Ear, nose, & throat journal最新文献

{"title":"Considerations for the Use of Biologics in Chronic Rhinosinusitis With Nasal Polyps.","authors":"Hannah G Luk, Tyler A Janz, Farrah N Siddiqui, Scott A Hardison","doi":"10.1177/01455613251363018","DOIUrl":"https://doi.org/10.1177/01455613251363018","url":null,"abstract":"<p><strong>Background: </strong>Interventions such as steroids, endoscopic sinus surgery (ESS), biologics, or a combination of these are available for the treatment of chronic rhinosinusitis with nasal polyposis (CRSwNP). However, despite evidence supporting the efficacy of each approach, factors such as timing, cost, side effects, and patient preference need to be considered. The objective of this work was to provide a comparison between current biologics and considerations for each intervention when developing a treatment plan.</p><p><strong>Methods: </strong>Recent studies are referenced in a detailed description of current and developing biologics to compare U.S. Food and Drug Administration (FDA) indications, mechanism of actions, notable side effects, dosage, and cost. Considerations for timing of treatment and duration of treatment when analyzing the utility of ESS, biologics, or a combination of both are highlighted.</p><p><strong>Results: </strong>Currently, 3 biologics are FDA-approved for the treatment of inadequately-controlled CRSwNP and 2 biologics demonstrate promise as potential agents. The overall trend in literature suggests that the combination of ESS to relieve polyps and improve medication delivery and biologics to facilitate anti-inflammatory effects is clinically impactful.</p><p><strong>Conclusion: </strong>Evidence to date aligns with current recommendations that biologics are a promising maintenance option for CRSwNP patients who have failed both medical management and complete ESS.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251363018"},"PeriodicalIF":0.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755487","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":"Life Expectancy in Patients Diagnosed with Extralaryngeal Malignancies and Vocal Cord Paralysis.","authors":"Danae Alexandrou, Veronica Drozdowski-Nuccio, Kayeromi Gomez, Steven Charous","doi":"10.1177/01455613251360134","DOIUrl":"https://doi.org/10.1177/01455613251360134","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether the presence of vocal cord paralysis (VCP) has an impact on overall survival (OS) and quality of life in patients diagnosed with extralaryngeal malignancies.</p><p><strong>Methods: </strong>This was a retrospective chart review of patients at a quaternary medical center from 2007 to 2022. Information on demographics, cancer diagnosis, treatment, and intervention for VCP was collected. Patients were identified using <i>International Classification of Diseases</i> (ICD)-9 and ICD-10 codes for various malignancies and VCP and cross-referenced. Patients with both VCP and extralaryngeal malignancy were included, while those without malignancy, with laryngeal cancer, VCP unrelated to cancer, or without laryngoscopy-confirmed VCP were excluded. No validated instruments to measure quality of life were utilized.</p><p><strong>Results: </strong>A total of 346 patients with VCP related to 52 distinct, extralaryngeal malignancies were identified. Mean OS was 97.35 months. Mean OS for those diagnosed with early (stage 1 or 2) cancers was 101.48 months and 79.88 months for late (stage 3 or 4) cancers (<i>P</i> = <.0001). Many of our patients (56.6%) did not receive VCP treatment.</p><p><strong>Conclusion: </strong>Treatment for cancer patients with VCP poses a unique challenge with a multitude of factors affecting management. However, given that patients survive months after VCP diagnosis, they should be offered treatments that carry low morbidity and increase their quality of life.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251360134"},"PeriodicalIF":0.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755488","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":"Reviewing the Efficiency of the Initial Work-Up for Hereditary Hemorrhagic Telangiectasia in a Tertiary Referral University Center in Belgium.","authors":"Palm Clément, Poirrier Anne-Lise, Caers Jo, Gester Fanny, Sepulchre Edith, Camby Séverine, Lefebvre Philippe, Rogister Florence","doi":"10.1177/01455613251363024","DOIUrl":"https://doi.org/10.1177/01455613251363024","url":null,"abstract":"<p><strong>Purpose: </strong>Hereditary hemorrhagic telangiectasia (HHT) is under-recognized, and specialized referral centers are limited, specifically in Belgium. The primary aim of this study was to describe the clinical characteristics of our patients with HHT, in particular the prevalence of vascular malformations (VMs). Secondary objective was to describe associations between patient's current work-up and anemia.