Journal of Rhinology最新文献

{"title":"Two Cases of Eosinophilic Granulomatosis With Polyangiitis Presenting With Rhinologic Manifestations.","authors":"Sae Hwan Park, Chan Ho Yoon, Dong Won Jung, Woo Yong Bae","doi":"10.18787/jr.2026.00009","DOIUrl":"10.18787/jr.2026.00009","url":null,"abstract":"<p><p>Eosinophilic granulomatosis with polyangiitis (EGPA) frequently presents with asthma and sinusitis, making otorhinolaryngologic manifestations potential early indicators of systemic vasculitis. However, these manifestations are often misdiagnosed as common inflammatory diseases. We report two cases of EGPA diagnosed based on distinct rhinologic presentations. The first case involved a 52-year-old woman who developed mononeuritis multiplex and cutaneous vasculitis following surgery for nasal polyps, which ultimately led to a definitive diagnosis of EGPA. The second case involved a 39-year-old woman who presented with nasal septal perforation and was subsequently diagnosed with an acute exacerbation of EGPA accompanied by pulmonary infiltrates. These cases highlight that not only nasal polyps but also atypical findings, such as nasal septal perforation, may serve as critical diagnostic clues for EGPA. Otorhinolaryngologists play a pivotal role in identifying this potentially fatal systemic vasculitis through careful evaluation of localized sinonasal manifestations.</p>","PeriodicalId":33935,"journal":{"name":"Journal of Rhinology","volume":"33 2","pages":"120-125"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670746","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":"The Impact of Adenotonsillectomy on Respiratory Tract Infections in Pediatric Patients: A Comparative Study Using a Korean Nationwide Population-Based Cohort.","authors":"Jun Young Kim, Sang Duk Hong, Yong Gi Jung, Hyo Yeol Kim, Gwanghui Ryu","doi":"10.18787/jr.2026.00011","DOIUrl":"10.18787/jr.2026.00011","url":null,"abstract":"<p><strong>Background and objectives: </strong>Although adenotonsillectomy (ATE) is widely accepted for obstructive sleep apnea and recurrent tonsillitis, its effectiveness in reducing respiratory tract infections (RTIs) remains a topic of debate. This nationwide population-based cohort study evaluated the association between ATE and the incidence of upper and lower RTIs in pediatric patients.</p><p><strong>Methods: </strong>Data were obtained from the Korean National Health Insurance Service sample cohort for 2010-2017. Children who underwent ATE were identified and matched with nonsurgical controls at a 1:5 ratio by age and sex. Hospital visits due to RTIs-including acute upper RTIs, influenza or pneumonia, and acute lower RTIs-were assessed from 1 year before surgery through 3 years after surgery. The odds of hospital visits were estimated using multivariable logistic regression, with odds ratios and 95% confidence intervals.</p><p><strong>Results: </strong>A total of 6,848 children who underwent ATE and 34,240 matched controls were included. Compared with the matched nonsurgical control group, the ATE group had higher odds of hospital visits due to upper and lower RTIs, whereas no significant difference was observed for pneumonia. Age-stratified analyses showed that lower RTIs increased first in younger children and later in older age groups during follow-up. Sex-stratified analyses showed increased lower RTIs in boys during postoperative years 1-2 and increased influenza or pneumonia in girls during postoperative years 2-3. Postoperative increases in RTIs were more pronounced among children without preoperative infection histories.</p><p><strong>Conclusion: </strong>ATE was not associated with fewer RTIs in pediatric patients. Instead, certain subgroups had a higher incidence of upper and lower RTIs after surgery. These findings suggest that ATE may have limited effectiveness in preventing RTIs and should not be performed solely for this purpose.</p>","PeriodicalId":33935,"journal":{"name":"Journal of Rhinology","volume":"33 2","pages":"107-113"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670822","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":"Current Updates on Pharmacotherapy for Obstructive Sleep Apnea.","authors":"Sang-Wook Kim","doi":"10.18787/jr.2026.00003","DOIUrl":"10.18787/jr.2026.00003","url":null,"abstract":"<p><p>Obstructive sleep apnea (OSA) is a common sleep disorder associated with substantial cardiovascular morbidity and mortality. Although positive airway pressure (PAP) remains the gold-standard treatment, poor long-term adherence often limits its clinical effectiveness, underscoring the need for safe and effective pharmacological alternatives. Advances in the understanding of