Auris Nasus Larynx最新文献

{"title":"Prevalence and associated factors of self-reported olfactory dysfunction in Japan: Findings from a nationwide web-based cross-sectional survey","authors":"Jun Suzuki ,&nbsp;Yuta Kobayashi ,&nbsp;Yoshihisa Fujino ,&nbsp;Takahiro Tabuchi ,&nbsp;Yukio Katori","doi":"10.1016/j.anl.2025.12.008","DOIUrl":"10.1016/j.anl.2025.12.008","url":null,"abstract":"<div><h3>Objective</h3><div>Olfactory dysfunction (OD) compromises safety and well-being in humans; however, large-scale Japanese data are lacking. We quantified the prevalence of subjective chronic OD (self-reported olfactory impairment persisting ≥3 months), identified associated health and occupational factors, and evaluated determinants for severity using data from a nationwide web-based survey in Japan.</div></div><div><h3>Methods</h3><div>We analyzed data from the Japan coronavirus disease 2019 and Society Internet Survey 2023, a stratified, nationwide, cross-sectional survey of community-dwelling residents in Japan. From the initial 33,000 participants, we used the data of 25,569 participants (12,323 men, 13,246 women), after excluding those with implausible responses and missing data, to calculate prevalence. Inverse probability weighting was used to align the sample with the 2019 National Living Conditions Survey. Group differences concerning the presence and severity of OD were tested with χ² or Wilcoxon tests after excluding participants with additional missing data; independent associations were examined using weighted multivariable logistic regression analyses.</div></div><div><h3>Results</h3><div>The weighted prevalence for chronic subjective OD was 1.3 % (95 % confidence interval [CI] 1.1–1.4); age-specific rates ranged from 0.6 % (40–49 years) to 2.1 % (60–69 years). Independent OD correlates included the factors current smoking (odds ratio [OR] 2.09, <em>p</em> = 0.016), homeworking (OR 2.75, <em>p</em> = 0.004), somatic symptoms (Somatic Symptom Scale-8 score ≥ 12; OR 2.66, <em>p</em> = 0.009), dysgeusia (OR 193.2, <em>p</em> &lt; 0.001), current hypertension (OR 3.69, <em>p</em> = 0.005), current bronchial asthma (OR 6.09, <em>p</em> &lt; 0.001), current allergic rhinitis (OR 1.97, <em>p</em> = 0.012), and moderate-severe presenteeism (Work Functioning Impairment Scale score ≥ 21; OR 3.04, <em>p</em> &lt; 0.020). Being a woman was associated with lower OD severity (OR 0.34, <em>p</em> = 0.035, for moderate-severe vs mild), whereas having ≥ 1 day of sick absences in the previous month was associated with higher OD severity (OR 3.17, <em>p</em> = 0.044).</div></div><div><h3>Conclusion</h3><div>Subjective OD prevalence in Japan was 1.3 %. Presenteeism was associated with OD and absenteeism was associated with moderate-severe OD. Further studies on the relationship between OD and work productivity are warranted.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"53 1","pages":"Pages 61-69"},"PeriodicalIF":1.5,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Possible patulous Eustachian tube: Clinical characteristics and diagnostic transition according to the Japan Otological Society criteria","authors":"Marin Yoshida ,&nbsp;Hidetoshi Oshima ,&nbsp;Hideshi Shindo ,&nbsp;Ryoji Hirai ,&nbsp;Takeshi Oshima","doi":"10.1016/j.anl.2025.11.005","DOIUrl":"10.1016/j.anl.2025.11.005","url":null,"abstract":"<div><h3>Objective</h3><div>The 2016 diagnostic criteria for patulous Eustachian tube (PET) proposed by the Japan Otological Society classify cases as “definite” or “possible.” However, the clinical characteristics and natural course of possible cases remain unclear. This study aimed to clarify the clinical profiles and diagnostic transition of possible PET by subclassifying them into two groups.