Ear, nose, & throat journal最新文献

{"title":"Expression of Alpha-Smooth Muscle Actin in Nasal Polyp Tissue of Chronic Rhinosinusitis Patients With and Without Aspirin Hypersensitivity.","authors":"Milica Labus, Milena Jović, Stevan Matić, Biserka Vukomanović Đurđević, Aleksandar Perić","doi":"10.1177/01455613251335470","DOIUrl":"https://doi.org/10.1177/01455613251335470","url":null,"abstract":"<p><strong>Background: </strong>Previous research has shown that myofibroblasts in the nasal/sinus mucosa are not only structural cells but also a rich source of inflammatory mediators. Thus, they influence the immune response and play an essential role in the pathogenesis of chronic rhinosinusitis with nasal polyposis. Previous research did not provide a clear answer to the question of whether the number of myofibroblasts in nasal polyps (NPs) affects the extent of sinus disease. This cross-sectional study investigates the relationship between the number of active myofibroblasts, eosinophil count, and clinical parameters in patients with NPs with and without aspirin sensitivity.</p><p><strong>Methods: </strong>Patients diagnosed with NPs, with and without aspirin sensitivity, and healthy subjects were assessed according to the severity of their symptoms as well as endoscopic and radiological findings. The quantification of myofibroblasts present in the surgically excised polyp tissue/healthy nasal mucosa was conducted based on the expression of alpha-smooth muscle actin (α-SMA) in the subepithelial and perivascular compartments. Eosinophils were counted in the subepithelium of the tissue samples from all subjects.</p><p><strong>Results: </strong>Forty-nine subjects were included: 23 NP patients without, 14 NP patients with aspirin sensitivity, and 12 control participants. The highest levels of α-SMA expression and eosinophil count were observed in NP patients with aspirin sensitivity and the lowest in healthy subjects (<i>P</i> < .001; <i>P</i> < .001, respectively). A strong correlation was noted between α-SMA expression and clinical parameters, particularly with disease extent evaluated radiologically and endoscopically.</p><p><strong>Conclusion: </strong>Our results suggest a positive correlation between the quantity of myofibroblasts and the severity of chronic inflammation in the sinonasal region. The number of myofibroblasts in the NP tissue may serve as a reliable marker for assessing the clinical status of the disease.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251335470"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058923","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":"Primary Ewing Sarcoma of the Ethmoid Sinus With Intracranial Involvement: A Rare Case and Literature Review.","authors":"Ameni Amri, Rim Braham, Salma Kamoun, Omar Feki, Alia Methnani, Mohamed Dhaha, Souheil Jbali, Sawssen Dhambri, Skander Kedous","doi":"10.1177/01455613251333184","DOIUrl":"https://doi.org/10.1177/01455613251333184","url":null,"abstract":"<p><p>Ewing sarcoma (ES) is a rare and highly-aggressive tumor. This malignancy derives from primitive neuroectodermal cells. The most frequently-affected population is adolescents and young adults, and the tumor typically grows in the bones. ES of the sinonasal tract is an exceedingly-rare situation. Particularly, primary occurrence in the ethmoid sinus is extremely scarce, with only 27 cases documented worldwide. Extension to the anterior cranial fossa is even thinner on the ground with limited cases in literature. We report the case of a 20-year-old female with history of Hodgkin disease presenting with facial pain, anosmia, and visual impairment on the right side. Imaging revealed a large invasive tumor originating from the right ethmoid sinus, with extension into the orbit and anterior cranial fossa. On biopsy, the tumor showed focal expression of Epithelial membrane antigen (EMA) and CD99 and EWSR1 rearrangement. The diagnosis of ES was confirmed. The patient underwent neoadjuvant chemotherapy with etoposide. Given the stability of the tumor, the patient was deemed inoperable. The decision was to proceed with chemoradiotherapy. Unfortunately, the patient passed away during treatment due to intracranial hypertension with seizures 12 months after diagnosis. This case underscores the rarity of sinonasal ES, particularly with primary involvement in the ethmoid sinus with anterior cranial fossa invasion. We conducted an exhaustive review of literature on similar cases to highlight the importance of a multidisciplinary approach combining advanced imaging, molecular diagnostics, chemotherapy, surgical intervention, and radiotherapy to optimize patients' survival. Sinonasal ES, especially in the ethmoid sinus with cranial extension, is a rare and challenging situation. Detection at an early stage through meticulous imaging, immunohistochemistry, and molecular biology tools is crucial to initiate a multimodal treatment approach. Through this case report and literature review, we aimed to contribute to the growing literature on rare sinonasal malignancies.