Ear, nose, & throat journal最新文献

{"title":"Extensive Subcutaneous Emphysema Post-Turbinate Surgery: Case Report on Mechanisms and Management.","authors":"Ahmad Alkheder, Nasser Alia, Adel Azar, Mariana Naief Sharaf Aldeen, Reem Abdullah, Ali Al-Youssef","doi":"10.1177/01455613251352292","DOIUrl":"https://doi.org/10.1177/01455613251352292","url":null,"abstract":"<p><p>Subcutaneous emphysema following nasal surgery is a rare yet potentially severe complication. This case report describes a 40-year-old woman who developed extensive subcutaneous emphysema involving the face, neck, mediastinum, and thorax after uneventful turbinate cauterization and nostril reduction. The patient, with a history of prior septoplasty and rhinoplasty, presented with nasal obstruction and underwent the procedure under general anesthesia. Postoperatively, she developed progressive neck swelling, which rapidly extended to cervicofacial, mediastinal, and thoracic regions. Imaging via noncontrast computed tomography (CT) confirmed widespread air infiltration, while fiberoptic laryngoscopy and bronchoscopy ruled out aerodigestive injuries. Multidisciplinary management included mediastinal drainage, leading to dramatic symptom resolution. The mechanism likely involved inadvertent mucosal perforation during thermal ablation, creating a one-way valve effect that permitted air ingress during Valsalva maneuvers. This case underscores the anatomical continuity between cervical and mediastinal fascial planes, enabling rapid air dissemination. Key lessons include the importance of early imaging for atypical postoperative swelling, judicious use of thermal energy during turbinate procedures to minimize mucosal injury, and patient counseling to avoid forceful maneuvers post-surgery. Despite an uncomplicated intraoperative course, occult tissue defects can precipitate life-threatening complications, necessitating prompt intervention. Surgeons should maintain a high index of suspicion for subcutaneous emphysema in nasal surgeries, particularly when employing thermal techniques, and prioritize multidisciplinary collaboration to optimize outcomes. This report highlights the critical balance between procedural efficacy and safety in preventing rare but consequential complications.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251352292"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478307","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":"Nasopharyngeal Microcystic Clear Cell Adenoma in a Child: A Rare Case Report.","authors":"Ruba Mshref, Ahmad Alkheder, Mariana Naief Sharaf Aldeen, Alma Mshref, Reham Eid, Raouf Salem Seif Eddin","doi":"10.1177/01455613251352716","DOIUrl":"https://doi.org/10.1177/01455613251352716","url":null,"abstract":"<p><p>Adenoidectomy, routinely performed for pediatric obstructive symptoms, typically reveals benign lymphoid hyperplasia. We report the first documented case of a primary clear cell microcystic adenoma within adenoid tissue in a 12-year-old male undergoing adenotonsillectomy for chronic snoring, recurrent tonsillitis, and mouth breathing. Intraoperative examination identified an unusual homogenous grayish-white adenoid mass. Histopathological analysis demonstrated benign epithelial hyperplasia with focal clusters of clear cells arranged in microcystic patterns, morphologically aligning with a low-grade microcystic adenoma-a lesion classically linked to von Hippel-Lindau (VHL) syndrome. This case emphasizes the critical role of histopathological scrutiny in routine surgical specimens, as incidental findings may reveal rare neoplasms with significant syndromic implications. While the lesion exhibited benign features, its histological resemblance to VHL-driven neoplasms necessitates vigilant long-term surveillance. This report advocates for multidisciplinary collaboration in managing such cases and highlights the importance of genetic assessment to guide familial screening. Further documentation of similar cases is required to establish this entity's clinical and molecular profile, refining diagnostic approaches for nasopharyngeal clear cell lesions.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251352716"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478308","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":"Surgical Outcomes of Malleus Head Interposition Ossiculoplasty During Canal Wall Down Tympano-Mastoidectomy in Cholesteatoma Patients.","authors":"Tarek Abdelrahman Abdelhafez, Ahmed Ragab, Ayman Ali Abdelfattah, Ahmed Sami Tahoun, Anwar Abdelaty Ibrahim","doi":"10.1177/01455613251348327","DOIUrl":"10.1177/01455613251348327","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the hearing outcomes and complications of primary malleus head interposition ossiculoplasty during canal wall down (CWD) tympano-mastoidectomy surgery in patients with cholesteatoma.