<abstract xmlns="http://www.w3.org/1999/xhtml">Invasive fungal rhinosinusitides are a group of disorders with three subtypes (acute invasive fungal rhinosinusitis, chronic invasive fungal rhinosinusitis and granulomatous invasive fungal rhinosinusitis), requiring urgent diagnosis and early treatment due to the reserved vital and functional prognosis. This disorder occurs in immunocompromised patients, but it can also occur in immunocompetent people. Aspergillus and Mucormicosis species are the most common microorganisms found in invasive fungal rhinosinusites. The otorhinolaryngologic clinical examination and imaging techniques provide important diagnostic information in patients with risk factors for invasive fungal rhinosinusitis, including intracranial or orbital extension identification. The treatment of invasive fungal rhinosinusites (acute or chronic) consists of reversing immunosuppression, appropriate systemic antifungal therapy and aggressive and prompt surgical debridement of the affected tissues.</abstract>

“Nicolae Testemitanu” State University of Medicine and Pharmacy

Invasive fungal rhinosinusitis

<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>OBJECTIVES.</bold> The aim of this paper is to review the united airway concept.<bold>MATERIAL AND METHODS.</bold> We searched Pubmed, Google, Google Scholar and Proquest Central database of Kırıkkale University.<bold>RESULTS.</bold> Upper and lower airways are thought as a morphological and functional unit. There is a link between rhinitis and asthma. Over 80% of asthmatics have rhinitis and 10-40% of rhinitis patients have asthma. Rhinosinusitis is related to asthma in 34-50% of the patients. The relationship between rhinosinusitis and asthma may include “nasobronchial reflex, pharyngobronchial reflex, inhalation of dry, cold air and environmental pollutants inhalation”.<bold>CONCLUSION.</bold> The united airway concept suggests that upper and lower airways are thought as a morphological and functional unit. It has been commonly accepted in recent years. Allergic rhinitis (AR) is a risk factor for asthma; and Allergic Rhinitis and Asthma (ARIA) suggest bronchial involvement in AR patients.</abstract>

The united airway disease

<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>BACKGROUND.</bold> There are not many works devoted to the structures of a nasal cavity in odontogenic maxillary sinusitis and to a condition of an alveolar ridge of the maxilla with a rhinogenous genesis of the disease.<bold>MATERIAL AND METHODS.</bold> 100 patients (N) with chronic sinusitis hospitalized at the ENT (N=50) and Oral and Maxillofacial Surgery (N=50) Departments were examined. The character of anatomic options of a nasal septum in chronic maxillary sinusitis is estimated according to a cone-beam computed tomography (CBCT) with use of our own developed scheme of coordinates in the form of “triangles” which allows establishing versions of the block of the ostiomeatal complex and nasal septum deviation.<bold>RESULTS.</bold> In cases of rhinogenous and odontogenic causes of maxillary sinusitis, the triangle deviation is detected more often, including a perpendicular plate of the ethmoid bone, the vomer and the quadrangular cartilage, contributing to the block of the ostiomeatal complex. This scheme has allowed us to establish a group of patients with the mixed genesis of maxillary sinusitis in the Otorhinolaryngology and MFS Departments (36% and 42% respectively) and that, in its turn, requires a cross-disciplinary approach when choosing a strategy of treatment.<bold>CONCLUSION.</bold> In case of rhinogenous genesis of the disease, the bilateral nature of the process with involvement of other paranasal sinuses in the inflammatory process is detected more often. The category of patients with mixed genesis (rhinogenous plus odontogenic) of sinusitis demands a cross-disciplinary approach to diagnosis and making a decision about treatment strategies.</abstract>

Department of Otorhinolaryngology, Medical Faculty

Comparative analysis of features of chronic maxillary sinusitis of various genesis

<abstract xmlns="http://www.w3.org/1999/xhtml">Adenotonsillectomy is one of the most performed surgical procedures in otorhinolaryngology. When it comes to hospitalization duration, there are no general available truths. Every patient is unique and only the physician should decide for how long he/she has to remain in the hospital after adenotonsillectomy, taking into consideration the used technique, the intraoperatory evolution and also the associated risk factors.The authors present some general aspects of this theme and their own point of view in what adenotonsillectomy is concerned in terms of ethics and moral responsibility of the surgeon, hospital and government for the hospitalization after the surgical intervention.</abstract>

CESITO Center, “Sfanta Maria” Hospital

”Carol Davila” University of Medicine and Pharmacy

The ethical and moral responsibility of the surgeon, hospital and government for the hospitalization after adenotonsillectomy

