Indian Journal of Otolaryngology and Head and Neck Surgery最新文献

{"title":"Immunoglobulin G4 Related Disease in the Paranasal Sinus: A Rare and Emerging Entity.","authors":"Manu Babu, Akshita Goyal, Paresh Chavan","doi":"10.1007/s12070-025-05398-4","DOIUrl":"https://doi.org/10.1007/s12070-025-05398-4","url":null,"abstract":"<p><p>Immunoglobulin G4 related disease (IgG4-RD) is a rare immune mediated condition characterized by extensive tissue fibrosis and infiltration by immunoglobulin G4 positive plasma cells in a single or multiple organs. Earlier known to be a rare occurrence, it is becoming increasingly documented worldwide. Organs predominantly involved in this condition are pancreas, salivary glands and biliary tract while in the head and neck region, the salivary, lacrimal and pituitary glands are commonly affected structures. There are limited documented cases reporting IgG4-RD affecting the nasal cavity and paranasal sinuses to the best of our knowledge. Here in we report a case of a young female with complains of chronic rhinosinusitis, previously misdiagnosed on multiple occasions, later diagnosed with IgG4-RD on the basis of histopathology. Even though the prognosis is favorable, but delay in diagnosis and therapy can lead to multi organ failure and premature death hence warranting the need for discussion.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 4","pages":"1891-1895"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993285","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":"Diagnostic Accuracy of Ultrasonography in Evaluation of Adenoid Hypertrophy.","authors":"Simrat Kaur, Kunwarpal Singh, Arvinder Singh","doi":"10.1007/s12070-025-05432-5","DOIUrl":"https://doi.org/10.1007/s12070-025-05432-5","url":null,"abstract":"<p><strong>Background: </strong>Adenoid hypertrophy is common in children and can cause several symptoms including nasal obstruction, mouth breathing and obstructive sleep apnoea. The popular method used in present era is X-ray nasopharynx which is the primary investigation used in evaluation of adenoid hypertrophy. It has the risk of exposure to radiation and the head posture may not be correct due to insufficient coordination of children. On the other hand, ultrasonography can be used to assess not only the size but also the shape and blood flow of adenoids. In this study, we have assessed the role of ultrasonography in diagnosing adenoid hypertrophy.</p><p><strong>Objective: </strong>To evaluate adenoid hypertrophy on X-ray Nasopharynx and ultrasonography neck.</p><p><strong>Method: </strong>This observational, cross-sectional study included 65 patients who presented with symptoms of adenoid hypertrophy. The antero-posterior thickness and adenoid/nasopharynx (A/N) ratio were measured on X-ray nasopharynx and ultrasonography of neck. Comparison of the findings obtained on both imaging modalities was done.</p><p><strong>Result: </strong>The statistical analysis was done and the correlation between X-ray and ultrasonography findings was found to be significant. On analysis of results, USG Nasopharynx was found reliable as a diagnostic tool in patients having adenoid hypertrophy and it can be used as an aid for preoperative investigation.</p><p><strong>Conclusion: </strong>A significant correlation was observed between the anteroposterior (AP) and adenoid nasopharyngeal ratio (ANR) values measured via both X-Ray and ultrasonography (USG). These findings suggest that USG holds promise as a reliable tool for assessing adenoid hypertrophy.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 4","pages":"1849-1855"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040178","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":"Neurothekeoma Presenting as a Rare Post Aural Swelling in an Adolescent Male with Review of Literature of Benign Spindle Cell Lesions.","authors":"Ravi Kishore Hubballi, B Madhura","doi":"10.1007/s12070-025-05417-4","DOIUrl":"https://doi.org/10.1007/s12070-025-05417-4","url":null,"abstract":"<p><p>An 18-year-old male patient presented with a swelling over the left post aural region of 3 months duration which gradually increased in size. On examination, the patient appeared well with normal vital signs. Examination of the left ear revealed a 2×2 cm well-defined, solitary, globular, firm, non-tender swelling in the postauricular region with no signs of inflammation. The left pinna, external auditory canal, and tympanic membrane were normal. The patient underwent surgical excision of the swelling, and the specimen was sent for histopathological examination, which revealed a Benign spindle cell tumour. Because the subvariant of benign spindle cell tumour could not be established by histological examination, the specimen was further subjected to immunohistochemistry, which confirmed the tumour as a neurothekeoma of nerve sheath origin. Benign spindle cell tumours, Nerve sheath tumours, Neurothekeomas are very rare superficial soft tissue tumours in adolescent males, hence we are reporting this case and reviewing the literature on these benign spindle cell lesions.