Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery最新文献

{"title":"Level V Metastases in Node-Positive Oral Squamous Cell Carcinoma: Beyond Level IIA and III.","authors":"Kinjal Shankar Majumdar, Vikramjit Singh Kailey, Akash Varshney, Thaduri Abhinav, Achyuth Panuganti, Shahab Ali Usmani, Pallvi Kaul, Dungala Dileep Maharaj, Abhijeet Singh, Areej Moideen, Ramesh Prasath, Nivedhan Ravichandran, Nongthombam Surjalata Devi, Abhishek Bhardwaj, Madhu Priya, Manu Malhotra","doi":"10.1159/000543140","DOIUrl":"10.1159/000543140","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical management of level V in clinically node positive (cN+) oral squamous cell carcinomas (OSCCs) is controversial. The objectives of the study were to identify predictors of level V metastases in cN+ OSCC.</p><p><strong>Methods: </strong>This retrospective study is based on institutional data of operated cN+ OSCC between April 2018 and December 2022. Clinical and pathological parameters were subjected to univariate analysis. Significant parameters in univariate analysis were further subjected to multivariate analysis. A p value of less than 0.05 was considered statistically significant.</p><p><strong>Results: </strong>None of cN1 or pN1 patients had a level V metastasis. No skip metastasis to level-V was noticed. Total number of positive lymph nodes, lymph node ratio (LNR), extranodal extension, pN classification, and the presence of level II and III metastases were found to be significant predictors for level V metastases. The post hoc analysis suggested that ≥5 positive nodes, LNR >0.1, and pN3 status were independent risk factors for level V metastases.</p><p><strong>Conclusion: </strong>Selective neck dissection for N+ OSCC is feasible in the N1 neck, preferably where nodal metastases is limited to level-I only. Patients with a bulky nodal disease, particularly those with N3 neck, ≥5 positive nodes, ENE, and metastatic lymph nodes in levels II and III should be offered comprehensive neck dissection.</p><p><strong>Introduction: </strong>Surgical management of level V in clinically node positive (cN+) oral squamous cell carcinomas (OSCCs) is controversial. The objectives of the study were to identify predictors of level V metastases in cN+ OSCC.</p><p><strong>Methods: </strong>This retrospective study is based on institutional data of operated cN+ OSCC between April 2018 and December 2022. Clinical and pathological parameters were subjected to univariate analysis. Significant parameters in univariate analysis were further subjected to multivariate analysis. A p value of less than 0.05 was considered statistically significant.</p><p><strong>Results: </strong>None of cN1 or pN1 patients had a level V metastasis. No skip metastasis to level-V was noticed. Total number of positive lymph nodes, lymph node ratio (LNR), extranodal extension, pN classification, and the presence of level II and III metastases were found to be significant predictors for level V metastases. The post hoc analysis suggested that ≥5 positive nodes, LNR >0.1, and pN3 status were independent risk factors for level V metastases.</p><p><strong>Conclusion: </strong>Selective neck dissection for N+ OSCC is feasible in the N1 neck, preferably where nodal metastases is limited to level-I only. Patients with a bulky nodal disease, particularly those with N3 neck, ≥5 positive nodes, ENE, and metastatic lymph nodes in levels II and III should be offered comprehensive neck dissection.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":" ","pages":"174-181"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Magnetic Resonance Imaging in Paranasal Mucocele with Visual Disturbance.","authors":"Haruo Yoshida, Fujinobu Tanaka, Kenji So, Yoshihiko Kumai","doi":"10.1159/000539891","DOIUrl":"10.1159/000539891","url":null,"abstract":"<p><strong>Introduction: </strong>Ocular imaging strategies have evolved to facilitate the diagnosis of optic neuropathy. This study aimed to evaluate the pathogenesis of visual disturbance associated with paranasal mucocele via magnetic resonance imaging (MRI).</p><p><strong>Methods: </strong>A total of 19 patients with mucocele and visual disturbance who underwent endoscopic sinus surgery, orbital MRI, and sinus computed tomography were included. The age, sex, days from onset to surgery, eye pain, and imaging findings were analyzed. The results were compared between two groups: 7 patients with preoperative visual acuity worse than 20/200 (the poor group) and 12 patients with equal or better than 20/200 (the fair group).