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Introduction: Retraction pocket is the pre-stadium of the cholesteatoma disease, and there is still no consensus on its management. The course is usually much worse in cleft palate patients because of severe Eustachian tube malformation and functional changes. Material and methodics: We evaluated 80 patients with retraction pocket surgery, 23of them with cleft palate, followed for minimum 10 years after surgery. The parameters were type of the tympanoplasty according to the grade of retraction, extent of the sanation procedure according to the grade of retraction and incidence of the re-retraction. Audiometry outcomes were evaluated and compared cleft to non cleft patients. Results: Those with cleft palate had significantly lower audiometric improvement after the surgery. Sanation procedures in cleft palate patients were also more extensive, probably because of higher grade of retraction process. Conclusion: The course and prognosis of adhesive otitis is more severe in cleft palate patients. To prevent cholesteatoma development is according to our experience most important careful follow up with otomicroscopic monitoring and early indication to surgical treatment according to the severity of changes and process dynamics.
MUDr. Lukáš Otruba Ph.D.
ENT surgeon and otologist with one of the interests in otologic pathology in cleft palate patients. 1993-2018 ENT dep 3.rd Medical Faculty Charles University Prague - member of the interdisciplinary ENT- plastic surgery Cleft palate research team. Published in The Journal of Laryngology and Otology, Czech Otorinolaryngology etc., Author of chapters in ENT and plastic surgery monographies. 2018 till now ENT dep. 1.st Medical Faculty Charles University Prague, head of the ENT dep. regional hospital Mělník.
Lukáš Otruba 1,
ORL Oddělení nemocnice Mělník a VFN Praha 1
Úvod: Anomálie první žaberní štěrbiny jsou vzácné. Poruchy vývoje spojené s branchiogenním systémem se týkají většinou druhé žaberní štěrbiny. Pouze asi v 6 % vycházejí krční píštěle/cysty z 1. žaberní štěrbiny. Označujeme je jako cystae/fistullae colloauralis. Jedná se vlastně o duplikaturu zevního zvukovodu. K píštělím colloaurálním nepočítáme drobné píštěle při předním, velmi vzácně zadním okraji boltce, které vznikají poruchou splývání 6 ušních hrbolků 1. a 2. žaberního oblouku, z nichž vzniká boltec (fistula auris congenita). Podle stavby rozlišujeme dva typy colloauráních píštělí dle přítomnosti chrupavčité tkáně. Dle přítomností obou ústí na kompletní a inkompletní. Cílem této práce je představit zkušenosti naší kliniky s touto vzácnou klinickou jednotkou, a to konkrétně u pediatrických pacientů. Metodika: Retrospektivní studie vycházející ze zkušeností Kliniky ušní, nosní a krční 2.LF UK a Fakultní nemocnice Motol a Homolka mezi lety 2011 a 2025. Jedná se o pacienty ve věku od narození do 18 let věku, postižení je přítomno unilaterálně, bilaterální lézi jsme nezaznamenali, pacienty byli jak muži, tak ženy. Všichni pacienti podstoupili operační výkon. Výsledky: V klinické praxi se setkáváme s oběma typy píštělí. Klinicky se anomálie 1. žaberní štěrbiny projevují jako cystické vyklenutí nebo píštěle kolem ucha nebo ve zvukovodu a na krku bývá často zanícené zevní ústí. Toto ústí nemusí být rozpoznané do prvního zánětu, pak se vytvoří zánětlivá zduření. Krční průběh píštěle může být i hmatný. Nález velmi často imituje abscedující lymfadenitidu, méně často se setkáváme s chronickou ušní sekrecí či pouhou přítomností vnitřní píštěle v zevním zvukovodu bez sekrece. Diagnostika není složitá, pokud je lékaři tato anomálie známá. Typické jsou tedy klinické příznaky a lokalizace zevního ústí píštěle na krku, méně často přítomnost vnitřní píštěle v zevním zvukovodu. Ze zobrazovacích metod je metodou volby magnetická resonance, která ukáže průběh píštěle a vztah k okolním tkáním. Od fistulografie je již téměř upuštěno. Kauzální terapií je kompletní odstranění provazce píštěle při zachování podstatných struktur (především n.VII) z přístupu na superficiální parotidektomii. Většina pacientů před kauzální exstirpací absolvovala minimálně jeden nedostačující výkon, nejčastěji prostou incisi a drenáž. Pacienti byli nadále pravidelně sledování až do 19 let věku. Závěr: Při poruše obliterace branchiálních štěrbin vznikají branchiogenní píštěle a cysty. Zevní ústí je uložena při mediálním okraji kývače a vnitřní ústí podle žaberního původu. Klinicky se projeví nejčastěji jako drobné ústní při kývači. Často dochází k jejich zanícení. Píštěle jsou patrné od narození, ale mohou být přehlédnuty. Cysty se objevují v pozdějším věku. V diagnostickém procesu je využívána především magnetická resonance. V akutní zánětlivé fázi je vhodné ATB zklidnění a poté metodou volby je chirurgické odstranění. Vypreparování kmene lícního nervu a neuromonitorace jeho funkce patří mezi základní prvky chirurgie anomálií 1. ŽŠ.
Background: Otitis media with effusion (OME) is one of the most common diseases in children. It manifests with hearing loss, which could lead to delayed speech or poor school performance. In recent years, novel etiopathogenetic factors, such as changes of microbiome of the adenoids and the middle ear, have emerged. The aim of this study is to analyze and compare the composition of adenoidal and middle ear microbiome in children with and without OME. Methods: A total of 31 children with adenoids and OME (study group), and 30 children with adenoids without OME (control group) were enrolled in study. Children in study group underwent endoscopic adenoidectomy and myringostomy. Samples of both adenoids and middle ear effusion were collected. Children in control group underwent adenoidectomy with samples collection. Collected samples were examined using molecular methods for detection of the DNA of common respiratory pathogens – Streptococcus pneumoniae (SRPN), Streptococcus pyogenes, Haemophillus influenzae (HAIN), Staphylococcus aureus and Mycoplasma pneumoniae. The microbiome of samples was also analyzed using 16s rRNA sequencing. Results: At least one pathogen was detected in adenoid samples in almost 97% of children in each group. In both groups, the most common pathogens were HAIN (23 and 20 positive samples) and SRPN (24 positive samples in each group). The relative abundance was significantly higher in the study group. Furthermore, pathogens were detected in middle ear fluid in children with OME, positivity was recorded in a total of 17 children. The most common pathogen was HAIN (n=9), followed by SRPN (n=7). Conclusions: The adenoidal microbiome may influence the development of otitis media with effusion. The presence of HAIN, which was significantly more common in adenoid tissue of children with OME than in children without OME, appears to be significant. This pathogen was also the most frequently found in middle ear effusion.
MUDr. Tomáš Valenta
Životopis není k dispozici
MUDr. Tomas Valenta 1, 2, , MUDr. Lenka Ryskova , Ph.D.3, MUDr. Kristyna Nema 2, Mgr. Rudolf Kukla , Ph.D.3, Mgr. Radka Bolehovska , Ph.D.3, RNDr. Filip Vrbacky , Ph.D.4, RNDr. Katerina Stefkova , Ph.D.5, MUDr. Jiri Kandera 1, doc. MUDr. Lukas Skoloudik , Ph.D.2,
Department of Otorhinolaryngology and Head and Neck Surgery, St. Anne’s University Hospital in Brno, Masaryk University, Faculty of Medicine 1
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove 2
Department of Clinical Microbiology, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove 3
4th Department of Internal Medicine, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove 4
Department of Anatomy, Charles University, Faculty of Medicine in Hradec Kralove 5
Tinnitus aurium is defined as an objecitv or a subjectiv sound of the inner ear and it's recognition within the central hearing region of the brain. It’s a clinical symptom, that still today isn’t really completely understood, cause it has multiple factors or causes to consider (e.g. sudden hearing loss, presbycusis, infections, trauma or a tumor on the acoustic nerve). Considering numbers named by the „Deutsche Tinnitus Liga“ (a german self-help group) there are at least 1,5 million patients yet in Germany alone, suffering from tinnitus aurium; the annual first diagnosis led by 250.000 patients with a chronic illness. Worldwide 740 million patients suffer from tinnitus aurium; yet alone 120 million patients who feel strongly restricted or limited to live there everyday life. The german guide line for acute tinnitus aurium is still under surveillance and is yet to be published within 2026. While the german guide line for chronic tinnitus aurium (meaning the tinnitus aurium has been lasting for more than 3 months) is still in charge. Considering chronic tinnitus aurium this guideline recommends “tinnitus retraining”, which mainly includes psycho-therapy with focus on behavioural therapy, hearing training and the learning of relaxation methods such like PMR or autogenic training. Due to changes within the german health care system, but also because of limited amount of specialists it’s difficult for german patients to find a clinical psychotherapist specialised on behavioural therapy and tinnitus aurium. So as a modern solution in a technological society, but also as an answer to the lack of health care specialists the “Digital health Applications” (DIGA) are on the rise. Still the question is, if there are still any other ways to treat patients with tinnitus aurium and if the “Autonomous sensory meridian response” might be another way to treat these patients more effectively.
Dr.med. Claudia Quast Dr. med.
Personal Data:
Name: Claudia Quast
Day of Birth and Place of Birth: 22. April 1984, in Siegen
Adress: Wachsbleiche 28B,
49076 Osnabrück
Specialist in ENT since 06/2021
Place of Work: ENT-Practice in Osnabrück, Germany
Former Places of Work:
ENT-Departement of the Marienhospital Osnabrück (Chief Prof. Dr. med. Konrad Sommer) from 07/2019 til 03/2022
ENT-Departement of the Klinikum Bielefeld Mitte, Bielefeld from 04/2016 til 06/2019
Universiy:
Rheinische Friedrich-Wilhelms-University Bonn from 10/2008 til 11/2015
Claudia Quast 1,
ENT-Practice Osnabrück 1
Endoscopic access to the middle ear has become a standard surgical approach in otologic surgery. It is particularly advantageous for the repair of tympanic membrane perforations, especially those located in the anterior quadrants. Owing to the excellent visualization of the retrotympanum, it also facilitates the management of mesotympanic retraction pockets. Furthermore, endoscopy enables the exclusive transcanal treatment of epitympanic pathologies extending to the aditus ad antrum. We present two case reports demonstrating the endoscopic management of two foreign bodies in the middle ear. The first case: The foreign body consisted of a fragment of mill scale that had entered through the external auditory canal, perforated the tympanic membrane, and become impacted in the bony portion of the Eustachian tube. Endoscopic tympanotomy was performed; however, the fragment of mill scale could not be identified within the middle ear. Therefore, a Eustachian tube balloon dilation catheter was introduced transnasally into the pharyngeal orifice of the Eustachian tube. The balloon was not inflated; instead, the catheter was used to gently displace the fragment of mill scale into the mesotympanum, where it was subsequently removed endoscopically. An underlay myringoplasty was performed simultaneously to repair the tympanic membrane perforation caused by the foreign body. The perforation healed uneventfully, and normal Eustachian tube function was preserved. The second case involved a pediatric patient with iatrogenic dislocation of the stapes following T-tube insertion. This case illustrates the importance of exploratory tympanotomy whenever a foreign body is visible beneath the posterosuperior quadrant of the tympanic membrane. The endoscopic approach provides excellent visualization of the incudostapedial joint and the retrotympanum, allowing safe assessment and management of pathology in this anatomically challenging region.
