Acta otorrinolaringologica espanola最新文献

{"title":"Decision-making in Petrous Bone Cholesteatoma (PBC): Surgical options according to PBC classification.","authors":"Monica Rueda Vega, Montserrat Asensi-Diaz, Carolina López Granados, Carlos Martín Oviedo, Ignacio Arístegui Torrano, Miguel Arístegui Ruiz","doi":"10.1016/j.otoeng.2025.512277","DOIUrl":"10.1016/j.otoeng.2025.512277","url":null,"abstract":"<p><strong>Introduction: </strong>Petrous bone cholesteatoma (PBC) is a rare, potentially life-threatening condition requiring surgical management to prevent severe complications. While classification systems, such as Sanna's, are widely used to guide surgical planning, actual decision-making is often influenced by additional clinical factors beyond lesion type.</p><p><strong>Material and methods: </strong>A retrospective analysis of 94 PBCs in 92 patients operated between 1995 and 2024 was conducted. Data included demographics, clinical presentation, PBC classification, surgical approach, use of endoscopic assistance, recurrence, follow-up, and hearing rehabilitation. The aim of this study is to describe the surgical strategies applied to different PBC types in a series of 94 cases, evaluate the practical utility of classification systems, and propose a decision-making approach based on inner ear involvement and other critical factors RESULTS: The most common PBC type was supralabyrinthine (40.43%), followed by massive (18.09%) and retrolabyrinthine-infralabyrinthine (11.7%). A total of 102 surgeries were performed using various approaches, including modified translabyrinthine (24.51%), subtotal petrosectomy (22.55%), and transotic approach (18.63%). Endoscopic assistance was used in 11 cases. Recurrence occurred in 8.51% of cases, with a median follow-up of 48.5 months. Cochlear implantation was used in 8 patients and bone conduction implants in 3.</p><p><strong>Conclusions: </strong>PBC classification provides valuable insights for understanding lesion behavior and planning surgery, but it is insufficient alone for determining the optimal surgical approach. Decisions must be individualized, considering hearing status, inner ear and facial nerve involvement, contralateral ear function, lesion extension, and anatomical factors. A classification-based strategy complemented by these considerations ensures safer and more effective management of PBC.</p>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512277"},"PeriodicalIF":0.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mucocutaneous leishmaniasis with upper airway involvement: A report of three cases.","authors":"Jaume Fiol Roig, Amaya Roldan Fidalgo, Fabián García Velasco, Meritxell Tomás Fernández, Daniela Mendizábal Cajal","doi":"10.1016/j.otoeng.2025.512276","DOIUrl":"10.1016/j.otoeng.2025.512276","url":null,"abstract":"<p><p>Mucocutaneous leishmaniasis (MCL) is a rare and challenging clinical presentation of tegumentary leishmaniasis, primarily affecting the mucosal surfaces of the upper airway. It is often misdiagnosed due to its non-specific symptoms, which can mimic inflammatory, infectious, or neoplastic conditions. This study reports three autochthonous cases of MCL diagnosed between 2023 and 2024. The patients presented chronic symptoms such as dysphagia, odynophagia, lip edema, and ulcerative mucosal lesions. Diagnosis was established through mucosal biopsies, revealing intracellular Leishmania amastigotes via histopathological examination. Treatment varied across the cases and included liposomal Amphotericin B, Meglumine Antimoniate, and Miltefosine, reflecting the complexity of managing MCL. All patients achieved complete clinical remission after individualized therapeutic regimens and careful follow-up. These cases emphasize the importance of considering MCL in the differential diagnosis of persistent upper airway lesions in endemic regions. Early and accurate diagnosis, coupled with tailored treatment strategies, is essential for preventing disease progression and achieving successful clinical outcomes. Furthermore, these findings underscore the need for heightened clinical awareness and multidisciplinary collaboration in managing this rare but significant disease presentation.</p>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512276"},"PeriodicalIF":0.