Iranian Journal of Otorhinolaryngology最新文献

{"title":"Investigation of Recurrence Rate and Associated Risk Factors of Laryngeal Squamous Cell Carcinoma in Patients Undergoing Transoral Laser Microsurgery: A Retrospective Cohort Study.","authors":"Mohammad Amin Zaeim Yekeh, Aslan Ahmadi, Pegah Alizade Pahlavan, Mohammad Mahdi Salem","doi":"10.22038/ijorl.2025.90331.4018","DOIUrl":"10.22038/ijorl.2025.90331.4018","url":null,"abstract":"<p><strong>Introduction: </strong>Laryngeal squamous cell carcinoma (SCC) remains a significant health challenge, with transoral laser microsurgery (TLM) emerging as a preferred treatment for early-stage disease. This retrospective cohort study investigates recurrence patterns, survival outcomes, and prognostic factors in patients treated with TLM, with a focus on the role of smoking exposure.</p><p><strong>Materials and methods: </strong>A retrospective cohort study was conducted on 142 patients with laryngeal SCC treated with TLM at Rasoul Akram Hospital (2016-2022). Patient demographics, tumor characteristics, smoking history (Pack-Years), and follow-up data were analyzed. Recurrence rates and survival were assessed using Kaplan-Meier analysis, and risk factors were evaluated using univariate logistic regression and Cox proportional hazards models.</p><p><strong>Results: </strong>The recurrence rate was 26.1% (n=37), predominantly local (70.3%), with a median time to recurrence of 15 months. Smoking exposure significantly correlated with recurrence risk (OR=1.02, 95% CI: 1.00-1.03, p=0.02; HR=1.01, 95% CI: 1.00-1.02, p=0.04). Kaplan-Meier analysis revealed reduced recurrence-free survival for patients with >20 Pack-Years (p=0.04), while disease-free survival (DFS) probability was approximately 0.75 at 80 months. No significant associations were found for age, sex, tumor stage, or comorbidities (all p>0.05), and no distant metastases were observed.</p><p><strong>Conclusions: </strong>TLM appears to be an effective treatment for early-stage laryngeal SCC in this cohort, with smoking identified as a critical modifiable risk factor for recurrence. The findings underscore the importance of smoking cessation interventions to enhance outcomes. Given the retrospective and single-center design, conclusions should be interpreted cautiously. Future multi-center studies with extended follow-up and molecular profiling are recommended.</p>","PeriodicalId":14607,"journal":{"name":"Iranian Journal of Otorhinolaryngology","volume":"38 1","pages":"19-27"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146052070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pepsin-induced Differential IL-6 Expression in Laryngeal and Laryngopharyngeal Tissue: Non-invasive Rat Model for Laryngopharyngeal Reflux.","authors":"Adelien Adelien, Irfannuddin Irfannuddin, Hardi Darmawan, Agus Surono, Krisna Murti, Debby Handayati Harahap, Elvie Zulka Kautzia Rachmawati","doi":"10.22038/ijorl.2026.93308.4101","DOIUrl":"10.22038/ijorl.2026.93308.4101","url":null,"abstract":"<p><strong>Introduction: </strong>Laryngopharyngeal reflux is a common condition caused by exposure of the upper aerodigestive tract to gastroduodenal content, resulting in inflammation to the area. Despite the condition being well documented in the human population, the literature on animal models for laryngopharyngeal reflux is currently limited. The aim of this study is to create a non-invasive model of laryngopharyngeal reflux using rats to investigate changes in IL-6 expression in the laryngeal and laryngopharyngeal regions.</p><p><strong>Materials and methods: </strong>Male Wistar rats, ranging from ages 10-14 weeks, were exposed to 0.5% bovine pepsin dissolved in artificial gastric juice three times daily for 5-15 days via a modified IV cannula in several volumes (0 mL, 0.1 mL, 0.15 mL, and 0.2 mL) according to the treatment groups. Subsequently, laryngeal and laryngopharyngeal tissue IL-6 concentrations were measured through ELISA on allotted days of sacrifice.