Jan Vodička
Životopis není k dispozici
Dr. Dvořák Lukáš
Životopis není k dispozici
Jan Vodička 1,
Department of Otorhinolaryngology and Head and Neck Surgery, Regional Hospital Pardubice and Faculty of Health Studies, University of Pardubice, Czech Republic 1
Background/Introduction: Obstructive sleep apnea (OSA) affects nearly 1 billion people worldwide. Surgery is variably effective and patients should be indicated very selectively. This study summarizes and presents our personal experience with TORS (not only) for OSA treatment, with the aim to provide information regarding its safety, efficacy, postoperative complications and its role in the Health system in Czech Republic. Methods: Our experiences with TORS surgery started in 2023 obtaining DaVinci Xi system. TORS is nowadays considered a common surgical minimally approach for Base of Tongue (BOT) reduction in cases of OSA due to a lingual tonsil obstruction. Furthermore, this procedure can be combined with other techniques, such as tonsillectomy, pharyngoplasty and many others in cases of a multilevel obstruction. Our patients have followed the standart indication protocol in OSA treatment (Endoscopy, PG, DISE). Pediatric patients were excluded from TORS program. Results: From 9/2023, 85 patients underwent transoral robotic surgery at our departement, 61 (72%) patients underwent surgery for oropharyngeal carcinoma, 8 (10%) for benign lesions of oropharynx, 14 (16%) for OSA. 7 patients underwent BOT reduction, 4 patients BOTr together with epiglotopalsty, in 3 cases the multilevel surgery was performed (BOTr, UPPP). There was 68% decrease of AHI in average in the patients after TORS. No patient with OSA had postoperative bleeding. No readmission was experienced. Conclusion(s): TORS for OSA treatment is an effective and safe procedure for adequately selected patients. Considering other effective ways of surgery (upper airway stimulation), in the Czech Republic, TORS is still being in its golden era regarding the surgical treatment of retrolingual space.
Transoral robotic surgery (TORS) has been established as a standard surgical approach in head and neck oncology for nearly 15 years. It has demonstrated clear superiority primarily in T1–T2 oropharyngeal carcinomas and carcinomas of unknown primary (CUP). In highly selected patients, its application extends to T3 oropharyngeal, as well as T1–T2 hypopharyngeal and supraglottic cancers. However, patients may also benefit from the advantages of this modality in several less conventional indications. First, parapharyngeal space tumors and the resection of an elongated styloid process represent ideal indications for TORS. Nonetheless, their low incidence and anatomical proximity to critical vascular structures—such as the internal carotid artery and branches of the external carotid artery—limit the widespread adoption of TORS for these pathologies in many centers. Furthermore, the inherent advantages of the robotic system, including enhanced 3D visualization and tremor reduction, can be successfully utilized in open neck indications. Due to the angled robotic arms, neck surgeries can be performed through distant incisions concealed in the hairline or the axilla. While robotic transaxillary or bilateral axillo-breast approach thyroidectomy is a standard procedure in the Far East, its adoption remains limited in European centers. Additionally, various neck procedures, including submandibulectomy, and elective neck dissection, can be safely executed through retroauricular or facelift incisions. In experienced hands, salvage surgery for persistent or recurrent oropharyngeal cancer represents another promising indication. In conclusion, advanced robotic surgery is driving a critical paradigm shift in head and neck oncology, expanding its scope from early-stage cancers to a significantly wider variety of complex indications.
Comparative Evaluation of RobOtol, Otoarm, and Manual Electrode Insertion.
MUDr Adam Kmeť
2018-2024 - 2. Lékařská fakulta Univerzity Karlovy v Praze, obor Všeobecné lékařství
9/2024 - Zařazen do specializačního vzdělávání v oboru otorinolaryngologie a chirurgie hlavy a krku
10/2024 - Zahájeno postgraduální doktorské studium v programu Experimentální chirurgie, téma práce: Složení ústního a střevního mikrobiomu jako prediktor odpovědi na léčbu u pacientů s karcinomem hlavy a krku.
Adam Kmeť 1,
KLINIKA OTORINOLARYNGOLOGIE A CHIRURGIE HLAVY A KRKU 1. LF UK A FNMH 1
Background Transoral robotic surgery (TORS) provides minimally invasive access to anatomically complex regions of the upper aerodigestive tract. Its principal indications include selected tumors of the palatine tonsil and base of tongue, as well as lesions of the parapharyngeal and retropharyngeal spaces. TORS may also be used in selected patients with obstructive sleep apnea. Objectives To present our institutional experience with TORS, describe the perioperative management of patients undergoing robotic surgery, and evaluate the clinical characteristics of patients treated between 2023 and 2026. Methods A retrospective descriptive analysis was performed of 85 patients who underwent TORS at the Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Králové, between 2023 and 2026. The evaluation included indications for surgery, diagnosis distribution, and clinical stage. The perioperative protocol comprised appropriate imaging and tumor staging, pre-anesthetic assessment, dental clearance and enteral access when indicated, antibiotic and venous thromboembolism prophylaxis, and postoperative intensive care monitoring. In oncological procedures, particular attention was paid to the prevention of oropharyngeal bleeding through external carotid artery ligation and intraoperative clipping of relevant vessels. Results TORS was used predominantly in patients with lesions involving the palatine tonsil and base of tongue, including selected T1 and T2 carcinomas. Additional indications included parapharyngeal and retropharyngeal tumors and procedures for obstructive sleep apnea. Robotic surgery enabled transoral access to anatomically challenging sites within a standardized multidisciplinary diagnostic and perioperative pathway. Specific attention to vascular control and postoperative monitoring formed an essential component of patient safety. Conclusions TORS represents an established minimally invasive option for selected oncological and non-oncological diseases in otorhinolaryngology. Appropriate patient selection, comprehensive staging, multidisciplinary management, meticulous intraoperative hemostasis, and structured postoperative monitoring are essential for its safe implementation. Further expansion of robotic surgery may include supraglottic laryngeal procedures, salvage surgery, and the use of single-port robotic systems.
as prof MD Jan Mejzlík PhD
Position : ENT specialist Department of Otorinolaryngology and Head and neck, Medical Faculty, Hradec Kralove, Charles university Prague. Czech Republic. 2014 – till now.
Education : Medical: MD in General Medicine Charles University, Medical Faculty in Hradec Kralove, Czech Republic, and Purkyne Military Academy Hradec Kralove, Czech Republic. 17/6/1998
Scientific: Ph.D. in Military Surgery, Purkyne Military Academy Hradec Kralove, Czech Republic. 21/2/2002
Academic. As. prof. in ENT, Charles university in Prague, Czech Republic, 2/4/2024
Medical Training
Residency: Department of Otorinolaryngology and Head and neck , Faculty of Medical Studies, Pardubice, Czech Republic. 1998-2001
Licenses & Certifications
• First Board Examination in Otolaryngology and Head and Neck Surgery, 3/5/2002
• Second Board Examination in Otolaryngology and Head and Neck Surgery, 19/4/2006
• Second Board Examination in Pediatric Otolaryngology and Head and Neck Surgery, 11/5/2011
• Certificate of The Czech Medical Chamber in otolaryngology 15/9/2008.
• Certificate of The Czech Medical Chamber in Systematic Medical Education, Czech Republic 4/9/2008
Professional Affiliations
• Czech Medical Association J.E. Purkyne, 1/2000
• Czech society of Otolaryngology and Head and Neck Surgery 1/1999
• The Czech Medical Chamber 9/1998
prof MUDr Chrobok Viktor, PhD CSc
Životopis není k dispozici
MUDr Homoláč Michal
Životopis není k dispozici
MUDr Dědková Jana
Životopis není k dispozici
doc MUDr Jan Mejzlík , PhD1, prof MUDr Viktor Chrobok , PhD CSc1, MUDr Michal Homoláč 1, MUDr Jana Dědková 2,
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Králové; Charles University, Faculty of Medicine in Hradec Králové, Czech Republic 1
Department of Radiology, University Hospital Hradec Králové, Czech Republic 2
Adenotomy has long been the most frequently performed surgical procedure in children. Since the mid-19th century, when the relationship between adenoid tissue and ear diseases was first described and when the first adenotomy was performed, there has been an interesting development in surgical techniques. The blind spot was the conservative procedure, where radioactivity was applied to the nasopharynx. Over the course of about 30 years, more than 2.5 million patients were irradiated before the connection of this procedure with carcinogenicity was described in the 1960s. The introduction of general anesthesia was a milestone for the safety and quality of the procedure. Currently, adenotomy is performed under endoscopic control using several possible techniques. Each of them has advantages and disadvantages. However, there has been a significant decrease in bleeding complications in particular. Individual techniques (especially laser, shaver and plasma coblation) will be described and evaluated with regard to safety and benefit for the patient. According to our own sample of more than 700 patients operated on using plasma coblation, we have recorded less than 0.5% bleeding complications and less than 0.4% recurrences. The disadvantages are a shallow learning curve and a greater risk of prolonged healing requiring the use of antibiotics compared to classic adenoidectomy.
MUDr Michal Jurovčík
Education: 1st Medical Faculty of Charles University, Prague , 1986-1992
Since 1992 – ENT dpt, 2nd Medical Faculty od Charles University and Motol and Homolka Hospital
Focus of interest: Endoscopy, Pediatric Airway Surgery, Cochlear implantation, Cleft Surgery, Head and Neck
Member of Czech Otolaryngological Society, ESPO and BLA
MUDr Michal Jurovčík 1, MUDr Zuzana Libáková 1, MUDr Karla Smolková 1, prof., MUDr Zdeněk Čada , PhD., MBA1,
ENT Dpt. of 2nd Medical Faculty of Charles University and Motol and Homolka Hospital 1
Introduction The TOTO study (tonsillectomy or tonsillotomy) for recurrent acute tonsillitis (RAT) in children and adults is a controlled, multicentric, randomised, surgical non-inferiority trial aiming to evaluate whether tonsillotomy is as effective as a tonsillectomy in RAT. The objective is to proof the non-inferiority of tonsillotomy (DRKS00020823). Methods About 2200 patients were screened across 24 study centres, a total of 531 patients were recruited. The last patient was included 05/2025, hence data analysis regarding the outcome criteria can start 05/2027 (last patient out). The correction of baseline data has been completed. Results 353 women (66%) and 178 (34%) men aged 24±10 years underwent tonsil surgery based on the German S3 tonsillitis guideline. The amount of treated sore throat episodes was 6±2 per year. Leading symptoms were dysphagia (95%) and recurrent fever (71%)s. Quality of life was at baseline: TOI-14 score 50±18, TAHSI score 57±17, SF-12 PCS score 41.9±5.1 and SF-12 MCS score 44±7. In underage patients(< 16 years; 14%) neither symptoms nor quality of life differed from adult patients (>16 years) except for a higher rate of fever during the episodes. The amount of sore throat episodes did not correlate with the quality of life: TOI-14 score r=0.12; TAHSI score r=0.08; SF-12 PCS score r=0.01 and SF-12 MCS score r=0.04. Conclusion Patient cohort showed representative characteristics for patients with severe RAT. Quality of life was on average moderately reduced and did not correlate with the amount of sore throat episodes. Potentially, measuring tonsil-specific quality of life could be the better way of assessing the severity of RAT than counting sore throat episodes. The study was financially supported by the “Gemeinsamer Bundesausschusses (G-BA)” as a “Erprobungsstudie”.
Dr. Claudio Bücking
I am currently completing my residency in Otorhinolaryngology at the Jena University Hospital.
