{"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}
Grace Anne Longfellow, Makayla Matthews, Gabrielle Adams, Ezer H Benaim, Trevor Hackman, Christopher Blake Sullivan
{"title":"Head and Neck Free-Flap Reconstruction in Patients With Pre-Existing Coagulopathies: A Case Series.","authors":"Grace Anne Longfellow, Makayla Matthews, Gabrielle Adams, Ezer H Benaim, Trevor Hackman, Christopher Blake Sullivan","doi":"10.1177/01455613251356340","DOIUrl":"https://doi.org/10.1177/01455613251356340","url":null,"abstract":"<p><p>Patients with inherited coagulopathies-including thrombophilias-undergoing microvascular reconstruction face elevated thrombotic risk, yet optimal perioperative strategies remain undefined. This retrospective case series evaluates perioperative outcomes in patients with confirmed inherited coagulopathies who underwent head and neck free flap reconstruction at a single tertiary academic center between April 2014 and October 2024. Fifteen patients met the inclusion criteria (53.3% female; median age 59 years). The most common coagulopathies were sickle cell trait (40.0%) and Factor V Leiden (26.7%). All patients received preoperative anticoagulation: 60.0% received subcutaneous (SC) unfractionated heparin (UFH), 33.3% enoxaparin, and 6.7% fondaparinux. Intraoperative anticoagulation was used in 20.0% of cases, primarily enoxaparin. Postoperative anticoagulation included SC UFH or low-molecular-weight heparin in 86.7% of patients, with 33.3% also receiving aspirin and 20.0% transitioning to direct oral anticoagulants. Two patients (13.3%) experienced flap loss due to thrombosis; neither received intraoperative anticoagulation. No major bleeding events occurred. Transfusions were required in 40.0% postoperatively and 20.0% intraoperatively. These findings underscore the need for targeted screening, multidisciplinary coordination, and individualized anticoagulation regimens to mitigate thrombotic complications in this high-risk population. Further prospective studies are warranted to develop standardized perioperative protocols and optimize microsurgical outcomes in patients with inherited coagulopathies, including hypercoagulable states.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251356340"},"PeriodicalIF":0.0,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621548","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}
Sydney Somers, Alexandra Vitale, Kaylee B Scott, Aaron Dadzie, Laurel Ormiston, Cori Agarwal
{"title":"Reconstruction of Helical Defects: A Reproducible, Two-Stage Technique.","authors":"Sydney Somers, Alexandra Vitale, Kaylee B Scott, Aaron Dadzie, Laurel Ormiston, Cori Agarwal","doi":"10.1177/01455613251351783","DOIUrl":"https://doi.org/10.1177/01455613251351783","url":null,"abstract":"<p><strong>Introduction: </strong>Large full-thickness helical rim defects following skin cancer resection are a reconstructive challenge. We present a low-morbid, reproducible technique for medium to large helical rim defects and their outcomes.</p><p><strong>Methods: </strong>A retrospective review of patients 18 years or older from 2014 to 2024 who underwent helical rim reconstruction using this technique following skin cancer resection was conducted. The technique begins with reducing the helical defect through wedge excision of the adjacent antihelix. Next, an ipsilateral conchal cartilage graft bridges the remaining defect. A local flap provides soft tissue coverage, and flap division occurs 3 to 4 weeks later.</p><p><strong>Results: </strong>A total of 22 patients, 5 females and 17 males (mean age 53.5) were identified. The average defect size was 3.79 cm by 2.90 cm. Flap coverage was achieved primarily by superiorly based postauricular flaps in 68.2% of cases. Complications included partial flap congestion in 2 patients (9.1%) and infection in 1 patient (4.5%). No flap failures or cartilage graft complications were observed. Three patients (13.6%) underwent in-office flap contour thinning.</p><p><strong>Discussion: </strong>The two-stage postauricular flap combined with wedge excision of the ipsilateral adjacent antihelix offers an effective, reproducible, low-morbid technique for auricular reconstruction.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251351783"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610693","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}
Yan Liu, Xiaohong Peng, Xiaopei Yuan, Min Wang, Congli Geng, Zhimin Xing
