Ear, nose, & throat journal最新文献

{"title":"Clinicoradiological Evaluation of Cholesteatoma: Integrating Clinical, CT, and MRI Diagnostics.","authors":"Tarek Mohamed M Mansour, Mahmoud Mohamed El Bahrawy, Mohamed Mohamed Elmoursy, Ahmed Elrahman Mohamed Azzam","doi":"10.1177/01455613251343790","DOIUrl":"https://doi.org/10.1177/01455613251343790","url":null,"abstract":"<p><strong>Objectives: </strong>The common chronic disorder, otitis media (COM), can lead to cholesteatoma, a destructive lesion of the middle ear that could potentially have major consequences. Correct diagnosis at an early stage is crucial for effective management. In this study, histopathology is used as the gold standard to compare how well a clinicoradiological method that uses clinical observations, high-resolution computed tomography (HRCT), and echo-planar imaging diffusion-weighted magnetic resonance imaging (EPI-DWI) can diagnose cholesteatoma.</p><p><strong>Methods: </strong>A prospective diagnostic accuracy study was conducted on 230 patients aged 15 to 50 years with COM and clinically-suspected cholesteatoma. All patients underwent clinical evaluation (history, otoscopy, and audiometry) followed by HRCT and EPI-DWI imaging. Imaging findings were interpreted independently by radiologists blinded to clinical and histopathological results. Surgical exploration and histopathological confirmation were performed in all cases.</p><p><strong>Results: </strong>Of the 230 patients, histopathology confirmed cholesteatoma in 110 cases (47.8%). Diffusion-weighted magnetic resonance imaging (DW-MRI) demonstrated superior sensitivity (92.7%) and specificity (89.4%) compared with HRCT (sensitivity: 75.5%; specificity: 70.2%). The clinicoradiological approach combining clinical assessment with EPI-DWI and HRCT improved diagnostic accuracy, achieving a sensitivity of 95.5%, specificity of 90.7%, positive predictive value of 93.2%, and negative predictive value of 94.3%. Receiver operating characteristic analysis revealed an area under the curve of 0.96 for DW-MRI and 0.88 for the clinicoradiological approach. Cohen's kappa showed an excellent agreement between the clinicoradiological assessment and histopathology (κ = .85).</p><p><strong>Conclusions: </strong>The integration of clinical findings with EPI-DWI and HRCT significantly enhances the diagnostic accuracy for cholesteatoma, making the clinicoradiological approach a valuable tool in the evaluation of patients with COM. EPI-DWI remains the preferred imaging modality for cholesteatoma diagnosis, while HRCT provides complementary information on middle ear anatomy and bone erosion.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251343790"},"PeriodicalIF":0.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136444","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 Review of Postoperative Care Following Endoscopic Sinus Surgery for Chronic Rhinosinusitis.","authors":"W Jared Martin, Lauren M Cook, Yasine Mirmozaffari, Ezer H Benaim, Jackson R Vuncannon, Cristine Klatt-Cromwell, Brent A Senior, Charles S Ebert","doi":"10.1177/01455613251342957","DOIUrl":"https://doi.org/10.1177/01455613251342957","url":null,"abstract":"<p><strong>Objectives: </strong>This study reviews current postoperative care recommendations following endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS), with the goal of optimizing recovery, minimizing complications, and reducing the risk of disease recurrence.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted to identify studies on postoperative care following ESS for CRS. Findings were synthesized to develop evidence-based recommendations for optimal postoperative management.</p><p><strong>Results: </strong>Postoperative care following ESS for CRS requires a multifaceted approach. Pain management should prioritize acetaminophen and nonsteroidal anti-inflammatory drugs, with opioids reserved for severe pain. Nasal irrigation, topical corticosteroids, and debridement are recommended for all patients. Nasal packing and drug-eluting devices may offer additional benefits, but are not universally required. The use of antibiotics and oral corticosteroids should be selective and guided by individual patient factors and risk profiles.</p><p><strong>Discussion: </strong>While general recommendations are made, patient-specific factors such as comorbidities, financial constraints, and adherence to care must be considered. Further evaluation of these factors is essential to establish a more comprehensive and individualized standard of care for postoperative management.