Clinical and Experimental Otorhinolaryngology最新文献

{"title":"Predominance of Auditory but not Vestibular Deficits in the Mouse Model of Congenital Cytomegalovirus Infection.","authors":"Chi-Chieh Chang, Ying-Chang Lu, Po-Nien Tsao, Yen-Hui Chan, Yi-Shan Lee, Pei-Hsuan Lin, Cheng-Yu Hsieh, Wei-Chung Hsu, Chuan-Jen Hsu, Chun-Yi Lu, Chen-Chi Wu","doi":"10.21053/ceo.2024.00305","DOIUrl":"https://doi.org/10.21053/ceo.2024.00305","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate the auditory and vestibular consequences of congenital cytomegalovirus (cCMV) infection in a C57BL/6 mouse model established by intraperitoneal inoculation and designed to mimic clinical phenotypes.</p><p><strong>Methods: </strong>A cCMV infection model was established by intraperitoneal inoculation of murine cytomegalovirus into C57BL/6 mice. Auditory and vestibular function were assessed by auditory brainstem response, open field, swim, and rotarod tests. Histologic evaluation of the inner ear was also performed.</p><p><strong>Results: </strong>The study successfully established a model of cCMV infection in C57BL/6 mice. Auditory deficits of varying severity and laterality were observed, reflecting the clinical spectrum in humans. Vestibular function was minimally affected and did not correlate with auditory deficits. Histopathologic examination revealed predominant damage to spiral ganglion neurons with relatively intact vestibular organs.</p><p><strong>Conclusion: </strong>Our optimized mouse model effectively recapitulates the inner ear manifestations of human cCMV infection. The predominance of auditory over vestibular deficits provides valuable insights for the development of targeted therapeutic interventions for inner ear sequelae of cCMV infection.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for hearing impairment in newborns using targeted genomic sequencing: a large pilot cohort study.","authors":"Pei-Hsuan Lin, Yu-Ting Chiang, Cheng-Yu Tsai, Chia-Huei Chu, Chia-Cheng Hung, Yi-Ning Su, Wei-Chung Hsu, Tien-Chen Liu, Chuan-Jen Hsu, Po-Nien Tsao, Chen-Chi Wu","doi":"10.21053/ceo.2024.00275","DOIUrl":"https://doi.org/10.21053/ceo.2024.00275","url":null,"abstract":"<p><strong>Objective: </strong>Current state-run newborn hearing screening (NBHS) programs have limitations in identifying children with mild or late-onset sensorineural hearing impairment (SNHI). As more than 50% of pediatric SNHI cases are attributed to genetic causes, these limitations may be addressed by the increasing accessibility of high-throughput, low-cost genomic sequencing. This study aims to investigate the feasibility of integrating a next-generation sequencing (NGS)-based genomic screening protocol into conventional NBHS and to examine its potential benefits and challenges.</p><p><strong>Methods: </strong>A total of 8,261 newborns who underwent simultaneous NBHS and NGSbased genomic screening targeting 46 deafness genes were prospectively enrolled in this study. The genotypes of the subjects were determined, and newborns with conclusive genetic diagnoses were subjected to audiological assessments.</p><p><strong>Results: </strong>A total of 164 subjects were confirmed to have conclusive genetic diagnoses, with 112 subjects carrying variants in GJB2 and MTRNR1, and 52 subjects carrying variants in other deafness genes. Of these, 126 subjects with conclusive genetic diagnoses passed the NBHS, suggesting that an additional 1.5% (126/8,261) of children at risk for SNHI but not detected by conventional physiological NBHS could be identified through targeted genomic screening in the general population. Notably, the father of one subject with the COL4A5 variant and three paternal relatives of another subject with the EDNRB variant, who were unaware of their conditions prior to this study, were diagnosed with Alport and Waardenburg syndromes, respectively, highlighting the benefit to families.</p><p><strong>Conclusion: </strong>Targeted genomic sequencing in newborns may complement the conventional NBHS in identifying children at risk for SNHI and facilitate early diagnosis in families with non-syndromic mimics.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balloon eustachian tuboplasty in chronic suppurative otitis media and dilatory eustachian tube dysfunction: a randomized controlled trial.","authors":"Hye Ah Joo, Sung-Min Park, Yehree Kim, Dong Kyu Lee, Yun Ji Lee, Yeonjoo Choi, Woo Seok Kang, Joong Ho Ahn, Jong Woo Chung, Won-Ho Chung, Ja-Won Koo, Hong Ju Park","doi":"10.21053/ceo.2024.00281","DOIUrl":"https://doi.org/10.21053/ceo.2024.00281","url":null,"abstract":"<p><strong>Objectives: </strong>Balloon eustachian tuboplasty (BET) is an emerging treatment for dilatory eustachian tube (ET) dysfunction. However, its efficacy in patients with both chronic suppurative otitis media (COM) and ET dysfunction remains unclear. The objective of the trial was to assess the efficacy and safety of BET versus medical management (MM) alone in adult patients with COM and chronic dilatory ET dysfunction, which was defined by a failed Valsalva maneuver.