</p><p><strong>Results: </strong>Imaging showed a high compression rate of the orbit in 17 (89.5%) and enlargement of the subarachnoid space around the optic nerve in 15 (78.9%) of 19 patients. Preoperative vision was significantly poor in cases with hyperintense regions in the optic nerve on T2-weighted imaging, indicating the presence of optic neuritis. No cases showed severe inflammation of the cyst or the presence of intraorbital fat tissue.</p><p><strong>Conclusion: </strong>MRI-based diagnosis proved useful in evaluating pathological factors, such as orbital compression, ischemia, and optic neuritis, in individual cases. It can help in gaining insight into the pathogenesis and developing appropriate treatment strategies for visual disturbances associated with paranasal mucocele.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":" ","pages":"132-139"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction Statement.","authors":"","doi":"10.1159/000535543","DOIUrl":"10.1159/000535543","url":null,"abstract":"","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":" ","pages":"54"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Rhinosinusitis Risk after Maxillectomy with Microvascular Reconstruction.","authors":"Michael T Werner, Ryan M Carey, Kush Panara, Jacob Harris, Kendall K Tasche, Robert M Brody, Karthik Rajasekaran, James N Palmer, Nithin D Adappa, Jason G Newman, Rabie M Shanti, Steven B Cannady","doi":"10.1159/000539604","DOIUrl":"10.1159/000539604","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic rhinosinusitis (CRS) can be associated with tumors involving the maxillary sinus, but outcomes after undergoing maxillectomy with free flap reconstruction remain unclear.</p><p><strong>Methods: </strong>A retrospective analysis of medical records was performed to evaluate evidence of CRS in patients who underwent maxillectomy with free flap reconstruction at a single tertiary care academic institution from 2013 through 2020.</p><p><strong>Results: </strong>Eighty-four patients were assessed. Nineteen (22.6%) patients were diagnosed with CRS after surgery, 23 (27.4%) patients were treated for sinus symptoms, and 49 (58.3%) had radiographic evidence of sinus inflammation for more than 6 months. Risk factors for requiring sinus treatment included adjuvant or neoadjuvant chemotherapy (p = 0.002) and pre-operative use of sinus medication (p < 0.001). Radiographic evidence of sinusitis 6 months after surgery is also closely associated with sinusitis treatment (p = 0.051).</p><p><strong>Conclusions: </strong>CRS may be underdiagnosed in patients undergoing maxillectomy with microvascular reconstruction. Further evaluation into patient sinus disease and symptoms following neoplastic surgery may lead to a higher quality of life in some long-term survivors.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":" ","pages":"124-131"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Experience and Preferences for the Assessment of Olfaction: The Patient International Clinical Assessment of Smell Survey.","authors":"Katherine L Whitcroft, Christine Kelly, Peter Andrews","doi":"10.1159/000535794","DOIUrl":"10.1159/000535794","url":null,"abstract":"<p><strong>Introduction: </strong>Olfactory dysfunction (OD) is common and carries significant personal and societal burden of disease. Accurate assessment of olfaction is required for good clinical care and affords patients insight into their condition. However, the accuracy of assessment varies with technique used, and there is presently little standardisation of clinical practice. We therefore aimed to determine experience of and preferences for olfactory assessment in healthcare-seeking adults.</p><p><strong>Methods: </strong>An anonymous patient co-produced survey was developed in collaboration with a UK-based OD charity. Distribution was via their social media patient forum. \"Healthcare seeking\" adults (i.e., who had undergone olfactory assessment by a healthcare professional [any care level/speciality] or may do so in the future) were included.