Alexander Delides

Background/Objectives: Radiation-induced laryngeal radionecrosis and chondroradionecrosis (LRN/LCRN) are uncommon but potentially severe complications of radiotherapy that may lead to airway compromise, persistent functional impairment, or total laryngectomy. This systematic review evaluated the available evidence on hyperbaric oxygen treatment (HBO₂) for established LRN/LCRN, with emphasis on laryngeal preservation, clinical response, functional outcomes, and adverse events. Methods: PubMed, Embase, Scopus, and the Cochrane Library were searched from inception to 8 August 2026, with additional reference and citation searching. Original human studies reporting therapeutic HBO₂ for established LRN/LCRN were included. Two reviewers independently screened studies, extracted data, and performed design-specific Joanna Briggs Institute critical appraisal. Owing to substantial clinical and methodological heterogeneity, findings were synthesized narratively without meta-analysis. Results: Twenty reports were included, predominantly case reports, small case series, and retrospective observational studies. No randomized trial specifically evaluating HBO₂ for LRN/LCRN was identified. Disease severity, treatment regimens, co-interventions, follow-up duration, and outcome definitions varied substantially. Clinical improvement and laryngeal preservation were reported in selected patients, but functional recovery was inconsistent, with persistent tracheostomy dependence documented despite anatomical preservation. Adverse-event reporting was incomplete. Conclusions: Clinical improvement and laryngeal preservation were reported following care that included HBO₂. However, the available evidence cannot distinguish its independent contribution from concomitant treatments and patient selection. Laryngeal preservation does not always translate into functional recovery, highlighting the need for prospective multicenter studies with standardized diagnostic, treatment, and functional outcomes.

There is a lack of community-dwelling population-based examinations of geriatric dysphagia and laryngopharyngeal reflux (LPR).To assess the prevalence of geriatric dysphagia and laryngopharyngeal reflux (LPR) in a community-dwelling population from a rural area.Volunteers from Velestino, a 4,000-person community, were given the Eating Assessment Tool (EAT-10) and Reflux Symptom Index (RSI) questionnaires at the health center. Demographic, medical, and pharmaceutical histories were recorded.160 participants (92 females, 68 males) self-presented. Ages were between 65–95 years (Mean 76.04). 27 (16.88%) scored an abnormal EAT-10 and 13 (8.13%) RSI over 13. RSI was statistically correlated with total and positive only EAT-10 scores. Age and gender did not affect EAT-10 or RSI scores. The EAT-10 score decreased with age progression.This is one of the few studies to investigate the relationship between geriatric dysphagia and LPR in a rural population. A 23.0% prevalence of dysphagia was observed in elderly adults as well as an increase in both EAT-10 and RSI scores with age progression. More studies are needed to explore this field.

Background: Primary ciliary dyskinesia (PCD) is a rare genetic disorder that affects the respiratory and auditory systems. This study aims to assess the prevalence, type, and severity of bilateral hearing loss (HL) in PCD and Kartagener syndrome (KS) patients, examining age-related differences and chronic impacts of otologic pathologies.Methods: A total of 19 patients (38 ears), including 6 children and 13 adults, were evaluated from June to September 2021. Comprehensive clinical examinations included otoscopy, tympanometry, and pure tone audiometry (PTA) for air and bone conduction. Tympanometry findings were compared with otoscopic results. Statistical analyses were conducted using SPSS v16.0 (SPSS Inc.; Chicago, IL, USA), with a significance threshold of P ≤ .05.Results: Hearing loss was identified in 42.1% of patients, with conductive HL predominant in children (3 out of 4), while mixed HL was more common in adults (3 out of 4). Tympanometry results showed 57.9% type A and 42.1% type B findings, correlating with otoscopic observations.Chronic otitis media with effusion (OME) and tympanosclerosis (TS) were the primary pathologies contributing to middle ear damage. Age was significantly correlated with HL severity (P=.005). Mild HL was most common (62.5%), followed by moderate HL (25%) and moderately severeHL (12.5%).Conclusion: This study identifies distinct age-related patterns in the type and severity of HL among PCD patients, with sensorineural components observed in adults due to progressive middle ear damage. Audiological evaluations are essential for identifying these complications. Further research is needed to optimize treatment approaches and understand the progression of HL in PCD/KS patients.Cite this article as: Avgeri C, Sideris G, Moriki D, Douros K, Delides A, Nikolopoulos T. Bilateral hearing loss in primary ciliary dyskinesia: A studyof conductive and sensorineural mechanisms from pediatric and adult cases. J Int Adv Otol. 2025, 21(2), 1872i doi: 10.5152/iao.2025.241872.