</p><p><strong>Methods: </strong>In this prospective, multicenter, randomized controlled trial, a total of 116 participants (121 ears) treated between January 2021 and June 2023 were randomly assigned (1:1) to receive either BET with MM or MM alone (fluticasone furoate nasal steroid spray). The short-term primary outcome was the normalization of the Valsalva maneuver at the 8-week follow-up. Secondary outcomes were improved Eustachian Tube Dysfunction Questionnaire- 7 (ETDQ-7) scores and decreased air-bone gap (ABG) analyzed at 8 weeks. Adverse events were monitored in both groups during the follow-up period.</p><p><strong>Results: </strong>Among the 116 participants (121 ears), 60 participants (62 ears) received BET and 56 participants (59 ears) received MM alone. Demographics, baseline characteristics, ETDQ-7 scores, bone conduction thresholds, and ABG did not differ significantly between the groups. In the BET group, 46.8% (29/62, ears) achieved a successful Valsalva maneuver compared with 15.3% (9/59, ears) in the MM-only group (p<0.001). BET group (-6.2±9.4) showed greater subjective symptom improvement than the MM-only group (-2.6±8.6) regarding ETDQ-7 scores (p=0.028). ABG decreased more in the BET group (-5.8±11.4 dB) compared with the MM-only group (-1.2±10.5 dB) (p=0.023). No serious procedure-related or device-related adverse events occurred in either group during the 8-week follow-up.</p><p><strong>Conclusion: </strong>Our trial suggests that BET, combined with MM, demonstrated superiority over MM alone, along with its safety, in treating dilatory ET dysfunction in patients with COM.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel EYA1 splicing mutation in a Chinese branchio-oto syndrome family with functional analysis and reproductive intervention.","authors":"Chen Anhai, Jiang Lu, Nie Zequn, Song Jian, He Chufeng, Mei Lingyun, Liu Yalan","doi":"10.21053/ceo.2024.00304","DOIUrl":"https://doi.org/10.21053/ceo.2024.00304","url":null,"abstract":"<p><strong>Objectives: </strong>Branchio-oto syndrome (BOS) is a group of autosomal dominant genetic diseases, multisystem disorders excluding renal anomalies. There are clinical heterogeneity and ethnic diversity in BOS, which reported in more studies in European populations than in Asian populations, with a prevalence rate of approximately 1/40000. As the most common disease-causing gene, the mutation types of EYA1 range from missense to various frameshift, splicing and nonsense variants. Although splicing mutations are one of the important factors in the disease, existed research has paid less attention to the novel mutations causing aberrant RNA splicing and their pathogenic mechanisms. Reproductive interventions that actively block the transmission of the disease to future generations have also not been reported.</p><p><strong>Methods: </strong>We had collected research samples from a three-generation Chinese family with BOS. Whole exome sequencing was applied for the screening of candidate causing gene. Minigene assay was performed to identify the aberrant splicing products, and molecular biology techniques were used to analyze the pathogenicity of potentially mistranslated proteins. pre-implantation genetic testing (PGT) has been employed to prevent hearing loss in this family based on SNP analysis.</p><p><strong>Results: </strong>A novel mutation EYA1:c.1598-2AG>TA was identified by whole-exome sequencing and classified as harmful refer to ACMG's evidence. An aberrant RNA splicing was verified and suggested that might prematurely terminates the translation of EYA1 protein, through the minigene assay. The EYA1 truncated protein presented unstable and difficultly translocated to the nucleus, also impaired EYA1-SIX1 interactions in cytological experiments. PGT helped the proband give birth to a healthy boy.</p><p><strong>Conclusion: </strong>A novel splicing variant of EYA1 gene was identified in this study, and the potential molecular pathogenic mechanism was elucidated by several functional experiments. On basis above findings, we successfully implemented the first instance of using PGT to ensure the birth of a healthy offspring free from this genetic disorder.