</p><p><strong>Results: </strong>576 people (88.5% female, mean 46 years) responded. Hyposmia, parosmia, and retronasal OD were most frequently reported. 55.2% had been assessed by a healthcare professional - GP most commonly, followed by ENT. Importantly, only 15.6% and 16.9% of respondents had undergone systematic assessment with smell tests or symptom questionnaires, respectively. Most respondents had not undergone imaging. Mean satisfaction was higher in those seen by ENT. Interestingly, respondents prioritise orthonasal odour identification over other forms of smell test. Unfortunately, many felt that healthcare professionals (across specialities) were dismissive towards OD and lacked appropriate knowledge of both its pathophysiology and effects. We propose simple steps that can be taken to improve olfactory assessment, including education and establishment of robust referral networks.</p><p><strong>Conclusion: </strong>We hope these results and supporting practical recommendations will inform future service planning, funding allocation and research, as well as better aligning patient and clinician priorities.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":" ","pages":"16-31"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10880803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Markers Predicting Clinically Occult Lymph Node Metastasis in Head and Neck Squamous Cell Carcinoma.","authors":"Piergiorgio Gaudioso, Daniele Borsetto, Jerry Polesel, Giancarlo Tirelli, Enzo Emanuelli, Anna Menegaldo, Gabriele Molteni, Piero Nicolai, Michele Tomasoni, Claudia Montenegro, Cesare Piazza, Paolo Bossi, Andrea Ciorba, Pietro Canzi, Vittorio Giacomarra, Fabiola Giudici, Jonathan Fussey, Paolo Boscolo-Rizzo","doi":"10.1159/000534079","DOIUrl":"10.1159/000534079","url":null,"abstract":"<p><strong>Introduction: </strong>The presence of cervical lymph node metastases is an unfavorable prognostic factor in head and neck squamous cell carcinoma (HNSCC) and a potential cause of treatment failure. Occult lymph node metastasis occurs in approximately 15-20% of HNSCC patients with a clinically negative neck (cN0), greatly impacting on their prognosis. The present study aimed to investigate the role of pre-treatment peripheral blood markers in predicting clinically occult cervical lymph node metastasis.</p><p><strong>Methods: </strong>This multicenter, retrospective study was performed in a cohort of 472 patients diagnosed with cN0 HNSCC who underwent up-front surgery. Baseline neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic inflammatory marker (SIM), and systemic immune-inflammation index (SII) were calculated from available blood parameters.</p><p><strong>Results: </strong>Oro-hypopharyngeal and oral cancers, locally advanced stage, moderately (G2), and poorly (G3) differentiated grade were associated with an increased risk of pathological lymph node involvement. NLR, LMR, PLR, SIM, and SII were significantly associated at multivariable analysis. NLR &gt;2.12 was the most reliable at predicting occult lymph node metastasis (OR = 5.22; 95% CI: 2.14-12.75). We describe a predictive score integrating cancer site, local stage, and NLR which is effective at predicting positive lymph node pathological status.</p><p><strong>Conclusions: </strong>The present study provides evidence that pre-treatment peripheral blood markers, in particular NLR, represent reliable predictors of clinically occult cervical lymph node metastasis in cN0 HNSCC. Therefore, the present study provides a novel useful predictive score for directing the elective management of the neck in patients with cN0 HNSCC.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":" ","pages":"32-40"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136400036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse Events Associated with Surgically Implanted Temporomandibular Joint Devices.","authors":"Christian Fritz, Kimberly Wei, Jinggang Ng, Deepak Lakshmipathy, Karthik Rajasekaran","doi":"10.1159/000543243","DOIUrl":"10.1159/000543243","url":null,"abstract":"<p><strong>Introduction: </strong>Temporomandibular disorder (TMD) is a common, yet potentially debilitating syndrome that negatively impacts patient quality of life. In patients with severe variants of TMD, temporomandibular joint (TMJ) devices have been utilized to replace the joint altogether. However, the risk profile and consequent cost-benefit ratio of these devices are largely debated. This report aimed to provide further insight on the safety of surgically implanted TMJ devices by analyzing adverse events from the Manufacturer and User Facility Device Experience (MAUDE) database.