Laryngo-rhino-otologie最新文献

Already in 2021 it was reported, that the COVID-19 pandemic influences the incidence of acute mastoiditis in children. The goal of this multicenter cross-regional study was to collect and analyze a substantial pre-, peri- and postpandemic data set.Absolute case frequencies were inquired from six segments: epidemiology, medical history taking, spectrum of pathogens, course of disease, therapy, and imaging. Nine ENT clinics in Germany reported about a 6 year time frame from 2018 to 2024.251 acute mastoiditis emergency cases were seen. There occured 69 pre-pandemic, 31 pandemic, and 151 post-pandemic cases, 100 female and 151 male. Among the general symptoms, fever was most frequent with 160 cases, and among the ear-specific symptoms, retrauricular ones (633 symptoms). The spectrum of pathogens was narrow, in only 21 out of 240 laboratory tests (8.8%) different pathogens than the four offered were found. In 42.2% of mastoiditis patients, a temporal bone CT scan was performed, surgical therapy took place in 223 cases. Complications, surgical therapy and spectrum of pathogens did not show changes in percentage.Postpandemic cases of pediatric acute mastoidites were more than twice the number of prepandemic cases. Surgical treatment in combination with antibiosis was the therapy of choice in 90%. Over the course of the pandemic, no changes of spectrum of pathogens, presentation, complications or epidemiology were observed.

Juvenile angiofibroma (JA) is an intriguing fibrovascular neoplasm that has prompted diverse theories of origin since 1853. While approaches focusing on isolated features of JA have not gained broad acceptance, the current explanation of JA tumorigenesis based on embryologic vascular remnants is gaining prominence. In the core embryologic process of epithelial-mesenchymal transition (EMT), the transcription factors Twist1 and Snail/Slug play key roles; their expression in JA is therefore of particular interest within this embryologic framework.In a cohort of 19 JAs, quantitative real-time PCR (qRT-PCR) analyses and immunohistochemical investigations were performed for the transcription factors Twist1 and Snail/Slug, as well as for CD31 (Pecam1) and vimentin.Twist1 and Snail2 were detectable by RT-PCR in all JAs examined (n=11). No correlation was observed with vessel-rich (CD31-positive) or fibrous (vimentin-positive) tumor regions. Immunohistochemistry for Twist1 and Snail/Sslug confirmed protein-level expression (n=19), with inter- and intratumoral heterogeneity of EMT markers.Demonstration of Twist1 and Snail/Slug expression in JA indicates involvement of the embryologic process of EMT in JA and supports the embryologic explanatory model, which accounts for the clinical characteristics of this unique fibrovascular neoplasm.

Malignant primary tracheal tumours are rare. The most common histological subtypes are squamous cell carcinoma and adenoid cystic carcinoma. These two entities have different prognoses and growth patterns. Tracheobronchoscopy and thoracic sectional imaging are standard diagnostic tools for tumour staging and local evaluation. Complete surgical resection of the affected tracheal segment is the treatment of choice for limited disease without distant metastases. Incomplete gross tumour resection with additional irradiation is an acceptable therapeutic option for adenoid cystic carcinoma. Interventional endoscopy with tumour debulking or tracheal stenting and/or definitive mediastinal radiotherapy are treatment alternatives in either a locally advanced or palliative setting.