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic Versus Manual Electrode Insertion in Cochlear Implant Surgery: An Experimental Study.","authors":"Salman F Alhabib, Farid Alzhrani, Abdulrahman Alsanosi, Mariam Al-Amro, Abdulaziz Alballaa, Ibrahim Shami, Abdulrahman Hagr, Asma Alahmadi, Tahir Sharif, Maximilian Stichling, Marco Matulic, Masoud Zoka Assadi, Yassin Abdelsamad, Fida Almuhawas","doi":"10.21053/ceo.2024.00253","DOIUrl":"10.21053/ceo.2024.00253","url":null,"abstract":"<p><strong>Objectives: </strong>This experimental study compared the precision and surgical outcomes of manual versus robotic electrode insertions in cochlear implantation.</p><p><strong>Methods: </strong>The study was conducted on formalin-fixed cadaveric heads, with nine senior neurotologists performing both manual and robotic insertions.</p><p><strong>Results: </strong>The results showed no statistically significant differences between the two methods in terms of insertion angle, cochlear coverage, or electrode coverage. However, the robotic method demonstrated a significantly slower and more controlled insertion speed (0.1 mm/sec) compared to manual insertion (0.66±0.31 mm/sec), which is crucial for minimizing intra-cochlear force and pressures. Although robotic insertions resulted in fewer complications such as tip fold-over or scala deviation, there were instances of incomplete insertion.</p><p><strong>Conclusion: </strong>The robotic system provided a consistent and controlled insertion process, potentially standardizing cochlear implant operations and reducing outcome variability. The study concludes that robotic-assisted insertion offers significant advantages in controlling insertion speed and consistency, supporting the continued development and clinical evaluation of robotic systems for cochlear implant surgery.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"21-29"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Surgical Outcome of Canal-Tympanoplasty in Patients With Schuknecht Type B Congenital Aural Stenosis.","authors":"Yoonjae Lee, Moo Kyun Park, Jun Ho Lee, Sang-Yeon Lee, Myung-Whan Suh","doi":"10.21053/ceo.2024.00189","DOIUrl":"10.21053/ceo.2024.00189","url":null,"abstract":"<p><strong>Objectives: </strong>Congenital aural atresia (CAA) is a complex condition that manifests in various forms, including Schuknecht type B stenosis, which is characterized by a congenitally narrow bony external auditory canal (EAC). This study aims to evaluate the long-term surgical outcomes of canal-tympanoplasty in patients with Schuknecht type B CAA.</p><p><strong>Methods: </strong>The study included 21 ears diagnosed with Schuknecht type B CAA, all of which underwent canal-tympanoplasty. Reconstruction of the large EAC and tympanic membrane involved conchal flap meatoplasty, bony EAC drilling, ossicular reconstruction, and overlay tympanoplasty. Standard pure-tone audiometry was analyzed at multiple post-surgery time points: 3, 6, 12, and 24-60 months. Additionally, the incidence of postoperative complications was assessed.</p><p><strong>Results: </strong>The hearing outcomes of canal-tympanoplasty in this case series were satisfactory. Serviceable hearing was achieved in all patients after 3 months and was maintained in 85% of patients for 1 year. The air-bone gap improved from a preoperative average of 39.3±15.1 dB to 13.7±7.4 dB at 3 months, 16.4±10.5 dB at 6 months, 19.1±11.7 dB at 12 months, and 21.5±16.1 dB at 2-5 years postoperatively. Three patients required revision canal-tympanoplasty due to hearing deterioration, representing 14.3% of the cases. There were no instances of postoperative infection, facial nerve weakness, vertigo, deterioration of bone conduction thresholds, or complete restenosis of the EAC.</p><p><strong>Conclusion: </strong>Canal-tympanoplasty proved to be a satisfactory surgical intervention for patients with Schuknecht type B CAA. This procedure led to significant improvements in hearing outcomes, providing serviceable hearing that lasted for several years. Moreover, the risk of postoperative hearing deterioration and/or the need for revision surgery within 1 year was considered acceptable.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"14-20"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Complex Impact of Smoking Habits on Allergic Rhinitis: A National Cross-Sectional Study.","authors":"Jae-Min Shin, Yujin Jeong, Jaehyeong Kim, Juhyun Lee, Tae Hoon Kim","doi":"10.21053/ceo.2024.00202","DOIUrl":"10.21053/ceo.2024.00202","url":null,"abstract":"<p><strong>Objectives: </strong>Allergic rhinitis (AR) significantly impacts quality of life and incurs socioeconomic costs. The influence of smoking habits, including the use of conventional cigarettes (CCs) and electronic cigarettes (ECs), on the prevalence and management of AR remains a subject of debate. This study aims to explore the association between smoking status (CC and EC use) and the prevalence and management of AR among Koreans by analyzing data from the Korea National Health and Nutrition Examination Survey (KNHANES) VII (2018) and VIII (2019-2021).