Dr. Claudio Bücking 1, Prof. Dr. Orlando Guntinas-Lichius 1,
ENT Department, Jena University Hospital, Jena, Germany 1
Background/Introduction Tonsillectomy (TE) is one of the most frequently performed head and neck surgeries across all age groups with diverse indications. Postoperative hemorrhage represents the most feared complication. This retrospective multicentric study aimed to analyze the incidence and risk factors for late post-tonsillectomy bleeding (over 24 hours) in a large Czech cohort. Methods Data from 8,166 patients who underwent TE between 2014-2018 across 18 hospitals were analyzed. The cohort included 3,889 (47.62%) men and 4,277 (52.28%) women with mean age 29.06 years. Variables examined included type of surgery (unilateral vs. bilateral), performing institution, patient demographics, anticoagulant/antiplatelet use, surgical indication, technique, and surgeon experience. Statistical analysis evaluated associations with late bleeding incidence. Results Late bleeding occurred significantly more frequently after bilateral versus unilateral procedures (18.11% vs. 9.43%, p<0.0001). Significant risk factors included performing institution (p<0.0001), patient age (p<0.0001), sex (p<0.0001), anticoagulant therapy (p=0.0449), and antiplatelet medication (p=0.016). Notably, surgical indication, technique, and surgeon experience did not significantly influence bleeding rates. The severity of bleeding was linked to us of anticoagulants (p=0.0002) and antiplatelets (p=0.0404). Conclusion(s) This nationwide multicentric study identified hospital choice and patient characteristics as primary determinants of late post-tonsillectomy bleeding, while surgical technique and surgeon experience showed no significant impact. These findings have important implications for risk stratification and quality improvement initiatives in tonsillectomy practice. Other authors: Chrobok V., Chovanec M., Urík M., Gál B., Salzman R., Katra R., Škopek P., Kolín J., Knížek Z., Doležalová H., Sychra L., Bursa P., Jetmarová L., Berková S., Strejček P., Hájek J., Kučera Z., Syrovátka J., Slouka D.
MUDr. Vojtěch Kubec
Životopis není k dispozici
MUDr. Vojtěch Kubec 1, MUDr. Tomáš Kostlivý , PhD.1, MUDr. Jan Vodička , PhD.2, 3, ,
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Charles University, 301 00, Pilsen, Czech Republic 1
Department of Otorhinolaryngology and Head and Neck Surgery, Hospitals of Pardubice Region-Hospital in Pardubice, Faculty of Health Studies, University of Pardubice, 532 03, Pardubice, Czech Republic 2
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove, 500 05, Hradec Kralove, Czech Republic 3
Introduction: Peritonsillar abscess (PTA) is the most common acute complication of tonsillitis. Comprehensive knowledge linking etiology, clinical presentation, and laboratory results is crucial for effective patient care. Methods: A retrospective study analyzed 577 hospitalized PTA surgical patients. Data included medical history, admission laboratory markers, operative findings, and postoperative outcomes. Statistical analysis comprised univariate methods (Fisher's exact test, Mann-Whitney U test), multivariable logistic regression (aOR), species co-occurrence, ROC curve analysis, and k-means cluster phenotyping. Results: Polymicrobial infection (≥ 2 pathogens) was present in 8.7% of patients (n = 50) and associated with significantly higher admission CRP (median 115.9 vs. 88.9 mg/L, p = 0.0299). A CRP threshold ≥ 160 mg/L optimally predicted polymicrobial etiology (specificity 76.7%, AUC = 0.595, p = 0.0299). Previous outpatient incision attempts (19.4%, n = 76) were associated with lower admission CRP (66.2 vs. 92.6 mg/L, p = 0.0276), reduced WBC count (12.7 vs. 14.3 × 10⁹/L, p = 0.0087), and shorter postoperative hospital stays (IQR 0.0 vs. 1.0, p = 0.0465). Multi-drug resistance (MDR) strain prevalence decreased with age (p = 0.0084), highest under 30 years (10.7%) versus over 50 years (1.1%; aOR = 0.955, p = 0.042). Significant microbial synergy was confirmed between Streptococcus anginosus group (SAG) and aerobes (p = 0.0001) and SAG with Prevotella spp. (p = 0.0469). K-means clustering identified three phenotypes: Low-reactive Monomicrobial (58.4%, n = 328), Complicated Polymicrobial with High MDR rate (8.4%, n = 47; 19.1% MDR rate), and Hyper-inflammatory Monomicrobial (33.3%, n = 187; median CRP 175.7 mg/L). Conclusion: Polymicrobial PTA accentuates acute inflammation, whereas outpatient incision attempts blunt admission inflammatory responses. MDR strains primarily affect young adults. Multi-parametric phenotyping enhances risk stratification and targeted empirical antibiotic selection.
MUDr. Bálint Tóth
MUDr. Bálint Tóth is an Otorhinolaryngology resident and PhD candidate at the Department of Otorhinolaryngology – Head and Neck Surgery, Faculty of Medicine, Comenius University and University Hospital Bratislava, Slovakia. His doctoral research focuses primarily on sleep medicine, alongside a clinical interest in sialendoscopy. He combines his medical practice with a strong affinity for programming and data science, and has experience creating precise anatomical illustrations for medical communications.
MUDr. Bálint Tóth 1, MUDr. Dimitros Paouris 1, MUDr. Žofia Füssy 2, 3, , prof. MUDr. Miroslav Tedla , PhD., MPH1,
Department of Otorhinolaryngology – Head and Neck Surgery, Faculty of Medicine Comenius University and University Hospital Bratislava, Slovakia 1
Department of Urology, St. Cyril and Methodius Hospital, University Hospital Bratislava, Slovakia 2
Institute of Microbiology, Faculty of Medicine, Comenius University and University Hospital Bratislava 3
Positive airway pressure (PAP) therapy represents the gold standard treatment for patients with severe obstructive sleep apnea (OSA). Despite the high efficacy of this treatment modality, long-term adherence remains one of its major limitations in a substantial proportion of patients. Surgical treatment may therefore represent a suitable alternative to PAP therapy in selected patients.
MUDr. Jan Lazák Ph.D.
Main topics and interest: Skull Base Surgery, Sleep Medicine.
Degrees:
2010 – 2016 1st Faculty of Medicine, Charles University, Prague.
2016 – up today Dpt. of ORL-HNS, 1st Faculty of Medicine, Charles University, Motol University Hospital.
2021 specialization exam in Otorhinolaryngology and Head and Neck Surgery.
2022 Ass’t Prof.
2025 Ph.D. (thesis: Quality of life in patients with vestibular schwannoma)
Selected scholarships and courses:
2017 Endoskopie und endoskopisches Management der Atemwege – Jetventilation, HNO-Klinik, Universitätsklinikum Jena,
Germany.
ENT Masterclass Europe, Berlin, Germany.
2019 1st Skull Base Surgery Dissection Course & Conference, Medical University of Warsaw, Dpt. of ORL-HNS, Poland.
2020 9th Theoretical Course of Sleep Medicine by Czech Sleep Research and Sleep Medicine Society, Brno, Czech Republic.
2022 Polysomnographic Course, Prague.
2023 two – week internship at the Dpt. of ORL-HNS, University Hospital, Mannheim, Germany.
two – week internship at the Dpt. of ORL-HNS & Audiology, University Hospital Copenhagen, Denmark.
2024 two – week internship at the Dpt. of ORL-HNS La Paz University Hospital Madrid, Spain.
2026 two – week internship at the Dpt. of ORL-HNS, Morgagni-Pierantoni Hospital, Forli, Italy.
Author and co-author of publications in Czech and foreign scientific journals.
Membership in professional societies:
Czech Society of ENT and Head and Neck Surgery.
General Secretary of Czech-German Society for Otorhinolaryngology, Head and Neck Surgery.
Young Confederation of European ORL – HNS.
Czech Sleep Research and Sleep Medicine Society
European Rhinologic Society.
YO – IFOS.
MUDr. Jan Lazák , Ph.D.1, MUDr. Jaroslav Betka , Ph.D.1, MUDr. Michal Matyášek 1, Prof., MUDr. Jan Klozar , CSc.1,
Department of ORL-HNS, 1st Faculty of Medicine, Charles University, University Hospital Motol and Homolka 1
Introduction: Acute epiglottitis (AE) is a rapidly progressing, potentially life-threatening inflammation of the epiglottis. Once primarily a pediatric disease caused by Haemophilus influenzae type b, acute epiglottitis now occurs predominantly in adults due to the widespread vaccination of children. The onset is typically sudden and urgent airway intervention may be necessary. This study aimed to describe the clinical characteristics of patients, assess the occurrence of complications, and identify their potential risk factors. Methods: A single-center study included 41 patients with AE hospitalized between March 2018 and September 2023. Data on age, sex, month of diagnosis, microbiological cultures, antibiotic therapy, and the presence of complications (such as epiglottic abscess, need for airway management, and its duration) were analyzed. Results: The cohort comprised 31 men and 10 women, with a mean age of 46.7 years. Adults predominated (39 vs. 2 children). The most commonly identified pathogens were Streptococcus pyogenes, Haemophilus spp., and anaerobes. An epiglottic abscess occurred in 15 patients (36.6%), but neither age (p = 0.60) nor sex (p = 0.27) was a significant risk factor. Intubation was required in 6 cases (14.6%). A trend toward increased risk was observed in older patients and those with an abscess, though these associations did not reach statistical significance (p = 0.13 and 0.17, respectively). Conclusion: AE occurs more commonly in adults nowadays, with a shifted spectrum of causative pathogens. Airway management is necessary in a minority of patients; however, the prediction of complications remains challenging.
MUDr. Tomáš Kostlivý Ph.D.
Narozen 1989 v Plzni. Promoval na LF UK v Plzni v roce 2015. Od roku 2017 je sekundárním lékařem, od roku 2019 odborným asistentem a od roku 2024 zástupcem přednoty pro vědu a výuku na Klinice Otorinolaryngologie a chirurgie hlavy a krku LF UK a FN v Plzni. Klinicky i vědecky se věnuje zejména spánkové medicíně a otologii. Pravidelně publikuje a přednáší na tuzemských i mezinárodních kongresech, aktuální H-index 5.
MUDr. Tomáš Kostlivý , Ph.D.1, MUDr. Petr Škopek 1, doc. MUDr. David Slouka , Ph.D., MBA1,
Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine in Pilsen, Charles University, University Hospital in Pilsen 1
Despite the very good prognosis for HPV-positive oropharyngeal cancer treated with chemoradiation, approximately 10% of patients experience locoregional recurrence, which can be managed surgically. Salvage surgery presents a number of challenges. Recently, transoral treatment has been preferred whenever possible; however, more extensive surgical procedures are also performed, often requiring reconstruction. The prognosis for patients treated surgically for locoregional recurrence remains poor, and the 5-year survival rate is generally reported to be between 20 and 40%.
Cancer of unknown primary (CUP) in the head and neck accounts for 1–5% of malignancies, and roughly half of primary tumors remain undetected despite standard workup (endoscopy, imaging, PET/CT). Transoral robotic surgery (TORS) base-of-tongue mucosectomy has been proposed since 2013 to improve detection by resecting the lingual tonsil lymphoid tissue. In a single-center series of 30 CUP patients (Oct 2021–Apr 2024) treated with TORS tonsillectomy and bilateral base-of-tongue mucosectomy, the primary tumor was identified in 19 cases (63.3%) — 6 tonsillar and 13 base-of-tongue carcinomas — with a low complication rate (3 postoperative bleeds, no permanent swallowing disorders) and no cases requiring treatment de-escalation compromise. These results support TORS mucosectomy as an effective, safe addition to the diagnostic algorithm for head and neck CUP.
M.D. Petr Lukeš Ph.D.