</p><p><strong>Results: </strong>Significant differences in laryngeal and laryngopharyngeal tissue IL-6 concentration were measured (p = 0.005 and p = 0.020 respectively). Laryngeal expression of IL-6 was related to the volume administered (p = 0.007) but not to the duration of exposure (p = 0.338), with no significant interaction between duration of exposure and administered volume (p = 0.515). On the other hand, laryngopharyngeal expression of IL-6 was related to the duration of exposure (p< 0.001) but not to the volume administered (p = 0.521) with significant interaction between duration and volume (p < 0.001).</p><p><strong>Conclusion: </strong>The study established the feasibility of using a non-invasive rat model for studying laryngopharyngeal reflux. Additionally, the study demonstrated the differential responses of IL-6 to the addition of the acid-pepsin insult, with dose-dependent IL-6 responding more in laryngeal tissue and time-dependent IL-6 responding in laryngopharyngeal tissue.</p>","PeriodicalId":14607,"journal":{"name":"Iranian Journal of Otorhinolaryngology","volume":"38 2","pages":"117-124"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thrombectomy in Lemierre's Syndrome: A Systematic Literature Review.","authors":"Jevaughn Davis, Crystal Adams, Puneet Gupta, Sonia Samant, Bridget Marcinkowski, Sarah Edwards, Wyatt Nice, Aryana Kavuri, Elaine Sullo, Akhil Patel","doi":"10.22038/ijorl.2025.91192.4043","DOIUrl":"10.22038/ijorl.2025.91192.4043","url":null,"abstract":"<p><strong>Introduction: </strong>Lemierre's syndrome (LS) is a rare but potentially life-threatening condition characterized by septic thrombophlebitis of the internal jugular vein, typically following an oropharyngeal infection. First described in 1936, the syndrome was once considered a \"forgotten disease\" due to its rarity in the post-antibiotic era. However, recent decades have witnessed a modest resurgence in reported cases, attributed in part to increased clinical awareness, improved diagnostic techniques, and evolving microbial resistance patterns. Antibiotics and anticoagulation remain mainstay of treatment with a high rate of treatment response. However, there is a small subset of patients that fail standard treatment and instead clinically deteriorate necessitating prolonged antibiotic therapy. This cohort of patients typically has unexpected critical care unit admissions and prolonged hospital stays. Historically, these patients would undergo vessel ligation. Thrombectomy has been proposed as an alternative to surgical vessel ligation for treatment resistant LS.</p><p><strong>Materials and methods: </strong>Using PubMed/MEDLINE and Scopus databases, we performed a comprehensive literature search on April 16, 2025, to identify studies relating to thrombectomy in Lemierre's Syndrome.</p><p><strong>Results: </strong>Four articles were found that fit inclusion criteria. Although limited by quantity, the studies found demonstrated that patients with treatment resistant disease usually had some clinical improvement after thrombectomy and on average had shorter intensive care unit and hospital stays.</p><p><strong>Conclusion: </strong>Thrombectomy use for treatment resistant LS is not well described in the literature. However, while not ideal or appropriate for every patient, there could exist a potential role for thrombectomy in patient with LS symptomology resistant to antibiotics and anticoagulation.</p>","PeriodicalId":14607,"journal":{"name":"Iranian Journal of Otorhinolaryngology","volume":"38 2","pages":"75-81"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Deviated Nasal Septum as an Etiological Factor for Antrochoanal Polyp.","authors":"Sreelakshmi Muraleedharan, Marina Saldanha, Shibin Samson, Raghuraj Uppoor","doi":"10.22038/ijorl.2026.86472.3898","DOIUrl":"10.22038/ijorl.2026.86472.3898","url":null,"abstract":"<p><strong>Introduction: </strong>The etiology of Antrochoanal polyp (ACP) has been a subject of controversy. A deviated nasal septum may contribute to ACP formation by forcing a maxillary cyst through the accessory ostium. This study aims to evaluate the role of DNS in the formation of ACP.</p><p><strong>Materials and methods: </strong>This retrospective case-control study included 40 diagnosed ACP cases (Group A) and 40 asymptomatic controls (Group B). The imaging scans of 80 patients were retrieved from the database and reviewed to correlate septal deviation with ACP using three septal deviation classifications- Mladina classification, classification based on the location of most prominent point of septal deviation and Baumann classification.