Natalia Zięba

Background Tonsillectomy is a common surgical procedure used to treat chronic tonsillitis, obstructive sleep apnoea, recurrent or chronic tonsillitis and Peritonsillar abscesses. Traditional methods like cold steel dissection and electrocautery are effective but often associated with significant bleeding, pain, and prolonged recovery. Carbon dioxide (CO₂) laser-assisted tonsillectomy offers a precise, haemostatic alternative with potential advantages in reducing surgical trauma. Purpose: This systematic review evaluates the clinical efficacy and safety of CO₂ laser tonsillectomy compared to conventional surgical techniques. Methods: A comprehensive search of PubMed, Embase, Scopus, and the Cochrane Library was conducted following PRISMA 2020 guidelines. Ten studies comparing CO₂ laser tonsillectomy with traditional approaches were included. Key outcomes assessed were intraoperative blood loss, postoperative pain, operative time, healing, complications, and patient satisfaction. Results: CO₂ laser tonsillectomy showed reduced intraoperative bleeding and, in many cases, lower postoperative pain and faster recovery. Operative times were sometimes longer, and partial tonsillotomy carried a risk of symptom recurrence. The laser method was especially beneficial for adults and patients unsuitable for general anaesthesia. Conclusions: CO₂ laser tonsillectomy is a safe and effective alternative to traditional methods, particularly in select patient groups. While it offers advantages in recovery and haemostasis, further research is needed to confirm long-term outcomes and optimize surgical protocols.

Background: This systematic review evaluated the efficacy of laser therapies and antimicrobial photodynamic therapy (aPDT) for the treatment of intraoral halitosis by synthesizing randomized controlled trials. Methods: A comprehensive search of the PubMed, Embase, Scopus, and Cochrane Library databases identified 14 eligible RCTs. Results: Laser-based interventions, including diode lasers and Er,Cr:YSGG lasers, and aPDT using photosensitizers such as methylene blue, toluidine blue, and Bixa orellana (annatto), effectively reduced volatile sulfur compound levels and associated bacterial populations compared to traditional methods like tongue scraping and antiseptic rinses. Combination treatments consistently demonstrated superior short-term efficacy, although treatment outcomes often declined after 7–14 days, indicating the necessity for repeated sessions or adjunctive oral hygiene measures. Conclusions: Methodological heterogeneity across studies regarding laser parameters, photosensitizer types, and outcome measurements highlighted the need for standardized protocols. Future research should focus on multicenter trials with extended follow-up and standardized microbiological evaluations to further validate these promising treatments and integrate them effectively into clinical practice.

Platelet-rich fibrin (PRF) has emerged as a promising scaffold for drug delivery, particularly in the context of antimicrobial therapies. This systematic review evaluates the incorporation of antibiotics into PRF to determine its efficacy as a localized antimicrobial delivery system compared to plain PRF without antibiotics. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, including 13 in vitro studies with a moderate risk of bias. Antibiotics were incorporated into PRF using different methodologies, including systemic administration before blood collection, addition to blood before centrifugation, and injection into formed PRF matrices. Outcomes were analyzed regarding antibacterial efficacy, structural integrity of PRF, and release kinetics. Antibiotic-enhanced PRF demonstrated significant antibacterial activity against various bacterial strains. The efficacy of the enhanced PRF was dependent on the type of antibiotic, its concentration, and incorporation method. Encapsulation approaches facilitated a sustained antibiotic release, while higher antibiotic concentrations occasionally disrupted PRF integrity. Systemic administration of antibiotics before blood collection enriches PRF effectively, producing significant inhibition zones. The antibacterial effects of PRF outperformed alternative carriers, such as collagen sponges. Antibiotic-loaded PRF is a potent tool for localized antimicrobial delivery, with promising applications in clinical settings. Further research is needed to standardize preparation protocols and explore the impact of different antibiotic delivery methods on PRF’s regenerative properties.

Background: Conventional treatments for cancers of the head and neck region are often associated with high recurrence rates and impaired quality of life. Photodynamic therapy (PDT) has emerged as a promising alternative, leveraging photosensitizers such as hypericin to selectively target tumour cells with minimal damage to surrounding healthy tissues. Objectives: We aimed to evaluate the efficacy and underlying mechanisms of hypericin-mediated PDT (HY-PDT) in treating head and neck cancers. Methods: Adhering to PRISMA 2020 guidelines, a systematic search was conducted across PubMed/Medline, Embase, Scopus, and the Cochrane Library for studies published between January 2000 and December 2024. Inclusion criteria encompassed preclinical in vitro and in vivo studies and clinical trials focusing on HY-PDT for head and neck malignancies and its subtypes. Results: A total of 13 studies met the inclusion criteria, comprising both in vitro and in vivo investigations. HY-PDT consistently demonstrated significant cytotoxicity against squamous cell carcinoma cells through apoptotic and necrotic pathways, primarily mediated by ROS generation. Hypericin exhibited selective uptake in cancer cells over normal keratinocytes. Additionally, HY-PDT modulated the tumour microenvironment by altering cytokine profiles, such as by increasing IL-20 and sIL-6R levels, which may enhance antitumor immunity and reduce metastasis. Conclusions: HY-PDT emerges as a highly promising and minimally toxic treatment modality for head and neck cancers, demonstrating efficacy in inducing selective tumour cell death and modulating the immune microenvironment. Despite the encouraging preclinical evidence, significant methodological variability and limited clinical data necessitate further large-scale, standardized and randomized controlled trials.