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the records of 292 patients diagnosed as possible PET at their first visit to our specialized outpatient clinic between June 2019 and May 2025. Patients were categorized as group A (symptom relief with Eustachian tube–closing maneuvers but lacking objective findings) or group B (objective findings present but without symptom relief). Clinical features, symptom profiles, and diagnostic transitions were analyzed. Survival analyses using the Kaplan–Meier method, Cox proportional hazards model, Weibull parametric model, and restricted mean survival time (RMST) were conducted to evaluate transition to definite PET.</div></div><div><h3>Results</h3><div>Voice autophony (81.8%¦vs. 59.9%) and breathing autophony (47.1%¦vs. 35.3%) were significantly more frequent in group A, whereas hearing loss was more common in group B (34.1%¦vs. 16.5%, p &lt; 0.001). During follow-up, 30 patients (25 in group A, 5 in group B) progressed to definite PET. Kaplan–Meier analysis showed a significantly higher transition rate in group A (log-rank, p &lt; 0.0001). Cox regression demonstrated a nearly five-fold higher hazard of progression in group A (HR = 4.95, 95% CI: 1.89–12.95, p = 0.001). RMST analysis indicated that group B required on average 1.5 more visits to reach diagnosis. Weibull analysis revealed that most group A patients were diagnosed by the third visit, whereas group B patients frequently remained undiagnosed.</div></div><div><h3>Conclusion</h3><div>Possible PET cases comprise heterogeneous conditions, with group A containing a higher proportion of true PET and group B including more non-PET cases with hearing loss. Careful follow-up and additional testing are warranted for group A, while differential diagnosis should be prioritized in group B. Subgroup-based evaluation may contribute to a more precise and practical diagnostic process for PET.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"53 1","pages":"Pages 55-60"},"PeriodicalIF":1.5,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional equity and declining laryngeal surgery in Japan: A nationwide claims-based analysis from 2014 to 2022","authors":"Masamitsu Kido ,&nbsp;Takahiro Tsujikawa ,&nbsp;Kengo Yoshii ,&nbsp;Shigeyuki Mukudai ,&nbsp;Shinya Fuse ,&nbsp;Katsutoshi Shoda ,&nbsp;Shigeru Hirano","doi":"10.1016/j.anl.2025.12.005","DOIUrl":"10.1016/j.anl.2025.12.005","url":null,"abstract":"<div><h3>Objective</h3><div>The epidemiology of major otolaryngological surgeries in Japan remains unclear. This study investigated the national trends in three representative procedures, with a particular focus on laryngeal surgery, by analyzing demographic patterns and regional disparities.</div></div><div><h3>Methods</h3><div>We performed a nationwide analysis using Japan’s National Database of Health Insurance Claims and Specific Health Checkups between 2014 and 2022. Three representative otolaryngological procedures–laryngeal surgery, endoscopic sinus surgery, and tympanoplasty–were selected based on their relevance to board certification requirements for otolaryngology specialists. The data were stratified by age, sex, and prefecture, and annual surgery counts as well as rates per 100,000 person-years were calculated. Trends over time were assessed using the Jonckheere-Terpstra trend test and Poisson regression models to estimate the annual risk ratios (RRs). Regional disparities in surgery counts and distribution of board-certified otorhinolaryngologists were evaluated using the Gini coefficient.</div></div><div><h3>Results</h3><div>Age-adjusted rates of laryngeal surgery declined significantly over time among males, females, and the overall population (risk ratio [RR] = 0.924, 0.908, and 0.919, respectively; <em>P</em> &lt; 0.0167). Tympanoplasty showed a smaller but significant decline, while the trends for endoscopic sinus surgery were minimal. Subgroup analyses indicated significant annual decreases among individuals aged 20–89 years, who comprised the majority of laryngeal surgery cases for males, females, and both sexes combined (RR range: 0.875–0.957; all <em>P</em> &lt; 0.0009). The Gini coefficients for all three procedures and the distribution of board-certified otorhinolaryngologists remained below 0.22, indicating low to moderate regional inequality.