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251333184"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994973","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":"Impact of a Multimodal Treatment of Auricular Keloids on the Patient's Health-Related Quality of Life: A Prospective Study.","authors":"Alexander Helmer, Marcio Cantillo, Lena Zaubitzer, Benedikt Kramer, Nicole Rottery, Haneen Sadick, Daniel Haeussler","doi":"10.1177/01455613251333673","DOIUrl":"https://doi.org/10.1177/01455613251333673","url":null,"abstract":"<p><strong>Introduction: </strong>Auricular keloids may be associated with social stigma and impair patients' quality of life (QoL) significantly. Little is known about the effect of different therapeutic concepts on the patient's QoL. This study aims to investigate the QoL in patients with auricular keloids undergoing a specific multimodal therapeutic regimen.</p><p><strong>Materials and methods: </strong>Patients suffering from auricular keloids were treated by a multimodal treatment comprising surgical excision, intralesional triamcinolone acetonide, and subsequent application of customized magnetic pressure splints. A prospective assessment of QoL was conducted using the validated Keloid Intervention Benefit Inventory-21 questionnaire at three time points.</p><p><strong>Results: </strong>In total, 22 auricular keloids were included in our study. All patients completed a comprehensive 1-year follow-up assessment, with an average follow-up duration of 29 months post-surgery. Quantitative analysis of QoL metrics demonstrated significant improvement of QoL at the three times of measurement (<i>P</i> < .0001). Significant results were also found for the subcategories general health, physical health, social interaction, and self-esteem.</p><p><strong>Conclusion: </strong>This study underscores the necessity of assessment of QoL in keloid treatment. Our findings highlight the advantages of multimodal treatment in enhancing patients' QoL throughout the treatment period and managing auricular keloids with low recurrence.</p><p><strong>Trial registration: </strong>The study was registered at the German Clinical Trials Register (Register ID: DRKS00016348, https://drks.de/search/en/trial/DRKS00016348).</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251333673"},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058924","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":"Computational Modeling of Nasal Cavity Aerodynamics: Implications for Surgical Outcomes and Targeted Drug Administration.","authors":"Guiliang Liu, W Jared Martin, Yasine Mirmozaffari, Rui Ni, Zheng Li","doi":"10.1177/01455613251335109","DOIUrl":"https://doi.org/10.1177/01455613251335109","url":null,"abstract":"<p><p>The primary goal of sinonasal surgery is to improve a patient's quality of life, which is generally achieved by enhancing drug delivery (eg, saline rinses, nasal steroids) and nasal airflow. Both drug delivery and nasal airflow are dependent on the anatomic structure of the sinonasal cavity and the relationship between this anatomy and airflow and drug delivery can be studied using computational fluid dynamics (CFD). CFD generally uses computed tomography scans and computational algorithms to predict airflow or drug delivery and can help us understand surgical outcomes and optimize drug delivery for patients. This study employs CFD to simulate nasal airflow dynamics and optimize drug delivery in the nasal cavity to highlight the utility of CFD for studying sinonasal disease. Utilizing COMSOL Multiphysics software, we developed detailed models to analyze changes in airflow characteristics before and after functional endoscopic sinus surgery, focusing on pressure distribution, velocity profiles, streamline patterns, and heat transfer. This research examines the impact of varying levels of nasal airway obstruction on airflow and heat transfer. In addition, we explore the characteristics of nasal drug delivery by simulating diverse spray parameters, including particle size, spray angle, and velocity. Our comprehensive approach allows for the visualization of drug particle trajectories and deposition patterns, providing crucial insights for enhancing surgical outcomes and improving targeted drug administration. By integrating patient-specific nasal cavity models and considering factors such as airway outlet pressure, this study offers valuable data on pressure cross-sections, flow rate variations, and particle behavior within the nasal passages. The findings of this research can be useful for both surgical planning and the development of more effective nasal drug delivery methods, potentially leading to enhanced clinical outcomes in respiratory treatment.