Journal of Rhinology最新文献

Background and objectives: Seromucinous hamartoma is a rare, benign epithelial tumor of the sinonasal tract, most commonly originating from the posterior nasal septum. Accurate diagnosis is essential due to its histopathological resemblance to low-grade sinonasal adenocarcinoma. This study aimed to evaluate the clinical characteristics, diagnostic considerations, and treatment outcomes of patients with seromucinous hamartoma treated at a single tertiary referral center.

Methods: We retrospectively reviewed the medical records of six patients with histologically confirmed seromucinous hamartoma treated between January 2010 and May 2025. Data collected included demographic characteristics, presenting symptoms, imaging findings, histopathological features, and surgical outcomes.

Results: Six patients with a total of seven lesions were identified; one patient presented with bilateral nasal involvement. The mean age at diagnosis was 33.9 years, and four patients were female. The most common presenting symptom was nasal obstruction, followed by epistaxis and rhinorrhea. Lesions were primarily located on the nasal septum, while some involved the inferior turbinate and sphenoid sinus. All patients underwent complete transnasal endoscopic resection. No recurrences were observed over a mean follow-up period of 58.6 months. One patient required medial maxillectomy due to difficulty distinguishing the lesion from adenocarcinoma.

Conclusion: Seromucinous hamartoma may arise at atypical sites and can mimic malignant tumors. Awareness of its variable presentation, along with complete surgical excision, is essential for optimal management and to avoid unnecessarily aggressive treatment.

With accelerated global urbanization, understanding the impact of pollutant emissions and air pollution on obstructive sleep apnea (OSA) and obesity has become increasingly important. Particulate matter (PM) is a major component of air pollution. Recent studies have reported that PM influences OSA, obesity, and obesity-related metabolic disorders. The primary mechanisms proposed to underlie the effects of PM on OSA involve chronic inflammation and oxidative stress in the nasal epithelia. Regarding obesity, PM induces chronic inflammation in the hypothalamus, adipose tissue, skeletal muscle, and mitochondria; oxidative stress in white adipose tissue, the lungs, and the thyroid; activation of lipogenesis genes; changes in adipose tissue distribution; dysbiosis of the intestinal microbiome; and disruption of circadian rhythms. Therefore, reducing air pollution, including PM concentrations, represents a potential strategy for treating OSA and obesity and preventing related complications. Further prospective longitudinal studies in human participants are needed to clarify the effects of PM on the risk of OSA and obesity and to elucidate the underlying mechanisms.

Background and objectives: Chronic rhinosinusitis (CRS) is a heterogeneous inflammatory disease, classified into eosinophilic and non-eosinophilic subtypes. Although CD4+ tissue-resident memory T (TRM) cells play diverse roles in tissue homeostasis, their phenotypic and functional characteristics in the nasal tissue of patients with eosinophilic CRS (ECRS) remain poorly defined.

Methods: Nasal polyp tissue and/or peripheral blood (PB) samples were obtained from patients with ECRS undergoing endoscopic sinus surgery. The phenotypes and functions of nasal CD69+ CD4+ T cells were analyzed using flow cytometry.

Results: The frequency of CD69+ CD103- cells among nasal CD4+ T cells was significantly higher in patients with ECRS compared to controls. Analysis of paired PB and nasal tissue samples from ECRS patients revealed that CD69+ CD103- CD4+ T cells were almost exclusively present in nasal tissues and exhibited tissue-resident phenotypes, marked by high expression of CD49a and CXCR6. In ECRS, these nasal CD69+ CD103- CD4+ T cells expressed high levels of T helper 2 (Th2) cell markers, including CRTH2 and GATA3. Consistently, these T cells demonstrated a robust capacity to produce IL-4 and IL-5. These findings were corroborated by analyses of publicly available single-cell RNA sequencing datasets. Furthermore, the frequency of nasal CD69+ CD103- CD4+ T cells was significantly associated with higher Lund-Mackay CT scores and reduced olfactory function in patients with ECRS.

Conclusion: The current investigation demonstrates that nasal CD69+ CD103- CD4+ TRM cells include a high frequency of Th2 cells and are associated with severe disease.

Oncocytic papilloma is the rarest type of sinonasal papilloma observed in the sinonasal cavity. It commonly arises from the lateral nasal wall, particularly involving the maxillary and ethmoid sinuses. It rarely originates in the middle ear cavity, nasopharynx, or lacrimal sac. This is a case report of a 61-year-old male patient who presented with complaints of epistaxis since 1 month, describing a rare case of sinonasal oncocytic papilloma located in the nasopharynx. This report explains the diagnostic evaluation and subsequent management. Early recognition and complete surgical excision contribute to effective treatment and reduced risk of recurrence.

Leiomyosarcoma (LMS) is a malignant tumor of smooth muscle origin that is most frequently found in the uterus and gastrointestinal tract. LMS involving the head and neck is rare, accounting for only 2.3% of all cases. In this region, LMS tends to be more aggressive and is associated with a poorer prognosis compared to its gastrointestinal counterparts. Furthermore, LMS of the nasal cavity and paranasal sinuses is extremely rare. Here, we present a case of malignant transformation of a leiomyoma originating from the inferior turbinate, which was successfully treated with endoscopic tumor resection followed by postoperative radiotherapy.