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transoral CO₂ laser microsurgery for early hypopharyngeal cancer: Still a viable option?","authors":"Carlos M Chiesa-Estomba, Alfonso Rodriguez-Urzay, Maria Landa-Garmendia, Aitor Vargas-Alvarez, Ehkiñe Larruscain-Sarasola, Jose A González-García, Maider Andueza-Guembe, Jon A Sistaga-Suarez","doi":"10.1016/j.otoeng.2025.512278","DOIUrl":"10.1016/j.otoeng.2025.512278","url":null,"abstract":"<p><strong>Introduction: </strong>Hypopharyngeal squamous cell carcinoma (HPSCC) is a highly aggressive malignancy with poor prognosis due to late-stage diagnosis and complex anatomical challenges. Advances in minimally invasive techniques, particularly transoral laser microsurgery (CO₂TOLMS), have demonstrated promise in improving oncologic and functional outcomes while preserving organ function.</p><p><strong>Materials and methods: </strong>A retrospective study analyzed 25 patients with histologically confirmed HPSCC treated with CO₂TOLMS at a tertiary academic hospital (2016-2021). Patients underwent curative-intent CO₂TOLMS, with outcomes assessed for survival, recurrence, and functional recovery.</p><p><strong>Results: </strong>The 3-year overall survival and disease-specific survival rates were 72% and 84%, respectively. Surgical margins were disease-free in 76% of patients, while postoperative complications were minimal (persistent tracheostomy in 4%, long-term nasogastric feeding tube dependency in 4%). Local and regional recurrence rates were each 8%. Laryngeal preservation was achieved in 95% of cases, significantly enhancing quality of life. Histologic grade correlated with recurrence risk, though survival outcomes were consistent across tumor stages and surgical margin status.</p><p><strong>Conclusions: </strong>CO₂TOLMS offers an effective and minimally invasive treatment for early-stage HPSCC, achieving good oncological and functional outcomes. While it provides low morbidity and high organ preservation rates, further research is needed to refine multimodal treatment strategies for advanced-stage disease.</p>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512278"},"PeriodicalIF":0.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Newborn nasal obstruction: Rare anatomical causes to consider.","authors":"Montserrat Asensi-Diaz, Alejandro Lowy Benoliel, Juan Antonio Pasamontes Pingarron, Ismael Nieva Pascual, Pilar Cifuentes Canorea, Monica Hernando Cuñado","doi":"10.1016/j.otoeng.2025.512279","DOIUrl":"10.1016/j.otoeng.2025.512279","url":null,"abstract":"<p><p>Neonatal nasal obstruction, though rare, can be life-threatening due to the obligate nasal breathing pattern in newborns. Even partial obstruction may compromise ventilation and feeding. This study aims to describe rare anatomical causes of neonatal nasal obstruction, highlighting their clinical presentation, diagnostic evaluation, and management. A retrospective review was conducted of four neonates with respiratory distress who were diagnosed with congenital nasal malformations through endoscopic examination and craniofacial imaging. The identified cases included bilateral choanal atresia in a patient with CHARGE syndrome, congenital nasal pyriform aperture stenosis (CNPAS) with a solitary median mega-incisor, isolated CNPAS with midnasal hypoplasia, and bilateral congenital dacryocystoceles. Symptoms ranged from noisy breathing to feeding intolerance. Management included both medical and surgical interventions depending on the severity of the obstruction. Although infrequent, anatomical nasal anomalies should be promptly considered in neonates presenting with respiratory distress, as early diagnosis and appropriate treatment are essential to avoid complications and ensure favourable outcomes.</p>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512279"},"PeriodicalIF":0.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient reported voice outcomes following multi-disciplinary approach to botulism toxin for spasmodic dysphonia","authors":"Sahil Kakar ,&nbsp;Keshav Kumar Gupta ,&nbsp;Emma Richards ,&nbsp;Colin Shirley ,&nbsp;Paige Bradley ,&nbsp;Anita Sonsale","doi":"10.1016/j.otoeng.2025.512261","DOIUrl":"10.1016/j.otoeng.2025.512261","url":null,"abstract":"<div><h3>Purpose</h3><div>Spasmodic dysphonia<span> (SD) is a debilitating disorder primarily affecting voice production. Current treatment includes repeat botulinum toxin<span> (botox) injections for symptomatic management. The aim of this study is to review the impact of botox injections on patient reported outcome measures (PROM), using a novel and unique quality of life<span>, proforma, and side effects in patients treated at our centre.