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 4","pages":"1831-1836"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051705","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":"Invasive Pituitary Macroprolactinoma with Spontaneous CSF Rhinorrhea- A Case Report with a Review of the Literature and a Strategical Plan of Management.","authors":"Palak Gupta, Neha Shakrawal, Vidhu Sharma, Ravindra Shukla, Mayank Garg, Darwin Kaushal, Amit Goyal","doi":"10.1007/s12070-025-05406-7","DOIUrl":"https://doi.org/10.1007/s12070-025-05406-7","url":null,"abstract":"<p><p>Cerebrospinal fluid (CSF) rhinorrhea is a rare and unexpected initial presentation of untreated invasive pituitary macroprolactinoma. This article aims to better understand the management of invasive pituitary macroprolactinoma, especially in cases where the patient initially presents with a CSF leak. We describe a case of a 36-year-old male with untreated invasive macroprolactinoma with a CSF leak at the initial presentation. The role and timing of medical and surgical treatment in such a setting are outlined in detail. Medical therapy has shown both worsening and resolution of the CSF leak. We propose a ''Sandwich Therapy'' in Dopamine agonist (DA) responsive cases where the leak persists, which includes initial DA therapy, followed by endoscopic Transsphenoidal surgery (TSS) with DA therapy and then followed by the post-operative continuation of DA therapy.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 4","pages":"1907-1911"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055340","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 Content Analysis of YouTube Videos on Allergic Rhinitis Management.","authors":"Sanjay Kumar, Anghusman Dutta, Srujan Vallur, Ran Singh","doi":"10.1007/s12070-025-05396-6","DOIUrl":"https://doi.org/10.1007/s12070-025-05396-6","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluates the quality, reliability, and usability of YouTube videos on allergic rhinitis (AR) management using validated assessment tools to determine their alignment with evidence-based practices and their potential impact on patient understanding.</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted on 50 YouTube videos identified using predefined keywords. Videos were assessed using DISCERN, JAMA, and PEMAT tools for quality, authorship, and usability, respectively. Engagement metrics such as views, likes, and comments were recorded. Videos were categorized by source (medical professionals, influencers, pharmaceutical companies, and alternative therapists) and format (testimonial, educational, promotional). Statistical analyses, including Spearman's correlation and chi-square tests, were performed to explore relationships between video quality and engagement.</p><p><strong>Results: </strong>The mean DISCERN, JAMA, and PEMAT scores across all videos were 3.1/5, 2.7/4, and 72%, respectively. Videos by medical professionals scored the highest in quality but had lower engagement, while influencer videos attracted the highest views (mean: 40,000) but scored poorly on quality metrics. Evidence-based treatments were discussed in 72% of videos, yet only 20% mentioned immunotherapy. Misinformation was identified in 36% of videos, with exaggerated claims about \"natural cures\" being the most common theme. A negative correlation was found between DISCERN scores and views (<i>r</i> = -0.42, <i>p</i> = 0.03), indicating that higher-quality videos received fewer views.</p><p><strong>Conclusions: </strong>YouTube videos on AR management exhibit significant variability in quality and engagement, highlighting a trade-off between reliability and popularity. Enhancing the accessibility and visibility of evidence-based content requires collaboration between medical professionals and content creators. Addressing misinformation and improving patient education through digital platforms is essential for optimizing health outcomes.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12070-025-05396-6.