Austin R Swisher, Simon Beatty, Amar Miglani, Devyani Lal
{"title":"A Report of Two Cases of Planum Sphenoidale Injuries With Cerebrospinal Rhinorrhea Following Office Balloon Dilation of the Sphenoid Ostium: Lessons Learned.","authors":"Austin R Swisher, Simon Beatty, Amar Miglani, Devyani Lal","doi":"10.1177/01455613251353643","DOIUrl":"https://doi.org/10.1177/01455613251353643","url":null,"abstract":"<p><p>Balloon-assisted dilation (BAD) of paranasal sinus ostia is a Food and Drug Administration (FDA)-approved minimally-invasive procedure used to treat medically refractory chronic rhinosinusitis. Several large cohort studies have reported relatively-low complication rates with BAD. Thus, users of this technology may perceive this to be a safer alternative to formal dissection of the frontal and sphenoid sinus and perform these as office-based procedures. Here, we present 2 patients who underwent BAD of the sphenoid sinus and developed cerebrospinal fluid leak (CSF) leaks with pneumocephalus. Both patients had thinning of the planum sphenoidale in generously-pneumatized sphenoid sinuses. Although BAD is considered safe, review of the current literature demonstrates that serious complications can occur. These case reports demonstrate the potential for skull base injury, particularly in hyper-pneumatized sphenoid sinuses with dehiscent bone. Preoperative anatomic evaluation is crucial to identify at-risk patients. During BAD, trauma to critical structures may cause CSF leak and result in pneumocephalus. This knowledge is important for improving surgical decision-making and patient counseling.<b>Level of Evidence:</b> III.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251353643"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661309","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":"Driven from Passion to Compulsion: The Soft Science and Philosophy Behind Authorship Misconduct.","authors":"Mainak Dutta","doi":"10.1177/01455613251360112","DOIUrl":"https://doi.org/10.1177/01455613251360112","url":null,"abstract":"","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251360112"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661310","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":"Vocal Cord Paralysis Secondary to Diffuse Idiopathic Skeletal Hyperostosis: A Case Report and Literature Review.","authors":"Xin-Tian He, Hsin-Chien Chen","doi":"10.1177/01455613251360123","DOIUrl":"https://doi.org/10.1177/01455613251360123","url":null,"abstract":"<p><p>Diffuse idiopathic skeletal hyperostosis (DISH) is a condition that causes excessive bone growth along the spinal ligaments. While often silent, it can lead to symptoms such as neck pain or difficulty swallowing and, in rare cases, vocal cord paralysis (VCP). We present a 61-year-old man with progressive hoarseness due to DISH-related VCP. Early recognition of DISH as a cause of VCP is crucial, as timely diagnosis can guide appropriate management, ranging from conservative observation to surgical intervention in severe cases.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251360123"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661312","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":"Hearing Improvement in a Vestibular Schwannoma Patient Undergoing Wait-and-Scan Management.","authors":"Jason K Adams, Zachary G Schwam, George B Wanna","doi":"10.1177/01455613251358653","DOIUrl":"https://doi.org/10.1177/01455613251358653","url":null,"abstract":"<p><p>Vestibular schwannomas are benign tumors originating from Schwann cells of the 8 cranial nerve. Patients with vestibular schwannoma most commonly present with hearing loss, followed by tinnitus and disequilibrium. We report the case of a 73-year-old gentleman who initially presented with an asymmetric hearing loss and was subsequently diagnosed to have a unilateral vestibular schwannoma. The patient elected to proceed with a wait-and-scan management approach. During his follow-up period, imaging showed there was limited growth of the tumor with solidification of a cystic component of the tumor. Notably, during the same period, his high-frequency sensorineural hearing loss (SNHL) worsened to a severe SNHL in all frequencies with very poor speech discrimination. At subsequent 1-year follow-up, his hearing had improved to a serviceable hearing level. While the natural history of vestibular schwannoma suggests hearing loss over time, this case highlights the variable nature of hearing changes, including slow decline, sudden hearing loss, and even some return of hearing function. This report underscores the potential for hearing recovery in conservatively managed vestibular schwannoma with implications for hearing rehabilitation and patient-centered decision-making.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251358653"},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644366","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}
Spencer H Short, Michael McGlone, Jason F Ohlstein
{"title":"A Rare Case of Granulomatosis With Polyangiitis With Cutaneous Pyoderma Gangrenosum-Like Lesions of the Bilateral Parotid Glands.","authors":"Spencer H Short, Michael McGlone, Jason F Ohlstein","doi":"10.1177/01455613251345431","DOIUrl":"https://doi.org/10.1177/01455613251345431","url":null,"abstract":"<p><p>Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis, is a small vessel vasculitis characterized by necrotizing granulomas affecting various organs. This case report presents a 79-year-old male with GPA manifesting as pyoderma gangrenosum-like cutaneous lesions involving the bilateral parotid glands. The patient presented with painful, progressively-enlarging wounds that were affecting his quality of life. The initial workup was inconclusive, and the patient was briefly lost to follow-up. Upon return, the lesions had progressed to salivary fistulas, and the patient exhibited facial nerve weakness. Chest radiographs revealed worsening lung densities. A punch biopsy indicated granulomatous inflammation with necrosis, and autoimmune lab work showed elevated antinuclear antibody, erythrocyte sedimentation rate, C-reactive protein, and cytoplasmic antineutrophilic cytoplasmic antibodies levels. The patient was diagnosed with GPA and started on Rituximab therapy. The patient responded well to therapy and had resolution of ulcerations and facial nerve weakness. This case is a rare presentation of GPA affecting bilateral parotid glands with involvement of the facial nerve. It underscores the importance of considering GPA in the differential diagnosis of necrotic skin lesions and highlights the challenges in diagnosing GPA due to nonspecific histologic findings and wide variation of clinical presentation.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251345431"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639019","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}