</p><p><strong>Methods: </strong>We performed a retrospective analysis of 118 patients treated at our center between 2015 and 2024. We analyzed documented VM and correlation with genetic work-up, prevalence of epistaxis, and referral of patients to specialist ENT services. We studied the correlation between anemia and clinical parameters such as documented digestive telangiectasia.</p><p><strong>Results: </strong>The main results confirmed the dominance of epistaxis among the documented symptoms. Anemia was correlated with age and presence of documented digestive telangiectasia. Only 55% of patients with epistaxis were referred to an otorhinolaryngologist. The majority of patients (65%) had documented multisystem involvement of at least 2 organs, and the majority of important VMs (lung and liver) were documented properly. However, liver malformations remain not documented in 41% of cases and lung malformations in 31% of cases. In our cohort, 61% of patients underwent genetic analysis (80% ENG and/or ACVRL1). However, there was no significant association between genetic and multisystem work-up or specific phenotype.</p><p><strong>Conclusions: </strong>We highlighted the importance of epistaxis as a cardinal symptom in the management of HHT. We also highlighted strengths and gaps that could lead to future improvements, such as systematic referral of patients with epistaxis to ENT and improved coordination of care. Further longitudinal studies would allow us to assess the impact of improved pathways to improve patient care nationwide.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251363024"},"PeriodicalIF":0.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755489","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":"Intracranial and Orbital Complications of Sinusitis: A Review of Rhinologic and Multidisciplinary Management Principles.","authors":"Michael T Werner, Jennifer S Gottfried, Bint-E Z Awan, Aron Z Pollack, Charles C L Tong, Judd H Fastenberg, Mark B Chaskes","doi":"10.1177/01455613251342857","DOIUrl":"https://doi.org/10.1177/01455613251342857","url":null,"abstract":"<p><strong>Objective: </strong>To provide an up-to-date review summarizing the pathophysiology and management of the most common orbital and intracranial complications of acute rhinosinusitis (ARS).</p><p><strong>Methods: </strong>A narrative literature review was conducted using the following search criteria in the PubMed database: \"sinusitis\" AND \"complications\" AND (\"orbital\" OR \"intracranial\" OR \"osseous\" OR \"Pott's puffy tumor\"). Titles and abstracts were screened for relevance. Additional articles were found by hand-searching references. Articles were chosen for inclusion based upon relevance, quality, full-text availability, and date of publication. Common or interesting radiographic findings were highlighted as figures using patient imaging data based on senior author expert opinion.</p><p><strong>Results: </strong>ARS is one of the most common diagnoses made in the United States. While the vast majority of these cases resolve with oral antibiotics and conservative medical management, rare instances of ARS may be complicated by the spread of infection into orbital, intracranial, and osseous spaces. This review seeks to guide physician management with evidence-based recommendations. The pathophysiology of complex sinusitis is explored and risk factors, evaluation, and up-to-date prevention and management recommendations are discussed. This review of the literature highlights that when orbital, intracranial, and osseus complications are suspected, a multidisciplinary team should be assembled to consider both medical and surgical management options. In this way, outcomes of these complex infections can be optimized.</p><p><strong>Conclusions: </strong>ARS is common and self-resolving in most cases. However, clinicians should suspect orbital and intracranial complications in at-risk individuals with worsening symptoms that do not respond to standard therapies, and initiate early interventions as directed by multidisciplinary teams.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251342857"},"PeriodicalIF":0.7,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746619","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 Diagnosis and Treatment of Solitary Fibrous Tumor of the Parotid Gland.","authors":"Shuang Wang, Biao Xing, Zhenzhang Lu, Danhui Yin, Xinming Yang, Weiyu Zhu","doi":"10.1177/01455613251362588","DOIUrl":"https://doi.org/10.1177/01455613251362588","url":null,"abstract":"<p><p>Solitary fibrous tumor is relatively rare, and solitary fibrous tumor of the parotid gland is even less common. The clinical features of solitary fibrous tumor are non-specific, making early diagnosis difficult. The diagnosis mainly depends on pathological histology and immunohistochemistry. The solitary fibrous tumor is considered as a borderline tumor. Most tumors are benign, while malignant transformation is less common. Currently, surgical treatment is the main approach, and radiotherapy may be