</p><p><strong>Background: </strong>Most ossiculoplasty techniques depend on interposition or reposition ossiculoplasty. Therefore, in cases where the Incus is eroded, the malleus becomes the only remaining ossicle and can be used for interposition ossiculoplasty.</p><p><strong>Patients and methods: </strong>This prospective study included 27 patients with cholesteatoma. All patients received primary malleus head interposition ossiculoplasty during CWD tympano-mastoidectomy. Follow-up of patients carried out in an outpatient clinic through routine follow-up visits at 1, 3, and 6 months using a pure tone audiometer.</p><p><strong>Results: </strong>Postoperative air bone gab (ABG) closure had values of 11.03, 9.63, 8.96, and 10.7 dB at 500, 1000, 2000, and 4000 Hz, respectively. The mean postoperative ABG decreased from 33.81 ± 5.69 to 24.85 ± 3.08 dB with an improvement of 9 dB that was statistically significant (<i>P</i> < .001).</p><p><strong>Conclusions: </strong>The malleus head interposition technique is simple and effective for ossiculoplasty in CWD tympano-mastoidectomy. This technique was considered effective in enhancing the stability of the graft and the efficacy of the overall ossiculoplasty procedure. It is characterized by availability, low cost, and low complication rate.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251348327"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334725","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":"Early-Onset Hearing Loss in Leber's Hereditary Optic Neuropathy: A Case Report.","authors":"Maria Al Bandari, Enas Nasr, Sharon L Cushing, Michal Inbar-Fiegenberg","doi":"10.1177/01455613251347923","DOIUrl":"10.1177/01455613251347923","url":null,"abstract":"<p><p>Leber hereditary optic neuropathy (LHON) is one of the most common mitochondrial disorders that is characterized in young adults and teenagers as bilateral, painless, subacute visual failure. Extraocular manifestations include neurological and cardiac features. Sensorineural hearing loss (SNHL) has not been reported as a clinical feature of this disorder. We report a patient diagnosed with LHON having the common m.11778G>A; p. Arg340 pathogenic variant who was also diagnosed with bilateral mild-to-moderate high-frequency SNHL as a neonate through our provincial newborn screening program. Genetic workup, including a next-generation sequencing \"Comprehensive Hereditary Hearing Loss Panel\" for common and non-syndromic hearing loss and sequencing of the mitochondrial genome, was negative for a second pathogenic variant. The infectious workup was negative. Non-enhanced magnetic resonance imaging of the brain and internal auditory canal was normal. To our knowledge, SNHL has not been reported before as a clinical feature of patients diagnosed with LHON, and hence this rare and unusual presentation merits reporting.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251347923"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334724","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 Embryonal Rhabdomyosarcoma With Parotid Gland and Cervical Infiltration in a Pediatric Patient With Congenital Ichthyosis Vulgaris: A Case Report.","authors":"Mohammad Hamdi, Yasser ALGhabra, Kinana Jamal Hammoud, Mohammad Tanani, Yahia Hamdi, Arige Alassaf","doi":"10.1177/01455613251350818","DOIUrl":"10.1177/01455613251350818","url":null,"abstract":"<p><p>Rhabdomyosarcoma (RMS), a rare pediatric soft tissue sarcoma, seldom involves the external ear. Congenital ichthyosis vulgaris (IV), a genetic disorder causing hyperkeratosis, has not been previously linked to RMS. We report the first case of embryonal RMS with unique extension in a patient with IV. A 13 year-old male with ichthyosis presented with a 1 year history of a progressive lesion in the right intertragic notch, unresponsive to antibiotics and topical therapies. Imaging revealed a mass infiltrating the parotid gland, external auditory canal, and sternocleidomastoid muscle. Wide surgical excision with facial nerve preservation was performed. Histopathology confirmed embryonal RMS. Postoperative chemoradiotherapy was initiated, and metastatic workup showed no dissemination. This case highlights diagnostic challenges in rare RMS locations, particularly when masked by dermatoses like ichthyosis. The association between ichthyosis and RMS remains speculative; potential mechanisms include ichthyosis. Clinicians should maintain a high index of suspicion for malignancy in persistent cutaneous lesions.