Olfactory dysfunction affects many individuals and may result from infections, trauma, neurodegenerative diseases, or genetic disorders. Unlike most neurons in the mammalian nervous system, olfactory sensory neurons (OSNs) continuously regenerate throughout life, a process facilitated by specialized stem cell niches in the olfactory epithelium. Horizontal basal cells are typically dormant under normal conditions but become activated following injury, differentiating into globose basal cells (GBCs) and other cell types. GBCs serve as the primary source for OSN regeneration and are regulated by key transcription factors such as Sox2, Pax6, and Ascl1. Olfactory ensheathing cells play a vital role in regeneration by guiding newly formed axons toward the olfactory bulb and secreting neurotrophic factors, including glial cell-derived neurotrophic factor. In addition, the olfactory bulb synthesizes trophic factors like brain-derived neurotrophic factor and nerve growth factor, which support neuronal survival and integration. Despite this intrinsic regenerative capacity, many cases of olfactory dysfunction remain challenging to treat. Current therapeutic strategies include corticosteroids, biologics, surgical interventions, and olfactory training, although their effectiveness varies. Advances in molecular and cellular research have provided insights into the regulatory mechanisms of olfactory neurogenesis, underscoring the need for further exploration of stem cell activation, neuronal survival, and olfactory circuit reorganization. Future research should focus on optimizing regenerative therapies-including stem cell-based approaches and neurotrophic factor modulation-to improve outcomes for patients with severe olfactory impairment.

Background and objectives: Obstructive sleep apnea (OSA) is a prevalent disorder that is commonly managed with continuous positive airway pressure (CPAP) therapy. Although CPAP is clinically effective, issues related to device hygiene and contamination remain understudied. This study aims to present a practical protocol for CPAP disassembly and cleaning and to report the outcomes of its implementation over a 2-year period.

Methods: We conducted a retrospective chart review of 359 OSA patients prescribed CPAP therapy between 2018 and 2025. Of these, 136 patients participated in a complimentary, comprehensive CPAP cleaning service. Contamination was assessed using a subjective visual analog scale (VAS) following photographic documentation of each device component. The relationship between contamination scores and device usage duration was analyzed.

Results: Patients who received the cleaning service did not differ significantly from the overall cohort in terms of age, sex, apnea-hypopnea index, or average daily usage time, except that they had a significantly shorter total duration of usage. Contamination was found on all device components, including internal parts that are not routinely inspected. Positive correlations between contamination levels and usage duration were statistically significant for every component. The cleaning process required approximately 2 days per device and was feasible for routine clinical implementation.

Conclusion: CPAP devices accumulate visible contamination over time, emphasizing the need for standardized cleaning protocols. Our experience indicates that physician-led education, patient cooperation, and dedicated involvement of paramedical staff are essential in reducing contamination risks. Interdisciplinary collaboration is recommended to develop evidence-based guidelines for CPAP hygiene management.

A diagnosis of granulomatosis with polyangiitis (GPA) can be challenging due to its diverse and nonspecific clinical manifestations, and it is often misdiagnosed as a simple inflammatory disease. Since the nasal septum is the most commonly involved site in the nose, GPA is typically suspected in cases presenting with septal perforation or inflammation. It is very rare for the septum to remain intact while GPA involves only the sinus, which may lead to misdiagnosis as simple sinusitis. A 64-year-old man visited our hospital after being diagnosed with chronic sinusitis at a private clinic. He showed no abnormalities in the septum, but pansinusitis was noted on computed tomography, and GPA was suspected based on a biopsy of a mass resembling a nasal polyp performed in the outpatient setting. The diagnosis of GPA was ultimately confirmed through further laboratory evaluation. Here, we present a case of GPA and review the recently revised diagnostic criteria for GPA.

Background and objectives: Nasal endoscopy is an essential diagnostic tool for allergic rhinitis (AR); however, endoscopic findings vary from person to person. This study aimed to identify definitive nasal endoscopic findings suggestive of AR and to explore factors influencing these findings.

Methods: Data were obtained from the 2010 Korea National Health and Nutrition Examination Survey (KNHANES), which included 8,958 participants. Of these, 7,636 who completed nasal endoscopic examinations were enrolled. AR was defined as a positive diagnosis if any Immunoradiometric Assay (ImmunoCAP) result was level 1+ or higher. Demographic characteristics, blood test results, and comorbid diseases, including ENT evaluation, were investigated. The prevalence estimates of AR and nasal endoscopic findings were calculated using a complex sampling design. Factors influencing these findings were identified using complex-sample logistic regression analysis.

Results: The weighted prevalence of AR was 13.6%. Nasal endoscopic findings suggestive of AR included watery secretion (WS) and mucoid discharge (MD), with prevalences of 22.2% and 9.6%, respectively. In multivariable analysis, age, nasal septal deviation, and sensitization to dog allergens were associated with WS. MD was associated only with nasal septal deviation. The correlation between AR symptoms and WS was stronger compared to MD. In a subgroup analysis of WS, higher levels of sensitization to dog allergens were associated with increased WS findings.

Conclusion: WS and MD are representative endoscopic findings in AR. Nasal septal deviation impacts the mucosal environment, causing nasal secretion and altering discharge characteristics. WS is correlated with dog allergen sensitization, and its prevalence is influenced by the level of dog allergen sensitization.