OSA endotypes, including anatomical collapsibility, upper airway muscle responsiveness, arousal threshold, and loop gain, have shifted research toward precision pharmacotherapy. Early studies of single-agent therapies, such as protriptyline and acetazolamide, were limited by modest efficacy or clinically significant adverse effects. More recent dual-drug combinations and anti-obesity medications have shown greater promise. In particular, atomoxetine plus oxybutynin has demonstrated significant reductions in the apnea-hypopnea index (AHI) by enhancing upper airway muscle tone across sleep stages. In parallel, glucagon-like peptide-1 receptor agonists have substantially changed the management of obesity-related OSA. Tirzepatide, in particular, has produced marked weight loss of nearly 20% and an AHI reduction of more than 50%, leading to its recent U.S. Food and Drug Administration approval for OSA. Despite earlier skepticism, the shift from broad-spectrum agents toward endotype-specific and metabolic-targeted therapies may improve the management of selected patients with OSA. However, long-term safety and cost-effectiveness require further evaluation before these emerging pharmacological options can be broadly integrated into care for patients who cannot tolerate conventional PAP therapy.</p>","PeriodicalId":33935,"journal":{"name":"Journal of Rhinology","volume":"33 2","pages":"87-94"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670816","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 Huge Intraosseous Hemangioma in the Maxillary Sinus Misdiagnosed as Osteosarcoma: A Case Report.","authors":"So Hee Kang, Myeong Sang Yu","doi":"10.18787/jr.2026.00012","DOIUrl":"10.18787/jr.2026.00012","url":null,"abstract":"<p><p>Intraosseous hemangiomas are rare benign vascular tumors that account for less than 1% of all bone tumors and are exceptionally uncommon in the sinonasal region. Their aggressive-appearing radiological features may mimic those of malignant bone tumors, creating diagnostic challenges. An 18-year-old man presented with right-sided nasal obstruction and epistaxis. Imaging revealed a large destructive mass in the right maxillary sinus that was suspicious for malignancy, including osteosarcoma. Endoscopic biopsy showed nonspecific benign osseous features that were discordant with the radiological findings. For this reason, endoscopic medial maxillectomy was performed. Histopathological examination with CD31 and CD34 immunostaining confirmed intraosseous venous hemangioma. Intraosseous hemangioma should be considered in the differential diagnosis of aggressive-appearing sinonasal masses, especially when imaging and biopsy findings are discordant, as its recognition may help prevent unnecessarily aggressive treatment.</p>","PeriodicalId":33935,"journal":{"name":"Journal of Rhinology","volume":"33 2","pages":"126-130"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670790","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":"Propensity Score Methods in Rhinologic Observational Research: Principles, Applications, Extensions, and Practical Considerations.","authors":"Jae Hoon Cho","doi":"10.18787/jr.2026.00017","DOIUrl":"10.18787/jr.2026.00017","url":null,"abstract":"<p><p>Randomized controlled trials (RCTs) remain the gold standard for evaluating treatment efficacy because randomization minimizes measured and unmeasured confounding. In rhinology, however, RCTs are often impractical because of ethical constraints, patient preferences, financial limitations, and logistical challenges related to surgical interventions or long-term follow-up. Consequently, observational studies based on real-world data have become increasingly important for comparative effectiveness research. Despite their practical advantages, observational studies are inherently vulnerable to confounding by indication, selection bias, prevalent-user bias, and immortal time bias. Propensity score (PS) methods were developed to mitigate measured confounding and improve the internal validity of nonrandomized comparisons. Since their introduction, PS approaches have expanded beyond traditional matching to include advanced weighting strategies, such as inverse probability of treatment weighting, overlap weighting, and doubly robust estimation. This review provides a clinician-oriented overview of PS methods, including their conceptual foundations, practical implementation, study design considerations, target population implications, diagnostic tools, strengths, limitations, and modern methodological extensions. The review emphasizes the application of these methods to rhinologic research, in which treatment allocation is frequently influenced by disease severity and patient characteristics.