</p><p><strong>Conclusions: </strong>Effective postoperative care following ESS for CRS should be individualized, multifaceted, and focused on improving recovery, minimizing complications, and ensuring the best possible patient outcomes.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251342957"},"PeriodicalIF":0.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136490","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 Palatal Perforation Secondary to Diffuse Large B-Cell Lymphoma: A Diagnostic Challenge.","authors":"Yasser ALGhabra, Mohammad Hamdi, Mudar Ismael, Abdulrahman Shaker, Adham Bader Aldeen Mohsen","doi":"10.1177/01455613251343739","DOIUrl":"https://doi.org/10.1177/01455613251343739","url":null,"abstract":"<p><p>Palatal perforation, a diagnostically complex condition, arises from diverse etiologies including neoplasms, infections, or inflammatory disorders. Patients often experience dysphagia, dysarthria, and social distress due to nasal regurgitation. We report a 22 year-old cachectic woman with isolated palatal perforation secondary to diffuse large B-cell lymphoma (DLBCL). She presented with a 2-month history of a painless, progressive midline ulcer unresponsive to antibiotics, culminating in a 2 cm perforation. Biopsies revealed necrotic tissue, fungal elements, and atypical lymphocytes; immunohistochemistry confirmed DLBCL (CD20+, CD3-). Imaging and labs excluded systemic involvement, infections (HIV, syphilis), and autoimmune conditions. Despite lacking classic B-symptoms, elevated lactate dehydrogenase (392 U/L) and iron-deficiency anemia suggested malignancy. This case highlights the diagnostic challenge of DLBCL mimicking benign lesions and underscores the need for multidisciplinary evaluation integrating histopathology and immunohistochemistry. Early diagnosis is critical, as R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy can improve outcomes. Clinicians should consider lymphoma in persistent palatal lesions, even without systemic signs. This report emphasizes the role of timely, targeted therapy in otolaryngologic manifestations of systemic malignancies.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251343739"},"PeriodicalIF":0.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136500","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":"Cohort Characteristics of Pediatric Candidates for Cochlear Implantation With Inner Ear Malformations: A Multicenter Retrospective Study.","authors":"Hejie Li, Wenting Yu, Wei Tang, Ting Li, Xuan Yu, Shimin Zong, Hongjun Xiao","doi":"10.1177/01455613251342846","DOIUrl":"https://doi.org/10.1177/01455613251342846","url":null,"abstract":"<p><strong>Objective: </strong>To investigate comorbidities and severity correlations among inner ear malformations (IEMs) classifications and analyze subtype characteristics to optimize preoperative evaluation and cochlear implantation (CI) strategies.</p><p><strong>Methods: </strong>Retrospective multicenter data from Hubei Province were analyzed for 336 children with IEMs who received unilateral CI (2012-2020). IEMs were classified and graded using Sennaroğlu and Adibelli criteria, and data visualization tools were used to assess subtypes, comorbidities, and severity correlations.</p><p><strong>Results: </strong>Among pediatric candidates for CI with IEMs, isolated enlarged vestibular aqueduct, isolated incomplete partition type II, and multiple malformations were the 3 most common subtypes, accounting for 80.7% of cases. Vestibular aqueduct malformation (VAM) primarily occurred as an isolated condition, whereas internal auditory canal malformation (IACM), cochlear nerve malformation (CNM), cochlear malformation (CM), and vestibular and semicircular canal malformation (VSCM) tended to coexist, exhibiting significant co-occurrence patterns. Severity analysis revealed a positive correlation between the severity of IACM and CNM (<i>r</i> = .13, <i>P</i> = .015), as well as between CM and VSCM (<i>r</i> = .17, <i>P</i> < .001). Additionally, VAM severity was significantly negatively correlated with the severity of IACM, CNM, CM, and VSCM (<i>r</i> = -.39, -.21, -.38, and -.30, respectively; <i>P</i> < .001).</p><p><strong>Conclusion: </strong>This study elucidated a detailed analysis of the subtype characteristics and comorbid relationships of IEMs in pediatric candidates for CI. Furthermore, it identified significant correlations between the severity levels of different malformation types. These insights contribute to refining preoperative evaluation protocols and tailoring treatment strategies for CI candidates.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251342846"},"PeriodicalIF":0.