Dr. Lukeš graduated from Charles University in Prague in 2005 and obtained board certification in Otorhinolaryngology in 2011. He is a senior physician at University Hospital Motol and Homolka and Assistant Professor at Charles University. His main interests include head and neck surgery, TOLS, TORS and advanced optical endoscopic imaging.
Petr Lukeš 1,
Department of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University and University Hospital Motol and Homolka 1
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a highly prevalent disease that results in significant healthcare costs as well as societal costs in the form of lost productivity and time. Unfortunately, a significant proportion of patients suffering from this disease find no relief from either current standard medications or surgical intervention. Biological therapy can offer a more targeted approach by blocking specific cytokines and immune signaling pathways involved in type 2 inflammation. These therapies have fundamentally changed treatment options for patients with severe CRSwNP who do not respond to conventional treatment. Biological therapy represents a new therapeutic class in the treatment of CRSwNP that has the potential to be a “game changer” for patients. At the same time, however, it poses a major challenge for us as physicians, especially for surgeons. Biological agents have demonstrated efficacy in treating CRSwNP, but they are also very expensive and may require long-term use. In our department, we began treating patients with dupilumab in 2024. Today, we see many satisfied patients who are quickly benefiting from the treatment with minimal side effects. On the other hand, however, there is a clear increase in healthcare costs associated with this therapy. The question for the future is what impact the long-term use of biologic medications will have, compared to the current standard of care for CRSwNP - not only on patients, but also on the healthcare system and on us as physicians.
prim. MUDr. Martin Šteffl Ph.D.
Martin Šteffl is a consultant otorhinolaryngologist and head of the ENT Department at Karlovy Vary Regional Hospital. He specializes in head and neck oncology, rhinology, olfactology, and head and neck ultrasonography.
He studied general medicine at the Faculty of Medicine of Masaryk University in Brno and completed his residency in otorhinolaryngology and head and neck surgery in 2016. He previously worked in the ENT department at Motol University Hospital and later at the ENT clinic at Královské Vinohrady University Hospital. From 2016 to 2023, he served as a lecturer at the Third Faculty of Medicine at Charles University.
Martin Šteffl 1,
ENT Department of the Karlovy Vary Regional Hospital 1
Malignant tumors of the nasal cavity are rare, representing only less than 1% of all malignancies. In spite of this fact, it is crucial not to leave them out in the differential diagnosis of the nasal obstruction, even more importantly in one-sided nasal obstruction and epistaxis. The main topic of this presentation is to sum up the history of a 50 year old patient, who initially presented with one-sided nasal obstruction with occasional nosebleeds. Even though surgical intervention was initially recommended, the symptoms resolved spontaneously, and no surgery took place. After a short asymptomatic period, the issues along with worsened nasal breathing started occurring again. The biopsy of the mass found on the rhinoendoscopic inspection was performed and thus the diagnosis of non-keratinizing squamous cell carcinoma was made. Afterwards the patient was referred to our department, where a primary surgical removal was indicated and performed and adjuvant chemoradiotherapy in the Proton Centre was considered. The principal aim is to emphasize the importance not only of a thorough history taking when approaching a patient presenting with unilateral nasal obstruction, but also the risks associated with omiting a histopathological examination of one-sided nasal masses.
Denisa Průšová
After graduating from the Second Faculty of Medicine in 2025, I started working in the department of Otorhinolaryngology and Head and Neck surgery of Nemocnice České Budějovice, where I am currently completing my specialty training.
Denisa Průšová 1,
Oddělení otorinolaryngologie a chirurgie hlavy a krku, Nemocnice České Budějovice a.s. 1
Background: Increasing evidence supports the use of surface functional electrical stimulation (FES) as a complementary therapy for treating patients with complete denervated facial paralysis. However, standardised studies using objective methods are needed to quantify its therapeutic effects. This pilot study examined the safety and feasibility of home-based FES for treating denervated muscle atrophy and improving facial symmetry, using ultrasound and automated image analysis. Methods: Ten patients (median age: 61 years; median duration of denervation: 130 days) with complete facial paralysis were enrolled in a prospective, monocentric feasibility study. They performed home-based FES with long (initially 100 to 250 ms phase duration), triangular biphasic impulses to evoke contractions of the zygomaticus muscle twice daily 20 minutes for up to one year. Monthly follow-ups included stimulation adjustments, sonography, and standardised photographs. To eliminate reinnervation bias, data points were excluded as soon as electromyography indicated voluntary muscular activity. Synkinesis as long-term sequel after 1 – 2 years after reinnervation were compared by blinded raters with photos of historic controls. Results: No serious adverse events occurred. The stimulation parameters were progressively adapted (reduction of phase duration from mean 150 to 50 ms after 20 weeks) while frequency could be increased (from mean 1 to 5 Hz), demonstrating effective muscle engagement. The cross-sectional area of the zygomaticus muscle increased significantly, in contrast to the decrease observed in non-stimulated muscles. Automated image analysis revealed a significant deterioration in the non-stimulated areas compared to the stimulated facial region. There was a trend to less synkinesis in the FES-group compared with no-stimulated historic controls. Conclusions: FES is a safe and feasible therapy model for patients with complete facial paralysis. Atrophy of the stimulated muscles could be reversed, as could facial asymmetry. These promising results justify conducting a future controlled, randomised, double-blind study to further investigate these initial findings. Sponsored by a research grant from MED-EL, Innsbruck, Austria, DFG GU-463/12-1 and IZKF
Gerd Fabian Volk
apl. Prof. Dr. med. habil. Gerd Fabian Volk
Senior Consultant and Leader of the Facial-Nerve-Center Jena
ENT-Department, Facial-Nerve-Center Jena, Center for Rare Diseases, Jena University Hospital
Haus A, Am Klinikum 1
07747 Jena, Germany
Fon: +49 3641 9329396
E-mail: fabian.volk@med.uni-jena.de
Gerd Fabian Volk is active since 2006 as a physician at the Department of Otorhinolaryngology of Jena University Hospital. Since 2012 he has built up and is the Leader of the interdisciplinary Facial-Nerve-Center Jena.
His clinical interests are: diagnostic and treatment of facial nerve palsy, telemedicine to improve diagnostic and treatment of rare diseases, application of botulinum toxin and electrostimulation in the head and neck region, functional diagnostics and therapy of peripheral nerve lesions, electrophysiological and imaging techniques, especially ultrasound and MRI, for the evaluation and rehabilitation of the muscles and nerves. Experimental topics: development of new methods of reconstruction of the facial and laryngeal nerve, electrostimulation as diagnostic and therapeutic tool, central changes after brain nerve failure, in particular of the facial and vestibular nerves, telemedicine and health care networks to improve treatment quality.
Jonas Ballmaier 1, 2, 3, , Dr. Johannes Kraus 1, 2, , Dr. Gabriel Meinke 1, 2, , Dr. Maren Geitner 1, 2, 3, , Lukas Hirsch 1, 2, , Dr. Anna-Maria Kuttenreich 1, 2, , Dr. Dirk Arnold 1, 2, , Prof. Dr. Winfried Mayr 4, Prof. Dr. Orlando Guntinas-Lichius 1, 2, 3, , Prof. Dr. Gerd Fabian Volk 1, 2, 3, ,
ENT-Department, Jena University Hospital, Jena, Germany 1
Facial-Nerve-Center, Jena University Hospital, Jena, Germany 2
Center of Rare Diseases, Jena University Hospital, Jena, Germany 3
Center for Medical Physics & Biomedical Engineering, Medical University Vienna, Austria 4
To achieve glottal gap closure in unilateral vocal fold paralysis (UVFP) through complementary ansa cervicalis nerve muscle pedicle laryngeal reinnervation (ANMP-LR). INTRODUCTION: ANMP-LR is easy to learn and does not require recurrent laryngeal nerve (RLN) transection. MATERIALS AND METHODS: Twelve patients with unilateral vocal fold paralysis (UVFP) were included, who received ANMP-LR and could be followed up for at least 6-24 months. At baseline, after 3-6 (T1), 12 (T2) and 24 months (T3), Voice Handicap Index (VHI), perceived roughness (R) and breathiness (B), sound pressure level (SPLmax), maximum phonation time (MPT), Dysphonia Severity Index (DSI) and glottal gap (GG) were recorded. RESULTS: R and B were significantly reduced at T1, MPT and SPLmax increased significantly up to T1 (MPT to 15.8 s; SPLmax to 91.5 dB). Similarly, VHI dropped significantly and the residual glottal gap (GG) was significantly reduced between T0 and T1. All outcomes remained stable until T3. There was a non-significant tendency to further improvement until T3 in SPLmax and GG. DISCUSSION: The T1-T3 outcomes of the complementary ANMP-LR are comparable with the standard LR and also with thyroplasty. As with all LR techniques, younger patients and those with shorter paralysis benefit more. Patients with evidence of unfavorable laryngeal synkinesis are more likely to benefit from a standard LR with RLN transection. CONCLUSIONS: Younger patients with insufficient synkinetic reinnervation and persisting or progressive glottis closure insufficiency in UVFP benefit from early reinnervation. When the easy-to-learn ANMP technique is used, any partial rehabilitation that has already been achieved or any remaining chance of spontaneous reinnervation via the RLN is not compromised.
Prof. Andreas Müller MD
Andreas H. Mueller studied medicine in Jena, Germany. He completed his specialist training in Otorhinolaryngology at the University of Jena in 1993 and was ORL consultant in Jena until 2004. Since 2005 he is head of the Department Otorhinolaryngology/Plastic Surgery, SRH Wald-Klinikum Gera, Germany. Prof. Mueller is a specialist for laryngotracheal stenosis, laryngology and rhinology. His main research interests are Neurolaryngology, vocal fold paralysis and laryngeal pacing.
Prof. Andreas H. Müller , MD1, Dr. Gerhard Förster , MD1, Dr. Kathleen Klinge , MD1,
SRH Wald-Klinikum Gera, Dept. ORL 1
Tumours of salivary glands form 3% of all neoplastic involvements. Majority of them is benign, parotid gland is most commonly involved. Risk of malignity is increasing with reduced size of involved gland. Clinical differentiation of salivary gland tumours is difficult. MRI is therefore important in their differential diagnosis. Ultrasound is first method of choice in diagnostics of pathological involvement of salivary glands. MRI is preferred for evaluation of foci involving deep lobe of parotid gland, sublingual gland, minor salivary glands, deeply placed soft tissue, involvement of lymphonodes and possible perineural spread. Pleomorphic adenoma is the most common tumour of salivary glands, mostly in superficial lobe with fibrous capsule. Carcinoma, usually multifocal, can develop later from adenoma. Inhomogeneity of parenchyma with solid and cystic portions, mild enhancement after contrast media application, higher wash out ratio and lower mean ADC value than in malignant tumours are characteristic for Warthin tumour, involving largely smokers. Mucoepidermoid carcinoma of lower grade can mimic pleomorphic adenoma, higher grade carcinoma often metastasizes to lymphatic nodes. Adenoid cystic carcinoma often spreads perineurally, makes recurrence in long delay after surgery. It has intermediate T2W signal, higher grade of tumour has even low T2W signal. Metastases into salivary gland are exceptional, commonly from lung and breast carcinoma, from skin squamous cell carcinoma or melanoma. Multiple small cystic structures in parenchyma of gland are characteristic for Sjögren syndrome. Lymphoma can involve lymphoid tissue of parotid gland or adjacent lymphatic nodes, either primary or secondary by systemic involvement.
MUDr. Jiří Lisý CSc.
