{"title":"An Unusually-Large Adult Rhabdomyoma of the Larynx in an Elderly Female: A Rare Case of Airway Obstruction and Diagnostic Challenges.","authors":"Ambuj Bhalla, Sidney Stewart","doi":"10.1177/01455613251344025","DOIUrl":"https://doi.org/10.1177/01455613251344025","url":null,"abstract":"<p><p>Adult rhabdomyoma is a rare benign tumor of striated muscle origin, predominantly occurring in the head and neck region of middle-aged males. Herein, we present a unique case of a 78 year-old woman with a 7.3 × 3.8 × 5.4 cm supraglottic rhabdomyoma causing progressive dysphagia, dysphonia, and life-threatening airway obstruction over 5 to 7 years. Despite its benign histology, the tumor's size and location necessitated emergent airway stabilization and partial resection. This report highlights the tumor's atypical presentation in an elderly female, its unprecedented dimensions, and the clinical challenges of managing large, obstructive benign neoplasms.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251344025"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129740","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":"Respiratory Epithelial Adenomatoid Hamartoma: Expanding the Spectrum of Rare and Misleading Nasopharyngeal Lesions.","authors":"Jihene Houas, Monia Ghammam, Sabrine Farhani, Maroua Naouar, Wafa Mokni, Badreddine Sriha, Mohamed Abdelkefi","doi":"10.1177/01455613251329672","DOIUrl":"https://doi.org/10.1177/01455613251329672","url":null,"abstract":"<p><p>Respiratory epithelial adenomatoid hamartoma (REAH) is a rare benign lesion of the upper airway. It exceptionally affects the nasal cavity pathway. Its resemblance to other nasal masses poses diagnostic challenges. We report a case of REAH in a 59-year-old man presenting with left nasal obstruction and nocturnal snoring evolving over 2 years. Nasal endoscopy revealed a rhinopharyngeal mass, which was confirmed as REAH by histopathological examination of the biopsy performed under endoscopic guidance, resulting in complete lesion removal. Two years of follow-up showed no recurrence. This case is reported due to its rarity and the risk of misdiagnosis.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251329672"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136560","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}
Majd Werda, Ahmed Ben Akacha, Salim Amouri, Malek Mnejja, Ilheme Charfeddine
{"title":"Rare Epiglottic Granulomatosis: Diagnostic Challenges and Therapeutic Implications.","authors":"Majd Werda, Ahmed Ben Akacha, Salim Amouri, Malek Mnejja, Ilheme Charfeddine","doi":"10.1177/01455613251343740","DOIUrl":"https://doi.org/10.1177/01455613251343740","url":null,"abstract":"<p><p>We report a rare case of epiglottic granulomatosis with polyangiitis (GPA) in a 72-year-old woman presenting with 5 years of progressive dysphagia and dyspnea. Initial laboratory studies revealed leukocytosis (White Blood Cells 14.2 × 10³/µL), eosinophilia (8%), elevated inflammatory markers (C-Reactive Protein 42 mg/L, Erythrocyte Sedimentation Rate 78 mm/hour), and Proteinase 3 Anti-Neutrophil Cytoplasmic Antibody (PR3-ANCA) positivity (65 IU/mL). Laryngoscopy identified supraglottic edema with a right-sided mass, confirmed by Computed Tomography as localized epiglottic thickening without cartilage destruction. Histopathology of the biopsied lesion demonstrated necrotizing granulomas, vasculitis, and multinucleated giant cells, establishing the GPA diagnosis. Treatment with high-dose corticosteroids (1 mg/kg/day prednisone) and rituximab (375 mg/m²/week × 4) induced rapid symptom resolution within 2 weeks. Follow-up laryngoscopy at 1 month showed complete mucosal healing, and the patient remains recurrence-free during 18 month surveillance with maintenance immunosuppression (5 mg/day prednisone). This case highlights 3 critical insights: (1) isolated epiglottic GPA, although rare, should be considered in chronic upper airway obstruction unresponsive to conventional therapy; (2) PR3-ANCA serology and histopathology are indispensable for diagnosis; and (3) rituximab-based regimens achieve excellent outcomes in laryngeal GPA, but prolonged monitoring is essential given relapse risks. Our findings reinforce the need for multidisciplinary management of otolaryngologic GPA manifestations.