Elias Edward Lahham, Marwan Qubaja, Rahmeh Deek, Mohammad Abuzir, Mahmoud Ramahi, Ibrahem Eid
{"title":"Primary Synovial Sarcoma of the Ethmoid Sinus in a Young Female: A Rare Case Associated With Tuberous Sclerosis Complex.","authors":"Elias Edward Lahham, Marwan Qubaja, Rahmeh Deek, Mohammad Abuzir, Mahmoud Ramahi, Ibrahem Eid","doi":"10.1177/01455613251377977","DOIUrl":"https://doi.org/10.1177/01455613251377977","url":null,"abstract":"<p><p>Synovial sarcoma is a rare and aggressive soft tissue malignancy, with head and neck involvement comprising a small fraction of cases. Ethmoid sinus localization is exceptionally rare, with only a few cases documented in the literature. We present the case of a 34-year-old female who developed progressive right-sided nasal obstruction and epistaxis, with imaging revealing a locally invasive ethmoidal mass. Histopathological and immunohistochemical analysis confirmed a diagnosis of poorly differentiated synovial sarcoma. Incidentally, renal and intracranial findings suggested a possible underlying tuberous sclerosis complex. The patient was managed with a multimodal approach, including neoadjuvant chemotherapy (ifosfamide and doxorubicin), radiotherapy, and endoscopic surgical resection. Postoperative imaging demonstrated complete tumor clearance, and histology confirmed no residual malignancy. This case highlights the diagnostic and therapeutic challenges posed by ethmoidal synovial sarcoma and underscores the importance of individualized, multidisciplinary care, while also presenting an association with tuberous sclerosis that warrants further exploration.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251377977"},"PeriodicalIF":0.7,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188078","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 Case of Bilateral Temporal Bone Fractures Treated With Cochlear Implantation and Customized Vestibular Rehabilitation.","authors":"Jeon Mi Lee, Hyun Jin Lee","doi":"10.1177/01455613251380072","DOIUrl":"https://doi.org/10.1177/01455613251380072","url":null,"abstract":"<p><p>Bilateral temporal bone fractures (TBFs) involving the otic capsule are uncommon, but can result in simultaneous severe auditory and vestibular dysfunction. We present the case of a 59 year-old male patient who experienced bilateral hearing loss and vertigo following a backward fall from a height of 2 m. Temporal bone computed tomography scans revealed bilateral fractures involving the otic capsule with hemorrhage in both mastoid cavities. Audiologic evaluation confirmed bilateral profound sensorineural hearing loss, and vestibular testing indicated bilateral vestibular hypofunction. The patient underwent unilateral cochlear implantation (CI) on the left side, resulting in improved aided hearing thresholds (~45 dB HL) and enhanced verbal communication. He also participated in customized vestibular rehabilitation, comprising 4 sessions over 8 weeks. Clinical improvement was observed in balance confidence, visual acuity during head movement, and postural control tests. The Dizziness Handicap Inventory score decreased from 16 to 0, while the Activities-Specific Balance Confidence Score increased from 59% to 78%. This case emphasizes the importance of integrated auditory and vestibular rehabilitation in patients with bilateral TBFs, demonstrating that CI combined with vestibular therapy can facilitate significant functional recovery.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251380072"},"PeriodicalIF":0.7,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182436","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}
Josette Graves, Heather Yeakel, Robert T Sataloff, Aaron J Jaworek
{"title":"Bamboo Nodules With Underlying Rheumatologic Disease.","authors":"Josette Graves, Heather Yeakel, Robert T Sataloff, Aaron J Jaworek","doi":"10.1177/01455613251378725","DOIUrl":"https://doi.org/10.1177/01455613251378725","url":null,"abstract":"<p><strong>Introduction: </strong>Bamboo nodules are rare and have been shown to present in patients with rheumatologic disease.</p><p><strong>Methods: </strong>Three cases of bamboo nodules were investigated retrospectively in patients with previously-established rheumatologic processes. Patient data were analyzed.</p><p><strong>Results: </strong>All cases involved women presenting with dysphonia. One patient had elevated erythrocyte sedimentation rate and the presence of perinuclear anti-neutrophil cytoplasmic antibody, another had systemic lupus erythematosus and rheumatoid arthritis (RA), and the third had RA and Sjögren's syndrome.