Introduction: Sudden sensorineural hearing loss (SSNHL) is defined as the sudden onset of hearing loss of 30 dB or more, across three consecutive frequencies in a pure-tone audiogram occurring within a 72-hour period. The term “sensorineural” indicates that the cause of the hearing loss lies in disturbances within the cochlea or auditory nerve. SSNHL typically presents as unilateral, transient hearing loss that occurs upon awakening. Bilateral hearing loss occurs in less than 2% of patients. Additionally, patients may report sensations of ear fullness or blockage, tinnitus, dizziness, nausea, and vomiting.Aim: Defining the management of SSNHL in pregnant women.Case report: This article describes the case of a 36-years-old pregnant woman who developed hearing impairment in the left ear in the third trimester along with tinnitus and balance disorders.Discussion: The occurrence of SSNHL in pregnant women is rare and not well understood. Majority of pregnant patients with SSNHL experienced the condition in second or third trimester. Key elements facilitating an accurate diagnosis include: interview and physical examination, hearing tests, balance evaluation, and imaging studies. The exact causes of SSNHL in pregnant women remain unknown. However, hormonal changes during pregnancy can have some contribution to development of this condition. Onset of SSNHL symptoms could resemble Ménière’s disease.Conclusions: Due to rare occurrence of SSNHL in pregnant women, there is no standardized approach to managing this medical issue. Given that most cases of SSNHL are classified as idiopathic, empirical treatment primarily involves steroids.

Background: Aberrant DNA methylation is a common epigenetic modification in cancers, including oropharyngeal squamous cell carcinoma (OPSCC) and oral squamous cell carcinoma (OSCC). Therefore, the analysis of methylation levels appears necessary to improve cancer therapy and prognosis. Methods: The enzyme-linked immunosorbent assay (ELISA) was used to analyse global DNA methylation levels in OPSCC and OSCC tumours and the margin samples after DNA isolation. HPV detection was conducted by hybridisation using GenoFlow HPV Array Test Kits (DiagCor Bioscience Inc., Hong Kong, China). EBV detection was performed using real-time PCR with an EBV PCR Kit (EBV/ISEX/100, GeneProof, Brno, Czech Republic). Results: OPSCC tumour samples obtained from women showed lower global DNA methylation levels than those from men (1.3% vs. 3.5%, p = 0.049). The margin samples from OPSCC patients with HPV and EBV coinfection showed global DNA methylation lower than those without coinfection (p = 0.042). G3 tumours from OSCC patients had significantly lower levels of global DNA methylation than G2 tumours (0.98% ± 0.74% vs. 3.77% ± 4.97%, p = 0.010). Additionally, tumours from HPV-positive OSCC patients had significantly lower global DNA methylation levels than those from HPV-negative patients (p = 0.013). In the margin samples, we observed a significant negative correlation between global DNA methylation and the N stage of OSCC patients (rS = −0.33, p = 0.039). HPV-positive OPSCC patients had higher global DNA methylation levels than HPV-positive OSCC patients (p = 0.015). Conclusion: We confirmed that methylation could be changed in relation to viral factors, such as HPV and EBV, as well as clinical and demographical parameters.