</span></span></span></div></div><div><h3>Methods</h3><div>This retrospective case series evaluated all patients who were treated in our specialised voice clinic, at a single tertiary referral centre between May 2019 and April 2024 with botox for SD. The primary outcome measure was PROM of voice quality weekly post-injection as per a unique proforma. Variables extracted included patient demographics, treatment specifics and complications.</div></div><div><h3>Results</h3><div><span>Fifty-two patients were included representing 21 (40.4%) males. Forty-two (80.8%) suffered from adductor spasmodic dysphonia with 8 (15.4%) having abductor dysphonia and 1 (1.92%) with mixed dysphonia. Patients with abductor dysphonia had a statistical improvement in voice following dose 2, (1.8–3.0, </span><em>p</em> <!-->=<!--> <!-->0.03) and dose 3 (1.4–3.2, <em>p</em> = &lt;0.001). Patients with adductor dysphonia had significant improvements in voice following all doses (2.1–2.9, <em>p</em> <!-->=<!--> <!-->0.01), (1.9–3.0, <em>p</em> = &lt;0.01) and (2.1–3.0, <em>p</em> = &lt;0.01). The most common complication was a ‘breathy voice’, ranging from 31.4% to 51.0% but all patients reported this as transient.</div></div><div><h3>Conclusion</h3><div>Patient reported quality of voice is improved following botox injections for spasmodic dysphonia, and most patients do not suffer from long-term complications.</div></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 5","pages":"Article 512261"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retropharyngeal adenopathy in carcinoma arising in Zenker’s diverticulum","authors":"Beatriz Pallarés Martí,&nbsp;Juan José Díaz Argüello,&nbsp;Yolanda Escamilla Carpintero","doi":"10.1016/j.otoeng.2025.512267","DOIUrl":"10.1016/j.otoeng.2025.512267","url":null,"abstract":"","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 5","pages":"Article 512267"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring DIAPH1 gene mutations in patients with sensorineural hearing loss of unknown etiology in Northern Spain","authors":"Rocío González-Aguado ,&nbsp;Aida Veiga-Alonso ,&nbsp;Esther Onecha-De La Fuente ,&nbsp;Carmelo Morales-Angulo","doi":"10.1016/j.otoeng.2025.512269","DOIUrl":"10.1016/j.otoeng.2025.512269","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the prevalence of variants in the DIAPH1 gene among patients with bilateral sensorineural hearing loss of unknown etiology in northern Spain and to characterize the associated phenotype. As a secondary objective, this study aims to improve genetic counseling by linking genotype to phenotype through clinical characterization of variant carriers.</div></div><div><h3>Patients and methods</h3><div>A six-year observational descriptive study was conducted at a tertiary referral center. Patients with bilateral sensorineural hearing loss of unknown origin were evaluated using DNA sequencing through next-generation sequencing. A gene panel was utilized to identify pathogenic or likely pathogenic variants in the DIAPH1 gene.</div></div><div><h3>Results</h3><div>Among 385 patients with SNHL, four (1%) harbored DIAPH1 variants. Two patients (0.5%) had pathogenic or likely pathogenic variants associated with macrothrombocytopenia and neutropenia (c.3586dupA, c.3575-3C<!--> <!-->&gt;<!--> <!-->G), exhibiting early-onset, progressive bilateral SNHL, and vestibular abnormalities. One received a cochlear implant with good outcomes. Conclusions: Pathogenic variants in the DIAPH1 gene are rare among patients with bilateral sensorineural hearing loss of unknown etiology in northern Spain. These variants lead to bilateral SNHL with autosomal dominant inheritance. In our study, we identified two novel pathogenic DIAPH1 variants associated with macrothrombocytopenia, and also presenting neutropenia and vestibular involvement.