<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>BACKGROUND.</bold> Acinic cell carcinoma (ACC) is a rare malignant salivary gland tumour. It is of a low-grade type. The commonest site involved is the parotid gland. ACC is not common in minor salivary glands; this tumour type mainly arises in the oral cavity.<bold>CASE REPORT.</bold> We present an 84-year-old Malay man with spontaneous, self-limiting, left-sided epistaxis for 2 days. He also had progressive left-sided nasal blockage. There was no hyposmia, blurry vision or headache. He had underlying hypertension. The clinical examination showed he was normotensive. There was no external nasal deformity. The anterior rhinoscopy demonstrated a fungating irregular mass filling up the left nasal vestibule. There was no neck node. The computed tomography showed a tumour localized in the nasal cavity. The biopsy showed features of acinic cell carcinoma. We proceeded with left lateral rhinotomy and wide excision. Intraoperatively, we discovered that the tumour aroused from the nasal septum and part of the septum had to be sacrificed for margin clearance. Currently, he is on routine surveillance and tumour-free.<bold>CONCLUSION.</bold> We highlighted the importance of recognizing nasal acinic cell carcinoma and the fact that early biopsy is important as surgery provides a good prognosis even in the extreme age group.</abstract>

Primary nasal septal acinic cell carcinoma

<abstract xmlns="http://www.w3.org/1999/xhtml">Wegener’s granulomatosis (Granulomatosis with Polyangiitis) is an autoimmune granulomatous disorder of unknown etiology. The basic pathology is necrotizing granulomatous inflammation with necrotizing vasculitis involving medium-sized blood vessels. The typical triad of involvement of the upper and lower respiratory tracts and the kidneys is observed in varying proportions in individual patients. The sinonasal involvement is observed in the majority of patients and it can be involved in isolation in up to a quarter of affected individuals. The sinonasal changes involve both the soft tissue and bony architecture, with refractory chronic sinusitis associated with erosion of the cartilaginous and bony skeleton and may lead to saddle nose and other facial deformities in advanced cases. The radiology has a contributory role as diagnostic and diseases monitoring aid.The various radiological findings associated with the disease (bone erosion with osteoneogenesis) have been mentioned in the literature. We present the progression of a radiological abnormality in a patient with a localized form of Wegener’s Granulomatosis and highlight some peculiar appearances observed on radiology in the patient.</abstract>

Department of Otolaryngology and Head and Neck Surgery

Division of Radiology and Nuclear Medicine

Evolution of sinonasal radiological findings in a case of granulomatosis with polyangiitis

<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>BACKGROUND.</bold> The malignant sinonasal tumour is very rare. Sinonasal adenocarcinoma comprises only 10-20% of all primary malignant sinonasal tumours. The commonest type is the maxillary squamous cell carcinoma. It commonly presents with nasal blockage, nasal discharge and epistaxis during the early stage. Headache and blurry vision may occur at an advanced stage when it has invaded the brain, the eye or the optic nerve.<bold>CASE REPORT.</bold> We present a 63-year-old patient with acute progressive worsening unilateral blurry vision and headache for 1 month. Epistaxis with anosmia developed only later. The patient had a neuroimaging by both Computed Tomography (CT) scan and Magnetic Resonance Imaging (MRI) scan which showed a skull base tumour, but early biopsy was inconclusive. He underwent combined transcranial and transsphenoidal tumor debulking in view of clinical impression of olfactory neuroblastoma. The histopathological examination showed adenocarcinoma. He was sent for postoperative radiotherapy.<bold>CONCLUSION.</bold> We highlighted that a patient with sinonasal adenocarcinoma may present initially with the symptom of invasion to neighbouring structures prior to the local symptom.</abstract>

Sinonasal adenocarcinoma with aggressive ocular symptom

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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. 

Romanian Journal of Rhinology

Volume 9 (2019): Issue 33 (March 2019)

LITERATURE REVIEW

Invasive fungal rhinosinusitis

The united airway disease

ORIGINAL STUDY

Comparative analysis of features of chronic maxillary sinusitis of various genesis

The ethical and moral responsibility of the surgeon, hospital and government for the hospitalization after adenotonsillectomy

CASE REPORT

Primary nasal septal acinic cell carcinoma

Evolution of sinonasal radiological findings in a case of granulomatosis with polyangiitis

Sinonasal adenocarcinoma with aggressive ocular symptom

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