</p><p><strong>Methods: </strong>Inclusion criteria consisted of all MAUDE reports from January 2013 to January 2023 containing the keyword \"TMJ.\" Duplicate reports, preimplantation events, reports extrapolated from published literature reviews, and those not related to TMJ implants were excluded from analysis. Adverse events were extracted, reviewed, and categorized according to complication type, management strategy, device manufacturer, causes of device malfunction, and reporting timeframe. Nonparametric χ2 and Levene's test were used to compare average values between groups with a two-tailed p value of 0.05 being considered statistically significant.</p><p><strong>Results: </strong>A total of 385 adverse event reports were reviewed. The most common complications were infection (59, 25.9%), ankylosis (57, 25.0%), and pain (33, 14.5%). The most common device failures were implant malposition (28, 39.4%), implant dislodgement (22, 31.0%), and screw osseointegration failure (11, 15.5%). Upon assessment of revision surgeries, those undertaken to address infections had the highest rate of device explantation (77%). In a separate analysis of 28 adverse events submitted directly by patients, infection was most common self-reported complication (42.9%). Comparison of device manufacturers revealed that Biomet implants had significantly more reports of pain (χ2 = 10.21, p = 0.003), whereas Stryker implants had more infections (χ2 = 29.87, p < 0.001).</p><p><strong>Conclusion: </strong>In summary, this in-depth analysis of adverse events provides a safety profile of TMJ implants. Understanding the complication types, management strategies, and outcomes according to device manufacturer may help set patient expectations and improve patient care.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":" ","pages":"182-190"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior Nasal Nerve Neurolysis in Addition to Radiofrequency Ablation of the Inferior Turbinates for Patients with Chronic Rhinitis.","authors":"Chien-Yu Huang, Jyun-Yi Liao, Han-Lo Teng, Bor-Hwang Kang, Yaoh-Shiang Lin, Jun-Wei Hsieh","doi":"10.1159/000543366","DOIUrl":"10.1159/000543366","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the outcome of radiofrequency ablation of the inferior turbinates (RFITs) combined with posterior nasal nerve neurolysis (RPN3) in comparison with RFIT alone in the treatment of patients with chronic rhinitis unresponsive to pharmacological therapy.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on adult and adolescent patients with chronic rhinitis who demonstrated a poor response to medication. Patients with a total 24-h reflective total nasal symptom score (rTNSS) of ≥5, rhinorrhea score of ≥2, and congestion score of ≥2 were included. The treatment outcomes of patients who underwent RPN3 and RFIT alone were assessed. The primary endpoint was the change from baseline in 24-h rTNSS, Nasal Obstruction Symptom Evaluation (NOSE) scores, and the response rate defined as rTNSS improved by ≧30% during follow-ups.</p><p><strong>Results: </strong>A total of 64 patients were included (45 males, 70.3%). Overall, 49 patients underwent RPN3, and 15 patients underwent RFIT alone. The rTNSS had improved by 78.4% and 65.8% in RPN3 and RFIT groups, respectively (both p < 0.001). The NOSE score had improved by 92.89% and 86.81% in the RPN3 and RFIT groups (both p < 0.001), respectively. Patients in the RPN3 group demonstrated statistically significantly better results after 3 months than patients in the RFIT alone group (p < 0.05). The response rate was 98% in the RPN3 group after 3 months.</p><p><strong>Conclusions: </strong>The proposed RPN3 alleviated rhinitis symptoms, which demonstrated a high response rate with a superior symptom control rate than RFIT alone in chronic rhinitis with severe rhinorrhea and nasal congestion cases.