{"title":"Clinical Manifestations and Management Challenges in Symptomatic Sinonasal Disorders With Normal CT Scans.","authors":"Yan Liu, Xiaohong Peng, Xiaopei Yuan, Min Wang, Congli Geng, Zhimin Xing","doi":"10.1177/01455613251356347","DOIUrl":"https://doi.org/10.1177/01455613251356347","url":null,"abstract":"<p><strong>Background: </strong>Clinicians frequently encounter patients manifesting with sinonasal symptoms meeting diagnostic criteria for rhinosinusitis, yet demonstrating radiologically-negative sinus computed tomography (CT) findings. These patients typically exhibit poor response to conventional pharmacological therapies. Investigating the pathogenesis of these patients is critically important.</p><p><strong>Methods: </strong>This retrospective cohort study characterizes 53 cases of CT-negative symptomatic sinonasal disorders (CTN-SSD) compared with 132 chronic rhinosinusitis without nasal polyps (CRSsNP) controls, utilizing standardized metrics including the following: symptom visual analog scale, Lund-Kennedy endoscopic scores, 22-item Sino-Nasal Outcome Test (SNOT-22), and Lund-Mackay CT scoring.</p><p><strong>Results: </strong>The CTN-SSD group demonstrated a greater proportion of female relative to the control group (73.58% vs 63.36%, <i>P</i> < .001). Of the patients with CTN-SSD in the study, 69.81% fulfilled the International Classification of Headache Disorders, third edition diagnostic criteria for migraine. The CTN-SSD cohort showed significantly-higher prevalence of posterior rhinorrhea (<i>P</i> = .028) and headache/facial pain (<i>P</i> < .001), whereas CRSsNP patients predominantly exhibited nasal obstruction, anterior rhinorrhea, and olfactory dysfunction (<i>P</i> < .001). While mucoid secretion rates were comparable between 2 groups (<i>P</i> = .153), purulent discharge exclusively occurred in CRSsNP cases (<i>P</i> < .001). In addition, mucosal swelling was significantly-more prevalent in CRSsNP patients than in patients with CTN-SSD (<i>P</i> < .001). There was no significant difference in SNOT-22 scores between the 2 groups. However, the CRSsNP group scored higher in the nasal subdomain, whereas the CTN-SSD group demonstrated elevated scores in the aural/facial and psychological subdomains (<i>P</i> < .001).</p><p><strong>Conclusions: </strong>Patients with symptoms of sinusitis but negative CT finding frequently meet the diagnostic criteria for migraine, and the possibility cannot be excluded that their symptoms are nasal presentations of migraine resembling those of rhinosinusitis, which may result in inappropriate therapies.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251356347"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602631","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}
Stavroula Mouratidou, Efthimia Polatidou, Dimitrios Askitis, Michael Katotomichelakis, Konstantinos Chaidas
{"title":"A Rare Anatomical Variation of the Right Common Carotid Artery Overlying the Trachea: A Case Report.","authors":"Stavroula Mouratidou, Efthimia Polatidou, Dimitrios Askitis, Michael Katotomichelakis, Konstantinos Chaidas","doi":"10.1177/01455613251338918","DOIUrl":"https://doi.org/10.1177/01455613251338918","url":null,"abstract":"","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251338918"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593224","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}
Jordan Kankam, Calah Burros, Joshua E Lewis, Raven J Hollis, Nia Hammett, Austin Biscotti, Jai Sehgal, Bryce Gantt, Ernst Nicarnord
{"title":"Mental Health Outcomes and Psychosocial Impacts of Facial Burns: A Scoping Review.","authors":"Jordan Kankam, Calah Burros, Joshua E Lewis, Raven J Hollis, Nia Hammett, Austin Biscotti, Jai Sehgal, Bryce Gantt, Ernst Nicarnord","doi":"10.1177/01455613251356341","DOIUrl":"https://doi.org/10.1177/01455613251356341","url":null,"abstract":"<p><strong>Introduction: </strong>Burn injuries have been proven to carry long-term psychological and social consequences.</p><p><strong>Objective: </strong>To identify the mental and psychosocial impacts of facial burns on patients' quality-of-life outcomes.</p><p><strong>Methods: </strong>The methods were developed in agreement with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extensions for Scoping Review guidelines. A literature search utilizing the PubMed and Scopus databases was performed. Peer-reviewed, English-language studies examining psychological, social, or quality-of-life outcomes associated with facial burns were included.</p><p><strong>Results: </strong>Anxiety and depression were significantly worse in facial burn patients [Hospital Anxiety and Depression Scale (HADS) score: 2.5 ± 2.8, <i>P</i> < .002, HADS Score: 2.1 ± 2.7, <i>P</i> < .001, respectively]. Body image dissatisfaction was significantly higher in adolescent facial burn patients compared to those without facial burns, 1 year after the injury (<i>P</i> < .001). After undergoing augmented reality coupled rehabilitation, quality of life scores were improved compared to baseline (<i>P</i> < .001).</p><p><strong>Conclusion: </strong>This scoping review highlights the negative impacts of facial burns on mental health and psychosocial outcomes. Additional research is needed to further substantiate interventions, such as cognitive behavioral strategies and virtual reality-based rehabilitation, in the long-term management of individuals with facial burns.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251356341"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593225","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}