</p><p><strong>Results: </strong>In Group A, septal deviation was present in 92.5% of patients, with 55% showing left-sided ACP with left DNS and 37.5% right-sided ACP with right DNS. In the control group, septal deviation was present in 90% of patients. On comparing septal deviation and ACP using Mladina classification (p value = 0.098) and Baumann classification (p value=0.805), no statistical significance was observed. A statistically significant difference (p value <0.001) was observed between the cases and control groups based on the classification of the location of most prominent point of septal deviation.</p><p><strong>Conclusion: </strong>In the present study, we were unable to establish a definitive causality between deviated nasal septum and the occurrence of an Antrochoanal polyp. However, deviation of the nasal septum between the anterior and posterior ends of the middle turbinate may act as a contributory factor in the formation of ACP.</p>","PeriodicalId":14607,"journal":{"name":"Iranian Journal of Otorhinolaryngology","volume":"38 2","pages":"93-98"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Maneuver: Impact of Structured Counselling on Functional Recovery in Benign Paroxysmal Positional Vertigo.","authors":"Shashank Nema, Ripu Daman Arora, Himanshi Grover","doi":"10.22038/ijorl.2026.92369.4075","DOIUrl":"10.22038/ijorl.2026.92369.4075","url":null,"abstract":"<p><strong>Introduction: </strong>This study assessed the effect of supplementing Canalith Repositioning Maneuvers (CRM) with structured counselling on functional recovery in patients with Benign Paroxysmal Positional Vertigo (BPPV).</p><p><strong>Materials and methods: </strong>In this prospective, controlled study, sixty patients with posterior or lateral canal BPPV underwent appropriate CRM. Patients were randomly allocated to receive either CRM alone or CRM combined with structured counselling. Functional recovery was assessed using the Dizziness Handicap Inventory (DHI) at baseline and one week after treatment. Handicap recovery was calculated as the change in DHI score (ΔDHI). Multivariate linear regression analysis was performed to determine whether counselling independently predicted handicap recovery after adjusting for age, sex, canal involvement, and baseline DHI severity.</p><p><strong>Results: </strong>Both groups showed significant DHI improvement after-CRM. However, the Intervention Group demonstrated a significantly greater mean ΔDHI (28.80 ± 3.13) compared to the Control Group (22.47 ± 4.66), with a mean difference of 6.33 point (p < 0.001). Furthermore, fewer patients in the Intervention Group (6.7% vs. 20%) returned to the clinic prematurely with concerns about persistent symptoms. After multivariate adjustment, structured counselling remained an independent predictor of greater handicap recovery (β = 5.07; 95% CI: 3.15-6.98; p < 0.001). Baseline DHI severity was also independently associated with recovery (p < 0.001), age, sex, and canal involvement were not significant predictors.</p><p><strong>Conclusion: </strong>Structured post-maneuver counselling independently enhances early functional recovery in patients with BPPV beyond the effect of CRM alone. Incorporating counselling into routine BPPV management may improve patient-perceived outcomes during the early recovery phase.</p>","PeriodicalId":14607,"journal":{"name":"Iranian Journal of Otorhinolaryngology","volume":"38 2","pages":"109-115"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Neuroglial Heterotopia of Nasopharynx.","authors":"Yellur Kavitha, Upendra Kumar Joish","doi":"10.22038/ijorl.2025.88070.3960","DOIUrl":"10.22038/ijorl.2025.88070.3960","url":null,"abstract":"<p><strong>Introduction: </strong>Neuroglial heterotopia (NGH), is a displaced mass of mature central neuroepithelial tissue unconnected to the brain proper. NGH presents mostly with respiratory distress, neck mass and feeding difficulties at early age.