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251343740"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113184","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":"Letter to the Editor: The Role of Corticosteroids in Pediatric Ludwig's Angina.","authors":"Yasser Al-Ghabra","doi":"10.1177/01455613251343488","DOIUrl":"https://doi.org/10.1177/01455613251343488","url":null,"abstract":"","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251343488"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113180","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":"Survival Analysis and Prognostic Factors for Nasopharyngeal Mucoepidermoid Carcinoma.","authors":"Yuting Lai, Xiaole Song, Huankang Zhang, Wanpeng Li, Jingyi Yang, Xicai Sun, Quan Liu, Dehui Wang, Hongmeng Yu","doi":"10.1177/01455613251336876","DOIUrl":"https://doi.org/10.1177/01455613251336876","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to explore survival outcomes of and prognostic factors in nasopharyngeal mucoepidermoid carcinoma (NPMEC).</p><p><strong>Patients and methods: </strong>We reviewed a total of 57 patients diagnosed with NPMEC, including 19 patients in our center and 38 patients with detailed individual survival data in the literature. The Kaplan-Meier method and the log-rank test were used to assess overall survival (OS) and progression-free survival (PFS). Furthermore, the multivariate survival analysis was evaluated using the Cox regression model.</p><p><strong>Results: </strong>The average age of the patients was 45.8 years (range 13-71 years), with a male-to-female ratio of 0.84. During the mean follow-up time of 49 months (range, 3-149 months), the OS rates at 1, 3 and 5 years were 96.1%, 78.7%, and 62.8%, respectively, and the PFS rates at 1, 3 and 5 years were 91.4%, 71.6%, and 51.3%, respectively. The log-rank test showed that lymphatic metastasis affected OS and PFS, while stage T affected PFS. Multivariate regression analysis showed that lymphatic metastasis was associated with worse OS and PFS, that stage T was associated with unfavorable PFS, and that combined therapy improved PFS independently.</p><p><strong>Conclusions: </strong>Patients with NPMEC have favorable 5 year OS and PFS. Lymphatic metastasis was the independent factor for OS, while lymphatic metastasis, stage T, and treatment modality were the independent factors for PFS.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251336876"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113128","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}
Avraham E Adelman, Akshay Tangutur, Amy Du, Erin Kelly, David Mandell
{"title":"Impact of Tympanostomy Tubes on Pediatric Otoacoustic Emission Testing.","authors":"Avraham E Adelman, Akshay Tangutur, Amy Du, Erin Kelly, David Mandell","doi":"10.1177/01455613251343734","DOIUrl":"https://doi.org/10.1177/01455613251343734","url":null,"abstract":"<p><strong>Background: </strong>Evaluate the impact of patent tympanostomy tubes (TT) on otoacoustic emissions (OAE) in patients with normal pure tone audiometry (PTA).</p><p><strong>Methods: </strong>Retrospective review of patients who underwent TT placement with paired postoperative audiogram and OAEs at 1, 2, 4, and 8 kHz were included. Frequencies with PTA >20 dB or nonpatent TTs were excluded. OAEs were graded by signal-to-noise ratio and distortion product as \"present,\" \"reduced,\" or \"absent.\"</p><p><strong>Results: </strong>In total, 124 patients (217 ears) were included with a mean age (SD) of 3.9 (3.2) years and OAE testing occurring 4.5 (4.7) months postoperatively. OAE absence rates were 85% at 1 kHz (n = 165), 57% at 2 kHz (n = 203), 56% at 4 kHz (n = 206), and 83% at 8 kHz (n = 135).</p><p><strong>Conclusion: </strong>Absent OAEs were the most common result at all frequencies, especially 1 and 8 kHz. Overall, 78.8% of patients failed at least one tested frequency, despite normal PTA and patent TTs, suggesting a potential direct impact of TTs on OAE outcomes. Clinicians may need to exercise caution when interpreting OAEs in patients with patent TTs, and further research may warrant a reevaluation of OAE utility in this context.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251343734"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113191","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}
Yue-Lin Hsieh, Xu Liu, Shenjiang Wang, Wuqing Wang