</p><p><strong>Conclusion: </strong>This case series supports an association of bamboo nodules with rheumatologic disease, and voice quality may be improved using voice therapy as a first-line treatment. Intra-lesional corticosteroid injection, as well as addressing aggravating factors such as reflux also benefit voice quality. Areas for further research include the impact of diet eliminations, such as gluten and dairy, and of immunosuppressive therapies on voice function in patients with bamboo nodules.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251378725"},"PeriodicalIF":0.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180833","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}
Yasser Al-Ghabra, Ahmad Alkheder, Mohammad Hamdi, Abdulrahman Shaker, Ahmed Hasoun, Adham Bader Aldeen Mohsen, Abdulmajeed Yousfan
{"title":"A Systematic Review of Submandibular Gland Primary Squamous Cell Carcinoma: Clinical Characteristics, Treatment Paradigms, and Survival Outcomes.","authors":"Yasser Al-Ghabra, Ahmad Alkheder, Mohammad Hamdi, Abdulrahman Shaker, Ahmed Hasoun, Adham Bader Aldeen Mohsen, Abdulmajeed Yousfan","doi":"10.1177/01455613251377556","DOIUrl":"https://doi.org/10.1177/01455613251377556","url":null,"abstract":"<p><strong>Background: </strong>This systematic review aims to synthesize evidence on primary squamous cell carcinoma (PSCC) of the submandibular gland (SMG), an exceptionally rare malignancy (<1% of salivary gland tumors, ~2% of submandibular malignancies). Key objectives include characterizing its epidemiology, diagnostic challenges, treatment paradigms, and prognostic outcomes to enhance clinical management.</p><p><strong>Methods: </strong>Literature search (PubMed, Web of Science, Scopus, Google Scholar) from inception through December 2024 identified English-language studies using MeSH terms (\"Carcinoma, Squamous Cell\" AND \"Submandibular Gland\"). After deduplication, 18 full texts were screened; 8 studies (case reports/series, 1992-2023) met the inclusion criteria. Two reviewers independently extracted data on epidemiology, clinical features, management, and outcomes.</p><p><strong>Results: </strong>PSCC of the SMG demonstrates a strong male predominance (M:F = 3:1) and a mean age of 57.1 years, with prior cervical radiotherapy representing a key risk factor. Clinically, all patients present with submandibular swelling, though only 25% report pain; symptom duration averages 3.9 months, frequently leading to advanced-stage diagnosis. Definitive diagnosis requires rigorous exclusion of metastatic squamous cell carcinoma and histological mimics, necessitating ultrasound-guided fine-needle aspiration cytology and cross-sectional imaging (CT/MRI). Management universally involves SMG resection, with 50% undergoing neck dissection (supraomohyoid or modified radical). Adjuvant therapy was administered to 75% of patients (radiotherapy: 50%; concurrent chemoradiotherapy [CCRT]: 25%). Outcomes reveal a 62.5% survival rate and 37.5% mortality, with 37.5% developing lung metastases. Limited follow-up data highlights both durable remission (no evidence of disease at 2 years) and aggressive progression, including 1 case of early contralateral recurrence 1 month post-CCRT.</p><p><strong>Conclusion: </strong>PSCC of the SMG is an aggressive malignancy requiring multimodal management. Surgical resection with adjuvant radiotherapy/chemotherapy is common, yet high recurrence rates and metastatic risk persist. Diagnostic rigor remains critical to exclude mimics and metastases. Future studies should establish standardized protocols integrating molecular targeting (eg, EGFR/Wnt pathways).</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251377556"},"PeriodicalIF":0.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138933","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":"Correlation of VAS and NOSE Score With CT Cross-Sectional Areas Perpendicular to the Direction of the Airflow in Patients Eligible for Functional Nasal Surgery.","authors":"Aris I Giotakis, Ioannis Koulentis","doi":"10.1177/01455613251380060","DOIUrl":"https://doi.org/10.1177/01455613251380060","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the correlation of nasal obstruction symptom score (NOSE) and visual analogue scale (VAS) score with standardized computed tomography cross-sectional areas (CT-CSA).