</div></div><div><h3>Conclusions</h3><div>This nationwide analysis identified distinct demographic trends and modest regional disparities in otolaryngological surgical care in Japan. The consistent decline in laryngeal surgery across major demographic groups suggests a systemic shift in clinical practice, rather than an isolated reduction in disease incidence. These findings highlight the importance of continued support from academic societies and coordinated policy efforts to maintain equitable access to surgical care.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"53 1","pages":"Pages 41-49"},"PeriodicalIF":1.5,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Boron neutron capture therapy for unresectable residual external auditory canal carcinoma","authors":"Hideto Shigemi ,&nbsp;Yoshinori Kadowaki ,&nbsp;Teruhito Aihara ,&nbsp;Satoshi Takeno ,&nbsp;Misaki Iwata ,&nbsp;Kaoru Hashimoto ,&nbsp;Shohei Iwano ,&nbsp;Kazuhiro Yoshinaga ,&nbsp;Yumi Kizu ,&nbsp;Masashi Suzuki ,&nbsp;Takashi Hirano","doi":"10.1016/j.anl.2025.12.007","DOIUrl":"10.1016/j.anl.2025.12.007","url":null,"abstract":"<div><div>Boron neutron capture therapy (BNCT) is a radiation therapy that utilizes the alpha rays produced by the thermal neutron capture reaction of boron nuclei. With BNCT, only unresectable head and neck cancer (HNC) is currently covered by medical insurance in Japan. Some authors have reported the outcomes of BNCT for HNC, but individual case reports are lacking; therefore, the detailed clinical course of such patients remains poorly understood. Herein, we report a case of BNCT treatment for an unresectable residual lesion of external auditory canal carcinoma. A 59-year-old man was diagnosed with squamous cell carcinoma of the right auditory canal. He underwent right lateral temporal bone resection surgery followed by additional chemoradiotherapy; however, a residual preauricular lesion and an unresectable residual lesion deep in the middle ear were identified 2 months later. BNCT was administered for the middle ear and preauricular lesion. Although the preauricular lesion required an additional surgical excision, the middle ear lesion remained locally controlled at the 3-year follow-up. Grade 3 brain radiation necrosis and skin disorders occurred as late adverse events, however, the patient continued his daily activities without any impairment in his quality of life.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"53 1","pages":"Pages 50-54"},"PeriodicalIF":1.5,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and adherence of mobile health-based myofunctional therapy for obstructive sleep apnea","authors":"Liqun Zhu ,&nbsp;Wenqian Zhong ,&nbsp;Meihong Zhang ,&nbsp;Chucheng Wu ,&nbsp;Yuxiang Zhou ,&nbsp;Jing Tao ,&nbsp;Beiping Miao ,&nbsp;Zhenzhang Lu","doi":"10.1016/j.anl.2025.12.003","DOIUrl":"10.1016/j.anl.2025.12.003","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the impact of WeChat applet-based myofunctional therapy (MFT) on the efficacy and adherence of patients with obstructive sleep apnea (OSA) compared to conventional hospital-guided programs.</div></div><div><h3>Methods</h3><div>A parallel-group randomized controlled trial was conducted, enrolling 78 patients with OSA who declined continuous positive airway pressure (CPAP) or surgical treatment (mean age 39.44 ± 9.82 years). Participants were randomly allocated to either the mini-program intervention group (<em>n</em> = 39) or the non-intervention group (<em>n</em> = 39). Both groups underwent a 12-week oropharyngeal muscle training program that targeted the soft palate, tongue, lips, and buccal muscles. The intervention group received video-based guidance, real-time feedback, and automated compliance monitoring via a customized WeChat application, whereas the non-intervention group maintained their records using paper diaries. Outcomes, including polysomnography results, sleep scale scores, and compliance rates, were subsequently compared between the two groups.