{"title":"Beyond the Inability to Burp: A Comprehensive Pathophysiological Theory of Retrograde Cricopharyngeal Dysfunction.","authors":"Jerome R Lechien","doi":"10.1177/01455613251353647","DOIUrl":"https://doi.org/10.1177/01455613251353647","url":null,"abstract":"","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251353647"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510012","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}
Surabhi Sivaratnam, Michael Xie, Phillip Staibano, Sepideh Mohajeri, Kelvin Zhou, Ali Zhang, Raphaelle Koerber, J E M Ted Young, Han Zhang
{"title":"Survival Outcomes in Upstaged Cutaneous Head and Neck Melanoma With Negative Sentinel Lymph Node Biopsy: A Retrospective Analysis.","authors":"Surabhi Sivaratnam, Michael Xie, Phillip Staibano, Sepideh Mohajeri, Kelvin Zhou, Ali Zhang, Raphaelle Koerber, J E M Ted Young, Han Zhang","doi":"10.1177/01455613251351388","DOIUrl":"https://doi.org/10.1177/01455613251351388","url":null,"abstract":"<p><strong>Background: </strong>Biopsy is required to stage cutaneous head and neck melanomas (cHNM), but cHNM can be pathologically upstaged following surgical resection. Here, we evaluated whether upstaged cHNM with negative sentinel lymph node biopsy (SLNB) impacts survival and time to cHNM recurrence.</p><p><strong>Methods: </strong>We retrospectively analyzed cHNM patients with negative SLNB treated from 2007 to 2014. We included adult cHNM patients with T2a-4a disease at biopsy who underwent SLNB-negative and wide local excision. We extracted patient demographics, treatment details, and survival outcomes. Melanoma-specific survival (MSS) and cHNM recurrence outcomes were analyzed using Cox regression analysis and 95% confidence intervals (95% CI).</p><p><strong>Results: </strong>Overall, 87 patients met inclusion criteria, 17 of whom were upstaged after definitive treatment. No significant baseline demographic or cHNM differences were observed between groups. Excisional biopsies were most performed (n = 57, 65.5%), yet upstaged patients more frequently underwent shave or punch biopsies. Most cHNM lesions were found on the face (n = 35, 40.2%). Univariable Cox regression revealed significant association between upstaged pathology (unadjusted hazard ratio: 3.20, 95% CI: 1.12-9.16), close margins (unadjusted hazard ratio: 4.95, 95% CI: 1.61-15.20), and worse MSS; however, multivariable Cox regression did not demonstrate any relationship between upstaged pathology or margin status and MSS.</p><p><strong>Conclusion: </strong>Among patients with pT2-4a, SLNB-negative cHNM, pathological upstaging does not independently predict MSS when adjusted for margin status, but large multicenter prospective cohort studies are needed to further validate these findings.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251351388"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510013","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}
Mohammed A Al Hamoud, Ali Jaber Asiry, Mohammed S Alahmari, Salmah M Alharbi, Ibrahem Hamad Erwe, Majed Assiri
{"title":"Outcomes of Cochlear Implantation in Postmeningitis Hearing Loss: A Systematic Review and Meta-Analysis.","authors":"Mohammed A Al Hamoud, Ali Jaber Asiry, Mohammed S Alahmari, Salmah M Alharbi, Ibrahem Hamad Erwe, Majed Assiri","doi":"10.1177/01455613251342847","DOIUrl":"https://doi.org/10.1177/01455613251342847","url":null,"abstract":"<p><strong>Background: </strong>Cochlear implantation (CI) has revolutionized auditory rehabilitation for patients with severe to profound hearing loss secondary to bacterial meningitis. This systematic review synthesizes current evidence on CI outcomes in this patient population. Demographic characteristics, surgical techniques, and audiometric outcomes across studies published from 1993 to 2024 are highlighted.</p><p><strong>Methodology: </strong>In a systematic search of electronic databases, 19 eligible studies from Europe, North America, China, and Turkey were identified. These studies included retrospective cohort designs, prospective cohorts, and case series that assessed various aspects of CI outcomes. Data extraction was focused on patient demographics, preimplantation characteristics, surgical details, and postoperative outcomes.</p><p><strong>Results: </strong>The studies reported heterogeneous but positive audiological outcomes following CI. Significant improvements in speech perception and quality-of-life metrics were observed across different patient subgroups. This review identified variability in surgical approaches (eg, cochleostomy and circumodiolar drill-out), implant devices (eg, nucleus and advanced bionics), and speech processing strategies (eg, SPEAK and ACE). Audiological gains were influenced by factors such as age at implantation, duration of deafness, and presence of cochlear ossification.</p><p><strong>Conclusion: </strong>CI offers significant benefits for patients with postmeningitis hearing loss, although the outcomes vary based on patient-specific factors and surgical techniques. The findings from this review underscore the importance of personalized treatment approaches and highlight areas for future research, including standardized outcome measures and long-term follow-up, to optimize patient outcomes and refine clinical protocols.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251342847"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499911","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}
Mohammad Jalaladdin, Saud T Alaidarous, Ahmed Althqafi, Alaa A Babkour