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 4","pages":"1760-1767"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055701","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 Association between Superior Concha Bullosa and Sphenoid Sinus Ostium: A Radio-Anatomic Investigation.","authors":"Hacer Baran, Melis Demirag Evman, Zeynep Erdogan Cetin","doi":"10.1007/s12070-025-05324-8","DOIUrl":"https://doi.org/10.1007/s12070-025-05324-8","url":null,"abstract":"<p><strong>Aim: </strong>Unusual pneumatization of paranasal sinuses may cause extraordinary localizations of neighboring anatomic structures, thus changing the planning of endoscopic sinus surgery.This study aimed to evaluate the association of superior concha bullosa (SCB) with the surrounding anatomical structures and its effects on the localization of the sphenoid sinus ostium.</p><p><strong>Material and methods: </strong>Paranasal Computerized Tomography sections of patients who visited our institution's otolaryngology department between 2018 and 2020 because of various complaints such as headache, nasal obstruction and smell disorder were retrospectively evaluated. Patients were divided into two groups as SCB group and control group. The association between the presence of the superior concha bullosa and the distance of the sphenoid ostium from the midline were evaluated.</p><p><strong>Results: </strong>Total number of sinuses evaluated was 412 from 206 patients. The study cohort included 107 patients (55 males and 52 females, mean age: 33 ± 14 years) with SCB (26 bilateral, 55 left sided, 26 right sided) and 99 patients (54 males and 45 females, mean age: 37 ± 14) without SCB on any side. The mean distance measured from the sphenoid sinus ostium to the midline was 3.98 ± 1.32 mm in sinuses with SCB and was 3.61 ± 1.50 mm in the SCB (-) control group (<i>p</i> = 0.006). Compared to control group, both distance of sphenoid sinus ostium from midline and frequency of lateral pneumatization of sphenoid sinus were significantly higher in patients with SCB (<i>p</i> < 0.01). In terms of lateral pneumatization of sphenoid sinus; no significant difference was found between groups (<i>p</i> = 0.331). An increased incidence of rostrum pneumatization in SCB (-) sinuses were found (<i>p</i> = 0.024).</p><p><strong>Conclusion: </strong>In patients with SCB, the sphenoid sinus ostium might be located more laterally than its expected localization.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 4","pages":"1723-1726"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048471","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":"Giant Dysplastic Sinonasal Inverted Papilloma.","authors":"J Poongkamali, Anbarasan Arunkumar","doi":"10.1007/s12070-025-05407-6","DOIUrl":"https://doi.org/10.1007/s12070-025-05407-6","url":null,"abstract":"<p><p>Sinonasal Inverted Papilloma is known for its malignant change, recurrence, and local aggressiveness. Though the long-practised method of treatment is extensive local excision of the tumor, recent trends are changing towards endoscopic approaches. Our aim in presenting this case report is to add on to the literature regarding the ease of the endoscopic approach in managing an extensive IP where complete clearance was possible contradicting the older notion of requiring an extensive and radical open approach for complete clearance. We also aim to discuss the diagnostic challenge faced and management options in the diagnosis of IP when histopathology shows dysplastic changes.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 4","pages":"1912-1915"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023036","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":"Multiomics: Two-Sample, Bidirectional, Multivariate and Mediated Mendelian Randomization Analysis of Allergic Rhinitis.","authors":"Cheng Zhong, Li-Hua Wang, Hao-Peng Zhang, Lin Ji, Yu Guo","doi":"10.1007/s12070-025-05413-8","DOIUrl":"https://doi.org/10.1007/s12070-025-05413-8","url":null,"abstract":"<p><p>This study investigates the potential causal relationships among immune cells, plasma liposomes, and plasma metabolites in allergic rhinitis (AR) using a two-sample bidirectional multivariate and mediated Mendelian Randomization (MR) approach. Genetic data from five GWAS datasets covering traits linked to immune cells, plasma liposomes, plasma metabolites, and AR were used. Instrumental variables were selected based on strict criteria to ensure independence and exclude confounders. The primary MR analysis employed the Inverse Variance Weighted method, supplemented by sensitivity analyses using the Weighted Median and MR-Egger methods. The MR analyses suggest a genetic correlation among immune cells, plasma liposomes, and plasma metabolites, influencing the risk of AR. Findings were robust across various sensitivity analyses, supporting the absence of pleiotropy and outliers. No reverse causality was found, indicating a unidirectional influence. Genetic predispositions to immune cells, plasma liposomes, and plasma metabolites significantly change the risk of developing AR. Further studies are needed to explore these associations in diverse populations and refine the underlying mechanisms.