used for malignant patients after surgery. This study presents 2 cases of solitary fibrous tumor arising in the parotid gland. Case 1 is a 49-year-old woman who presented with right cervical mass. Imaging studies demonstrated a well-defined mass in the deep lobe of the parotid gland extending into the right parapharyngeal space. The patient underwent right total parotidectomy and had manifestations of facial paralysis after surgery, but recovered about 5 months later. Case 2 is a 16-year-old female who presented with left cervical mass. Imaging studies showed a round mass in the superficial lobe of the parotid gland with significant enhancement. The patient underwent left superficial parotidectomy and recovered well without any manifest facial nerve palsy. The accurate diagnosis of benign solitary fibrous tumors was obtained by the immunohistochemistry. These 2 patients were regularly followed up after the operation, and no obvious recurrence changes were observed.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251362588"},"PeriodicalIF":0.7,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746620","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":"How Far Can We Push the Limit in Palliative Surgery? A Case Report of Massive Chondroblastic Osteosarcoma of the Maxilla.","authors":"Eiman Abu Bandora, Nariman Abd Elhadi, Sofi Matot, Arik Zaritski, Ofer Merimsky, Orit Gutfeld, Leonor Leider-Trejo, Nidal Muhanna, Jobran Mansour","doi":"10.1177/01455613251361246","DOIUrl":"https://doi.org/10.1177/01455613251361246","url":null,"abstract":"<p><p>Surgical management of head and neck sarcomas presents significant challenges, particularly in advanced stages where curative options are limited. In such cases, palliative care becomes essential to alleviate symptoms and enhance the patient's quality of life. When chemoradiation therapy fails to provide adequate symptom control, palliative surgery may be a viable option. We report the case of a 24-year-old male diagnosed with an extensive and aggressive maxillary chondroblastic osteosarcoma. Despite multiple chemoradiation regimens, the disease progressed rapidly. Due to the substantial deterioration in the patient's quality of life, he underwent major palliative surgery. The procedure involved a left total maxillectomy, right subtotal maxillectomy, left segmental mandibulectomy, orbital exenteration, and resection of the left upper lip, cheek, and nose. Reconstruction was performed using an osteocutaneous fibula free flap and an anterolateral thigh flap. Postoperatively, the patient experienced significant symptom relief without major complications. He was followed for 12 months before being lost to follow-up, remaining disease-free for approximately 8 to 10 months. This case illustrates that in select patients with unresectable and extensively invasive tumors, major palliative resections combined with microvascular reconstruction may offer meaningful improvements in quality of life.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251361246"},"PeriodicalIF":0.7,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746618","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 Role of Preoperative Serum Phosphate Screening in Thyroidectomy: Practical Reflections and Future Directions.","authors":"Asimakis D Asimakopoulos, Spyridon Koulas, Sotiria Alexiou, Stelios Tigas, Dimitrios-Nikiforos Kiortsis, Konstantinos Vlachos, Georgios K Glantzounis","doi":"10.1177/01455613251358666","DOIUrl":"https://doi.org/10.1177/01455613251358666","url":null,"abstract":"","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251358666"},"PeriodicalIF":0.7,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736312","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":"Sonopalpation for Ultrasound Evaluation of Plunging Ranula.","authors":"Evgeniya Molotkova, Joan Maley, Henry Hoffman","doi":"10.1177/01455613251358082","DOIUrl":"https://doi.org/10.1177/01455613251358082","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound (US) has been supported as a preferred imaging technique to evaluate neck masses suspicious for plunging ranula, but to date, there have been no reports addressing the role of adjunctive sonopalpation.</p><p><strong>Objectives: </strong>In this proof-of-concept technical case series, we describe the technique of sonopalpation and provide surgical and pathological correlates.</p><p><strong>Methods: </strong>Patients with surgically-treated plunging ranula were identified from the senior author's case log. Three patients were included in a retrospective chart review targeting imaging results, surgical findings, and final pathology results.</p><p><strong>Results: </strong>US with sonopalpation identified anatomy consistent with plunging ranula in all 3 cases. These findings were confirmed surgically and pathologically.