{"title":"Delayed Diagnosis of a Nasal Foreign Body (Battery) Retained for 13 Years.","authors":"Mohammad Jalaladdin, Saud T Alaidarous, Ahmed Althqafi, Alaa A Babkour","doi":"10.1177/01455613251347925","DOIUrl":"https://doi.org/10.1177/01455613251347925","url":null,"abstract":"<p><p>Retained nasal foreign bodies are commonly encountered in pediatric patients but can go unrecognized when symptoms mimic other chronic nasal conditions. We report the rare case of a 17-year-old female who presented with a 13-year history of unilateral nasal obstruction, purulent discharge, hyposmia, and sleep disturbances. Imaging revealed a metallic foreign body, consistent with a button battery, lodged in the right nasal cavity with associated fibrotic obliteration of the nasal vestibule. The patient underwent endoscopic surgical removal of the battery with favorable postoperative outcomes. This case underscores the importance of considering nasal foreign bodies in the differential diagnosis of chronic unilateral nasal symptoms, regardless of patient age, and highlights the critical role of imaging in prolonged or atypical presentations.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251347925"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499907","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":"Auricular Vascular Leiomyoma: A Case Report and Literature Review.","authors":"Cheng-Hung Lai, Hsin-Chien Chen","doi":"10.1177/01455613251350815","DOIUrl":"https://doi.org/10.1177/01455613251350815","url":null,"abstract":"<p><p>Vascular leiomyoma (VL; angioleiomyoma) is an uncommon benign tumor arising from smooth muscle cells within the tunica media of blood vessels, typically presenting as solitary, firm nodules. It predominantly occurs in the lower extremities but rarely involves the head and neck region, particularly the auricle. Auricular VLs commonly appear as small, sharply-demarcated nodules that are generally asymptomatic. Nonetheless, a subset of patients may experience episodic pain, which can be elicited or intensified by environmental or mechanical factors including pressure and cold exposure, complicating clinical diagnosis. Due to the nonspecific presentation, auricular lesions are frequently misdiagnosed preoperatively. Definitive diagnosis relies on histological examination. Herein, we present a rare case involving the right auricle, accompanied by a concise review of the relevant literature to enhance clinical awareness, support early diagnosis, and guide appropriate surgical management of this rare entity.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251350815"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499905","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":"Increased Efficiency of Tumor Board With Introduction of the Consensus Slate.","authors":"Lana Mnajjed, Greg Krempl","doi":"10.1177/01455613251351773","DOIUrl":"https://doi.org/10.1177/01455613251351773","url":null,"abstract":"<p><strong>Background: </strong>The multidisciplinary tumor board (TB) meeting is a vital aspect of comprehensive cancer care worldwide. Functional flaws in TBs can interfere with maximal performance, leading to several inefficiencies and potentially impacting treatment outcomes.</p><p><strong>Objective: </strong>The aim of this study was to analyze the effect of a prospectively-developed list of straightforward patients and their consensus treatment options, also known as a \"consensus slate,\" on TB efficiency.</p><p><strong>Methods: </strong>The consensus slate was developed prior to each weekly TB meeting, and effect of the slate on TB efficiency was analyzed. The main measurement of efficiency was time difference in presentation of those straightforward patients before and after slate implementation.</p><p><strong>Results: </strong>Consensus slate implementation resulted in a 78.5% decrease in average discussion time of straightforward patients during TB. An average of 25% of each week's TB list was presented using the slate.</p><p><strong>Conclusion: </strong>This series demonstrates the efficacy of a tool such as the consensus slate in streamlining the TB process. The ultimate result of this streamlining is greater meeting productivity through increased number of patients that can be presented, improved clinician engagement, and increased standardization of patient presentations.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251351773"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499909","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":"Penetrating Sphenoid Sinus Injuries in Children: A Comprehensive Literature Review.","authors":"Adel Azar, Ahmad Alkheder, Ahmad Mustafa","doi":"10.1177/01455613251352290","DOIUrl":"https://doi.org/10.1177/01455613251352290","url":null,"abstract":"<p><p>Penetrating foreign bodies in the pediatric sphenoid sinus are exceptionally rare and pose significant diagnostic and surgical challenges due to the sinus's proximity to critical neurovascular structures. We present the case of an 11 year-old boy who sustained a penetrating injury from a 7 mm bullet that entered through the floor of the frontal sinus, traversed the ethmoid sinus, and lodged in the right sphenoid sinus near the carotid canal and optic nerve. Initial assessment revealed hemodynamic stability and no active bleeding or neurological deficits. Non-contrast computed tomography precisely localized the metallic foreign body and confirmed an intact surrounding neurovascular architecture, with no intracranial injury. A multidisciplinary team opted for functional endoscopic sinus surgery to minimize risks to adjacent structures. The bullet was successfully extracted under endoscopic guidance without any complications. Postoperative recovery was uneventful, with no evidence of infection, nor cerebrospinal fluid leak, nor neurological sequelae. This case underscores the pivotal role of advanced imaging in guiding surgical planning and the efficacy of minimally-invasive endoscopic techniques in pediatric sinonasal trauma. The absence of intraoperative complications highlights the importance of interdisciplinary collaboration, anatomical knowledge, and early intervention to mitigate risks of infection or increasing surrounding fibrosis. delayed neurovascular injury might be avoided. While isolated pediatric sphenoid sinus foreign bodies remain rare, this report reinforces the value of tailored imaging protocols, endoscopic proficiency, and collaborative care in optimizing outcomes. Future studies should focus on standardizing management strategies and exploring emerging technologies to enhance precision in this anatomically-complex population.