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12070-025-05413-8.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 4","pages":"1823-1830"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042017","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":"Enhanced Detection of Sinonasal and Nasopharyngeal Pathologies by Narrow-Band Imaging- a Prospective Observational Study.","authors":"Sachin Bhatt, Angshuman Dutta, Rahul Naga, Sanjay Kumar","doi":"10.1007/s12070-025-05390-y","DOIUrl":"https://doi.org/10.1007/s12070-025-05390-y","url":null,"abstract":"<p><p>Narrow-band imaging (NBI) is an advanced endoscopic technique that uses filtered light to enhance the visualization of microvascular patterns, which can aid in identifying preneoplastic and cancerous lesions in the upper aerodigestive tract. While conventional fiber optic endoscopy under white light (WL) is essential for examining the sinonasal region, NBI offers a unique advantage by focusing on the vascular patterns rather than the lesions themselves. Literature on NBI's diagnostic applications, especially for distinguishing normal from pathological nasal mucosa, remains sparse. This study aims to classify sinonasal lesions based on the Bruno et al. classification system and evaluate the microvascular features of various pathologies under NBI, comparing these findings with histopathological results. A prospective observational study was conducted in a tertiary care setting enrolling 60 patients presenting with endoscopically identified sinonasal and nasopharyngeal lesions requiring biopsy. All patients were subjected to narrow-band imaging, followed by biopsy. Microvascular changes in the mucosa were classified using the Bruno et al. system, and were then compared against blinded histopathology results. Among the 60 patients, 50 exhibited NBI patterns classified as SN 1, 2, 3, or 4 (considered unsuspicious), while 10 displayed the SN 5 pattern (suspicious). Of the lesions categorized as suspicious, 9 were confirmed malignant through biopsy, while 1 was negative for malignancy. Using HPE as the gold standard, NBI demonstrated 88.8% sensitivity and 96% specificity in identifying malignancy with a PPV of 80%, NPV of 98% and diagnostic accuracy of 95%. Narrow-band imaging (NBI) proves to be an effective tool for distinguishing between benign and malignant sinonasal pathologies. Our study contributes valuable insights to the limited literature on the application of NBI technology in nasal pathologies.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 4","pages":"1753-1759"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989477","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":"Potential Cost Savings in Medicare Part D for Otolaryngologic Medications.","authors":"Om B Tripathi, Aman M Patel, Hassaam S Choudhry, David W Wassef, Paul T Cowan, Richard Chan Woo Park, Andrey Filimonov","doi":"10.1007/s12070-025-05446-z","DOIUrl":"https://doi.org/10.1007/s12070-025-05446-z","url":null,"abstract":"<p><p>Our study analyzes potential savings and losses for Medicare Part D using Mark Cuban Cost Plus Drug Company (MCCPDC) as an alternative medication procurement method for the 75 most commonly prescribed medications by otolaryngologists in 2022. Monthly standard MCCPDC costs and imputed Medicare Part D monthly costs for each prescription medication were compared. Our results indicated heterogenous efficiency of sourcing medications through MCCPDC due to some potential cost savings but other substantial losses. 45.3% of the top 75 otolaryngologic prescription medications sorted by total spending were not available on MCCPDC, indicating the need for more affordable access to expensive medications. Additionally, antibiotics consistently displayed potential losses through MCCPDC procurement, suggesting Medicare's ability to achieve discount pricing for particular drug categories. Hence, providers should consider utilizing direct-to-consumer (DTC) models on a case-by-case basis, and future cost-saving investigations including additional DTC models should be conducted.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 4","pages":"1969-1980"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003906","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}