</p><p><strong>Methods: </strong>In this cross-sectional study, candidates for functional septo(-rhino)plasty due to chronic nasal obstruction, with a preoperative CT scan were eligible. Subjects filled out a NOSE (0-100) score and a VAS (0-4) score. Nine CT-CSA were segmented. We measured the absolute difference of the right from the left nose as a measure of asymmetry. We examined the correlation of NOSE and VAS score with the mean value of asymmetry of these CT-CSA and with the largest asymmetry among these CT-CSA.</p><p><strong>Results: </strong>In 40 subjects, the median value (minimum-maximum) of NOSE and VAS score was 75.0 (20-95) and 3.0 (1-4), respectively. NOSE score correlated significantly with VAS score (<i>r</i> = 0.74; <i>P</i> < .001). The median value of the mean asymmetry and largest asymmetry was 0.37 (0.18-1.11) and 0.83 (0.33-1.94) cm<sup>2</sup>, respectively. NOSE score correlated neither with the mean asymmetry (<i>r</i> = 0.28; <i>P</i> = .085) nor with the largest asymmetry (<i>r</i> = 0.22; <i>P</i> = .18). VAS score correlated significantly, still poorly, with the mean asymmetry (<i>r</i> = 0.51; <i>P</i> < .001) and lesser with the largest asymmetry (<i>r</i> = 0.39; <i>P</i> = .012).</p><p><strong>Conclusion: </strong>Despite the limited sample size, VAS score correlated significantly, but poorly, with CT-CSA in candidates for functional nasal surgery. On the contrary, NOSE score did not correlate with CT-CSA preoperatively.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251380060"},"PeriodicalIF":0.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139373","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}
Nina Wijnants, Josine C C Widdershoven, Stan C J van Boxel, Sander M J van Kuijk, Jan W Brunings, Darren I Booi, René R W J van der Hulst, Rutger M Schols
{"title":"Impact of Tympanostomy Tube Placement on Hearing Outcomes in Children With Cleft Palate-Related Otitis Media: Retrospective Analysis of a Primary Single-Stage Cleft Palate Repair Cohort.","authors":"Nina Wijnants, Josine C C Widdershoven, Stan C J van Boxel, Sander M J van Kuijk, Jan W Brunings, Darren I Booi, René R W J van der Hulst, Rutger M Schols","doi":"10.1177/01455613251376792","DOIUrl":"https://doi.org/10.1177/01455613251376792","url":null,"abstract":"<p><strong>Background: </strong>Children with cleft palate commonly experience otitis media with effusion (OME), leading to conductive hearing loss. The effectiveness of tympanostomy tube placement in improving hearing outcomes in this population remains limited.</p><p><strong>Methods: </strong>A retrospective cohort study included 44 non-syndromic children undergoing primary single-stage cleft palate repair at Maastricht University Medical Centre. Tympanostomy tubes were placed during primary surgery. The primary outcome was the change in hearing thresholds post-intervention. Secondary outcomes included OME prevalence, hearing loss type, frequency of tube placements, and tympanic membrane abnormalities.</p><p><strong>Results: </strong>OME was present in 88.6% of patients. Conductive hearing loss was found in 31.8% and sensorineural loss in 4.5%. A significant mean improvement of 14.13 dB (<i>P</i> < .001) was observed post-intervention. No significant difference was found between ears (<i>P</i> = .916). Random intercept variance at the child level was 49.07 (standard deviation = 7.00), indicating substantial interindividual variability. Tympanic membrane abnormalities were observed in patients with repeated tube placements, but did not cause long-term hearing deterioration.</p><p><strong>Conclusion: </strong>Tympanostomy tube placement improves hearing outcomes in children with cleft palate. When OME is present at the time of cleft surgery or there is a documented history of recurrent OME or acute otitis media, concurrent tube placement should be considered to alleviate conductive hearing loss. Prospective studies are warranted to confirm these findings and optimize care.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251376792"},"PeriodicalIF":0.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139343","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}
Ahmad Alkheder, Lin Ahmad Ibrahim, Khaled Ziadah, Aliaa Issa, Mona Abbas, Ghassan Hamzeh