PERSONAL DETAILS
Date of birth: 03 November 1967
WORKING EXPERIENCE
2020 - up till now - Radiodiagnostic dept., Hospital Na Homolce, Praha 5, Czech Republic
2011- 2020 – deputy for education, Department of Imaging Methods 2nd Medical Faculty, Charles University, University Hospital Motol, Praha 5
2004- 2020 – head of MRI unit, Clinic of Imaging Methods, University Hospital Motol,
Prague, Czech Republic
1996- 2020 - Assistant Professor Charles University, Prague, Czech Republic, 2nd
Medical Faculty,
1993- up till now - Department of Imaging Methods, University Hospital Motol, Prague Republic,
1992-1993- Radiodiagnostic dept., State Hospital Kladno, Czech Republic
Foreign experience
2000-2026 - Norrlands Universitetssjukhus, Umea, Sweden (neuroradiology) cisiting radiologist
Schoolarship:
2001- RSNA Chicago, International Seminar of Young Radiologists
1997/VII/-1997/IX/- Texas Children Hospital, Houston, USA, Texas
Czech Physician Exchange Program, training in pediatric neuroradiology
1994/XI/-1995/IV/- American Hospital Paris, France, MRI dept., GE´s scholarship, training in
MRI
EDUCATION
1992- Graduation M.D.
1986-1992 -University studies, Charles University, Prague, 2nd Medical Faculty
PROFESSIONAL QUALIFICATION
2008- Board Certification in Paediatric Radiology
2007- Board Certification in Neuroradiology
2001- PhD thesis in radiology (Balloon dilation of esophageal and laryngeal strictures in
Children)
1999-Radiology Board Certification of 2st degree
1995-Radiology Board Certification of 1st degree
Jiří Lisý 1,
Radiologické oddělení , Fakultní nemocnice Motol a Homolka, V Úvalu 84/1, Motol, 150 00 Praha 1
Introduction: Benign tumors of the parotid gland are the most common salivary gland tumors and are primarily treated surgically. Although parotid surgery is an established treatment, postoperative morbidity, particularly facial nerve dysfunction, remains a significant clinical concern. Population-based data on surgical treatment patterns and postoperative outcomes for benign parotid tumors are limited. Therefore, this study analyzed the inpatient surgery of benign parotid tumors in Thuringia between 2016 and 2020. Material and Methods: In this retrospective, multicentre, population-based cohort study, clinical routine data of 1,157 patients who underwent surgery for benign parotid tumors in Thuringian hospitals between January 2016 and December 2020 were analyzed. Patient characteristics, preoperative diagnostic procedures, surgical techniques, histopathological findings, postoperative complications, facial nerve function, recurrence, and surgery rates were evaluated. Univariate and multivariate analyses were performed to identify factors associated with postoperative complications, facial nerve palsy, and recurrence. Results: The cohort included 621 men and 536 women, with a mean age of 62.5 ± 13.9 years. Preoperative ultrasound was performed on 97.7% of patients. The most common procedures were partial parotidectomy (50.7%) and lateral parotidectomy (41.0%). Facial nerve monitoring was employed in 99.3% cases. Histologically, Warthin tumors were most common, accounting for 60.8% of cases, followed by pleomorphic adenomas in 31.9%. Complete tumor resection was achieved in 99.3% of patients. Postoperative complications occurred in 16.7% of cases. Facial nerve palsy was documented in 8.2%, including transient palsy in 7.2% and permanent palsy in 1.0%. The median follow-up time was 0,23 months (range, 0-75 months). Recurrence was observed in 3.6% of patients. In univariate analyses, postoperative complications were significantly associated with female sex and more surgical extent (p < 0,05). The surgery rate was highest in the 60- 75 age group with 99-138/100,000 population. Conclusion: In Thuringia, surgery for benign parotid tumors was associated with high rates of complete tumor resection and low rates of permanent facial nerve dysfunction. The extent of surgery was an important factor influencing postoperative morbidity. These population-based data provide a comprehensive overview of current surgical practices and outcomes in treatment of benign parotid tumor and could support future quality assessment and treatment standardization.
Alaa Khalil
Životopis není k dispozici
Kouka Mussab, PD Dr. med.
Životopis není k dispozici
Holger Kaftan , Prof. Dr. med. 6, Andreas Mueller , Prof. Dr. med. 7, Sylvia Tresselt , Prof. Dr. med. 8, Orlando Guntinas-Lichius , Prof. Dr. med. 1, Daniel Boeger , Prof. Dr. med. 2, Jens Buentzel , Prof. Dr. med. 3, Kerstin Hoffmann , Prof. Dr. med. 4, Jiří Podzimek , Prof. Dr. med. 5,
Department of Otorhinolaryngology, Helios Klinikum Erfurt, Erfurt, Germany 6
Department of Otorhinolaryngology, SRH Wald-Klinikum Gera, Gera, Germany 7
Department of Otorhinolaryngology, Ilm-Kreis-Kliniken, Arnstadt, Germany 8
Department of Otorhinolaryngology, Jena University Hospital, 07747 Jena, Germany 1
Department of Otorhinolaryngology, SRH Zentralklinikum Suhl, Suhl, Germany 2
Department of Otorhinolaryngology, Südharz-Krankenhaus, Nordhausen, Germany 3
Department of Otorhinolaryngology, Sophien- und Hufeland-Klinikum, Weimar, Germany 4
Department of Otorhinolaryngology, Klinikum Bad Salzungen, Bad Salzungen, Germany 5
Background: The Ligasure sealing system is a bipolar diathermy sealing device using high current with low voltage for creating a consistent seal to up to 7mm diameter vessels with reduced thermal spread. The electrosurgical generator is responsible for the detection of the characteristics of the tissue closed between the instrument jaws so it can deliver the exact amount of energy needed to seal it permanently. The Ligasure sealing system has been in standard use in our ENT department in Mladá Boleslav since January 2016. Methods: Reflecting on the sample of 751 standard total thyroidectomy procedures performed since January 2003 we are going to evaluate the demographic features, the effect on the surgery length, complications and patient outcome. To compare the data objectively we included solely total thyroidectomies and excluded every procedure including collar mediastinotomy, lymph node resection or any other accompanying procedure. We use the Ligasure sealing system in 218 patients and traditional hemostatic procedures in the other 573, we also tested the harmonic scalpel technology, but it will not be part of this overview. Results: In the Ligasure group the surgery length average was 89,62 minutes, the median was 88 minutes. In the traditional group the average was 98,10 minutes and the median 95 minutes. Other demographics and safety data are yet to be determined, based on the data set we have collected. Conclusion: Ligasure is an effective tool for hemostasis control and it shows reduction in the operating time. It has now become a standard tool in total thyroidectomy and other major surgeries in the ENT department Mladá Boleslav.
Keratoacanthoma is a distinctive skin tumor with a variable clinical course that often closely mimics malignant lesions, particularly squamous cell carcinoma. Its characteristic rapid growth, followed by the potential for spontaneous regression, makes accurate diagnosis and treatment selection challenging. This may lead to unnecessary radical surgical procedures, especially in functionally and aesthetically sensitive areas such as the nose. Careful clinical evaluation and close interdisciplinary collaboration are therefore essential for appropriate management. We present two case reports of patients with keratoacanthoma located in the nasal region, demonstrating different clinical courses and therapeutic approaches. Clinical presentation, disease progression, histological findings, treatment strategy, and final outcomes were assessed. In the first case, the lesion was initially suspected to be squamous cell carcinoma, and surgical excision was considered. However, due to spontaneous regression observed during follow-up, a watchful waiting strategy was chosen, resulting in complete regression without the need for surgery and leaving only minimal scarring. In the second case, a patient presented with a large keratoacanthoma of the nasal apex with rapid progression and central necrosis. Based on the clinical appearance and disease course, conservative treatment with intralesional methotrexate was initiated. Gradual tumor regression was achieved; however, residual nasal deformity remained and required subsequent reconstructive plastic surgery. Keratoacanthoma represents a significant diagnostic challenge because of its clinical and histological similarity to squamous cell carcinoma. An individualized interdisciplinary approach can enable more conservative management in selected patients, helping to avoid unnecessarily mutilating surgery while preserving both functional and aesthetic outcomes.
MUDr. Polina Golovach
Medical doctor at the Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Pilsen. Graduate of the Faculty of Medicine in Pilsen, Charles University.
MUDr. Polina Golovach 1, MUDr. Robert Sakař 1, MUDr. David Slouka , PhD, MBA1, MUDr. Karel Pizinger , CSc.2,
Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine in Pilsen, Charles University, University Hospital Pilsen, Pilsen, Czech Republic 1
Department of Dermatovenereology, Faculty of Medicine in Pilsen, Charles University, University Hospital Pilsen, Pilsen, Czech Republic 2
Background: Retrograde cricopharyngeal dysfunction (RCPD) is a poorly recognized disorder of upper esophageal sphincter (UES) relaxation characterized by an inability to belch. Patients commonly also present with inability to vomit, chest bubbling, gurgling noises, bloating, and abdominal pain. The current gold standard of treatment is botulinum toxin injection into the UES. The aim of this work is to present the first experience with treatment of RCPD at the Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava. Methods: Since the beginning of 2026, we have treated three consecutive patients. One patient had UES spasm demonstrated on high-resolution manometry, and two patients were diagnosed clinically. All patients received transoral Dysport injections (150 SU) into the cricopharyngeus muscle under general anesthesia. Clinical severity and treatment effect were assessed using the BURP questionnaire pre- and post-operatively. Results: All patients reported marked clinical improvement and better psychosocial functioning. The mean BURP score decreased from 90.3 preoperatively to 16.0 postoperatively, a mean reduction of 82.3%. Reported adverse effects included transient aphagia, reflux symptoms, and reduced voluntary control of belching. These effects were transient and resolved spontaneously. Conclusion: RCPD is a somatic condition with a major impact on quality of life. Botulinum toxin injection into the cricopharyngeus muscle is a simple, safe and effective treatment that provides substantial benefit for patients.
MUDr. Peter Kántor Ph.D.
Životopis není k dispozici
MUDr. Peter Kántor , Ph.D1, MUDr. Dominik Tichý 1, Prof. MUDr. Karol Zeleník , Ph.D., MBA1,
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava and Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic 1
Introduction: Cervical lymphadenopathy represents a common and relatively nonspecific clinical manifestation of a broad spectrum of pathological conditions. In this context, malignancies of the head and neck region are of major consideration, though systemic malignancies, most notably lymphomas, should also be considered. Case report: In this retrospective study, we describe a rare presentation of a female patient with bilateral multilevel cervical lymphadenopathy with no other clinical symptoms, who was referred to our department with an initial clinical suspicion of lymphoma. However, subsequent biopsy and colonoscopy revealed the underlying etiology to be metastatic colorectal carcinoma. Discussion and conclusion: While otherwise asymptomatic colonic cancer presenting with cervical lymphadenopathy is almost unheard of, tumours especially from the upper GI tract are known to metastasize into cervical nodes via the well described pathway of the thoracic duct and presenting as Virchow’s node. While these are a small minority of cases, they always have to be considered. A proper diagnostic algorithm for cervical lymphadenopathy should lead to correct and timely diagnosis even in such rare cases.
MUDr. Martin Bortlík
The author is a first-year otolaryngology resident, working at the General Military Hospital in Prague. He graduated the Second Faculty of Medicine, Charles University, Prague, having participated in several clinical ENT internships. He has a particular interest in tumours of the head and neck.