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251352290"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499912","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":"Isolated Horner Syndrome as the Sole Presentation of Pediatric Parapharyngeal Rhabdomyosarcoma.","authors":"Molham Alahmad, Ahmad Alkheder, Arige Alassaf","doi":"10.1177/01455613251352732","DOIUrl":"https://doi.org/10.1177/01455613251352732","url":null,"abstract":"<p><p>Isolated Horner syndrome (HS) in young children warrants thorough investigation for occult malignancy, despite its rarity as a presenting sign. This report details a unique case of a 30 month-old male presenting with sudden-onset, isolated left HS as the sole manifestation of rhabdomyosarcoma (RMS) in parapharyngeal space. Contrast-enhanced magnetic resonance imaging (MRI) revealed a 2.5 × 3.5 × 5 cm lesion within the left poststyloid parapharyngeal space, displacing the carotid artery anteriorly, and the internal jugular vein posteriorly. Gross total resection via a transcervical approach was performed; intraoperatively, the tumor involved the cervical sympathetic trunk, necessitating its sacrifice, resulting in persistent postoperative HS. Histopathological and immunohistochemical analysis (positive CK, PLAP, CD99) confirmed a diagnosis of embryonal RMS. The child received adjuvant chemoradiotherapy. One-year follow-up with positron emission tomography - computed tomography (PET-CT) showed no evidence of recurrence. This case underscores several critical points: (1) Isolated HS in young children necessitates urgent neuroimaging to exclude malignancy, even in the absence of palpable masses or neurological deficits; (2) The parapharyngeal space, though an exceptionally rare primary site for RMS (constituting a minor subset of head and neck cases), carries significant implications due to its proximity to the sympathetic chain, readily causing HS via mass effect; (3) MRI is pivotal for diagnosis and surgical planning in this anatomically complex region; (4) Multimodal therapy is essential for local control in embryonal RMS; (5) Sacrifice of the sympathetic trunk during resection likely leads to permanent HS, a factor for preoperative counseling. Vigilant long-term follow-up remains crucial.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251352732"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499910","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}
Francesco Giombi, Gian Marco Pace, Giulia Mari, Michele Cerasuolo, Giulio Sandri, Luca Cerri, Enrico Heffler, Giovanni Paoletti, Francesca Puggioni, Giuseppe Mercante, Giuseppe Spriano, Luca Malvezzi
{"title":"Assessing Nasal Obstruction Improvement in Dupilumab-Treated Patients With Active Anterior Rhinomanometry: A Preliminary Study.","authors":"Francesco Giombi, Gian Marco Pace, Giulia Mari, Michele Cerasuolo, Giulio Sandri, Luca Cerri, Enrico Heffler, Giovanni Paoletti, Francesca Puggioni, Giuseppe Mercante, Giuseppe Spriano, Luca Malvezzi","doi":"10.1177/01455613251350508","DOIUrl":"https://doi.org/10.1177/01455613251350508","url":null,"abstract":"<p><strong>Objective: </strong>To objectively assess nasal flow obstruction improvement through anterior active rhinomanometry (AAR) in patients with severe chronic rhinosinusitis with nasal polyps treated with dupilumab.</p><p><strong>Methods: </strong>Dupilumab-treated patients were evaluated at baseline (T0), 3rd month (T1) and 6th month (T2) after therapy initiation by AAR, and nasal airway resistances were measured using the Rinopocket ED200 system™. The Lund-Mackay Score (LMS), the Nasal Polyp Score (NPS) and the Lund-Kennedy Score (LKS) were assessed. Also, patients were required to fill in the Nasal Obstruction Symptom Evaluation scale, the 22-Item Sinonasal Outcome Test and the Visual Analogue Scale for sinonasal symptoms.</p><p><strong>Results: </strong>Twenty-one patients (n = 21) were included. By T1, both inspiratory and expiratory resistances, as well as total nasal resistance, showed a significant reduction. At T2, these improvements were sustained but did not differ significantly from T1. Patient-reported outcomes followed a similar trend, showing marked improvement at T1 but no further significant changes at T2. Conversely, endoscopic and radiologic outcomes (NPS, LKS, LMS) demonstrated significant improvements across all timepoints.</p><p><strong>Conclusions: </strong>This preliminary study shows the rapid effectiveness of dupilumab in relieving nasal obstruction. Interestingly, while endoscopic and radiologic assessments showed ongoing improvement at each time point, nasal airway resistance measured with AAR did not significantly decrease beyond the initial 3 months of treatment.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251350508"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499904","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}