</p><p><strong>Case report: </strong>In our case, the nasopharyngeal NGH, a nine years old female child presented with otalgia and reduced hearing of left ear. Otological examination showed secretory otitis media. On nasal endoscopy solitary, smooth, mucosa covered mass on the eustachian tube opening of left side blocking eustachian tube orifice. Imaging showed a well-defined, non-enhancing, isodense soft tissue lesion arising from left lateral wall of nasopharynx with complete opacification of middle ear and mastoid. Patient underwent left myringotomy and grommet insertion. Nasopharyngeal mass removed trans-nasally under endoscopic guidance. Histopathological examination of the mass showed features of Neuroglial heterotopia. Patient improved symptomatically.</p><p><strong>Conclusion: </strong>Possibility of NGH should be considered while evaluating children with congenital nasopharyngeal mass. Thorough clinical evaluation, radiological imaging to rule out intracranial connection and complete excision are necessary for successful management of such cases.</p>","PeriodicalId":14607,"journal":{"name":"Iranian Journal of Otorhinolaryngology","volume":"38 1","pages":"67-71"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mantle Cell Lymphoma Mimicking Parotid Neoplasm: A Rare Case Report.","authors":"Tejaswi Gupta, Sanjeev Yadav, Ahmed Aseem Naseem, Sanjeev Kumar Singh, Rashmi Rashmi","doi":"10.22038/ijorl.2025.88661.3973","DOIUrl":"10.22038/ijorl.2025.88661.3973","url":null,"abstract":"<p><strong>Introduction: </strong>Mantle cell lymphoma (MCL) is a rare and aggressive B-cell non-Hodgkin lymphoma, commonly affecting lymph nodes, spleen, bone marrow, and gastrointestinal tract. Salivary gland involvement, especially in the parotid gland, is unusual and often mimics benign conditions, complicating diagnosis.</p><p><strong>Case report: </strong>A 58-year-old male presented with a painless, progressively enlarging swelling in the right preauricular region without facial nerve involvement. Imaging revealed a mass within the parotid gland, leading to superficial parotidectomy. Histopathology confirmed mantle cell lymphoma. Immunohistochemical studies showed positivity for CD20, BCL2, CD5, and Cyclin D1; negativity for CD23, CD10, BCL6, and MUM1; and scattered CD3-positive T lymphocytes. The Ki-67 proliferation index was approximately 40%, indicating intermediate proliferative activity. Whole-body PET-CT revealed additional metabolically active lesions suggestive of systemic disease. The patient was started on bendamustine and rituximab chemotherapy.</p><p><strong>Conclusion: </strong>This case highlights that parotid swellings may conceal systemic lymphomas, and misleading cytology can delay diagnosis. Clinicians should consider MCL in atypical parotid lesions to ensure early systemic therapy.</p>","PeriodicalId":14607,"journal":{"name":"Iranian Journal of Otorhinolaryngology","volume":"38 1","pages":"61-65"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146052006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracheal Nodular Fasciitis Presenting with Stridor: A Rare Case Report.","authors":"Manaswini Mallick, Debasmita Rath, Alok Das, Aparna Mohanty, Krishna Sai Sharan, Swagatika Samal","doi":"10.22038/ijorl.2025.85764.3885","DOIUrl":"10.22038/ijorl.2025.85764.3885","url":null,"abstract":"<p><strong>Introduction: </strong>Nodular fasciitis (NF) is a benign, rapidly growing, non-neoplastic myofibroblastic lesion of the subcutaneous tissue affecting various anatomical sites throughout the body. NF of the trachea is rare, and its occurrence in the pediatric age group is highly uncommon in clinical practice.</p><p><strong>Case report: </strong>2-year-old female child who presented to the emergency department with severe stridor causing critical airway obstruction. The mass was successfully excised via an emergent surgical procedure, and the definitive diagnosis of nodular fasciitis was established through histopathology examination, which revealed proliferation of spindle-shaped myofibroblasts in a myxoid stroma without features of malignancy.</p><p><strong>Conclusion: </strong>Early resuscitation is essential to save the patient's life, and histopathology confirms the diagnosis.