MUDr. Martin Bortlík 1, prof. MUDr. Jaromír Astl , CSc.1, MUDr. Kristýna Mamiňák 1,
Klinika otorhinolaryngologie a maxilofaciálníchirurgie 3. LF UK a ÚVN 1
Background Incidence of thyroid cancer is increasing worldwide specially for small size papillary thyroid carcinoma, while the mortality remains low. Thyroid cancers are the most common endocrine disorders. Bangladesh is one of the countries with the high prevalence of thyroid cancer. The actual burden of thyroid dysfunction in Bangladesh is unknown. Surgery is the mainstay of treatment for thyroid cancer. In addition, active surveillance is proven as a valid option in patients with low-risk papillary thyroid cancer. The aim of this study is to assess the possibility of implementation of active surveillance in Bangladesh by physicians and to identify potential barriers to its widespread adoption. Methods Me & my group surveyed participants, Endocrinologists, ENT & Head-Neck surgeons of Bangladesh by distributing questionnaires & talking to them over telephone. The questionnaire included dichotomous, multiple choice questions, and multiple answer questions. Results We got responses from 50 surgeons. Most of the respondents agreed that AS is a valid modality for low-risk papillary thyroid cancer but no one has patients on active surveillance. ENT surgeons, Endocrinologists with >15 years of experience, and & practicing in clinics, private hospitals & university hospitals were involved. We have started an active surveillance program with a very small group of patients & awareness activities among different groups of doctors. Conclusion Obstacles to implementing active surveillance were, patient noncompliance and lack of national awareness as well as acceptance among the Bangladeshi doctors. Still active surveillance is possible in Bangladesh with differences in health care system & health care organization and even outside academic centers. Efforts to decentralize knowledge and expertise to health-care practitioners and community hospitals would encourage its implementation.
Dr. Dewan Mahmud Hasan MBBS, DLO
Dr. Dewan Mahmud Hasan
Otolaryngologist & Head-Neck Surgeon
Professor, Bangladesh Institute of Health Science General Hospital
Consultant, Bangladesh Specialized Hospital PLC
Life Member, Society of Otolaryngology & Head-Neck Surgeons of Bangladesh
Member, Society of Head and Neck Surgeons of Bangladesh
Member Executive Committee, APTS (Asia Pacific Society of Thyroid surgeons)
Member Executive Committee, International Guild of Robotic & Endoscopic Head and Neck Surgery (IGReHNS)
Member, Bangladesh Medical Association
Member (Ex). Editorial Board- Medical Journal of Shaheed Suhrawardy Medical College Hospital, Dhaka.
Treasurer (Ex) SAARC ENT Society
Dewan Mahmud Dasan Hasan 1,
Bangladesh Specialized Hospital 1
Introduction: Laryngomalacia is the most common congenital anomaly of the larynx and also the most common cause of inspiratory stridor in children. The condition usually requires only observation and resolves spontaneously within 1–2 years. Severe cases are indicated for endoscopy under general anaesthesia to rule out any associated pathology. Direct laryngoscopy also allows a surgical treatment depending on the type of obstruction. Methods: A retrospective study of 50 paediatric patients who underwent dissection of aryepiglottic folds between the 1st of January 2013 and the 30th of June 2024 at the Department of ENT, 2nd Faculty of Medicine Charles University and Motol and Homolka University Hospital, Prague based on information from surgical records, medical records, outpatient records and the UNIS hospital information system. Results: In the patient cohort studied, a high success rate of surgical treatment (94%) was recorded, with a low incidence of post-operative complications (6%). Conclusions: The results of surgical treatment of laryngomalacia at our department are consistent with those of leading paediatric endoscopic centres worldwide. Associated comorbidities have been shown to be a potentially significant factor that negatively affects not only the course of the disease itself, but also leads to a higher incidence of complications and treatment failure. The post-operative course was uncomplicated in the majority of patients, particularly those who were otherwise healthy, allowing discharge by the second post-operative day (70%) with subsequent rapid regression of symptoms.
Zuzana Libáková
After completing her studies at Pavol Jozef Šafárik University in Košice, Slovakia, in 2019, Dr. Zuzana Libáková began working at the Department of Otorhinolaryngology at Bulovka University Hospital in Prague. In 2022, she began working at the Department of ENT, 2nd Faculty of Medicine, Motol and Homolka University Hospital, Prague to specialize more closely in paediatric patients, with laryngology among her main areas of interest. She is currently a PhD student in the field of Experimental surgery, where she focuses on directional hearing in patients who have undergone metachronous cochlear implantation with a longer time interval between procedures.
MUDr. Zuzana Libáková 1, MUDr. Michal Jurovčík 1, prof. MUDr. Zdeněk Čada , Ph.D., MBA1,
Department of ENT, 2nd Faculty of Medicine Charles University and Motol and Homolka University Hospital 1
Myasthenia gravis (MG) is an autoimmune disorder that affects neuromuscular transmission. It is caused by autoantibodies directed against acetylcholine receptors, which impair the normal function of the neuromuscular junction. The initial symptoms frequently involve the head and neck muscles, and patients may present with voice, swallowing, and speech disorders. Consequently, otorhinolaryngologists (ENT specialists) are often the first physicians to evaluate these early manifestations before a formal neurological diagnosis is established. Dysphagia, dysphonia, and dysarthria may be the initial presenting symptoms. ENT specialists play an important role in the initial evaluation of patients with unexplained pharyngeal or vocal cord weakness, in the assessment and management of aspiration risk to prevent serious airway and swallowing complications, and in the timely referral of patients to a neurologist for confirmatory diagnostic testing, including antibody assays and electrophysiological studies. In this presentation, we will review the most common ENT manifestations of myasthenia gravis and present two illustrative case reports demonstrating its clinical presentation.
MUDr. Iva Bártová
CV
e-mail iva.bartova@nempk.cz
Education:
1997 – 2003 Charles University in Prague, Faculty of medicine in Hradec Králové, general medicine, degree M.D.
1993 – 1997 Grammar school K.V.Raise, Hlinsko
Professional experience:
09/2003 – still, doctor, Clinic of Otolaryngology and Head and Neck Surgery, Regional Hospital Pardubice 05/2013 Deputy head of department
12/2009 specialization in ENT
10/2015 specialization in pediatric ENT
Field of interests: dysphagiology, otology, thyroid gland surgery, facial plastic surgery
Pedagogical acivity – assistance in medical students and nurses education
- Swallowing disorders (lectures, workshops)
Memberships – 2007 ČLS JEP
2021 The Czech-German Society for Otorhinolaryngology, Head and Neck Surgery
Prizes - 1st prize for lecture of young authors in Regional Hospital Pardubice, 2009 (Swallowing disorders)
MUDr. Iva Bártová 1, Mgr. Karolína Divíšková 1,
Klinika otorinolaryngologie a chirurgie hlavy a krku, Nemocnice Pardubického Kraje a.s., Pardubická nemicnice 1
Background: Routine grading of facial palsy is largely subjective and overlooks functions that matter to patients – facial symmetry, eye protection during blinking, and emotional expression. We present four objective tools developed in Jena, covering facial asymmetry, blinking, and muscle activity. Methods: AI-based angle mapping quantified facial asymmetry automatically from clinical photographs using 478 landmarks in 405 datasets from 198 patients. Automated blinking analysis (JeFaPaTo) extracted facial features from smartphone video in patients with acute palsy, patients with synkinesis, and healthy controls. Bilateral high-resolution surface EMG (HR-sEMG; 58 electrodes, muscle-oriented Fridlund and symmetrical Kuramoto schemes) recorded muscle activity during 11 movements in 36 synkinesis patients and 36 healthy controls. A proof-of-concept model (EIFER) mapped facial geometry to muscle activity via a 3D morphable model, toward electrode-free EMG. Results: Angle-map scores correlated moderately to strongly with the clinical Stennert index score (r = 0.32–0.73, p < 0.001), were robust to head rotation, and produced reference-free maps. Blinking analysis separated acute palsy, synkinesis, and controls: in acute palsy the minimal Eye-Aspect-Ratio (incomplete closure) was higher on the affected side, while blink frequency was lower and duration longer in both patient groups; these differences were not reflected in patient-reported outcome measures. On HR-sEMG, each movement activated nearly the entire muscle network rather than isolated muscles. In synkinesis, off-target muscles were overactive on the synkinetic and often the clinically unaffected contralateral side — evidence of a bilateral disorder relevant for contralateral treatment; the Fridlund scheme gave more specific contrasts. The electrode-free model showed that muscle activity can be inferred from video alone. Conclusions: The tools quantify facial asymmetry and muscle activity objectively in both flaccid and synkinetic palsy. Within multidisciplinary ENT-led care, they complement physician-based grading and patient-reported outcome measures and help standardize recovery monitoring. * Orlando Guntinas-Lichius and Joachim Denzler acknowledge support by the Deutsche Forschungsgemeinschaft (DFG), grant GU-463/12-1 and DE-735/15-1
Jonas Ballmaier
Životopis není k dispozici
Jonas Ballmaier 1, 2, 3, , Andreas Heinrich 4, Lukas Schuhmann 1, 2, , Tim Büchner 5, Paul F. Funk 1, 2, 6, , Richard Schneider 1, 6, , Maren Schramm 1, 6, , Joachim Denzler 5, Christoph Anders 6, Gerd Fabian Volk 1, 2, 3, , Orlando Guntinas-Lichius 1, 2, 3, ,
Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany 1
Facial-Nerve-Center, Jena University Hospital, Jena, Germany 2
Center for Rare Diseases, Jena University Hospital, Jena, Germany 3
Department of Radiology, Jena University Hospital, Jena, Germany 4
Computer Vision Group, Friedrich Schiller University Jena, Jena, Germany 5
Division of Motor Research, Pathophysiology and Biomechanics, Clinic for Trauma, Hand and Reconstructive Surgery, Jena University Hospital, Jena, Germany 6
Introduction: Accurate delineation of tumor margins is a persistent challenge in surgery of oropharyngeal squamous cell carcinoma (OPSCC). The rising incidence of OPSCC further highlights the need for reliable, real-time tissue characterization tools. Hyperspectral imaging (HSI) captures spatially resolved spectral information across a broad wavelength range, enabling label-free, non-contact differentiation of tissue types. This study aims to evaluate the feasibility of HSI combined with machine learning (ML) for distinguishing tumor from healthy tissue in patients with OPSCC. Methods: In the prospective feasibility study HSI-HEAD-NECK (DRKS00033009) in vivo HSI data were acquired in 35 patients with OPSCC (91% males, mean age 68 ± 11 years, 71% of stage IV) using a hyperspectral endoscopy camera system with100 spectral channels. For each patient, HSI datacubes were collected intraoperatively from tumor-bearing and adjacent healthy tissue regions. Regions of interest were annotated in cooperation with an independent surgeon. Mean spectral profiles were extracted per tissue class and used to train ML approaches, evaluation was realized using cross-validation. Results: Preliminary results demonstrate visually distinct spectral profiles between tumor and healthy tissue across all investigated anatomical sites. Classifiers achieved promising discrimination accuracy higher than 80%. Consistent spectral differences were observed over the whole measured wavelength region, suggesting tumor-associated changes in tissue oxygenation and structural composition. Analysis is ongoing with a larger patient cohort. Conclusion: HSI represents a promising non-invasive approach for intraoperative in vivo tissue characterization in OPSCC. The combination with ML classification has the potential to support surgical decision-making regarding tumor margin assessment. This feasibility study will provide a foundation for prospective clinical validation. This work was funded by BMFTR/DVI under the HyperTUM project (Grant Agreement No. 16SV9564) and by EU Horizon Programme under the CHARM project (Grant Agreement No. 101058004).