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":" ","pages":"191-199"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mood Impairment in Patients with Olfactory Loss Predicts a More Pronounced Recovery of Olfactory Function.","authors":"Agnieszka Sabiniewicz, Thomas Hummel","doi":"10.1159/000533629","DOIUrl":"10.1159/000533629","url":null,"abstract":"<p><strong>Background: </strong>Here, we refer to our publication \"Symptoms of depression change with olfactory function\" [Sci Rep. 2022 Apr 5;12(1):5656].</p><p><strong>Objectives: </strong>Depression decreases with olfactory improvement, but the question remains open of whether patients who indicate more suffering regarding mood impairment exhibit a different pattern of recovery from olfactory loss compared to those who suffer less.</p><p><strong>Method: </strong>In the course of an additional investigation of our previously published dataset, we established groups of participants (N = 171) with low (≤8 points on a depression [ADSL] scale; 47%; n = 45) and high (≥14 points on ADSL scale; 53%; n = 53) mood impairment.</p><p><strong>Results: </strong>We found that the group that reported more sufferance on a depression [ADSL] scale improved more in change of olfactory function, and, more importantly, odor discrimination change over a period of an average of 11 months.</p><p><strong>Conclusion: </strong>Patients, who suffered more, as indicated by higher scores on ADSL scale, may have been more willing to commit to the study protocol, and thus their improvement was more notable.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":" ","pages":"13-15"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Common Characteristics of Sinonasal Inflammation Associated with IgG4-Related Disease and Other Chronic Inflammatory Diseases: A Retrospective Observational Study.","authors":"Ryosuke Sato, Takumi Kumai, Ryota Yuasa, Risa Wakisaka, Hiroki Komatsuda, Hidekiyo Yamaki, Yoshiya Ishida, Tetsuji Wada, Miki Takahara","doi":"10.1159/000538365","DOIUrl":"10.1159/000538365","url":null,"abstract":"<p><strong>Introduction: </strong>Immunoglobulin G4-related disease (IgG4-RD) is a systemic inflammatory disease characterized by elevated serum IgG4, tissue infiltration of IgG4-positive cells, and fibrosis. Although a number of IgG4-RD patients show sinonasal involvement, there is little known about sinonasal inflammation associated with IgG4-RD. This study aimed to describe the clinicopathological features of sinonasal inflammation associated with IgG4-RD and to compare with other inflammatory diseases, such as eosinophilic chronic rhinosinusitis (ECRS) and granulomatosis with polyangiitis (GPA).</p><p><strong>Methods: </strong>A retrospective analysis of clinicopathological features of patients with sinonasal lesions and high serum IgG4 was performed. Patient data were reviewed to determine whether they fulfilled the diagnostic criteria for other inflammatory diseases.</p><p><strong>Results: </strong>Six of 7 patients were diagnosed with IgG4-RD, while 1 patient was diagnosed with GPA. In the 6 patients with IgG4-RD, intranasal findings showed nasal polyps in 3 patients (50%) and nasal crusting in the 3 patients (50%). Computed tomography showed ethmoid sinus involvement in 5 patients (83%). Five of the 6 patients (83%) were diagnosed with IgG4-RD based on nasal biopsy, whereas 1 patient (17%) was diagnosed based on lacrimal gland biopsy. Four patients fulfilled the Japanese epidemiological survey of refractory ECRS (JESREC) criteria. However, none of the patients showed eosinophil infiltration. Although the patient with GPA showed high levels of serum IgG4 and tissue infiltration of IgG4-positive cells in the nasal biopsy, the patient showed common clinical features of GPA.</p><p><strong>Conclusion: </strong>Patients with sinonasal inflammation associated with IgG4-RD had similar clinical characteristics with ECRS and GPA. Histopathological findings of the nasal biopsy from clinically diagnosed GPA was consistent with that of IgG4-RD. Sinonasal inflammation associated with IgG4-RD should be diagnosed based not only on tissue infiltration of IgG4-positive cells but in conjunction with clinical findings such as local nasal characteristics, involvement of other organs, and serum antineutrophil cytoplasmic antibody levels. IgG4-RD should be ruled out in patients with eosinophilia without histopathological eosinophil infiltration.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":" ","pages":"95-100"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}