Auris Nasus Larynx最新文献

{"title":"Can the nasal area ratio of the left and right nasal cavities measured by computed tomography serve as an objective diagnostic criterion for caudal septal deviation?","authors":"Yu Hosokawa, Masafumi Sawada, Yuki Shiko, Maiko Osawa, Yohei Kawasaki, Yasuhiro Kase, Tetsuo Ikezono","doi":"10.1016/j.anl.2025.07.007","DOIUrl":"https://doi.org/10.1016/j.anl.2025.07.007","url":null,"abstract":"<p><strong>Objective: </strong>Nasal septal surgery is an effective procedure for nasal obstruction; however, caudal deviation (CD) must be managed carefully. The diagnosis of CD is often subjective, and an objective index test method is required. Accordingly, we established reference values for the nasal area ratio in the horizontal section (NAR-H) and nasal area ratio in the coronal section (NAR-C) on computed tomography in CD.</p><p><strong>Methods: </strong>This retrospective observational study included 120 patients who underwent septoplasty for nasal obstruction. Patients who underwent caudal septoplasty were categorised into the CD group, while those who underwent classical septoplasty were categorised into the septal deviation (SD) group. The mean NAR-H and NAR-C values of both groups were compared. Moreover, the cutoff NAR-H and NAR-C values in the CD group were calculated, and the sensitivity and specificity of each were calculated.</p><p><strong>Results: </strong>CD and SD groups included 49 and 71 patients, respectively. The mean NAR-H was 0.43 and 0.75 in the CD and SD groups, respectively (p < 0.0001). The mean NAR-C was 0.56 and 0.80 in the CD and SD groups, respectively (p < 0.0001). The cutoff NAR-H and NAR-C values in the CD group were 0.56 and 0.675, respectively. The area under the ROC curve of the NAR-H and NAR-C were 0.90 and 0.88, respectively.</p><p><strong>Conclusions: </strong>The NAR-H and NAR-C may be useful for diagnosing CD. An NAR-H of <0.56 and NAR-C of <0.675 indicates the need to prepare for a caudal septoplasty.</p>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762441","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":"New evaluation method using sound stimulation for asymptomatic vestibular dysfunction.","authors":"Masumi Kobayashi, Naomi Katayama, Tadao Yoshida, Michihiko Sone","doi":"10.1016/j.anl.2025.07.006","DOIUrl":"https://doi.org/10.1016/j.anl.2025.07.006","url":null,"abstract":"<p><p>The currently available evaluation methods for determining appropriate treatment strategies in patients with asymptomatic inner ear dysfunction are insufficient. Recently, we demonstrated the efficacy of 100-Hz sound stimulation for treating vestibular dysfunction in Meniere's disease. This case report presents the utility of 100-Hz sound stimulation as a new method for evaluating cases with asymptomatic vestibular dysfunction and their potential for recovery with early medical intervention. We evaluated the change in cervical vestibular-evoked myogenic potential (cVEMP) amplitude before and after sound stimulation (75 dB at a frequency of 100 Hz for 5 to 10 min) in two female patients with endolymphatic hydrops (EH), comparing the change based on the presence of EH. One patient presented with hearing difficulty and the other with otalgia, and neither had hearing loss and vestibular symptoms. As a result, cVEMP amplitudes in ears without EH showed no changes after the stimulation. Conversely, cVEMP amplitudes showed significant increases in ears with vestibular EH compared with the values before stimulation. Application of a 100-Hz sound stimulus might be a new method for evaluating asymptomatic vestibular dysfunction associated with EH, and for providing information about the potential for recovery from the dysfunction, facilitating early medical intervention.</p>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755206","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":"Robotic and computer-assisted techniques in ear surgery.","authors":"Takeshi Fujita, Taku Ito, Masaya Uchida, Hajime Koyama, Masahiro Takahashi, Takara Nakazawa, Takashi Fujiwara, Nozomu Matsumoto, Tadao Yoshida, Naohiro Yoshida, Seiji Kakehata, Manabu Komori, Naohito Hato","doi":"10.1016/j.anl.2025.06.013","DOIUrl":"https://doi.org/10.1016/j.anl.2025.06.013","url":null,"abstract":"<p><p>Robotic and computer-assisted systems for ear surgery are receiving growing attention as tools to overcome the challenges intrinsic to the delicate, restricted operative field of the middle and inner ear. This