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251350818"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334722","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":"Post-COVID-19 Vocal Process Granuloma With Dysphonia and Dysphagia.","authors":"Sabrina L Maoz, Sepehr Hamidi, Ashley E Kita","doi":"10.1177/01455613251350801","DOIUrl":"https://doi.org/10.1177/01455613251350801","url":null,"abstract":"<p><p>Dysphagia and dysphonia are commonly-presenting symptoms to ENT clinic. This case report highlights a case of prior COVID-19 infection and subsequent development of a vocal process granuloma associated with persistent dysphagia and dysphonia symptoms. The approach to management is discussed, highlighting the importance of surgical excision to rule out malignancy, the typical histological findings, and the resulting sustained improvement in symptom burden on the patient.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251350801"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328103","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":"Cytokine Sampling in the Nasal Cavity and Paranasal Sinuses.","authors":"Yasine Mirmozaffari, Michael Ly, Ezer H Benaim, Luke O Barron, Meghan E Rebuli","doi":"10.1177/01455613251346570","DOIUrl":"10.1177/01455613251346570","url":null,"abstract":"<p><strong>Background: </strong>Cytokines are crucial mediators in cell-to-cell communication, immune regulation, and the pathophysiology of rhinologic diseases. Distinguishing cytokine profiles can elucidate inflammation types [eg, T-helper type 1 (Th1), Th2, and Th17] and guide therapeutic options. Various methods for cytokine sampling in the sinonasal cavity exist. This review aimed to provide an in-depth review of these methods, including their advantages, limitations, and analytical techniques.</p><p><strong>Methods: </strong>A narrative literature review was conducted using Medical Subject Headings (MeSH) keywords in PubMed and Google Scholar. Key MeSH terms include \"cytokines,\" \"mucus,\" \"interleukins,\" \"biomarkers,\" \"sinonasal disease,\" \"chemokines,\" \"paranasal sinuses,\" and \"sampling.\"</p><p><strong>Results: </strong>There are many different methods of cytokine sampling in the sinonasal cavity. Common methods include nasal lavage, forced exhalation, collection of nasal epithelial lining fluid, nasopharyngeal swab, cytobrush, sponge, suction, and tissue biopsy. Each method used has advantages and limitations, such as type of sample collected, location specificity, invasiveness, sample dilution and volume variability, and utility for downstream analytical assays.</p><p><strong>Conclusions: </strong>Advancements in cytokine sampling and pharmacological targeting in sinonasal disease are instrumental for the diagnosis and management of patients with sinonasal disease. Understanding these methods' strengths and weaknesses can improve patient care and guide treatment development.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251346570"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334723","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":"Voice Feminization in Male-to-Female Transgender Patients: A Perspective on Modified Wendler Glottoplasty.","authors":"Raja Fakhoury, Asimakis D Asimakopoulos, Vyas M N Prasad, Mariam Mella, Zeina Yazbeck, Marc Remacle","doi":"10.1177/01455613251350486","DOIUrl":"https://doi.org/10.1177/01455613251350486","url":null,"abstract":"","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251350486"},"PeriodicalIF":0.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319011","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":"Facial Nerve Paralysis in Keratosis Obturans: A Systematic Review of Clinical Patterns, Management Outcomes, and Prognostic Insights.","authors":"Yasser Al-Ghabra, Ahmad Alkheder, Mohammad Hamdi, Adel Azar, Adham Bader Aldeen Mohsen, Abdulmajeed Yousfan","doi":"10.1177/01455613251349608","DOIUrl":"https://doi.org/10.1177/01455613251349608","url":null,"abstract":"<p><strong>Objectives: </strong>This review consolidates all reported cases of facial nerve paralysis (FNP) complicating keratosis obturans (KO), a rare disorder characterized by keratin accumulation in the external auditory canal. The study aims to analyze clinical patterns, diagnostic findings, management outcomes, and prognostic factors to enhance understanding and guide evidence-based management of this underrecognized complication.