Third window syndrome (TWS) is an inner ear condition caused by an additional compliant point in the otic capsule that disrupts auditory and vestibular functions. Superior semicircular canal dehiscence is the most common cause, presenting with hearing loss, vertigo, and autophony, significantly impairing quality of life. This study evaluated the pathophysiology, diagnostics, treatments, and recent advancements in TWS while identifying research gaps. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 70 studies from Embase, MEDLINE, Cochrane, and UpToDate databases were analyzed. TWS affects inner ear mechanics, enhancing bone conduction and reducing air conduction. Diagnosis involves clinical evaluations, high-resolution imaging, and functional tests such as vestibular evoked myogenic potentials, which are known for their high sensitivity and specificity. Management strategies range from vestibular rehabilitation and pharmacotherapy to surgical interventions, including transmastoid and middle cranial fossa approaches, which achieve over 75% success. Emerging minimally invasive techniques, such as underwater endoscopic ear surgery and round window reinforcement, show promise but carry risks like cerebrospinal fluid leakage and inconsistent symptom relief. Advancements in TWS management have improved outcomes, yet gaps remain, particularly in terms of false-positive imaging and long-term efficacy. Future studies should prioritize predictive models and minimally invasive techniques. A multidisciplinary approach is essential to improve patient care.

Introduction The complex nature of xerostomia prevents the establishment of a definite cure. Recently, research has pivoted towards stem cell transplantation for glandular reconstruction. The aim of this study is to provide an updated review of the existing research, to highlight the encountered challenges and research pathways, potentially enhancing the therapeutic applications of stem cell transplantation. Methods This is a systematic review according to PRISMA guidelines, using the following databases: PubMed (PMC), PMC Europe, Scopus, Medline, Research Gate, Elsevier. The main question was whether stem cell therapies can contribute to the treatment of xerostomia. Results 19 of 226 publications met the criteria for this review, including ‘in vivo’, ‘in vitro’ studies and clinical trials. All 19 studies described thoroughly the stem cell source and the transplantation method, and documented results based on analytical and statistical methods of confirmation. Data show that the various sources of stem cells play a significant role, with bone marrow or adipose tissue-derived pluripotent blasts being the most utilized. Human transplants in mice have also been accepted and reversed hyposalivation. The effects have been beneficial especially in models undergone radiotherapy (IR) or exhibit Sjogren Syndrome-like symptoms (SS), suggesting that with appropriate treatment and enrichment techniques, stem cell transplantation seems effective regardless of the cause of the disorder. Extracts and co-cultures of gland and stem cells also seem to improve gland function. Conclusion Although in its initial stages, the use of stem cells seems to be a promising therapy to alleviate xerostomia regardless of its cause.

The incidence of head and neck cancer (HNC), constituting approximately one in ten cancer cases worldwide, affects approximately 644,000 individuals annually. Managing this complex disease involves various treatment modalities such as systemic therapy, radiation, and surgery, particularly for patients with locally advanced disease. HNC treatment necessitates a multidisciplinary approach due to alterations in patients’ genomes affecting their functionality. Predominantly, squamous cell carcinomas (SCCs), the majority of HNCs, arise from the upper aerodigestive tract epithelium. The epidemiology, staging, diagnosis, and management techniques of head and neck squamous cell carcinoma (HNSCC), encompassing clinical, image-based, histopathological and molecular profiling, have been extensively reviewed. Lymph node metastasis (LNM) is a well-known predictive factor for HNSCC that initiates metastasis and significantly impacts HNSCC prognosis. Distant metastasis (DM) in HNSCC has been correlated to aberrant expression of cancer cell-derived cytokines and growth factors triggering abnormal activation of several signaling pathways that boost cancer cell aggressiveness. Recent advances in genetic profiling, understanding tumor microenvironment, oligometastatic disease, and immunotherapy have revolutionized treatment strategies and disease control. Future research may leverage genomics and proteomics to identify biomarkers aiding individualized HNSCC treatment. Understanding the molecular basis, genetic landscape, atypical signaling pathways, and tumor microenvironment have enhanced the comprehension of HNSCC molecular etiology. This critical review sheds light on regional and distant metastases in HNSCC, presenting major clinical and laboratory features, predictive biomarkers, and available therapeutic approaches.

Oral squamous cell carcinoma (OSCC) is a head and neck cancer (HNC) with a high mortality rate. OSCC is developed in the oral cavity and it is triggered by many etiologic factors and can metastasize both regionally and distantly. Recent research advances in OSCC improved our understanding on the molecular mechanisms involved in and the initiation of OSCC metastasis. The key roles of the extracellular matrix (ECM) in OSCC are an emerging area of intensive research as the ECM macromolecular network is actively involved in events that regulate cellular morphological and functional properties, transcription and cell signaling mechanisms in invasion and metastasis. The provisional matrix that is formed by cancer cells is profoundly different in composition and functions as compared with the matrix of normal tissue. Fibroblasts are mainly responsible for matrix production and remodeling, but in cancer, the tumor matrix in the tumor microenvironment (TME) also originates from cancer cells. Even though extensive research has been conducted on the role of ECM in regulating cancer pathogenesis, its role in modulating OSCC is less elucidated since there are several issues yet to be fully understood. This critical review is focused on recent research as to present and discuss on the involvement of ECM macromolecular effectors (i.e., proteoglycans, integrins, matrix metalloproteinases) in OSCC development and progression.