</p>","PeriodicalId":33935,"journal":{"name":"Journal of Rhinology","volume":"33 2","pages":"75-80"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670762","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":"Acute Pansinusitis Caused by a Retained Merocel Pack Forgotten for 50 Days: A Case Report With Histopathologic Insights.","authors":"Joo Hyung Lee, Dong Hwan Kwon, Hyunjong Jeon, Hee Sung Chae, Eun Jung Lee, Young-Ha Lee","doi":"10.18787/jr.2026.00015","DOIUrl":"10.18787/jr.2026.00015","url":null,"abstract":"<p><p>Merocel, a polyvinyl acetal sponge, is a nonabsorbable nasal packing material widely used after sinonasal surgery because of its hemostatic efficacy and ease of placement. However, nonabsorbable packing is generally removed within 48 hours to reduce the risks of mucosal injury, infection, and adhesion. A 48-year-old man underwent endoscopic sinus surgery (ESS) for chronic rhinosinusitis at a secondary hospital. The Merocel pack was inadvertently retained for 50 days, resulting in acute pansinusitis with foul odor, postnasal drip, and facial pain. Attempts to remove the packing by traction and irrigation at the secondary hospital were unsuccessful and caused fragmentation of the Merocel. The patient was subsequently referred to our tertiary center, where revision ESS revealed firmly adherent Merocel fragments. Histopathological examination demonstrated inflammatory tissue ingrowth into the porous Merocel structure without bone fragment entrapment or osseous ingrowth. The patient recovered uneventfully, with no recurrence at the 3-month follow-up. Prolonged retention of a Merocel nasal pack may cause acute sinusitis and firm adhesion through inflammatory tissue ingrowth, even without histopathological evidence of bone involvement. Prevention requires timely pack removal, structured follow-up, and comprehensive patient education.</p>","PeriodicalId":33935,"journal":{"name":"Journal of Rhinology","volume":"33 2","pages":"131-136"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670811","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":"Nasopharyngeal Lipoma Anterior to the Eustachian Tube Orifice: A Case Report.","authors":"Yanggyun Lee, Sung Yool Park, Ho Jin Jung, Seong Kook Park","doi":"10.18787/jr.2026.00019","DOIUrl":"10.18787/jr.2026.00019","url":null,"abstract":"<p><p>Nasopharyngeal lipoma is a rare benign tumor, with only a small number of cases reported in the English-language literature. We present the case of a 43-year-old woman in whom nasal endoscopy incidentally identified a 1.5-cm pedunculated mass immediately anterior to the left Eustachian tube orifice. Computed tomography showed a well-circumscribed, homogeneous lesion with fat attenuation. Although these imaging findings strongly supported the diagnosis of conventional lipoma, complete endoscopic excision was performed to obtain definitive histologic confirmation because the lesion was small, pedunculated, and readily accessible for complete removal. Histopathologic examination confirmed conventional lipoma, with no nuclear atypia or lipoblasts, and the patient had no evidence of recurrence at 12 months. This case describes a nasopharyngeal lipoma arising at an uncommon anatomic site immediately anterior to the Eustachian tube orifice and suggests that limited posterior inferior turbinectomy can facilitate safe endoscopic access in selected cases.</p>","PeriodicalId":33935,"journal":{"name":"Journal of Rhinology","volume":"33 2","pages":"137-141"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670730","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":"IL-5Rα-Mediated Signaling in Eosinophils May Contribute to the Epithelial-Mesenchymal Transition in Eosinophilic Chronic Rhinosinusitis With Nasal Polyps.","authors":"Hosung Choi, Hyunsu Choi, Jeong-Min Oh, Sung Won Kim, Soo Whan Kim, Byung Guk Kim, Jin Hee Cho, Dong Chang Lee","doi":"10.18787/jr.2025.00065","DOIUrl":"10.18787/jr.2025.00065","url":null,"abstract":"<p><strong>Background and objectives: </strong>Eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) is characterized by type 2 inflammation, prominent eosinophil accumulation, and enhanced epithelial-mesenchymal transition (EMT). Although interleukin (IL)-5 plays a central role in eosinophil differentiation and activation, its involvement in driving EMT in human nasal epithelial cells (HNECs) remains unclear. This study investigated IL-5 receptor α (IL-5Rα)-mediated signaling and EMT profiles in ECRSwNP, aiming to determine whether IL-5-activated eosinophil-like cells promote EMT in HNECs.