Ear, nose, & throat journal最新文献

{"title":"Computerized Dynamic Posturography-Guided Vestibular Rehabilitation Improves Vestibular Sensory Ratios.","authors":"Eytan A David, Navid Shahnaz, Isabel Wiseman, Yael David, Chris L Cochrane","doi":"10.1177/01455613251321978","DOIUrl":"https://doi.org/10.1177/01455613251321978","url":null,"abstract":"<p><p><b>Background:</b> Vestibular deficits are common and debilitating, and many patients struggle with dynamic balance, even after treatment with standard rehabilitation techniques. <b>Objective:</b> The objective of this study was to measure changes in computerized dynamic posturography sensory ratio information after computerized vestibular retraining therapy (CVRT). <b>Methods:</b> This prospective, single-group, interventional study enrolled adult participants with stable, unilateral vestibular deficits. Sensory ratios were obtained from sensory organization test scores before and after 12 twice-weekly sessions of CVRT. <b>Results:</b> Prior to CVRT, sensory organization test ratios indicated significant difficulty maintaining equilibrium on the moving, sway-referenced platform. After CVRT, the visual ratio (VIS) increased by 0.12 (-0.09 to 0.30; <i>P</i> = .0498), the vestibular ration (VEST) increased by 0.10 (-0.060 to 0.25; <i>P</i> = .0122), and the dynamic stability ration (DSR) increased by 0.15 (0.03 to 0.24; <i>P</i> = .0012). The somatosensory and visual preference ratios changed negligibly. Participants with mild disability [Dizziness Handicap Inventory (DHI) ≤30] showed no change while participants with moderate-to-severe disability (DHI >30) had significant improvements in VIS, VEST, and DSR. <b>Conclusions:</b> CVRT was associated with changes in VIS and VEST sensory ratios and improved postural control under conditions that favor use of vestibular information, consistent with increased weighting of vestibular information over vision <b>(</b>Clinicaltrials.gov registration NCT04875013; April 27, 2021).</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251321978"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618064","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":"Interobserver Variability Regarding Adequacy of Oropharyngeal Exposure for Transoral Robotic Surgery May Necessitate Staging Endoscopy: Evaluating TORS Exposure.","authors":"Colleen Schinderle, Kevin J Carlson, Reem Sharaf Alddin, Jeffery J Houlton, Matthew J Bak, Daniel W Karakla, Jonathan R Mark","doi":"10.1177/01455613251319156","DOIUrl":"10.1177/01455613251319156","url":null,"abstract":"","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251319156"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607026","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":"RE: Real-World Survival Impact and Utilization of Adjuvant Radiation in Advanced Laryngeal Cancer.","authors":"Yuanli Xia","doi":"10.1177/01455613251323059","DOIUrl":"https://doi.org/10.1177/01455613251323059","url":null,"abstract":"","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251323059"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618003","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":"Persistent Vocal Fold Hemorrhagic Polyp.","authors":"Quang Pham, Zoë Thijs, Robert T Sataloff","doi":"10.1177/01455613251318510","DOIUrl":"10.1177/01455613251318510","url":null,"abstract":"","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251318510"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607211","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":"Lemierre's Syndrome With Cavernous Sinus Thrombosis: A Life-Threatening Complication of Peritonsillar Abscess.","authors":"Sana Ferchichi, Ghada Kharrat, Becem Trabelsi, Zahra Jouini, Siwar Sbaihi, Chiraz Halwani","doi":"10.1177/01455613251324341","DOIUrl":"https://doi.org/10.1177/01455613251324341","url":null,"abstract":"<p><p><b>Introduction:</b> Lemierre's syndrome is a rare and life-threatening form of septic thrombophlebitis that can complicate head and neck infections. In most cases, septic thrombophlebitis affects the internal jugular vein. Its extension into the cerebral venous sinus is extremely rare, especially in the cavernous sinus. Herein, we report a rare and fatal case of peritonsillar phlegmon complicated by extensive cervicofacial fasciitis, with both internal jugular vein and cavernous sinus thrombophlebitis. <b>Observation:</b> It was a 72-year-old patient with a history of type II diabetes and chronic renal failure. He presented with painful right swelling of the neck and face, fever, and dyspnea. Physical examination revealed a conscious patient with right inflammatory cervicofacial swelling, trismus, and para-pharyngeal bulging. Contrast-enhanced computed tomography revealed extensive right cervicofacial fasciitis, thrombosis of the ipsilateral internal jugular vein and transversal sinus. He received intravenous antibiotic therapy, surgical drainage, and monitoring in the intensive care unit with mechanical ventilation. However, evolution was pejorative. He presented a right cavernous sinus thrombosis, then septic shock and died 4 days after admission. <b>Conclusion:</b> Oropharyngeal infections must be properly and promptly managed, as they carry the risk of leading to severe, potentially life-threatening complications, such as Lemierre's syndrome. Lemierre's syndrome prognosis is particularly worsened by the extension to intracranial sinuses. A rapid diagnosis remains the best guarantee for optimizing patient management.