Gennadii Ustinov
PhD student in the Clinical Biophotonics Research Group in Jena, Germany, focusing on hyperspectral imaging for biomedical applications. His research involves in-vivo measurements in the operating room and ex-vivo tissue analysis using hyperspectral cameras, with a focus on machine learning-based tissue type classification and development of advanced optical diagnostic methods.
Gennadii Ustinov 1, Saskia Wolter 1, Tammam Alamatouri 1, Thomas Bitter 2, Mussab Kouka 2, Katharina Geißler 2, Orlando Orlando Guntinas-Lichius 2, 3, , Anna Mühlig 1, 3, ,
Clinical Biophotonics, Department of Otorhinolaryngology, Jena University Hospital, 07747 Jena, Germany 1
Department of Otorhinolaryngology, Jena University Hospital, 07747 Jena, Germany 2
Comprehensive Cancer Center Central Germany, 07747 Jena, Germany 3
Introduction Artificial intelligence (AI) is becoming an increasingly important tool in healthcare, supporting diagnosis, prognosis, treatment planning, and patient monitoring. In rehabilitation medicine, AI offers opportunities to transform subjective clinical assessments into objective, data-driven evaluations. However, successful implementation of AI requires access to high-quality clinical data and digital tools capable of collecting standardized patient information. Methods As a case study of AI integration into rehabilitation practice, we present Rehapple, a digital platform developed for patients with facial palsy. The platform supports rehabilitation exercises while collecting facial movement data during routine use. These data are subsequently analyzed using machine learning and deep learning approaches. Current research focuses on automated classification of facial nerve impairment according to the House–Brackmann (HB) grading system using convolutional neural networks, as well as detection of synkineses through machine learning models based on extracted movement features. Results The platform has enabled systematic collection of facial movement recordings from patients undergoing rehabilitation. Preliminary analyses indicate that AI models can identify clinically relevant patterns within the collected data and provide automated assessments of facial function. The continuously growing dataset supports further model development and validation. Conclusion AI has the potential to enhance rehabilitation by providing objective, reproducible, and scalable assessment methods. The Rehapple platform demonstrates how digital data collection and AI-based analysis can be combined in clinical practice to support evaluation of facial palsy. Such approaches may contribute to improved monitoring of patient progress, more standardized assessments, and future development of personalized rehabilitation strategies.
Ing Jakub Ciler
I am a Ph.D. student at the University of Chemistry and Technology, Prague, focusing on the application of AI in medicine. In 2025, I completed my master’s degree at the same university in the field of Sensors and Cybernetics in Chemistry. Over the past few years, I have been focusing on the application of AI for people suffering from facial nerve palsy and related conditions.
Ing. Jakub Ciler 4, Ing. Karel Štícha 4, Ing. Jan Kohout , Ph.D.4, MUDr. Ludmila Verešpejová 2, MUDr. Zuzana Urbániová 2, Ing. Josef Böhm 3, doc. MUDr. Martin Chovanec , Ph.D.2, prof. Ing. Jan Mareš , Ph.D.4,
Department of Otorhinolaryngology, University Hospital Kralovske Vinohrady, Charles University Prague, 3rd Faculty of Medicine 2
Faculty of electrical engineering and informatics, University of Pardubice 3
Department of Mathematics, Informatics, and Cybernetics, Faculty of chemical engineering, University of Chemistry and Technology Prague 4
Background: Human listener-based assessment of alaryngeal speech is clinically established but time-consuming and influenced by listener experience. We investigated whether automatic speech recognition (ASR) can provide a standardized adjunct for assessing speech intelligibility. Methods: Speech samples from 17 alaryngeal speakers (10 tracheoesophageal, 7 electrolaryngeal) were evaluated using 21 complete PLTT datasets. ENT physicians, speech professionals, and speech science students transcribed the recordings. The same samples were processed independently with the locally installed Whisper large-v3 model without fine-tuning and evaluated using identical reference texts and scoring rules. Analyses compared absolute PLTT scores, speaker-level correlations, rehabilitation methods, and exploratory classification of clearly well versus poorly intelligible speakers. Results: ASR produced substantially lower PLTT scores than human listeners (25.36% vs. 55.21–72.03%; all p < 0.001). Nevertheless, ASR scores strongly correlated with pooled human ratings at speaker level (Pearson r = 0.858; Spearman ρ= 0.898; both p < 0.001). Tracheoesophageal speakers achieved higher ASR scores than electrolaryngeal speakers (33.88% vs. 14.46%; p = 0.035). After excluding moderately intelligible speakers, ASR completely separated six well-intelligible from four poorly intelligible speakers in an exploratory analysis (AUC = 1.000; cutoff ≥ 37.5%). Conclusions: The evaluated ASR system underestimated speech intelligibility after laryngectomy and cannot yet replace human assessment. However, its ability to distinguish clearly well from poorly intelligible speakers suggests clinical relevance. External validation in larger cohorts and across languages is required.
Tino Hanusch
Tino Hanusch, MD is a Senior Consultant in the Department of Otorhinolaryngology, Head and Neck Surgery at SRH Wald-Klinikum Gera, Germany. He completed his medical training at Friedrich Schiller University Jena, became board-certified in Otorhinolaryngology in 2015. He holds additional qualifications in Plastic and Aesthetic Surgery, Head and Neck Oncologic Surgery as well as Edoscopic Sinunasal and Skull Base Surgery.
His research focuses on voice rehabilitation after total laryngectomy and the use of artificial intelligence for the objective assessment of speech intelligibility.
Tino Hanusch 1, Prof. Dr. med. Orlando Guntinas-Lichius 2, Prof. Dr. med. Andreas Müller 1,
Department of Otorhinolaryngology, SRH Wald-Klinikum Gera, Gera, Germany 1
Department of Otorhinolaryngology, University Hospital Jena, Friedrich Schiller University Jena, Jena, Germany 2
Introduction: Broadband stimulated Raman scattering (bSRS) microscopy provides label-free, chemically specific contrast reflecting intrinsic molecular composition of cells and tissues. Its capability to resolve biochemical heterogeneity in head and neck cancer specimens makes it a promising ex vivo biosensing approach for diagnostic tissue characterization. We present a clinically deployable multimodal bSRS imaging device, COherent Raman PLatform (CORAL), integrating 38 Raman channels with simultaneous second harmonic generation (SHG) and two-photon excited fluorescence (TPEF) acquisition in a single platform. Methods: The system architecture was specifically engineered for operation under routine clinical laboratory conditions. To ensure compatibility with standard histopathological workflows, a robust and reproducible dewaxing protocol was established. Measurement parameters and calibration routines were optimized to balance data quality, acquisition time, and operational stability. Head and neck cancer specimens were analyzed using whole-section scans. A dedicated processing pipeline was developed for visualization and analysis of multimodal bSRS data and integrated into a user-friendly graphical user interface, enabling rapid quality control. Following bSRS imaging, all samples underwent conventional hematoxylin and eosin (H&E) staining. Digitized H&E sections were annotated by expert pathologists, providing systematic correlation of Raman-derived biochemical information with established histopathological features, including tumor cell density, stromal composition, and tissue architecture. Results: Measurement protocols were successfully optimized to achieve reproducible molecular contrast and stable multimodal image acquisition under routine laboratory conditions. Whole-section imaging of clinical tumor specimens generated consistent bSRS, SHG, and TPEF datasets across samples. Comparison with pathologist-annotated H&E sections revealed that the multimodal measurements captured tissue-specific biochemical and structural features corresponding to histopathological tissue organization. Conclusion Multimodal bSRS enables reproducible, label-free biochemical tissue characterization in head and neck cancer specimens and provides diagnostically interpretable contrast at the cell and tissue level. These findings support its potential as an ex vivo biosensing modality complementing conventional histopathology. Acknowledgements: This work was funded by the EU Horizon Programme under the CHARM project (Grant Agreement No. 101058004). Furthermore, we acknowledge funding from the German Cancer Aid (Deutsche Krebshilfe) under the ARBOR- Automated RoBOt Tumor Resection project (grant number: 70116061), TROPHY- ulTRafast holograPHic FTIR microscopY funded by the European and Innovation Council under the Horizon Europe program in the PATHFINDEROPEN-01 call. (HORIZON-EIC-2021 PATHFINDER-OPEN-01, grant number: 101047137), QUANCER- Quantum microscopy with non-detected light for chemical-selective imaging of tumor tissue in a clinical setting (BMFTR, grant number: 13N16444), and TOOLS- Tailored Optics fOr Life Sciences Engineering funded by the German Research Foundation (Deutsche Forschungsgemeinschaft, grant number: 528591139– FIP 31).
Tammam Alamatouri
A PhD student/ researcher at the Blinical Biophotonics Research Group in the ENT-Department of the Jena University Hospital, Germany. Has been working in the ENT research field for one year, with the focus being on acquisition, processing and Machine and Deep Learning-based analysis of head and neck samples using multimodal spectroscopic and imaging data, which include spontaneous Raman spectroscopy, broadband Stimulated Raman Scattering (bSRS), and hyperspectral Imaging.
Tammam Alamatouri 1, Anna Xylander 2, Nadja Ziller 1, Federico Casafiri 5, Eric Fantuzzi 5, Guilio Cerullo 5, Orlando Guntinas-Lichius 2, 4, , Anna Mühlig 1, 4, ,
Clinical Biophotonics Research Group, Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany 1
Department of Pathology, Jena University Hospital, Jena, Germany 2
Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany 3
Comprehensive Cancer Center Central Germany, Jena, Germany 4
Cambridge Raman Imaging Srl, Milan, Italy 5
Introduction : Surgical resection is the primary treatment for head and neck squamous cell carcinoma (HNSCC), where complete tumor removal is critical for prognosis. However, current intraoperative margin assessment using frozen section analysis is time-consuming and subjective. Raman spectroscopy is a label-free biophotonic technique that provides a molecular fingerprint of tissue based on inelastic light scattering. It has shown potential for distinguishing tumors for discriminating between tumors and precancerous lesions or benign changes and inflammations. Methods: This prospective, monocentric feasibility trial (DRKS00028114) evaluated the applicability of in vivo Raman spectroscopy for the detection of tumours during surgery in patients with primary head and neck squamous cell carcinoma (HNSCC). The workflow was fully established by the time the 30th patient had been examined. Using a clinical Raman system (InvaScope), spectra were acquired intraoperatively from tumour and healthy tissue sites. Subsequent histopathological analysis served as the diagnostic gold standard. The protocol was designed to integrate seamlessly into the standard surgical workflow. The probe measures in the wavenumber range of 500 cm⁻¹ to 3300 cm⁻¹ (numerical aperture of individual fibres (NA) = 0.22; spectral resolution ≈ 20 cm⁻¹). Results: Following the establishment of the clinical protocol, measurement time was significantly reduced, decreasing from over 30 minutes initially to approximately two minutes. High-quality, interpretable data was obtained from 90% of patients, revealing consistent and clear spectral differences between malignant and healthy tissues in both the fingerprint and high-wavenumber spectral regions. Recruitment of the planned 100 HNSCC patients (intention-to-treat) was completed in May 2025. The final analysis is ongoing. Conclusions: This study demonstrates that Raman spectroscopy, performed in compliance with clinical regulatory standards, is a feasible and rapid technique for the in vivo discrimination of HNSCC. The results support its potential role as a real-time, adjunctive optical biopsy tool for real-time margin assessment during surgery.
Priv. Doz. Dr. med. Mussab Kouka
Current Position:
Since 01/2026 – Consultant, Department of Otorhinolaryngology (ENT), University Hospital Jena, Germany.
Academic Career:
05/2025: Habilitation, University Hospital Jena.