</p>","PeriodicalId":14607,"journal":{"name":"Iranian Journal of Otorhinolaryngology","volume":"38 1","pages":"55-59"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146052016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Thyroid Nodules in Children: A single-center experience.","authors":"Malika El Omri, Oumaima Gabsi, Mouna Bellakhdher, Monia Ghammem, Wassim Kermani, Mohamed Abdelkefi","doi":"10.22038/ijorl.2024.78964.3659","DOIUrl":"10.22038/ijorl.2024.78964.3659","url":null,"abstract":"<p><strong>Introduction: </strong>Thyroid nodules are a common diagnosis in adults. However, in children, they are rare, occurring in only 1-5% of cases. Early diagnosis and prompt management are crucial due to the higher likelihood of malignancy. The aim of this study was to describe the characteristics of thyroid nodules in children and plan their therapeutic management.</p><p><strong>Materials and methods: </strong>A retrospective study was conducted on 29 children who underwent surgery for thyroid nodules at our ENT department between 2000 and 2022.</p><p><strong>Results: </strong>The average age of the patients was 14.4 years, with a clear predominance of females (sex ratio of 0.16). The primary complaint was the appearance of an anterior cervical swelling in 82.7% of cases. The surgical procedures performed on the thyroid gland included isthmectomy in one patient, lobectomy in 16 patients, and total thyroidectomy in 12 patients. Total thyroidectomy was performed in one step in 10 cases and in two steps in 2 cases where papillary carcinoma was found in the final histological examination of the lobectomy parts. Papillary carcinoma was confirmed in four cases (13.8%) after definitive histological examination. All patients had favourable outcomes. The mean follow-up was 31 months for benign cases and 15 months after the last course of radioactive iodine therapy for malignant cases.</p><p><strong>Conclusion: </strong>Thyroid nodules are uncommon in children. To evaluate the risk of malignancy in children with thyroid nodules, ultrasound and cytology should be performed. This will help determine the appropriate surgical management.</p>","PeriodicalId":14607,"journal":{"name":"Iranian Journal of Otorhinolaryngology","volume":"37 2","pages":"65-71"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insight into Covid Associated Mucormycosis: A Prospective Study.","authors":"Avinash-Shekhar Jaiswal, Aanchal Kakkar, Kavneet Kaur, Alok Thakar, Kapil Sikka, Hitesh Verma","doi":"10.22038/ijorl.2024.78990.3662","DOIUrl":"10.22038/ijorl.2024.78990.3662","url":null,"abstract":"<p><strong>Introduction: </strong>The notable increase in cases of rhino-orbito-cerebral Mucormycosis during the COVID pandemic is alarming. Both share a common route of entry, the nasal mucosa, leading to speculation about whether similar receptors play a role in both diseases. We aim to compare the expression of ACE2 and TMPRSS2 in the nasal and paranasal sinus tissues among patients with COVID-19-associated Mucormycosis (CAM), COVID-19-negative mucormycosis (CNM), and healthy individuals.</p><p><strong>Materials and methods: </strong>This prospective study included patients with CAM, CNM, and healthy individuals who underwent surgical management. Immunohistochemistry was performed in the sino-nasal tissue to detect the presence of ACE2 and TMPRSS2 receptors. The level was compared among the three groups.</p><p><strong>Results: </strong>The study encompassed 44 patients with CAN, 20 with CNM, and ten healthy individuals. ACE2 positivity was seen only in the apical cilia, with no significant difference among the groups (p=0.6). In contrast, TMPRSS2 positivity was seen in the cytoplasm and nucleus of epithelium and submucosal glands in addition to apical cilia. TMPRSS2 was increasingly expressed in patients with CAM compared to CNM (p=0.009) and the healthy group (p=0.002).</p><p><strong>Conclusion: </strong>The expression of TMPRSS2 receptors is elevated in patients with COVID-19-associated mucormycosis with no significant change in the expression of ACE2 receptors. This finding could account for the heightened susceptibility to infection by SARS-CoV-2 and the subsequent immune dysregulation, providing a fertile ground for Mucorales co-infection.</p>","PeriodicalId":14607,"journal":{"name":"Iranian Journal of Otorhinolaryngology","volume":"37 1","pages":"27-32"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}