Remo Accorona
I graduated in Medicine and Surgery in 2011 at the University of Brescia, Italy summa cum laude. In 2017 I completed the residency program in Otorhinolaryngology – Head and Neck Surgery summa cum laude in the same Institute under the guidance of Prof. Piero Nicolai. During my formative years I performed a visiting fellowship at the Section of Head and Neck Oncology of the University Hospital of Leuven, Belgium, and at the Division of Head and Neck Surgery of the University of Hong Kong.
During my training I dealt with head and neck oncology, rhinology, and endoscopic skull base surgery with special interest for oral cavity and maxillary and paranasal sinuses cancers. During my attendance at the University of Hong Kong I increased my experience in the management of some specific tumors such nasopharyngeal cancer.
I carried out my activity in 2017 at the Otolaryngology Unit of the Humanitas Clincal and Research Center - Rozzano (MI) and in 2018-2019, at the Otolaryngology Division of the Bolzano Hospital under the guidance of Dr. Luca Calabrese. In this period, I mainly dealt with advanced oncological surgery of the head and neck. I have also greatly developed my experience in functional surgery of the nose and paranasal sinuses. From 2020 to 2022, I worked at the Otolaryngology Department of the Ospedale Maggiore Policlinico in Milan, mainly dealing with rhinology, orbital surgery, and skull base surgery.
In 2022 I started my activity at the Unit of Otorhinolaryngology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy where I am referent Consultant for Head and Neck and Skull Base patients.
Sessions
Characteristics and objectives of multiple access routes to Maxillary sinus
The management of head and neck cancer (HNC) requires a multidisciplinary, guideline-driven approach to optimize outcomes and minimize morbidity. Unfortunately, a subset of patients is still being treated outside of established protocols, often leading to suboptimal oncologic control, functional impairments, and complex salvage scenarios. This retrospective clinical reflection highlights several emblematic cases of inadequately treated HNC patients referred to our center for secondary management.
Our analysis focuses on patients who initially underwent incomplete, inappropriate, or delayed treatment in non-specialized centers. Common issues included: lack of proper staging before treatment, non-standard surgical approaches without clear margins, omission of adjuvant therapy when indicated, or poorly planned radiotherapy. These deviations frequently resulted in early recurrence, persistent disease, or major complications involving speech, swallowing, and airway integrity.
Through selected clinical cases, we explore the practical, ethical, and therapeutic challenges involved in managing these patients. Salvage treatments – whether surgical, radiotherapeutic, or systemic – are often technically more demanding and oncologically less effective than primary treatments delivered within guidelines. In addition, prior suboptimal treatment often compromises anatomical structures and patient performance status, making optimal recovery difficult.
This clinical case-based review also raises broader questions regarding referral practices, the role of second opinions, and the need for early multidisciplinary evaluation. It aims to prompt reflection among clinicians on the consequences of deviating from evidence-based care in HNC and to encourage systemic improvements in patient pathways. We also emphasize the psychological burden these patients carry and the difficulty in restoring their trust after prior mismanagement.
Ultimately, while reconstructive and salvage interventions are necessary and sometimes life-saving, they are rarely equivalent to getting it right the first time. Prevention, through timely referral and coordinated care in high-volume, specialized centers, remains the most effective and ethical solution.