books, journals and collections.  Plagiarism Policy  The editorial board is participating in a growing community of Similarity Check System's users in order to ensure that the content published is original and trustworthy. Similarity Check is a medium that allows for comprehensive manuscripts screening, aimed to eliminate plagiarism and provide a high standard and quality peer-review process. 