</p><p><strong>Methods: </strong>This cross-sectional study involved 22,290 participants aged 19 years and older from the KNHANES. Participants self-reported their smoking status, and urinary cotinine levels were measured to assess nicotine exposure. We employed statistical analyses, including logistic regression, to examine the relationships between smoking status, cotinine levels, and the prevalence and management of AR.</p><p><strong>Results: </strong>In univariable logistic regression analysis, EC users exhibited a 35.8% increased risk of AR compared to non-smokers, whereas CC users experienced a 27.7% reduced risk. Multivariable logistic regression analysis showed a 20.3% lower risk of AR among CC users; however, no significant association was observed for EC users. Higher cotinine levels (>500 ng/mL) were associated with a lower prevalence of AR. Specifically, heavy CC users with high cotinine levels demonstrated a 35% reduced risk of AR. Nonetheless, after adjusting for confounders, this association was no longer significant, indicating that other variables might influence this relationship.</p><p><strong>Conclusion: </strong>Smoking status is associated with the prevalence of AR in Koreans. Notably, heavy use of CCs is negatively correlated with the prevalence of AR.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"30-39"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gene Expression Alteration by Non-thermal Plasma-Activated Media Treatment in Radioresistant Head and Neck Squamous Cell Carcinoma.","authors":"Sicong Zheng, Yudan Piao, Seung-Nam Jung, Chan Oh, Mi Ae Lim, QuocKhanh Nguyen, Shan Shen, Se-Hee Park, Shengzhe Cui, Shuyu Piao, Young Il Kim, Ji Won Kim, Ho-Ryun Won, Jae Won Chang, Yujuan Shan, Lihua Liu, Bon Seok Koo","doi":"10.21053/ceo.2024.00238","DOIUrl":"10.21053/ceo.2024.00238","url":null,"abstract":"<p><strong>Objectives: </strong>Head and neck squamous cell carcinoma (HNSCC) exhibits high recurrence rates, particularly in cases of radioresistant HNSCC (RR-HNSCC). Non-thermal plasma (NTP) therapy effectively suppresses the progression of HNSCC. However, the therapeutic mechanisms of NTP therapy in treating RR-HNSCC are not well understood. In this study, we explored the regulatory role of NTP in the RR-HNSCC signaling pathway and identified its signature genes.</p><p><strong>Methods: </strong>After constructing two RR-HNSCC cell lines, we prepared cell lysates from cells treated or not treated with NTP-activated media (NTPAM) and performed RNA sequencing to determine their mRNA expression profiles. Based on the RNA sequencing results, we identified differentially expressed genes (DEGs), followed by a bioinformatics analysis to identify candidate molecules potentially associated with NTPAM therapy for RR-HNSCC.</p><p><strong>Results: </strong>NTPAM reduced RR-HNSCC cell viability in vitro. RNA sequencing results indicated that NTPAM treatment activated the reactive oxygen species (ROS) pathway and induced ferroptosis in RR-HNSCC cell lines. Among the 1,924 genes correlated with radiation treatment, eight showed statistical significance in both the cell lines and The Cancer Genome Atlas (TCGA) cohort. Only five genes-ABCC3, DUSP16, PDGFB, RAF1, and THBS1-showed consistent results between the NTPAM data sequencing and TCGA data. LASSO regression analysis revealed that five genes were associated with cancer prognosis, with a hazard ratio of 2.26. In RR-HNSCC cells, NTPAM affected DUSP16, PDGFB, and THBS1 as activated markers within 6 hours, and this effect persisted for 12 hours. Furthermore, enrichment analysis indicated that these three DEGs were associated with the extracellular matrix, transforming growth factor-beta, phosphoinositide 3-kinase/protein kinase B, and mesenchymal-epithelial transition factor pathways.</p><p><strong>Conclusion: </strong>NTPAM therapy exerts cytotoxic effects in RR-HNSCC cell lines by inducing specific ROS-mediated ferroptosis. DUSP16, PDGFB, and THBS1 were identified as crucial targets for reversing the radiation resistance induced by NTPAM therapy, providing insights into the mechanisms and clinical applications of NTPAM treatment in RR-HNSCC.