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251335109"},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015000","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":"Delayed Tracheal Perforation After Microwave Ablation of Papillary Thyroid Microcarcinoma: A Case Report and Literature Review.","authors":"Xiao Yang, Jingyi Wang, Qing Tang, Rixiang Gong, Tao Wei, Zhihui Li","doi":"10.1177/01455613251333185","DOIUrl":"https://doi.org/10.1177/01455613251333185","url":null,"abstract":"<p><p>Microwave ablation (MWA) is a relatively new, well-tolerated, minimally invasive approach, developed in recent years as an alternative to surgery for low-risk papillary thyroid microcarcinoma (PTMC). We describe an 81-year-old patient with unifocal PTMC who refused active surveillance and underwent percutaneous MWA. Two weeks after the procedure, the patient presented dyspnea and cough, and delayed tracheal perforation was confirmed by computed tomography. Conservative therapy was chosen as the initial treatment, and the tracheal defect was confirmed healing successfully 1 month later. Radiologists should be aware of the possibility of delayed tracheal perforation following MWA even in the absence of unusual intraoperative events.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251333185"},"PeriodicalIF":0.0,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061020","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":"Infected Ranula Misdiagnosed as Wharton's Duct Obstruction and Sialadenitis.","authors":"Gökhan Polat, Enes Yılmaz, Büşra Şahin Toprak","doi":"10.1177/01455613251335462","DOIUrl":"https://doi.org/10.1177/01455613251335462","url":null,"abstract":"","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251335462"},"PeriodicalIF":0.0,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047050","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":"Bilateral External Ear Canal Duplication: A Case Report.","authors":"Landon E Ebbert, David Crockett, Nathan C Page, Joshua L Ebbert, Grace Amoo-Quaye, Nana Andoh Mensah Hanson, Peter Appiah-Thompson","doi":"10.1177/01455613251333233","DOIUrl":"https://doi.org/10.1177/01455613251333233","url":null,"abstract":"<p><p>Herein described is an eight-year-old female patient presenting with bilateral external ear canal duplication and a history of recurrent postauricular abscesses, otorrhea, and moderate left-sided conductive hearing loss. Previous incision and drainage of the postauricular abscesses yielded little long-term success. Medical history was otherwise unremarkable. Physical examination revealed a cystic mass in the right ear and postauricular fibrosis, likely a result of previous surgical interventions. An audiogram revealed asymmetric hearing function, with mild-to-moderate conductive hearing loss in the left ear contrasting normal hearing in the right ear, while tympanometry confirmed an intact right tympanic membrane but was precluded on the left due to purulent otorrhea. A head CT scan revealed postauricular soft tissue swelling and well-pneumatized mastoid air cells. Both ears were explored intraoperatively via postauricular incisions. Surgical excision included removal of a cyst, cartilaginous remnants, and fibrotic tissue. The patient was followed up to assess for postsurgical complications. The surgical site healed uneventfully; no new symptoms or recurrences of past symptoms of otorrhea, cyst formation, or abscesses had developed within the twelve weeks post-surgery. Although external ear canal duplications are rare, it is imperative that early, accurate diagnoses be made to ensure optimal patient outcomes.