</p><p><strong>Methods: </strong>Nasal tissues from healthy controls, non-ECRSwNP patients, and ECRSwNP patients (n=12 per group) were analyzed using hematoxylin and eosin staining, quantitative real-time polymerase chain reaction, immunohistochemistry, and Western blotting. HL-60 promyelocytic leukemia cells were differentiated into eosinophil-like cells and subsequently stimulated with IL-5. HNECs were cocultured with undifferentiated HL-60 cells, differentiated HL-60 cells, or IL-5-stimulated differentiated HL-60 cells using a Transwell system. Expression of EMT-related markers was assessed by Western blotting and immunofluorescence.</p><p><strong>Results: </strong>ECRSwNP tissues demonstrated markedly increased eosinophil infiltration, elevated IL-4 and IL-5 transcript levels, and significantly higher expression of IL-5Rα, phosphorylated Janus kinase 2 (JAK2), and phosphorylated signal transducer and activator of transcription 5 (STAT5) compared with controls and non-ECRSwNP tissues. EMT-associated changes, characterized by reduced E-cadherin and increased vimentin expression, were most pronounced in ECRSwNP. In vitro, IL-5 stimulation enhanced IL-5Rα expression, activated JAK2/STAT5 signaling, and increased secretion of eosinophil-associated mediators in differentiated HL-60 cells. Co-culture with IL-5-stimulated eosinophil-like cells induced EMT in HNECs, whereas unstimulated HL-60 cells exerted minimal effects.</p><p><strong>Conclusion: </strong>IL-5Rα-mediated signaling is upregulated in ECRSwNP and may contribute to EMT through eosinophil-dependent mechanisms. IL-5-activated eosinophils promote EMT-related changes in HNECs, providing a mechanistic link between type 2 inflammation and epithelial remodeling. These findings suggest that IL-5Rα signaling may represent a potential therapeutic target for modulating tissue remodeling in ECRSwNP.</p>","PeriodicalId":33935,"journal":{"name":"Journal of Rhinology","volume":"33 2","pages":"95-106"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670782","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 Case of Allergic Fungal Sinusitis-Like Syndrome: Clinical and Immunopathological Comparison With Allergic Bronchopulmonary Aspergillosis.","authors":"Se Yeon Lee, Dong Won Jung, Song Hee Han, Woo Yong Bae","doi":"10.18787/jr.2026.00006","DOIUrl":"10.18787/jr.2026.00006","url":null,"abstract":"<p><p>Allergic fungal sinusitis (AFS)-like syndrome refers to clinical presentations resembling AFS that do not fully satisfy established diagnostic criteria. We report a case of AFS-like syndrome in a 33-year-old woman, characterized by the presence of fungal hyphae within eosinophilic mucin despite negative systemic allergy testing, and we evaluate the limitations of current diagnostic frameworks. This report further examines the shared immunopathological spectrum between AFS and allergic bronchopulmonary aspergillosis, highlighting the importance of an integrated clinical approach to fungal hypersensitivity disorders affecting both the upper and lower airways.</p>","PeriodicalId":33935,"journal":{"name":"Journal of Rhinology","volume":"33 2","pages":"114-119"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670804","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":"Microplastics in the Human Nasal Cavity and Upper Airway: Emerging Evidence and Rhinologic Implications.","authors":"Hyun Jin Min","doi":"10.18787/jr.2026.00020","DOIUrl":"10.18787/jr.2026.00020","url":null,"abstract":"<p><p>Microplastics (MPs) are pervasive environmental contaminants with potential implications for human health. Although inhalation is considered a major route of exposure, most investigations have focused on the lower respiratory tract, leaving the upper airway relatively understudied. Recent studies have detected MPs in nasal lavage fluid, specimens from patients with allergic rhinitis, tissue from patients with chronic rhinosinusitis, and the olfactory bulb of the human brain. Concerns have also been raised that synthetic polymerbased medical devices, including nasal irrigation bottles and continuous positive airway pressure systems, may contribute to upper airway exposure. This review summarizes current evidence on the detection and characterization of MPs in the human nasal cavity and upper airway, discusses environmental and medical device-related exposure pathways, and examines emerging implications for rhinologic diseases. Methodological limitations and priorities for future research are also reviewed.</p>","PeriodicalId":33935,"journal":{"name":"Journal of Rhinology","volume":"33 2","pages":"81-86"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670819","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}