Iranian Journal of Otorhinolaryngology最新文献

Introduction: The ratio of neutrophils to peripheral lymphocytes is an inflammatory marker, and, based on previous studies, this ratio is associated with poor survival in several cancers. This study was conducted to compare the neutrophils-to-lymphocytes ratio (NLR) and platelets-to-lymphocytes ratio (PLR) in two groups of patients with benign and malignant salivary gland tumors.

Materials and methods: This study was cross-sectional, comparing two groups of patients with benign and malignant salivary gland masses. During the last 6 years (from 2018 to 2024), 380 Patients with a definite diagnosis of salivary gland tumors were included in the study, and NLR and PLR data were obtained from pre-operation laboratory exams.

Results: NLR and PLR were significantly higher on average than in benign masses (P<0.05). The best cut point was 2.24 for NLR (sensitivity: 78%, specificity: 80%) and 104.35 for PLR (sensitivity: 68%, specificity: 60%).

Conclusion: NLR and PLR are easy, practical methods that provide valuable information for diagnosing, assessing severity, and predicting prognosis of various diseases, such as salivary gland masses.

Introduction: Esophageal squamous cell carcinoma (ESCC) is the eighth most prevalent cancer worldwide. Head and neck squamous cell carcinoma (HNSCC) represents over 90% of all head and neck cancers, and nearly 40% of patients fail treatment. Therefore, discussion of cancer treatment is essential. In this in vitro study, we examined how conditioned medium from dental pulp stem cells (DPSC-CM) influences the ESCC cell line (KYSE-30).

Materials and methods: First, the middle pulp tissue of the wisdom tooth was extracted and, following sterilization, transferred to a cell culture flask containing MEM-α. After completing the culture procedures, conditioned medium (CM) was collected from the fourth passage culture after 72 hours in serum-free medium. The KYSE-30 cells were then treated with the CM for an additional 72 hours, and cell survival was assessed using the MTT assay. Statistical significance was evaluated using one-way ANOVA followed by Tukey's post-hoc test.

Results: The results demonstrated that treatment of esophageal cancer cells with conditioned medium (CM) significantly reduced the survival rate of cancer cells compared to control samples. The treatment of KYSE-30 cells with DPSC-CM led to a notable reduction in cell viability (CM group: 51.2 ± 4.1% vs. control group: 72.6 ± 3.3%; P = 0.004).

Conclusion: DPSC-CM demonstrates the ability to reduce the proliferation of cancer cells; therefore, this medium can be considered a potential drug (therapeutic) candidate for the treatment of esophageal cancer. However, further studies are required to confirm these results.

Introduction: Postoperative dysphagia significantly affects the quality of life of patients with oral and oropharyngeal cancer. We aimed to objectively analyze swallowing function in these patients using quantitative biomechanical indices from Videofluoroscopic swallowing studies (VFSS) as well as to identify independent predictors of key swallowing outcomes.

Materials and methods: We included 60 patients with postoperative oral and oropharyngeal cancers. VFSS were performed at 3 months (for patients without adjuvant therapy) or 6-7 months (for patients with adjuvant therapy) to assess swallowing safety (Penetration-Aspiration Scale); post-swallowing pharyngeal residue; and biomechanical functions, including pharyngeal transit time (PTT), laryngeal vestibule closure duration, pharyngoesophageal segment opening duration/dimension, and laryngeal elevation. Generalized linear models (GLMs) were used to identify independent predictors.

Results: The cohort was predominantly male (78.3%); further, 58.4% of the patients received adjuvant therapy. Thin liquids had the highest penetration and aspiration rates, whereas extremely thick liquids had the lowest rates. The GLM identified sex, adjuvant treatment, and suprahyoid muscle defects as independent predictors of different VFSS parameters. Specifically, adjuvant therapy and sex were associated with a prolonged PTT, while suprahyoid muscle defects were significant predictors of reduced laryngeal elevation.

Conclusion: Swallowing impairment remains prevalent after surgery for oral and oropharyngeal cancers. VFSS analysis could highlight specific biomechanical deficits; further, we identified predictors of key swallowing outcomes, including sex, adjuvant treatment, and suprahyoid defects.

Introduction: Chronic rhinosinusitis with nasal polyps is a heterogeneous inflammatory disorder often driven by type 2 inflammation. Identification of non-invasive biomarkers, such as fractional exhaled nitric oxide (FeNO), may support the assessment and personalized management.

Materials and methods: In this cross-sectional study, 141 patients with clinically and radiologically confirmed CRSwNP were assessed. FeNO levels, nasal eosinophilia, serum IgE, peripheral blood eosinophil counts, and skin prick test results were evaluated. Disease severity was measured using the SNOT-22 and Lund-Mackay CT scores.

Results: FeNO showed a significant correlation with nasal eosinophilia (r = 0.53, p < 0.001), a moderate correlation with serum IgE (r = 0.40, p < 0.001), and a weak correlation with blood eosinophils (r = 0.17, p = 0.047). Serum IgE was significantly associated with both SNOT-22 and Lund-Mackay scores. FeNO did not show significant correlation with symptom severity or radiological extent, suggesting its use as a supportive marker rather than a stand-alone predictor.

Conclusion: FeNO may serve as a potential non-invasive marker for type 2 inflammation in CRSwNP, though it may not predict disease severity. Combining FeNO with other markers could improve clinical endotyping and management.

Introduction: Acute bacterial rhinosinusitis (ABRS) is an inflammation of the paranasal sinuses caused by bacterial infection, primarily involving inflammatory responses and oxidative stress. While antibiotics are the standard treatment, their effectiveness can sometimes be limited. Kaempferia galanga (K. galanga), a medicinal plant known for its anti-inflammatory and antioxidant properties, has shown potential as a therapeutic agent. This study aimed to evaluate the therapeutic efficacy of K. galanga extract in a mouse model of ABRS.