</div></div><div><h3>Results</h3><div>Sixty-six patients completed the study (32 in the intervention group and 34 in non-intervention group). Improvement in AHI was significantly better in the intervention group than in the non-intervention group (Δ8.92±9.27 vs. Δ2.66±6.80 beats/hour, <em>P</em> &lt; 0.001), and adherence rates were higher at all time points (12 weeks: 73 % vs. 66 %, <em>P</em> = 0.002).</div></div><div><h3>Conclusions</h3><div>Mobile health guided MFT significantly improved treatment adherence in patients with OSA and outperformed traditional modality in terms of improvement in the core metric AHI, providing a digital solution for CPAP-intolerant patients.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"53 1","pages":"Pages 19-26"},"PeriodicalIF":1.5,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical outcome of primary hyperparathyroidism and factors correlated with preoperative serum iPTH concentration","authors":"Akiko Uchida ,&nbsp;Takeshi Igarashi ,&nbsp;Miki Nozawa,&nbsp;Tomohiko Yamauchi,&nbsp;Kota Matsuyama,&nbsp;Ryutaro Onaga,&nbsp;Mari Dias Shimada,&nbsp;Takahiro Fukuhara,&nbsp;Hiroshi Nishino,&nbsp;Makoto Ito,&nbsp;Takeharu Kanazawa","doi":"10.1016/j.anl.2025.11.003","DOIUrl":"10.1016/j.anl.2025.11.003","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to evaluate whether early surgical intervention remains the optimal treatment strategy for primary hyperparathyroidism (PHPT), in light of recent advances in conservative management, by assessing surgical outcomes and examining the clinicopathological factors associated with preoperative intact parathyroid hormone (iPTH) levels.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 80 patients (19 men and 61 women; mean age, 56.8 years) who underwent parathyroidectomy for PHPT between 2014 and 2023. Clinical subtypes were classified as renal, biochemical, or skeletal. Collected data included preoperative and postoperative serum calcium and iPTH levels, imaging findings from ultrasonography and 99mTc-methoxyisobutylisonitrile (MIBI) scintigraphy, pathological diagnoses, and immunohistochemical expression of Cyclin D1 and Ki-67.</div></div><div><h3>Results</h3><div>Renal-type PHPT was the most common subtype (52.5%), followed by biochemical (26.3%) and skeletal (21.2%) types. Parathyroid adenomas accounted for the majority of pathological diagnoses (79.6%). The concordance rate for gland localization using combined ultrasonography and MIBI scintigraphy was 72.1%. Surgery led to significant reductions in serum calcium (from 11.1 to 9.1 mg/dL) and iPTH levels (from 201.8 to 37.5 pg/mL). Tumor size was positively correlated with preoperative iPTH levels, whereas Cyclin D1 and Ki-67 expression were not.</div></div><div><h3>Conclusion</h3><div>Parathyroidectomy yields favorable biochemical outcomes in patients with PHPT and remains the most effective strategy for preventing disease progression. Tumor size was the only factor associated with elevated preoperative iPTH levels. Persistent postoperative iPTH elevation in some patients underscores the importance of early diagnosis and timely surgical intervention, particularly before irreversible systemic complications arise.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"53 1","pages":"Pages 35-40"},"PeriodicalIF":1.5,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C-C chemokine receptor 4 is a candidate for regulatory T-cell-depletion immunotherapy in differentiated thyroid cancer","authors":"Rui Sano ,&nbsp;Hiromu Nakamura ,&nbsp;Susumu Suzuki ,&nbsp;Daisuke Inukai ,&nbsp;Hiroki Okamoto ,&nbsp;Shunpei Yamanaka ,&nbsp;Taishi Takahara ,&nbsp;Akira Satou ,&nbsp;Yasushi Fujimoto ,&nbsp;Toyonori Tsuzuki ,&nbsp;Ryuzo Ueda ,&nbsp;Tetsuya Ogawa","doi":"10.1016/j.anl.2025.12.004","DOIUrl":"10.1016/j.anl.2025.12.004","url":null,"abstract":"<div><h3>Objective</h3><div>Immunotherapy using immune checkpoint inhibitors is a standard treatment option for many types of malignancies but is not effective for differentiated thyroid cancer (DTC). Regulatory T-cells (Tregs), which are one of the main suppressive factors in the tumor microenvironment, are another important target for immunotherapy. This study investigated the characteristics of Tregs in DTC with the aim of further developing immunotherapy.