</p><p><strong>Methods: </strong>A comprehensive literature search of PubMed, Web of Science, Scopus, and Google Scholar (inception-December 2024) identified English-language case reports and observational studies linking KO to FNP. Two reviewers independently screened titles/abstracts, performed full-text assessments, and extracted data on demographics, clinical features, imaging, interventions, and outcomes.</p><p><strong>Results: </strong>Seven cases (mean age: 32.4 years; 57.1% female) were analyzed. All exhibited left-sided FNP, with House-Brackmann grades III to VI at presentation. Hearing loss (71.4%) and keratin debris on otoscopy (71.4%) were common. High-resolution computed tomography (HRCT) revealed bony erosion (28.6%-57.1%) and soft-tissue involvement (57.1%). Surgical intervention (85.7%), primarily debridement or mastoidectomy, resulted in complete/partial FNP recovery in 85.7% of cases, while conservative management (14.3%) also showed improvement. Limitations of this review included the small number of cases, heterogeneity in management approaches, and lack of standardized outcome measures.</p><p><strong>Conclusion: </strong>KO-related FNP, though rare, carries significant morbidity. Timely surgical decompression or conservative care may reverse neural injury, emphasizing early diagnosis via clinical-radiological correlation. The predominance of left-sided involvement and favorable outcomes postintervention warrant further investigation. Prospective studies are needed to establish standardized protocols and validate these findings in larger cohorts.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251349608"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311077","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":"Long-Term Outcomes of Medical Treatment of Adenotonsillar Hypertrophy in Children With Obstructive Sleep Disordered Breathing.","authors":"Andrew C Li, Glenn Isaacson","doi":"10.1177/01455613251350660","DOIUrl":"https://doi.org/10.1177/01455613251350660","url":null,"abstract":"<p><strong>Objective: </strong>Adenotonsillectomy is widely recognized as first-line treatment for obstructive sleep disordered breathing (oSDB), especially for older children with severe disease. The best course of treatment for children with milder oSDB is less clear. It has been our practice to offer surgical candidates with mild symptoms (snoring with occasional short, infrequent pauses by parental report) the option of medical treatment with an antibiotic and oral steroid. We examine the immediate and long term-effects of this intervention.</p><p><strong>Methods: </strong>We reviewed the records of children presenting to our academic Pediatric Otolaryngology practice in the years 2000 to 2023. Tonsil size before and after treatment, resolution of snoring, and ultimate need for surgery were recorded. Follow-up phone calls were made to patient families when information was incomplete.</p><p><strong>Results: </strong>One hundred sixty-nine patients underwent medical treatment for mild oSDB. Among children with acute (≤2 months) symptoms, 38% (20/53) had resolution of snoring and 42% (18/43) did not require surgery. Mean tonsil size (Brodsky grade) decreased from 2.58 to 2.20 after medical treatment in this group. Among children with chronic symptoms, 34% (26/77) had resolution of snoring and 30.0% (18/60) did not require surgery. Their mean tonsil size decreased from 2.58 to 2.13.</p><p><strong>Conclusions: </strong>These results suggest that treatment of mild oSDB treatment with short-course amoxicillin-clavulanate and 5 days of prednisolone is safe and can result in resolution of snoring in many children. More than one third of children treated this way avoided surgery with follow-up averaging 5 years. These observations argue for a prospective, randomized trial of this medical treatment as an alternative to immediate surgery.</p><p><strong>Level of evidence: </strong>3 - retrospective review.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251350660"},"PeriodicalIF":0.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295526","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}