{"title":"Reversible Profound Sensorineural Hearing Loss Complicating Cryptococcal Meningitis in an Immunocompetent Adult: Diagnostic and Therapeutic Insights.","authors":"Ahmad Alkheder, Lin Ahmad Ibrahim, Khaled Ziadah, Aliaa Issa, Mona Abbas, Ghassan Hamzeh","doi":"10.1177/01455613251380077","DOIUrl":"https://doi.org/10.1177/01455613251380077","url":null,"abstract":"<p><p>This report describes an atypical presentation of cryptococcal meningitis (CM) in a 51 year-old HIV-negative male with diabetes, hypertension, and psoriasis. The patient presented with a 10 day history of subacute headache, vomiting, and fever, followed by the abrupt onset of profound bilateral sensorineural hearing loss (SNHL), ataxia, diplopia, anosmia, ageusia, drowsiness, meningismus, absent gag reflex, and bilateral abducens palsy. Brain MRI revealed inflammatory changes involving the sellar diaphragm, thalamus, and pituitary stalk. Cerebrospinal fluid analysis confirmed CM (pleocytosis, elevated protein, hypoglycorrhachia, opening pressure >60 cmH<sub>2</sub>O, positive cryptococcal antigen), with negative HIV and malignancy screens. Audiometry confirmed profound bilateral SNHL. Treatment included intravenous liposomal amphotericin B followed by high-dose oral fluconazole, augmented by serial therapeutic lumbar punctures for intracranial pressure (ICP) control. Partial hearing recovery was observed at 1 month follow-up. This case highlights that sudden bilateral SNHL-rarely the dominant initial manifestation-can herald CM even in hosts without overt immunosuppression, posing significant diagnostic challenges. The constellation of profound SNHL, multiple cranial neuropathies (including VIII), cerebellar signs, and markedly-elevated ICP strongly implicates retrocochlear pathology, likely resulting from meningeal inflammation, direct vestibulocochlear nerve invasion, and/or neural compression. Critically, timely-antifungal therapy combined with aggressive ICP reduction facilitated neurological recovery, demonstrating potential reversibility and avoiding premature cochlear implantation. Clinicians should consider CM in patients presenting with acute bilateral audiovestibular dysfunction accompanied by cranial neuropathies or elevated ICP, particularly with subacute prodromal symptoms. This case underscores the essential role of concurrent ICP-directed management alongside antifungals to optimize neurological outcomes, including hearing recovery.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251380077"},"PeriodicalIF":0.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133105","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 Relationship Between Tumor Size and Electrocardiographic Findings in Carotid Body Paragangliomas: A Retrospective Observational Study.","authors":"Ahmet Baki, Berkay Güzel, Oğuzhan Cumalı, Şahin Öğreden, İskender Bayram, Özgür Yiğit, Emrah Bozbeyoğlu, Ece Eskici","doi":"10.1177/01455613251377560","DOIUrl":"https://doi.org/10.1177/01455613251377560","url":null,"abstract":"<p><strong>Objective: </strong>Carotid body tumors (CBTs) are rare neurogenic tumors that may indirectly affect cardiac autonomic regulation. This study aims to investigate the relationship between tumor size and electrocardiographic (ECG) findings, particularly the corrected QT (QTc) interval.</p><p><strong>Methods: </strong>This retrospective study included 21 patients with histologically or radiologically confirmed CBTs treated at a tertiary center between 2021 and 2025. Patients with comorbidities or medications affecting cardiac conduction were excluded. Tumor sizes were measured via contrast-enhanced computed tomography or magnetic resonance imaging. Preoperative ECGs were analyzed for heart rate, P wave, PR, QRS, T wave, and QTc intervals. The correlation between tumor size and ECG parameters was assessed using Spearman's rank correlation.</p><p><strong>Results: </strong>A statistically significant and strong positive correlation was observed between tumor size and QTc interval (<i>r</i> = 0.940, <i>P</i> < .001). No other ECG parameter showed a significant association with tumor size. Tumor size explained 88.36% of the variance in QTc duration (<i>r</i><sup>2</sup> = 0.8836).</p><p><strong>Conclusion: </strong>This study demonstrates a strong correlation between CBT size and QTc prolongation, suggesting vagal overactivity as a possible mechanism. QTc may serve as a noninvasive marker of subclinical autonomic dysregulation in CBT patients. Larger prospective studies are warranted to validate this association and explore its clinical significance.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251377560"},"PeriodicalIF":0.7,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093262","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}