</div></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 5","pages":"Article 512269"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bamboo nodules on the vocal cords: A rare clinical challenge","authors":"María San Millán-González ,&nbsp;Michael Bauer ,&nbsp;Ana Fernández-Rodríguez ,&nbsp;José Antonio Cámara-Arnaz","doi":"10.1016/j.otoeng.2025.512266","DOIUrl":"10.1016/j.otoeng.2025.512266","url":null,"abstract":"","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 5","pages":"Article 512266"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skull base surgery via extended endoscopic endonasal approach: Predictors of ear-nose-throat complications","authors":"Anna Penella ,&nbsp;Alejandro Portillo ,&nbsp;Ricardo Bartel ,&nbsp;Jose María Caballero ,&nbsp;Enric Cisa ,&nbsp;Francesc Cruellas ,&nbsp;Mireia Golet ,&nbsp;Jose L Sanmillan ,&nbsp;Alberto Torres ,&nbsp;Xavier González-Compta","doi":"10.1016/j.otoeng.2025.512264","DOIUrl":"10.1016/j.otoeng.2025.512264","url":null,"abstract":"<div><h3>Objective</h3><div>To identify predictive factors for ear-nose-throat (ENT) complications in patients undergoing skull base surgery via extended endoscopic endonasal approaches (EEEA).</div></div><div><h3>Methods</h3><div>Single-center retrospective observational study of a cohort of patients who underwent EEEA for skull base surgery between January 2015 and December 2021. Patients were stratified according to ENT complications.</div></div><div><h3>Results</h3><div><span>Sixty-one patients were included in the study: 37 women (60.66%) and 24 men (39.34%). Craniopharyngioma<span> was the most frequently observed pathology (36%). 40 patients (65,57%) presented with ENT complications, being olfactory disturbance the most common complication (40,98%), followed by nasal obstruction (24,59%) and synechiae<span> formation (18,03%). Logistic regression analysis revealed that younger age (</span></span></span><em>P</em><span> = .026) and excision of middle turbinates during EEEA surgery (</span><em>P</em> = .034) were independent factors with a significant association with ENT complications. Anterior septal deviation was an independent factor significantly associated with synechiae formation (<em>P</em> = .023).</div></div><div><h3>Conclusion</h3><div>Surgeons performing skull base surgery using EEEA should be aware that excision of middle turbinate, younger age and anterior septal deviation may be risk factors for ENT postoperative complications.</div></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 5","pages":"Article 512264"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Speech discrimination and binaural processing in bilateral symmetric vs. asymmetric sensorineural hearing loss","authors":"Mai El Ghazaly,&nbsp;Esraa Meckawy,&nbsp;Hesham Kozou,&nbsp;Doaa Elmoazen","doi":"10.1016/j.otoeng.2025.512265","DOIUrl":"10.1016/j.otoeng.2025.512265","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the effects of symmetric and asymmetric sensorineural hearing loss (SSNHL and ASNHL) on speech discrimination abilities and binaural processing, including integration and interaction.</div></div><div><h3>Materials and methods</h3><div>This cross-sectional study included 36 adult patients with bilateral sensorineural hearing loss<span>, divided into two groups based on the symmetry of their hearing<span> loss: ASNHL and SSNHL. Speech discrimination abilities were evaluated using the maximum speech discrimination score (SDSmax) with Arabic monosyllabic words. Binaural integration was assessed using the free-recall double dichotic digit test (DDT), while binaural interaction was evaluated through the binaural fusion test (BFT).</span></span></div></div><div><h3>Results</h3><div>The SDSmax of the worse-hearing ear in ASNHL patients (48.89 ± 10.13%) was significantly lower than in SSNHL patients (69.33 ± 7.97%) with comparable degrees of hearing loss. ASNHL patients exhibited a greater disparity between the better and worse-hearing ears in DDT scores (53.15 ± 13.98%) compared to SSNHL patients (22.96 ± 5.93%). Additionally, the BFT scores in ASNHL patients (55.14 ± 13.30%) were significantly lower than in SSNHL patients (72.92 ± 12.55%).</div></div><div><h3>Conclusions</h3><div>ASNHL patients experience greater impairments in speech discrimination, binaural integration, and interaction compared to SSNHL patients. These differences likely stem from auditory deprivation and asymmetry-induced deficits. Developing tailored hearing rehabilitation strategies is critical to addressing the unique challenges posed by asymmetric hearing loss.</div></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 5","pages":"Article 512265"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}