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"73-87"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Emergency Room Visits Among Patients With Head and Neck Cancer: A Longitudinal Cohort Study Within the Korean Healthcare System.","authors":"Heejun Yi, Hyojun Kim, Younghac Kim, Ye-Jin Suh, Joo Hyun Park, Nayeon Choi, Han-Sin Jeong","doi":"10.21053/ceo.2024.00257","DOIUrl":"10.21053/ceo.2024.00257","url":null,"abstract":"<p><strong>Objectives: </strong>A substantial proportion of patients with head and neck cancer (HNC) require emergency room (ER) visits or unplanned hospitalizations during or after treatment with various modalities. We investigated HNC cases that necessitated ER visitation after cancer treatment, aiming to identify potential risk factors in the context of the Korean healthcare system.</p><p><strong>Methods: </strong>This single-center cohort study examined patients with HNC who received cancer treatments at Samsung Medical Center in 2019 (n=566). Treatment modalities included surgery alone (n=184), surgery and adjuvant therapy (n=138), curative non-surgical treatment such as radiation or chemoradiation (n=209), and palliative treatments (n=35). We followed these cases for up to 3 years, focusing on those who visited the ER during or after cancer treatment, and analyzed the primary reasons and risk factors associated with these visits.</p><p><strong>Results: </strong>The ER visitation rate was 8.0% (n=45) among patients with HNC, with a total of 70 ER visits (12.4%; mean, 1.56; range, 1-4). The rate of treatment-related ER visitation was 4.6%. Common reasons for ER visits included surgical site or wound complications (31.1% of patients visiting the ER, 22.9% of ER visits) and issues with oral intake or feeding (22.2% of patients, 31.4% of visits). Significant risk factors for ER visits included tumor subsite (with hypopharyngeal cancer associated with a 17.9% rate of treatment-related ER visits), tumor stage (T2-4, 8.6%-12.2%; N+ status, 6.7%), and treatment modality (surgery with adjuvant chemoradiation, 19.4%). Patient age and comorbidities did not represent significant factors.</p><p><strong>Conclusion: </strong>The most frequent reasons for ER visits among patients with HNC included complications with wounds and feeding. Additionally, tumor characteristics and treatment modality were independent risk factors for ER visits. Adequate planning and management to address these issues could potentially decrease the number of ER visits, lower costs, and improve patient care.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"64-72"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Core Needle Biopsy May Predict Prognosis Preoperatively in Parotid Cancer.","authors":"Jeong-Yeon Ji, Wonjae Cha, Young Ho Jung, Soon-Hyun Ahn, Woo-Jin Jeong","doi":"10.21053/ceo.2024.00227","DOIUrl":"10.21053/ceo.2024.00227","url":null,"abstract":"<p><strong>Objectives: </strong>Salivary gland tumors present a diagnostic challenge, with preoperative false-negative results frequently leading to an unexpected diagnosis of malignancy after parotidectomy. This study was conducted to explore the clinical utility of preoperative core needle biopsy (CNB) in diagnosing malignancies before primary parotidectomy and to assess the prognostic implications of CNB for parotid gland cancers.</p><p><strong>Methods: </strong>This retrospective cohort study included 615 patients who underwent preoperative CNB and parotidectomy for primary parotid tumors from 2003 to 2023 at a tertiary referral hospital. Among these patients, 102 who were diagnosed with primary parotid malignancy following parotidectomy were examined regarding survival outcomes. Disease-free survival (DFS) and predictive factors were assessed through univariable and multivariable analyses. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of CNB were determined. These metrics were then compared to those of a separate cohort of 547 patients who underwent ultrasound-guided fine needle aspiration (FNA) and parotidectomy within the same timeframe.</p><p><strong>Results: </strong>In the CNB group, the 5-year predicted DFS was 86.9% (95% CI, 79.2%-95.3%). Multivariable analysis identified male sex (hazard ratio [HR], 8.48; 95% CI, 1.05-68.76) and a CNB finding of malignancy (HR, 8.20; 95% CI, 1.01-66.15) as factors significantly associated with decreased DFS. CNB demonstrated significantly higher sensitivity (89.0%; 95% CI, 81.2%-94.4%) and NPV (97.6%; 95% CI, 95.7%-98.8%) compared to FNA, which had a sensitivity of 45.2% (95% CI, 33.5%-57.3%) and an NPV of 90.8% (95% CI, 87.7%-93.3%).</p><p><strong>Conclusion: </strong>Preoperative CNB may be predictive of parotid cancer prognosis. Patients receiving a diagnosis of malignancy on preoperative CNB demonstrated a worse prognosis compared to those with a \"less-than-malignant\" diagnosis. Additionally, CNB exhibited higher sensitivity than FNA in identifying malignancies of the parotid gland.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"57-63"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}