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136447","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":"Papillary Thyroid Microcarcinoma Revealed by Contralateral Cystic Metastasis Mimicking a Branchial Cleft Cyst.","authors":"Chiraz Halwani, Anas Ammar, Salma Elbessi, Karima Tlili, Khemaies Akkari, Sonia Esseghaier","doi":"10.1177/01455613251343725","DOIUrl":"https://doi.org/10.1177/01455613251343725","url":null,"abstract":"<p><strong>Introduction: </strong>Papillary thyroid microcarcinomas (PTMC) can exhibit invasive behavior with lymph node metastasis despite their small size. In some cases, they may present as cystic lymph node metastases, clinically and radiologically mimicking benign lesions such as branchial cleft cysts. These misleading presentations may delay the diagnosis of an underlying thyroid malignancy. We report a rare and atypical presentation of PTMC as a large contralateral cystic lymph node metastasis initially diagnosed as a branchial cleft cyst, highlighting the need to consider metastatic thyroid carcinoma in the differential diagnosis of lateral neck cysts.</p><p><strong>Observation: </strong>A 51-year-old woman presented with a left lateral cervical mass diagnosed as a second branchial cleft cyst. Surgical excision and histology revealed a metastatic lymph node from papillary thyroid carcinoma. Subsequent workup identified a 4 mm PTMC in the right thyroid lobe. The patient underwent total thyroidectomy, lymph node dissection, and radioactive iodine therapy.</p><p><strong>Conclusion: </strong>PTMC may behave aggressively and present with misleading cystic nodal metastases. Clinicians should include metastatic papillary thyroid carcinoma in the differential diagnosis of isolated cystic neck masses, even in the absence of an identifiable thyroid lesion on initial imaging.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251343725"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129771","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":"Recurrent Anterior Epistaxis in Children With Allergic Rhinitis and Non-Allergic Rhinitis: Clinical Features.","authors":"Linyan Tao, Zhengcai Lou","doi":"10.1177/01455613251342916","DOIUrl":"https://doi.org/10.1177/01455613251342916","url":null,"abstract":"<p><strong>Objective: </strong>This study described the endoscopic characteristics of recurrent anterior epistaxis (RAE) with and without allergic rhinitis (AR), and the outcomes of treatment with mupirocin ointment.</p><p><strong>Material and methods: </strong>Children with RAE were examined using nasal endoscopy, serum specific immunoglobulin E antibodies, and skin-prick test. The children were divided into AR (RAE with AR) and non-AR (RAE without AR) groups. All children received mupirocin ointment topically twice daily for 4 weeks. Recurrent epistaxis and epistaxis severity scores were compared at 2, 4, and 12 weeks of follow-up.</p><p><strong>Results: </strong>A total of 326 patients with 432 nostrils with RAE were included; 76.4% of patients had the bad habit of frequent nose-picking or rubbing. Of the 178 nostrils in the AR group, diffuse telangiectasia was found in 89.3%, scattered telangiectasia in 8.4%, and mucosal ulceration in 2.3%. Of the 254 nostrils in the non-AR group, the endoscopic findings of the anterior septum in the bleeding nostrils included mucosal ulceration in 77.6%, scattered telangiectasia in 17.7%, isolated punctate telangiectasias in 3.1%, and diffuse telangiectasia in 1.6%. In addition, the prevalence of mucosal crusts in the non-AR group was significantly higher than in the AR group (76.8% vs 20.8%), whereas the prevalence of severe hypertrophic inferior turbinates or nasal secretion was significantly higher in the AR group. The prevalence of recurrent epistaxis was significantly higher in the AR group than in the non-AR group at 2 (71.3% vs 57.7%), 4 (65.7% vs 37.8%), and 12 (78.1% vs 43.5%) weeks post-treatment.</p><p><strong>Conclusions: </strong>AR was common in children with RAE, with prominent diffuse telangiectasia evident by endoscopy in most, while most non-AR RAE children had mucosal ulceration or scattered telangiectasia. Compared with outcomes in non-AR RAE children, the efficacy of mupirocin ointment in the treatment of RAE with AR was not satisfactory.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251342916"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129773","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":"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}

{"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}