review highlights recent advances in robotic platforms, clinical outcomes, and emerging technologies such as augmented reality (AR), virtual reality (VR), and artificial intelligence (AI). Multiple groups worldwide have introduced robotic devices that aid or automate tasks like mastoid drilling, stapes footplate fenestration, and cochlear implant (CI) electrode insertion. Seminal studies involving systems such as HEARO, iotaSoft, and RobOtol reveal sub-millimeter accuracy and minimized trauma during CI, suggesting the potential to reduce postoperative complications and improve hearing preservation. Although these technologies have progressed from proof-of-concept prototypes to early clinical usage, significant barriers remain before they become routine. Cost is a key concern, given the relatively small patient population for otologic procedures compared to other surgical fields. Regulatory pathways also require strict safety validations, particularly for semi-autonomous or fully autonomous functions. Nevertheless, FDA and European CE approvals for certain robotic systems illustrate their growing feasibility. Meanwhile, AR- and VR-based navigation is improving intraoperative visualization by overlaying critical structures such as the facial nerve onto the surgeon's field, while AI-driven algorithms for instrument tracking and real-time monitoring offer further enhancements in safety and precision. In addition, simulation-based training in VR environments can accelerate surgical expertise and reduce learning curves. Larger-scale clinical trials that directly compare robotic and conventional approaches are still needed to quantify benefits related to complication rates, operative times, and long-term auditory outcomes. Ongoing innovations in software integration and miniaturized hardware are likely to broaden the range of feasible robotic tasks within the ear's narrow anatomical boundaries.</p>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719159","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":"Feingold syndrome with GJB2 variants.","authors":"Yoshihiro Nitta, Hajime Sano, Yoshihiro Yoshimura, Fumio Takada, Taku Yamashita","doi":"10.1016/j.anl.2025.07.005","DOIUrl":"https://doi.org/10.1016/j.anl.2025.07.005","url":null,"abstract":"<p><p>Congenital hearing loss is the most common birth defect, with genetic factors implicated in 50 % of prelingual cases. GJB2 variant, causing up to 50 % of autosomal recessive non-syndromic hearing loss, typically show stable hearing profiles and favorable cochlear implant (CI) outcomes. In this case, however, the atypical clinical course prompted further evaluation. A 3-year-6-month-old girl, born at 35 weeks presented with profound bilateral hearing loss detected by auditory brainstem response. The patient had normal tympanic membranes, angulated ears, microcephaly, short stature, narrow palpebral fissures, and digital anomalies. CT revealed inner ear malformations including bilateral vestibular enlargement and cochlear nerve canal stenosis. Genetic testing showed a homozygous GJB2 c.235delC (p.L79fs) variant. Initial hearing aids proved insufficient, leading to CI placement, which improved hearing thresholds. Language and social delays persisted. As her older sister, without a GJB2 variant, had hearing loss and a family history of characteristic physical symptoms, further genetic analysis revealed a heterozygous MYCN variant (NM_005378:c.1138_1139del:p.S380fs), confirming Feingold syndrome type 1 (FS1). This report is a very rare report of FS 1 combined with severe hearing loss due to a GJB2 variant. Early screening for malformations not detected by GJB2 led to accurate diagnosis and provision of information to the family.</p>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692551","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":"Comparison of Mupirocin ointment and Basic Fibroblast Growth Factor Gel in the treatment of pediatric recurrent anterior epistaxis: Randomized, controlled, single blind study.","authors":"Zhengcai Lou, Zihan Lou, Zhengnong Chen","doi":"10.1016/j.anl.2025.07.004","DOIUrl":"https://doi.org/10.1016/j.anl.2025.07.004","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to compare the short-and medium-term effectiveness of Mupirocin ointment (2 %) (MUO) and recombinant bovine basic fibroblast growth factor eye-gel (bFGF) in the treatment of recurrent anterior epistaxis (RAE) in children.