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251324341"},"PeriodicalIF":0.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143589021","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":"Delayed Pulsatile Tinnitus by an Ascending Pharyngeal Artery-Internal Jugular Vein Fistula Caused by Blunt Trauma: A Case Report and Review of the Literature.","authors":"Yoon Heo, Seung Jin Lee, Tae Su Kim","doi":"10.1177/01455613241229974","DOIUrl":"10.1177/01455613241229974","url":null,"abstract":"<p><p>Head and neck trauma-induced pulsatile tinnitus (PT) should be approached with caution, as it can rarely be attributed to an arteriovenous fistula (AVF). We present a 26-year-old male with a history of blunt trauma who presented delayed PT with direct AVF between the ascending pharyngeal artery (APA) and the internal jugular vein (IJV). The patient underwent occlusion of the fistula with transarterial embolization using coils and PT was completely resolved, confirming successful treatment. The delayed manifestation of PT in the APA-IJV fistula is probably due to the gradual formation of a pseudoaneurysm and subsequent AVF. This case highlights the importance of investigating PT in head trauma patients, as it can be a sign of AVF and possible complications. Overall, this case contributes to understanding delayed PT with AVF and emphasizes the importance of prompt diagnosis and treatment of AVF in patients with head and neck trauma.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"145-150"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673906","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":"Middle Ear Cholesteatoma Complicated By Lemierre's Syndrome: A Case Report and Literature Review.","authors":"Xiaoyu Zhu, Hua Deng, Ming Yu, Shasha Yang, Qingxin Cao, Chengyan Zhao, Ying Wang, Jiexi Jiang, Yusui Zhang","doi":"10.1177/01455613251323992","DOIUrl":"https://doi.org/10.1177/01455613251323992","url":null,"abstract":"<p><p>Septic thrombophlebitis of the internal jugular vein (IJV), known as Lemierre's syndrome, is a rare complication secondary to infections in the head and neck. Cholesteatoma of the middle ear complicated with Lemierre's syndrome is rarely observed in clinical practice. Currently, the treatment controversy centers on whether anticoagulation therapy is necessary for IJV and distant metastatic emboli induced by Lemierre's syndrome. A 46-year-old female patient with middle ear cholesteatoma underwent modified radical mastoidectomy and tympanoplasty surgery and complicated with Lemierre's syndrome, presenting with intermittent high fever, chills, headache, and left lateral neck pain. Computed tomography (CT) revealed thrombosis and internal gas in the left IJV, while blood culture and blood pathogenic microorganism metagenomic detection were negative. We administered sodium ceftriaxone (1 g every 12 hours) for 3 days. According to the secretion culture results showing 90% Actinomyces europaeus and 10% Corynebacterium without mycolic acid, penicillin (2.4 million IU) was added intravenously every 6 hours. The patient's infection worsened on the first day after surgery. We adjusted to upgrade anti-infection vancomycin 1 g every 12 hours, combined with meropenem (1 g every 8 hours) and metronidazole (0.5 g) every 8 hours for 4 weeks, and subcutaneous injection of enoxaparin 0.4 mL every 12 hours for 1 week, then adjusted to rivaroxaban tablets (15 mg bid). Amoxicillin-clavulanate for 2 weeks and rivaroxaban 10 mg were administered orally for 3 months after discharge. A follow-up neck CT scan with intravenous contrast suggested that the gas in the left IJV had disappeared, but the thrombus persisted. During the 3 month follow-up, the patient's vital signs, blood routine, and D-dimer levels were within the normal range. The surgical area healed well, and the patient reported no discomfort. Lemierre's syndrome represents a potentially-fatal complication that results in considerable mortality and must be identified early and aggressively treated.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251323992"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525545","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":"The Role of Immunotherapy in Salivary Gland Cancer: A Systematic Review.","authors":"Sul Gi Kim, Jason Tasoulas, Siddharth Sheth, Wendell G Yarbrough, Trevor Hackman, Antonio L Amelio, Christopher Blake Sullivan","doi":"10.1177/01455613251324353","DOIUrl":"https://doi.org/10.1177/01455613251324353","url":null,"abstract":"<p><p><b>Background:</b> Salivary gland cancer (SGC) comprises a very heterogeneous group of rare neoplasms, accounting for approximately 2% to 6% of head and neck malignancies. Surgery with or without adjuvant radiotherapy is the main treatment regimen. However, patients who are ineligible for surgery, including late-stage, recurrent, or metastatic disease, have very limited options. Chemotherapeutic schemes have failed to offer meaningful survival benefit, while the role of immune checkpoint inhibitors (ICIs) like anti-PD1, anti-PDL1, and anti-CTLA4 is largely unknown. <b>Methods:</b> A systematic database