Background: Actinomyces is a genus of Gram-positive anaerobic or microaerophilic bacteria with a branched filamentous shape. Their presence in tonsil tissue is usually determined by histopathological examination. In the crypts of removed tonsils, they have a prevalence ranging from 0.8% to 61.6%. The role of Actinomyces in diseases of the palatine tonsils is not clearly defined. The aim of the study was to determine the importance of Actinomyces in the pathology of palatine tonsils and to assess the impact of these bacteria on the clinical data. Methods: the retrospective analysis of the histopathological findings of patients undergoing tonsillectomy in our hospital from January 2017 to the end of December 2019 was performed in terms of the occurrence of Actinomyces. The data were collected based on the medical history. The study included 481 patients aged 3–82 years. From the study group, 100 adult patients were randomly selected, and a telephone survey was conducted. The questions included the co-occurrence of bronchial asthma, halitosis, tonsilloliths, and cigarette smoking. The questions were related to the complications following tonsillectomy and the severity of postoperative pain. Existence of a relationship was investigated between occurrence of tonsillar Actinomyces and age, sex, body mass index, and medical condition (obstructive sleep apnea, chronic palatine tonsillitis), respectively. The size of the removed tonsils was assessed and compared depending on the presence of the bacteria. Results: patients aged 18 years and older had a higher probability of presenting Actinomyces. The estimated odds ratio for the presence of the bacteria per year of age was 1.023 [1.007, 1.041]. No statistically significant results were found for the other variables. The co-occurrence of the bacteria and halitosis was close to statistical significance (p = 0.064). Conclusions: multivariate analysis of the role of Actinomyces in tonsillar pathology showed that these microorganisms should be considered saprophytes of the oropharyngeal microflora that had no significant relationship with the pathology of palatine tonsils. Further studies on their influence on halitosis are warranted.

Background: E2F transcription factor 2 (E2F2), murine double minute 2 (MDM2) and p16 are some of the key proteins associated with the control of the cell cycle. The aim of this study was to evaluate E2F2, MDM2 and p16 concentrations in the tumour and margin samples of oral squamous cell carcinoma and to assess their association with some selected sociodemographic and clinicopathological characteristics of the patients. Methods: The study group consisted of 73 patients. Protein concentrations were measured by enzyme-linked immunosorbent assay (ELISA). Results: There were no statistically significant differences in the levels of E2F2, MDM2 or p16 in the tumour samples as compared to the margin specimens. We found that patients with N0 showed significantly lower E2F2 concentrations than patients with N1 in the tumour samples and the median protein concentration of E2F2 was higher in HPV-negative patients in the tumour samples. Moreover, the level of p16 in the margin samples was lower in alcohol drinkers as compared to non-drinkers. Similar observations were found in concurrent drinkers and smokers compared to non-drinkers and non-smokers. Conclusions: E2F2 could potentially promote tumour progression and metastasis. Moreover, our results showed a differential level of the analysed proteins in response to alcohol consumption and the HPV status.

It is known that E2F2 (E2F transcription factor 2) plays an important role as controller in the cell cycle. This study aimed to analyse the expression of the E2F2 gene and E2F2 protein and demonstrate E2F2 target microRNAs (miRNAs) candidates (miR-125b-5p, miR-155-3p, and miR-214-5p) in oral squamous cell carcinoma tumour and margin samples. The study group consisted 50 patients. The E2F2 gene and miRNAs expression levels were assessed by qPCR, while the E2F2 protein was assessed by ELISA. When analysing the effect of miRNAs expression on E2F2 gene expression and E2F2 protein level, we observed no statistically significant correlations. miR-125b-5p was downregulated, while miR-155-3p, and miR-214-5p were upregulated in tumour samples compared to margin. We observed a difference between the miR-125b-5p expression level in smokers and non-smokers in margin samples. Furthermore, HPV-positive individuals had a significantly higher miR-125b-5p and miR-214-5p expression level compared to HPV-negative patients in tumour samples. The study result showed that the E2F2 gene is not the target for analysed miRNAs in OSCC. Moreover, miR-155-3p and miR-125b-5p could play roles in the pathogenesis of OSCC. A differential expression of the analysed miRNAs was observed in response to tobacco smoke and HPV status.

Chronic tonsillitis is a problem related to bacterial and viral infections. Ficolins play a key role in the defence against various pathogens. In the present study, we investigated the associations between the selected single nucleotide polymorphisms (SNPs) of the FCN2 gene and chronic tonsillitis in the Polish population. The study included 101 patients with chronic tonsillitis and 101 healthy individuals. The selected SNPs of FCN2 (rs3124953, rs17514136 and rs3124954) were genotyped using TaqMan SNP Genotyping Assays (Applied Biosystem, Foster City, CA, USA). The analysis of rs17514136 and rs3124953 showed no significant differences in genotype frequencies between the chronic tonsillitis patients and controls (p > 0.01). The CT genotype of rs3124954 was significantly more frequent, while the CC genotype was less frequent in chronic tonsillitis patients (p = 0.003 and p = 0.001, respectively). The frequency of the A/G/T haplotype (rs17514136/rs3124953/rs3124954) was significantly more common in chronic tonsillitis patients (p = 0.0011). Moreover, the FCN2 CT genotype of rs3124954 was associated with a higher risk of chronic tonsillitis, while the CC genotype of rs3124954 decreased this risk. Our findings demonstrate that FCN2 rs3124954 may be associated with chronic tonsillitis in the Polish adult population.