</p><p><strong>Material and methods: </strong>children with RAE were randomly allocated into MUO group or bFGF group. The recurrence epistaxis,epistaxis severity score (ESS),and visual analog scale (VAS) were compared among two groups at 4 weeks and 3 months.</p><p><strong>Results: </strong>This study included 371 children with RAE.The recurrence epistaxis was 44.57 % in the MUO group and 30.81 % in the bFGF group at posttreatment 4 weeks (P < 0.05). Also, the recurrence epistaxis rate was 63.59 % in the MUO group and 28.65 % in the bFGF group at posttreatment 3 months (P < 0.001). Furthermore, in the MUO group, there was not significant difference in the recurrence epistaxis rate between the patients with AR and non-AR at posttreatment 4 weeks (P > 0.05), while there was not significant difference in the recurrence epistaxis rate between the patients with AR and non-AR at posttreatment 4 weeks (P = 0.309) in the bFGF group. In the MUO group, 42.5 % patients reported the pricking of nasal cavity and discomfort in 70.4 %, whereas no any patients did in the bFGF group. Moreover, at each follow-up time point, the mean ESS score in the bFGF group was significantly lower than that in the MUO group.VAS scores for itchy nose or nasal crusts, the improvement in the bFGF group was better compared with the MUO group at 4 weeks and 3 months.</p><p><strong>Conclusion: </strong>bFGF Gel has a lower rate of recurrent epistaxis and better short-and medium-term effectiveness in the treatment of RAE in children compared with Mupirocin ointment, additionally, bFGF has no the pricking and discomfort of nasal cavity,thus resulting in well children's compliance.</p>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676643","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":"Early detection and successful management of postoperative external jugular vein thrombosis using color doppler ultrasonography after free jejunal transfer.","authors":"Kohei Ida, Hideki Kadota, Ryo Shimamoto, Chikafumi Oryoji, Do Emura, Atsushi Imaizumi","doi":"10.1016/j.anl.2025.07.001","DOIUrl":"https://doi.org/10.1016/j.anl.2025.07.001","url":null,"abstract":"<p><p>Postoperative venous thrombosis is a known complication of free flap reconstruction, yet thrombosis of the external jugular vein (EJV) remains underreported. We present two cases of EJV thrombosis following free jejunal transfer, both detected early using color Doppler ultrasonography (CDU) and successfully managed with anticoagulation therapy. In Case 1, EJV was used after failure of a prior jejunal flap anastomosed to the internal jugular vein (IJV). CDU on postoperative day (POD) 0 showed thrombus characterized by flow voids and incomplete vein collapse, prompting heparin administration. In Case 2, CDU on POD 1 similarly revealed early thrombus in the EJV. In both cases, daily CDU monitoring demonstrated progressive improvement, allowing flap salvage without surgical reintervention. These cases highlight the utility of CDU for early postoperative surveillance and timely clinical decision-making. CDU facilitated early detection of venous thrombosis, often preceding clinical signs of vascular compromise. Although less favored than the IJV, the EJV can be safely used for microvascular anastomosis with careful monitoring. Our experience supports the use of CDU to guide anticoagulation therapy and optimize outcomes in free flap reconstruction involving the EJV.</p>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669058","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":"Course of a sudden sensorineural hearing loss case diagnosed as intra-labyrinthine hemorrhage with MRI in the early phase","authors":"Kenta Ide,&nbsp;Makoto Hosoya,&nbsp;Takanori Nishiyama,&nbsp;Marie N Shimanuki,&nbsp;Masafumi Ueno,&nbsp;Hiroyuki Ozawa,&nbsp;Naoki Oishi","doi":"10.1016/j.anl.2025.06.012","DOIUrl":"10.1016/j.anl.2025.06.012","url":null,"abstract":"<div><div>Intralabyrinthine hemorrhage (ILH) is a rare differential diagnosis of sudden sensorineural hearing loss. Investigations using magnetic resonance imaging (MRI) in the early phase from the onset are inevitable to diagnose ILH. However, MRI is not usually performed during the early phases of sudden sensorineural hearing loss. Hence, ILH is rarely diagnosed, and the hearing prognosis and vestibular function in patients have been poorly understood.