Materials and methods: An in vivo experimental study was conducted using Sprague-Dawley rats with induced ABRS. The animals were randomly divided into three treatment groups that received K. galanga extract at doses of 150 mg/kg (KG150), 300 mg/kg (KG300), or 450 mg/kg (KG450) based on body weight. Therapeutic effects were assessed by measuring serum levels of MDA, NF-κB, and CRP.

Results: Eighteen rats with ABRS were included in the study. The KG300 group exhibited significantly lower levels of MDA, NF-κB, and CRP compared to the KG150 and KG450 groups (p < 0.05). These findings suggest that the 300 mg/kg dose of K. galanga extract provides optimal therapeutic benefit.

Conclusion: K. galanga extract at 300 mg/kg demonstrated the most potent anti-inflammatory and antioxidant effects in a mouse model of ABRS, indicating its potential as an effective alternative or adjunctive therapy.

Introduction: Laryngeal squamous cell carcinoma (SCC) remains a significant health challenge, with transoral laser microsurgery (TLM) emerging as a preferred treatment for early-stage disease. This retrospective cohort study investigates recurrence patterns, survival outcomes, and prognostic factors in patients treated with TLM, with a focus on the role of smoking exposure.

Materials and methods: A retrospective cohort study was conducted on 142 patients with laryngeal SCC treated with TLM at Rasoul Akram Hospital (2016-2022). Patient demographics, tumor characteristics, smoking history (Pack-Years), and follow-up data were analyzed. Recurrence rates and survival were assessed using Kaplan-Meier analysis, and risk factors were evaluated using univariate logistic regression and Cox proportional hazards models.

Results: The recurrence rate was 26.1% (n=37), predominantly local (70.3%), with a median time to recurrence of 15 months. Smoking exposure significantly correlated with recurrence risk (OR=1.02, 95% CI: 1.00-1.03, p=0.02; HR=1.01, 95% CI: 1.00-1.02, p=0.04). Kaplan-Meier analysis revealed reduced recurrence-free survival for patients with >20 Pack-Years (p=0.04), while disease-free survival (DFS) probability was approximately 0.75 at 80 months. No significant associations were found for age, sex, tumor stage, or comorbidities (all p>0.05), and no distant metastases were observed.

Conclusions: TLM appears to be an effective treatment for early-stage laryngeal SCC in this cohort, with smoking identified as a critical modifiable risk factor for recurrence. The findings underscore the importance of smoking cessation interventions to enhance outcomes. Given the retrospective and single-center design, conclusions should be interpreted cautiously. Future multi-center studies with extended follow-up and molecular profiling are recommended.

Introduction: Neuroglial heterotopia (NGH), is a displaced mass of mature central neuroepithelial tissue unconnected to the brain proper. NGH presents mostly with respiratory distress, neck mass and feeding difficulties at early age.

Case report: In our case, the nasopharyngeal NGH, a nine years old female child presented with otalgia and reduced hearing of left ear. Otological examination showed secretory otitis media. On nasal endoscopy solitary, smooth, mucosa covered mass on the eustachian tube opening of left side blocking eustachian tube orifice. Imaging showed a well-defined, non-enhancing, isodense soft tissue lesion arising from left lateral wall of nasopharynx with complete opacification of middle ear and mastoid. Patient underwent left myringotomy and grommet insertion. Nasopharyngeal mass removed trans-nasally under endoscopic guidance. Histopathological examination of the mass showed features of Neuroglial heterotopia. Patient improved symptomatically.

Conclusion: Possibility of NGH should be considered while evaluating children with congenital nasopharyngeal mass. Thorough clinical evaluation, radiological imaging to rule out intracranial connection and complete excision are necessary for successful management of such cases.

Introduction: Mantle cell lymphoma (MCL) is a rare and aggressive B-cell non-Hodgkin lymphoma, commonly affecting lymph nodes, spleen, bone marrow, and gastrointestinal tract. Salivary gland involvement, especially in the parotid gland, is unusual and often mimics benign conditions, complicating diagnosis.

Case report: A 58-year-old male presented with a painless, progressively enlarging swelling in the right preauricular region without facial nerve involvement. Imaging revealed a mass within the parotid gland, leading to superficial parotidectomy. Histopathology confirmed mantle cell lymphoma. Immunohistochemical studies showed positivity for CD20, BCL2, CD5, and Cyclin D1; negativity for CD23, CD10, BCL6, and MUM1; and scattered CD3-positive T lymphocytes. The Ki-67 proliferation index was approximately 40%, indicating intermediate proliferative activity. Whole-body PET-CT revealed additional metabolically active lesions suggestive of systemic disease. The patient was started on bendamustine and rituximab chemotherapy.

Conclusion: This case highlights that parotid swellings may conceal systemic lymphomas, and misleading cytology can delay diagnosis. Clinicians should consider MCL in atypical parotid lesions to ensure early systemic therapy.

Introduction: Nodular fasciitis (NF) is a benign, rapidly growing, non-neoplastic myofibroblastic lesion of the subcutaneous tissue affecting various anatomical sites throughout the body. NF of the trachea is rare, and its occurrence in the pediatric age group is highly uncommon in clinical practice.

Case report: 2-year-old female child who presented to the emergency department with severe stridor causing critical airway obstruction. The mass was successfully excised via an emergent surgical procedure, and the definitive diagnosis of nodular fasciitis was established through histopathology examination, which revealed proliferation of spindle-shaped myofibroblasts in a myxoid stroma without features of malignancy.

Conclusion: Early resuscitation is essential to save the patient's life, and histopathology confirms the diagnosis.