{"title":"Intracranial Dural Arteriovenous Fistula Can Mimic Sigmoid Sinus Wall Anomalies Induced Pulsatile Tinnitus: Caution Before Considering It's Venous.","authors":"Yue-Lin Hsieh, Xu Liu, Shenjiang Wang, Wuqing Wang","doi":"10.1177/01455613251342851","DOIUrl":"https://doi.org/10.1177/01455613251342851","url":null,"abstract":"<p><strong>Objective: </strong>To highlight that dural arteriovenous fistula (DAVF) can exist in subjects with unilateral vascular pulsatile tinnitus (PT), positive internal jugular vein (IJV) compression tests, and radiologic evidence of sigmoid sinus wall anomalies (SSWA).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 80 subjects with PT as the primary symptom and intracranial DAVF detected based on magnetic resonance angiography results. Among them, IJV and retroauricular compression tests and temporal bone computed tomography (CT) were performed. The moth-eaten sigmoid plate sign and DAVF-induced SSWA were defined, and their correlation with PT duration was studied.</p><p><strong>Results: </strong>Significant differences were observed between ipsilateral IJV and retroauricular compression outcomes in DAVFs located at the transverse-sigmoid sinus (<i>P</i> < .001) and hypoglossal canal (<i>P</i> = .026). Among 71 subjects with CT data, the moth-eaten sign was found in 29 of 37 subjects (sensitivity 78.4%, 95% CI 0.63-0.89) with DAVFs at the transverse-sigmoid sinus. SSWA and jugular bulb (JB) anomalies were observed in 40.8% of subjects. PT duration significantly differed between subjects with SSWA and those without SSWA (<i>P</i> < .0026).</p><p><strong>Conclusion: </strong>The presence of SSWA on CT and a positive IJV compression test should <i>not</i> be considered conclusive for diagnosing venous PT. The \"moth-eaten sigmoid plate\" sign on non-contrast CT and positive retroauricular compression are strong indicators of DAVF as the primary cause of PT.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251342851"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113177","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":"A Quasi-Experimental Study on the Impact of Blended Assessment on Performance and Anxiety Levels of Otorhinolaryngology Clinical Interns.","authors":"Shuo Wu, Feitong Jian, Qintai Yang","doi":"10.1177/01455613251339760","DOIUrl":"https://doi.org/10.1177/01455613251339760","url":null,"abstract":"<p><strong>Objective: </strong>Traditional assessments for otorhinolaryngology clinical interns primarily rely on closed-book examinations (CBE) to evaluate foundational knowledge and reinforce long-term retention. This quasi-experimental study investigates the impact of a blended assessment model-integrating both open-book and closed-book components-on academic performance, test anxiety, and preparation time, compared to the conventional CBE approach.</p><p><strong>Methods: </strong>A total of 240 medical students from the 2019 (CBE, n = 115) and 2020 (blended assessment, n = 125) cohorts at the Third Affiliated Hospital of Sun Yat-sen University were enrolled. Exam scores, preparation time, test format preferences, and Revised Test Anxiety Scale (RTA) scores were collected and analyzed. Statistical comparisons between the 2 groups were performed.</p><p><strong>Results: </strong>All 240 participants (123 males and 117 females) completed the study, achieving a 100% participation rate. No significant differences were found between the CBE and blended assessment groups in academic performance (<i>P</i> = .906) or anxiety levels (<i>P</i> = .411). However, the blended assessment group reported significantly longer preparation times (<i>P</i> = .027). RTA scores were not significantly correlated with gender (<i>P</i> = .416), exam scores (<i>P</i> = .282), or preparation time (<i>P</i> = .410), though female students exhibited slightly higher anxiety levels. Regarding exam format preferences, 19.2% of students favored CBE (70.8% female), while 80.2% preferred open-book exams (43.6% female).</p><p><strong>Conclusion: </strong>The blended assessment model, incorporating both CBE and open-book examinations, serves as a feasible alternative for evaluating clinical interns, fostering their problem-solving abilities. While it demands increased preparation time, it is well-received by students and holds promise for broader adoption in medical education.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251339760"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113186","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":"Primary Cutaneous Follicle Center Lymphoma of the Cheek: A Rare Cutaneous Malignancy.","authors":"Peiran Zhou, Zhao Ming Dong, Zain H Rizvi","doi":"10.1177/01455613251343741","DOIUrl":"https://doi.org/10.1177/01455613251343741","url":null,"abstract":"","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251343741"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113182","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}