</div><div>In the present study, we report the detailed course of ILH with relatively good hearing recovery. Additionally, vestibular function recovery was quantitatively examined using a video head impulse test. A 75-year-old man presented at our clinic with a chief complaint of dizziness, sudden hearing loss, left sensorineural hearing loss, and nystagmus. MRI 18 days after onset showed a left ILH. Following treatment with prednisone, the patient's hearing level partially recovered and nystagmus disappeared.</div><div>Our experience emphasizes that MRI in the early phase is crucial for diagnosing ILH. Furthermore, MRI in the early phase should be considered in cases of sudden sensorineural hearing loss or dizziness and is beneficial for investigating ILH as a subpopulation of sudden sensorineural hearing loss.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 4","pages":"Pages 479-483"},"PeriodicalIF":1.6,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604765","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":"Long-term outcomes of cochlear implantation in adolescents with early-onset hearing loss","authors":"Haruo Yoshida ,&nbsp;Yukihiko Kanda ,&nbsp;Satomi Shojinaga ,&nbsp;Chisei Satoh ,&nbsp;Yoshihiko Kumai ,&nbsp;Haruo Takahashi","doi":"10.1016/j.anl.2025.06.010","DOIUrl":"10.1016/j.anl.2025.06.010","url":null,"abstract":"<div><h3>Objective</h3><div>Neonatal hearing screening (NHS) has long-term beneficial effects on the outcomes of cochlear implantation (CI); however, some adolescents still require CI evaluation because of progressive hearing loss. This study aimed to investigate long-term postoperative effects and to identify prognostic factors in adolescents with CI.</div></div><div><h3>Methods</h3><div>Thirty-four patients with pre- or perilingual severe-to-profound hearing loss who underwent CI after the age of 10 years (adolescent group) were included. The pre- and postoperative outcomes of this group were compared with those of 138 patients with pre- or perilingual severe-to-profound hearing loss who underwent CI before the age of 10 years (pediatric group). We collected data on the age at diagnosis of hearing loss, age at initiating hearing aid (HA) use, age at CI, postoperative observation time, pure-tone hearing thresholds on the affected and unaffected sides, preoperative (HA) and postoperative (CI) aided hearing levels, speech discrimination scores (SDSs), and communication mode. The prognostic factors for CI in the adolescent group were investigated based on postoperative SDS. In patients who provided consent for a questionnaire survey, postoperative listening comprehension, articulation, satisfaction, and expectations after CI were also evaluated.</div></div><div><h3>Results</h3><div>In the adolescent group, significant improvements were noted in the aided hearing threshold and SDS after implantation (both <em>p</em> &lt; 0.001) except for two cases, but both variables were significantly worse in the adolescent group than in the pediatric group (both <em>p</em> &lt; 0.05). Postoperative SDS significantly correlated with preoperative SDS (ρ = 0.5056) and preoperative hearing level on the unaffected side (ρ = −0.3864; both <em>p</em> &lt; 0.05). The age at CI, age at diagnosis, and age at initiating HA use were not significantly different between the two groups. In the adolescent group, users of the auditory–verbal communication mode scored the highest and showed significant differences in preoperative and postoperative factors. The questionnaire survey findings indicated that postoperative listening and articulation were significantly worse in the adolescent group (both <em>p</em> &lt; 0.05), but satisfaction and expectations after CI did not significantly differ between the two groups.</div></div><div><h3>Conclusion</h3><div>CI appears to provide satisfactory long-term outcomes even among adolescents with hearing loss. Better preoperative SDS and hearing might be important for the outcomes of CI in this age group.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 4","pages":"Pages 471-478"},"PeriodicalIF":1.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571996","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":"Differential diagnosis of skull base osteomyelitis from malignancies focusing on the radiological features on HRCT","authors":"Kuniyuki Takahashi ,&nbsp;Ogawa Takahashi ,&nbsp;Takeshi Nakamura ,&nbsp;Shinsuke Ide ,&nbsp;Takashi Goto ,&nbsp;Takumi Okuda ,&nbsp;Yuka Morita ,&nbsp;Manabu Ogi ,&nbsp;Meiko Kitazawa ,&nbsp;Chihiro Yagi ,&nbsp;Tatsuya Yamagishi ,&nbsp;Shinsuke Ohshima ,&nbsp;Shuji Izumi ,&nbsp;Arata Horii","doi":"10.1016/j.anl.2025.06.011","DOIUrl":"10.1016/j.anl.2025.06.011","url":null,"abstract":"<div><h3>Objective</h3><div>Skull base osteomyelitis (SBO) is a rare but life-threatening inflammatory disease often misdiagnosed as a malignancy, such as nasopharyngeal carcinoma (NPC) and external auditory canal cancer (EACC), due to extensive bone destruction. This study aimed to identify the radiological features of SBO using high-resolution CT, which could help in the differential diagnosis of malignancies.