</div></div><div><h3>Methods</h3><div>Peripheral blood lymphocytes (PBLs) and tumor-infiltrating lymphocytes (TILs) were obtained from 12 patients with DTC and 12 patients with goiter (benign control group) who underwent primary surgery between February 2017 and September 2022. Flow cytometry analyses were performed for CD4, CD45RA, FOXP3, C<img>C chemokine receptor 4 (CCR4; a candidate Treg-targeting molecule), and immune checkpoint molecules in order to characterize the features of Tregs.</div></div><div><h3>Results</h3><div>In the DTC patients, age ranged from 39 to 84 years, and the male:female ratio was 7:5. Pathological staging was pT1 or pT2 in 4 patients, pT3 in 8, pN0 in 5, and pN1 in 7, and extrathyroidal extension was observed in 5 patients. Effector Treg (eTreg) frequency in CD4⁺ <em>T</em>-cells in TILs and PBLs was significantly higher in DTC than in goiter. Extrathyroidal extension was associated with a higher eTreg frequency in TILs. A positive correlation was found between eTreg frequency and the expression of immune checkpoint molecules (PD-1, TIM3, GITR, and OX40) on eTregs in TILs from DTC patients. These findings suggest that Tregs are activated in DTC and are important in the creation of an immunosuppressive microenvironment. In addition, the mean positive rate (±standard deviation) of CCR4 on eTregs was high in PBLs (95.8 % ± 3.8 %) and TILs (92.8 % ± 9.8 %) from DTC patients, suggesting that CCR4 is a potential target for eTreg-depletion immunotherapy for DTC.</div></div><div><h3>Conclusion</h3><div>Tregs were increased and activated in DTC tumor tissue, indicating that they play an important role in creating an immunosuppressive microenvironment in DTC. The results suggest that eTreg-depletion immunotherapy using an anti-CCR4 antibody (mogamulizumab) might be effective for treating DTC.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"53 1","pages":"Pages 27-34"},"PeriodicalIF":1.5,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subtotal petrosectomy for extensive cholesteatoma: A case series from Japan","authors":"Hiroshi Sakaida,&nbsp;Kazuhiko Takeuchi","doi":"10.1016/j.anl.2025.12.001","DOIUrl":"10.1016/j.anl.2025.12.001","url":null,"abstract":"<div><h3>Objective</h3><div>Subtotal petrosectomy (STP) is a standard procedure for intractable middle ear disease in Western countries, but reports from Japan are scarce. This report describes the clinical experience, patient characteristics, and surgical outcomes of STP at a tertiary center in Japan.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the medical records of all patients who underwent STP in our department between January 2018 and April 2022. We analyzed patient demographics, underlying pathology, preoperative findings, postoperative complications, and the cholesteatoma recurrence rate.</div></div><div><h3>Results</h3><div>The cohort included 11 patients (7 male, 4 female) with a median age of 75 years. The primary indication was extensive cholesteatoma (11 cases), which was often complicated by dural exposure (6 cases) and labyrinthine fistula (6 cases). Postoperative complications occurred in 1 patient (9 %), who developed a fistula at the blind sac closure site. There were no instances of postoperative facial nerve palsy or inner ear complications. MRI surveillance revealed a residual cholesteatoma recurrence rate of 27 % (3 cases).</div></div><div><h3>Conclusion</h3><div>STP is an option for managing extensive primary cholesteatoma where hearing reconstruction is not feasible, particularly in the elderly population. However, the risk of residual cholesteatoma is significant, as evidenced by a 27 % recurrence rate in this series, and careful surgical indication is essential to avoid potential over-indication. This finding highlights the critical importance of meticulous surgical technique and rigorous postoperative imaging surveillance to ensure long-term disease control.