search of clinical trials evaluating the role of anti-PD1 and anti-CTLA4 immunotherapy in the survival of patients with SGC was conducted in EMBASE, MEDLINE, and Scopus databases. Primary outcomes were overall survival, progression-free survival, complete responses (CRs), partial responses (PRs), stable disease (SD), and objective response rates. <b>Results:</b> We identified 770 relevant studies. Nine clinical trials and 4 retrospective studies met the inclusion criteria and were eligible for further analysis. A total of 473 patients were studied, with an average age of 61 ± 4 years old for prospective trials and 60 ± 11 years old for retrospective studies. For studies that provided gender, the male-to-female ratio was 1.2:1 for prospective trials versus 4:1 for retrospective studies. All patients in the clinical trials had recurrent or metastatic disease. All patients received anti-PD1 ICI with either pembrolizumab or nivolumab, 7 study arms administering pembrolizumab, 10 study arms administering nivolumab. For prospective trials, 6/9 studies also reported an additional intervention. Most prevalent histology was adenoid cystic carcinoma (n = 230). Outcome of prospective trial were 1 CR, 19 PRs 145 SD, and 80% of patients reporting an adverse event (AE) of any grade. For retrospective studies, 1 patient reported CR, 3 patients reported PR, 11 patients reported SD, and 92% of patients reported an AE of any grade. <b>Conclusion:</b> Anti-PD1 immunotherapeutic modalities can be a safe and potentially-beneficial option for patients with advanced, recurrent, or metastatic SGC. However, the literature suffers from small cohorts, lack of randomization, and heterogeneity among different histologies of SGC. Prospective trials evaluating the role of anti-PD1 in patients with SGC, stratified by histology are warranted to determine the potential role of immunotherapy in the treatment of this disease.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251324353"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525568","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":"Orbital Apex Syndrome Caused by Herpes Zoster Ophthalmicus Following Nasal Endoscopic Surgery: A Case Report.","authors":"Chen Peng, Zhimin Xing, Congli Geng, Yan Liu, Yidi Liu","doi":"10.1177/01455613251316258","DOIUrl":"https://doi.org/10.1177/01455613251316258","url":null,"abstract":"<p><p>Orbital apex syndrome (OAS) is a severe orbital condition caused by impairment of cranial nerves after inflammation or local compression. The report details an uncommon case of OAS caused by herpes zoster ophthalmicus (HZO) following endoscopic sinus surgery. A 52-year-old male exhibited symptoms of OAS in the postoperative phase; however, imaging examination and endoscopic evaluations failed to support that surgical damage and bacterial infection were the cause. The distinctive skin manifestations of herpes zoster around eye were the important clue for diagnosis. The patient was diagnosed with OAS caused by HZO and recovered after antiviral treatment for two weeks. During a one-month follow-up, the patient reported no eye-related sequelae. This case highlights the significance of early diagnosis and prompt intervention to achieve optimal clinical outcomes.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251316258"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517770","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":"Skip Metastasis in a Pediatric Patient with Medullary Thyroid Cancer: A Case Report and a Review of the Literature.","authors":"Shravan Gowrishankar, John Ceremsak, Ryan H Belcher","doi":"10.1177/01455613251323035","DOIUrl":"https://doi.org/10.1177/01455613251323035","url":null,"abstract":"<p><p>Skip metastasis in thyroid cancer occurs when there is lateral neck lymph node involvement of tumor without central neck lymph node involvement. Here, cancer spreads to the lateral neck while \"skipping\" more proximal central neck nodes. While this unusual pattern of spread has been previously described in adults with thyroid cancer, to our knowledge it has never been described in children. Here, we report a case of an adolescent female with medullary thyroid cancer with isolated lateral neck metastatic disease. In summary, a 15-year-old female with no medical conditions presented with an asymptomatic neck mass. A computed tomography (CT) scan of the neck showed a heterogenous nodule in the right thyroid lobe with both cystic and solid components which were also illustrated on ultrasound. There was no CT evidence of metastatic disease, but a thyroid and cervical neck ultrasound showed a <1 cm calcified nodule in right neck level II concerning for metastasis. Fine needle aspiration highlighted medullary thyroid cancer. The patient underwent total thyroidectomy with both central and right lateral neck dissection. Central neck dissection revealed no metastatic lymph nodes, while metastatic nodes were found with right lateral neck dissection, highlighting skip metastasis. The patient had an uneventful postoperative course and was well at 1-month follow-up with a strong voice and no dysphagia.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251323035"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517772","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}