</div></div><div><h3>Methods</h3><div>High-resolution CT findings of 14 patients with SBO, 25 with NPC, and 19 with EACC were retrospectively reviewed. Abnormal findings at seven sites: 1) external auditory canal, 2) mastoid portion, 3) petrous portion of the temporal bone, 4) clivus, 5) jugular foramen, 6) nasopharyngeal soft tissue thickness, and 7) torus tubarius shape were compared among the patient groups on axial slice of HRCT.</div></div><div><h3>Results</h3><div>When comparing SBO and NPC, there were significant differences in sites 1) (<em>p</em> = 0.0001), 3) (<em>p</em> = 0.0064), 5), and 7) (<em>p</em> &lt; 0.0001); among them, the most specific finding was the site 7). When comparing SBO and EACC, there were significant differences in sites 1) (<em>p</em> = 0.0084), 3) (<em>p</em> &lt; 0.0001), 4) (<em>p</em> = 0.0013), 5) (<em>p</em> = 0.0015), and 6) (<em>p</em> &lt; 0.0001); among them, the most specific finding was cortical bone destruction in site 3).</div></div><div><h3>Conclusion</h3><div>Our findings indicated that the bilateral preservation of “μ-shape sign” in the torus tubarius and bone destruction in the petrous portion on HRCT were the most specific signs differentiating SBO from NPC and EACC, respectively. Knowledge of these features can contribute to prompt diagnosis and treatment of SBO.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 4","pages":"Pages 456-462"},"PeriodicalIF":1.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144536126","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":"Tonsil-induced autoimmune/inflammatory syndrome: Current insights into the pathogenic role of tonsils in immunoglobulin a nephropathy, palmoplantar pustulosis and psoriasis","authors":"Yasuaki Harabuchi","doi":"10.1016/j.anl.2025.06.004","DOIUrl":"10.1016/j.anl.2025.06.004","url":null,"abstract":"<div><div>The tonsils, specifically the palatine tonsils, serve as a first line of defense against pathogenic microorganisms that enter the nasal or oral cavity. They release antigen-specific immune cells and antibodies that circulate not only in the upper respiratory tract but also throughout the rest of the body. Numerous clinical studies, including randomized prospective trials, have shown that tonsillectomy is highly effective in treating immunoglobulin A nephropathy (IgAN), palmoplantar pustulosis (PPP), and psoriasis. However, the precise pathogenic association of the tonsils with these diseases remains incompletely understood. The author previously proposed the concept of tonsil-induced autoimmune/inflammatory syndrome (TIAS) as a common underlying mechanism for these diseases. TIAS suggests that an excessive immune response initiated by the tonsils, often triggered by common bacteria such as α- and β-hemolytic streptococcus and <em>Haemophilus parainfluenzae</em>, which are indigenously present in the oral cavity, can become dysregulated. This immune response also involves unmethylated DNA sequences (CpG-ODN) that are shared among various bacteria. In reaction to these bacteria or CpG-ODN, tonsillar T-cell populations, including type 17 helper T (Th17), Th22, Th1, and cytotoxic T cells, become proliferative. Simultaneously, tonsillar B-cell populations responding to these triggers produce antibodies against epidermal keratins and heat shock proteins, or aberrant IgA1. These tonsillar T-cell populations and the antibodies then enter the systemic circulation, migrating to the kidneys or skin. Upon reaching the organs, they contribute to tissue damage, aided by various cytokine actions. IgAN, PPP, and psoriasis, which are representative disorders of TIAS, all share this common pathogenic mechanism. In this article, the author discusses the pathogenesis of TIAS based on recent research findings.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 4","pages":"Pages 463-470"},"PeriodicalIF":1.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144536127","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}