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251333233"},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058922","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":"Lateral Displacement of Cochlea and Erosion of Internal Auditory Canal by a Congenital Cholesteatoma in a Young Child.","authors":"Colyn White, Ryan Lauzardo, Si Chen","doi":"10.1177/01455613251333988","DOIUrl":"https://doi.org/10.1177/01455613251333988","url":null,"abstract":"<p><p>The main objective of this report is to describe a unique clinical case of a congenital cholesteatoma with complete lateral displacement of the cochlea and aggressive erosion of the internal auditory canal and lateral semicircular canals in a very young child. This report involves a 10-month-old female who initially presented with left intermittently bloody otorrhea at 2.5 months of age and audiology testing in the clinic demonstrated sensorineural hearing loss in the left ear. Initial computerized tomography (CT) revealed a destructive left temporal bone lesion displacing the left otic capsule and vestibular aqueduct with erosion and involvement of the inner ear structures including erosion into the cochlea and semicircular canals, and posterior fossa dura. A left transtemporal approach for cholesteatoma removal and ear canal closure was done. 4 months postoperatively, the patient required revision of the left transtemporal approach to the posterior fossa for recurrent cholesteatoma in the hypotympanum adjacent to the carotid artery and eustachian tube. This case is unique in the complete lateral displacement of the cochlea and aggressive erosion of the internal auditory canal and lateral semicircular canals in a very young child. It serves to remind otolaryngologists of the silent yet infiltrative nature of congenital cholesteatoma. The very young age of the patient and the presence of otorrhea at 1 month of age raise the question of whether this lesion could have been developing in utero. It lends support to the theory of developmental epithelial rests in congenital cholesteatoma.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251333988"},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059587","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":"Computed Tomography Assessment of Nasal Septal Mucosa: Establishing Criteria for Thickness Classification.","authors":"Ahmad Alroqi, Fadi Mamdouh Arafeh, Mohammed Alyousef, Saud Alromaih, Saad Alsaleh","doi":"10.1177/01455613251332156","DOIUrl":"https://doi.org/10.1177/01455613251332156","url":null,"abstract":"<p><strong>Objectives: </strong>To establish a standardized method for classifying nasal septal mucoperichondrial flap (NSMF) thickness using computed tomography (CT) scans and correlate preoperative measurements with intraoperative findings to improve surgical planning and outcomes.</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>A private hospital.</p><p><strong>Participants: </strong>A total of 196 adult patients (mean age 31.99 years) who underwent septoplasty between April 2021 and February 2024.</p><p><strong>Main outcome measures: </strong>The primary outcomes included the optimal CT thickness cutoff to differentiate NSMF as \"thin\" or \"thick\" and its sensitivity and specificity. Secondary outcomes included demographic predictors of intraoperative complications.</p><p><strong>Results: </strong>Our study determined that a 3.65 mm cutoff in CT scans could differentiate between \"thin\" and \"thick\" NSMF with 80.9% sensitivity and 78.5% specificity. The average age of participants was 31.99 years. No gender-based differences were observed in the subjective reporting of nasal thickness during surgery. Logistic regression identified age as a significant predictor for the occurrence of tears during surgery.</p><p><strong>Conclusions: </strong>The research validates the use of a 3.65 mm CT scan cutoff for preoperative NSMF thickness classification, correlating with surgical findings and demonstrating high accuracy. These findings suggest the potential for CT measurements to become a routine part of preoperative nasal surgery planning, improving outcomes and reducing the risk of complications. Further investigation into direct measurement techniques for septal thickness is recommended to enhance surgical precision.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251332156"},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995163","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":"Large-Cell Neuroendocrine Carcinoma of the Parotid Gland: Diagnostic and Therapeutic Considerations in a Rare Entity.","authors":"Asimakis D Asimakopoulos, Avinash Beharry, Stéphane Yerly, Salim Bouayed","doi":"10.1177/01455613251331882","DOIUrl":"https://doi.org/10.1177/01455613251331882","url":null,"abstract":"","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251331882"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047217","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}