11/2022: MD Doctorate, University of Heidelberg.
06/2019: German license to practise medicine.
09/2012–06/2019: MD program, Ruprecht-Karls-University of Heidelberg.
Professional Experience:
01/2025: specialist (ENT), University Hospital Jena.
2020–2024: resident, ENT Department, University Hospital Jena.
2019–2020: resident, Department of Surgery, University Hospital Mannheim.
Research Funding & Awards:
08/2024: DFG third-party funding for MSOT imaging in head and neck tumors.
01/2016–07/2017: Scholarship holder, DFG Research Training Group 1126, Heidelberg.
Selected Publications (SCI):
Cancers (2022): Early Mortality among Patients with Head and Neck Cancer Diagnosed in Thuringia, Germany, between 1996 and 2016-A Population-Based Study.
Cancers (2022): Role of Intraparotid and Neck Lymph Node Metastasis in Primary Parotid Cancer Surgery: A Population-Based Analysis.
Scientific Reports (2024): Multispectral optoacoustic tomography of benign parotid tumors in vivo: a prospective observational pilot study.
Scientific Reports (2025): Establishment of a clinical workflow for in vivo Raman spectroscopy during head and neck cancer surgery.
PD Dr. Mussab Kouka 1, Dr. Ayman Bali 1, Tammam Alamatouri 1, PD Dr. Thomas Bitter 1, Ines Latka 2, Florian Windirsch 2, Dr. Anna Xylander 3, Prof. Dr. Nikolaus Gaßler 3, Dr. David Pertzborn 1, Dr. Anna Mühlig 1, Prof. Dr. Jürgen Popp 2, 4, , Prof. Dr. Ferdinand von Eggeling 1, Prof. Iwan Schie 2, 5, , Prof. Dr. Thomas Ernst 6, Prof. Dr. Orlando Guntinas-Lichius 1,
Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany 1
Leibniz Institute of Photonic Technology, Jena, Germany 2
Section Pathology of the Institute of Forensic Medicine, Jena University Hospital, Jena, Germany 3
Institute of Physical Chemistry and Abbe Centre of Photonics, Friedrich Schiller University Jena, Germany 4
Department for Medical Engineering and Biotechnology, University of Applied Sciences Jena, Germany 5
University Tumor Center, Jena University Hospital, Jena, Germany 6
Introduction: Secondary malignancies occur in 10–25 % of patients with head and neck (HN) cancers. The most common locations include the lungs, other HN regions, and the esophagus. Methods: We retrospectively analyzed patients treated for laryngeal or hypopharyngeal carcinoma, focusing on synchronous and metachronous second primary tumors, their association with clinicopathological characteristics, and prognostic relevance. Patients and Results: The cohort included 225 patients (197 men, 28 women; mean age 65 years), including 171 with stage III–IV disease and 162 with T3–T4 tumors. Regional metastases were present in 93 patients and distant metastases in 7; 102 tumors were poorly differentiated. Treatment was surgical in 122 patients, non-surgical in 103. Synchronous or metachronous second primary tumors, or multiple malignancies, were identified in 31 patients, with 34 tumors- 7 synchronous and 27 metachronous. The most frequent secondary malignancies were bronchogenic (n= 11), skin (n= 4) and thyroid (n= 3) carcinomas. Tumors were diagnosed 0–262 months after completion of treatment (mean 52, median 34). Seven patients were symptomatic at diagnosis, while 27 tumors were detected incidentally during follow-up, predominantly by PET/CT (n = 20), CT (n = 2), ENT examination (n = 1), colonoscopy (n = 1), and histopathology after thyroidectomy (n = 3). Median overall survival (OS) was 63 months. Median disease-free interval (DFI) was 129 months. Second primary tumors had no significant impact on OS or DFI. None of the analyzed parameters (smoking, age, sex, tumor size, grade, stage, metastases, treatment modality) influenced their development. Conclusion: Second primary tumors did not affect prognosis in patients treated for laryngeal carcinoma. As no predictors for risk stratification were identified, uniform follow-up is recommended, including head and neck examination and whole-body PET/CT, or chest CT, as one-third originated in the lungs. Follow-up is essential for at least 3 years, when half were diagnosed. Supported by MH CZ – DRO (FNOl, 00098892) and internal research IGA_LF_2026_018.
MUDr. Kristína Vallušová
Second- year resident in the Department of Otorhinolaryngology and Head and Neck surgery at the University Hospital Olomouc.
MUDr. Kristína Vallušová 1, 2, , MUDr. Zuzana Horáková , Ph.D.1, 2, , doc. MUDr. Richard Salzman , Ph.D. 1, 2, ,
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Olomouc 1
Faculty of Medicine and Dentistry, Palacky University Olomouc 2
Introduction Transoral surgery is a primary treatment option for selected patients with early to moderately advanced oropharyngeal squamous cell carcinoma (OPSCC). Transoral robotic surgery (TORS) was introduced to potentially improve tumor resection precision and reduce treatment-related morbidity compared to conventional transoral surgery (CTS). This study compared oncologic outcomes, treatment burden, and functional surrogates between TORS and CTS. Material & Methods This retrospective cohort study included 74 TORS patients (Sept 2021–Oct 2023) and 48 CTS patients (Oct 2015–Oct 2023) with T1–T3, N0–N2 OPSCC. Variables analyzed included margin status, operative time, hospital stay, functional surrogates (tracheostomy, nasogastric tube dependence), need for adjuvant therapy, and recurrence. Results Mean operative time was significantly shorter for TORS (150,405 min) versus CTS (191,104 min). TORS demonstrated improved perioperative metrics: shorter median hospital stay (7,732 days vs 9,468 days), lower temporary tracheostomy rate (12,162 % vs 14,583 %), and faster nasogastric tube removal (4,142 days vs 6,137 days). The recurrence rate was lower in the TORS cohort (1,351 %) compared to the CTS cohort (10,417 %). However, TORS had a higher rate of positive surgical margins (16,216 % vs 12.5%). The need for adjuvant oncologic therapy was comparable between TORS (82,432 %) and CTS (81,250 %). Conclusions In this cohort, TORS was associated with superior perioperative and functional recovery metrics, including shorter operative time, faster return to oral intake, and lower recurrence, despite a higher rate of positive margins. These findings suggest TORS offers reduced treatment burden and may be beneficial for carefully selected OPSCC patients.
Introduction: Robototic head & neck surgery offers numerous benefits & is a better option for delicate and complex head & neck surgery. Reduced blood loss, shorter hospital stays, and improved postoperative outcomes are huge advantages, but its adoption and widespread implementation in Bangladesh present a unique set of challenges. Huge financial expenses& the lack of training among surgeons are 2 major challenges. This study explores the current state, barriers, successes, and facilitators of Robotic Surgery in Bangladesh. Furthermore, it highlights strategies that will help adoption Robotic surgery and the implementation of training. Methodology: We conducted a literature search using PubMed, Google Scholar, and Google search engine. We identified, reviewed, and extracted key information from relevant articles to ensure a comprehensive understanding of the practice of Robotic surgery and identify barriers, facilitators, and strategies for training in developing countries. Results: From different relevant articles the subject matter were identified, analyzed, and reviewed. The data reveals that training programs borne from collaborations with international institutions can help capacity building to implement robotic surgery training successfully. This review also identified the current barriers to robotic surgery training & other barriers and potential strategies to help overcome them. The barriers identified were inadequate financial resources, poor support from health care stakeholders, lack of adequate training equipment, limited training curriculum, and the lack of qualified personnel & reluctant to accept new technology out of fear are important. Conclusions: Despite the financial constraint & challenges in Robotic surgery training in Bangladesh, we hope help from some authorities can bring this technology close to us. Training programs and workshops have been recorded in different Asian countries. To further advance the progress made, joint efforts from the local surgical workforce, the government, (allocation of budget to purchase robots, subsidy & discount for Poor patients), the robotic companies (request for creating cheap robots), and health care stakeholders will be required.
Dr. Akm Shafiul Alam MBBS, MS
Dr. Akm Shafiul Alam
Senior Consultant & Head of division,
Minimally invasive surgery (MIS)
Narayanganj Specialized Hospital
Narayanganj
Life Member, Society of endo laperoscopic Surgeons of Bangladesh
Life Member, Bangladesh Medical Association
Life Member. Society of Surgeons of Bangladesh
Member , International Guild Robotic & Thyroid Surgery
Member, Association of sleep surgeons of Bangladesh.
Akm Shafiul Alam 1,
AKM Shafiul Alam 1
Purpose: Differentiating benign branchial cleft cysts from cystic metastatic squamous cell carcinoma (SCC) remains challenging in adults, particularly because fine-needle aspiration biopsy (FNAB) may yield false-negative results in cystic lesions. This study aimed to evaluate diagnostic misclassification in adult lateral cystic neck masses operated on under a benign diagnosis and to assess its oncologic consequences. Methods: A retrospective cohort study (2016–2024) included adults undergoing surgery for a presumed branchial cleft cyst with unequivocally benign FNAB findings. Patients with equivocal cytology or any clinical, endoscopic, or radiologic suspicion of malignancy were excluded. Demographic, clinical, radiologic, pathologic, and survival data were analyzed. Outcomes were additionally compared with a cohort of surgically treated thyroglossal duct cysts managed at the same institution. Results: Among 72 patients operated on for a presumed branchial cleft cyst, definitive histology confirmed a benign cyst in 64 cases (88.9%) and metastatic SCC in 8 cases (11.1%). Advanced nodal disease (N1–N2b) was identified only after surgery, despite the absence of suspicious clinical or radiologic findings. Diagnostic misclassification delayed definitive oncologic treatment by a mean of 5.1 months. Two tumor-related deaths occurred, resulting in 2- and 5-year disease-specific survival rates of 75%. In contrast, all 49 patients with thyroglossal duct cysts had concordant preoperative and histopathologic diagnoses, and no malignancy was identified during follow-up. Conclusion: Even with benign FNAB findings and no clinical or radiologic suspicion, metastatic SCC may be present in adult lateral cystic neck masses. Early surgical intervention and routine frozen section analysis should therefore be considered in adult patients.
Štěpán Novák
Stepan Novak, MD, PhD
Contact
Department of Otorhinolaryngology and Head and Neck Surgery
First Faculty of Medicine, Charles University and University Hospital Motol
V Úvalu 84
150 06 Prague 5
Czech Republic
E-mail: stepan.novak@fnmotol.cz
ORCID: https://orcid.org/0000-0002-1174-0878
Date of Birth
9 January 1988
Professional Education
2008–2015
MD, First Faculty of Medicine, Charles University, Prague, Czech Republic
2013–2014
University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Erasmus Programme)
2015–2023
PhD studies in Experimental Surgery, First Faculty of Medicine, Charles University
Research topic: Mutual communication and interactions between tumour cells and the tumour microenvironment
Since September 2015
Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, Prague
2020
Board Certification in Otorhinolaryngology
Study Visits
• Department of Otorhinolaryngology and Head and Neck Surgery, Leipzig, Germany
• Department of Otorhinolaryngology – Head and Neck Surgery, University of Insubria, Varese, Italy
• Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Erlangen, Germany (2026)
Clinical Trial Experience
• Sub-Investigator – EVEREST clinical trial (2022–2024)
• Principal Investigator – CEREN 2 clinical trial (since 2025)
Membership in Professional Societies
• Czech Society of Otorhinolaryngology and Head and Neck Surgery (Czech Medical Association J. E. Purkyně)
• Czech Cooperative Group for Head and Neck Tumours
Štěpán Novák 1,
Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University, University Hospital Motol and Homolka, Prague, Czech Republic 1
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