</p><p><strong>Conclusion: </strong>US with sonopalpation was effective in demonstrating anatomic abnormalities consistent with plunging ranula. Sonopalpation helped define relationships between the sublingual gland, ranula fluid, and the frequently-associated mylohyoid dehiscence. Sonopalpation is a useful adjunctive technique to standard US in the evaluation of plunging ranula. Additional investigation into this technique may be helpful in further evaluating its use in the diagnostic process.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251358082"},"PeriodicalIF":0.7,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736311","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":"Different Response Criteria and Response Rates for Biologic Therapy in Patients With Chronic Rhinosinusitis With Nasal Polyps: A Systematic Review and Meta-Analysis.","authors":"Shirong Xu, Yankun Li, Xingchen Pan, Yi Zhao, Dawei Wu","doi":"10.1177/01455613251362034","DOIUrl":"https://doi.org/10.1177/01455613251362034","url":null,"abstract":"<p><strong>Objective: </strong>Different criteria have been proposed for the response to biologic treatment to evaluate the efficacy of treatment among patients with chronic rhinosinusitis with nasal polyps (CRSwNP). This review aimed to summarize current response criteria and evaluate response rates of patients with CRSwNP after biologic therapies.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library from the inception to July 2024 to identify clinical studies exploring the response to biologic treatment in patients with CRSwNP.</p><p><strong>Results: </strong>Twenty-nine studies were included, comprising 3735 patients in 25 studies suitable for meta-analysis. These were various comprehensive and single criteria for response to biologic therapy in patients with CRSwNP. The comprehensive evaluation measures of patient responsiveness included 5 key outcome measures: nasal polyp size, systemic corticosteroid need, disease-specific quality of life, sense of smell, and impact of comorbidities. The single evaluation measure of treatment response included nasal polyp size, disease-specific quality of life, and sense of smell. The minimum clinically important difference and the thresholds of these parameters are used to determine the clinical improvement or the severity of the disease after treatment. These existing treatment response instruments categorized patients as follows: 4 (excellent, moderate, poor, and no response), 3 (good-to-excellent, moderate-poor, and no response), and 2 (response and no response). The pooled moderate-to-excellent response rate after biologic therapy assessed by comprehensive criteria was from 39.3% (95% confidence interval [CI], 0.231-0.670) to 87.7% (95% CI, 0.774-0.994). The pooled response rates evaluated by the single measures ranged from 62.9% (95% CI, 0.518-0.746) to 82.8% (95% CI, 0.801-0.857).</p><p><strong>Conclusion: </strong>The critical components and parameters of the response criteria for CRSwNP patients receiving biologic treatment have yet to be reached, leading to significantly heterogeneous response rates to biologics. The development of consistent criteria for the response to biologic treatment is critical to help define treatment efficacy.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251362034"},"PeriodicalIF":0.7,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983851","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":"Systemic Imaging for Early Laryngeal Cancer: A Single-Centre Review of Guideline Application in Contemporary Clinical Practice.","authors":"Parth Ankur Tagdiwala, Sneha Kanth, Paul Stimpson","doi":"10.1177/01455613251357445","DOIUrl":"https://doi.org/10.1177/01455613251357445","url":null,"abstract":"<p><strong>Objective: </strong>National Institute for Health and Care Excellence (NICE) no longer recommends offering systemic staging for early laryngeal cancer (T1N0 and T2N0). We aim to evaluate (1) whether guidance is being followed in our centre, (2) assess the impact on our patients and (3) perform a cost analysis.</p><p><strong>Methods: </strong>We retrospectively reviewed all laryngeal cases at a major Head and Neck cancer centre between January 01, 2020, and January 01, 2025. The following information was collected for all the patients: neck/systemic imaging modalities performed on patients, demographics, site of original laryngeal tumour and any metastatic disease detected by systemic imaging. We performed a cost analysis based on methods undertaken by NICE.</p><p><strong>Results: </strong>n = 83 patients had laryngeal cancer, n = 30 had T1N0 and T2N0 disease. Systemic imaging found no metastatic disease, n = 2 primary tumours and n = 1 lung infection. Systemic imaging cost £4207.12 and neck imaging cost £12 335.07.</p><p><strong>Conclusions: </strong>NICE guidance is not being followed at our centre, with limited benefits.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251357445"},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710381","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}