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"53 1","pages":"Pages 13-18"},"PeriodicalIF":1.5,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracranial antitumor efficacy of combination treatment with encorafenib plus binimetinib in BRAF V600E-mutated anaplastic thyroid carcinoma","authors":"Ryutaro Onaga ,&nbsp;Tomohiro Enokida ,&nbsp;Toshifumi Tomioka ,&nbsp;Shingo Sakashita ,&nbsp;Masanobu Sato ,&nbsp;Nobukazu Tanaka ,&nbsp;Yuta Hoshi ,&nbsp;Takuma Kishida ,&nbsp;Ryo Kuboki ,&nbsp;Takao Fujisawa ,&nbsp;Susumu Okano ,&nbsp;Kazuto Matsuura ,&nbsp;Makoto Tahara","doi":"10.1016/j.anl.2025.11.007","DOIUrl":"10.1016/j.anl.2025.11.007","url":null,"abstract":"<div><div>The intracranial antitumor efficacy of combination therapy with BRAF and MEK inhibitors in <em>BRAF</em>-mutated thyroid cancer has not been reported. Here, we describe a case of anaplastic thyroid cancer harboring <em>BRAF</em> V600E mutation with brain metastases which was treated with encorafenib plus binimetinib. The patient was initially diagnosed with T4bN1bM1 and experienced disease progression following surgery and lenvatinib treatment. Encorafenib plus binimetinib was initiated as second-line treatment seven months after the surgery. After achieving sustained disease stabilization, a solitary asymptomatic brain metastasis was detected following a three-week interruption due to COVID-19 infection. The lesion shrank after only two weeks of resumed encorafenib plus binimetinib, and additional stereotactic radiosurgery was performed without significant adverse events. This case suggests that the combination of BRAF and MEK inhibitors may be a viable treatment option for brain metastasis in <em>BRAF</em>-mutated thyroid cancer, despite general prioritization of local treatments. In addition, encorafenib plus binimetinib treatment may suppress the growth of microscopic metastasis. This possibility is supported by reliable evidence for the use of BRAF plus MEK inhibitor for brain metastasis from <em>BRAF</em>-mutated malignant melanoma. We conclude that encorafenib plus binimetinib treatment for brain metastasis from <em>BRAF</em>-mutated thyroid cancer is a safe and effective treatment choice.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"53 1","pages":"Pages 7-12"},"PeriodicalIF":1.5,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prognostic impact of sarcopenia and systemic inflammation in head and neck cancer patients treated with immune checkpoint inhibitors","authors":"Ken Kasahara ,&nbsp;Takeyuki Kono ,&nbsp;Yoichiro Sato ,&nbsp;Keisuke Okubo ,&nbsp;Ayaka Sasaki ,&nbsp;Ko Hentona ,&nbsp;Yutaro Mokudai ,&nbsp;Keigo Oguchi ,&nbsp;Motoki Izawa ,&nbsp;Seiichi Shinden ,&nbsp;Hiroyuki Ozawa","doi":"10.1016/j.anl.2025.11.006","DOIUrl":"10.1016/j.anl.2025.11.006","url":null,"abstract":"<div><h3>Objective</h3><div>Sarcopenia and systemic inflammatory markers predict prognosis in various cancers, including head and neck cancer (HNC) treated with surgery or chemoradiotherapy. Their significance in patients receiving immune checkpoint inhibitors (ICIs), however, remains unclear. This study aims to determine whether skeletal muscle loss and systemic inflammation influence treatment response and survival in ICI-treated HNC, and whether composite indices provide prognostic value.</div></div><div><h3>Methods</h3><div>A retrospective cohort of 179 patients with histologically confirmed recurrent or metastatic (R/M) HNC who received ICI therapy between April 2017 and July 2024 was analyzed. Sarcopenia was assessed using the lumbar skeletal muscle index (LSMI), calculated from cervical CT images. Inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) were derived from pre-treatment blood samples. Overall survival (OS) and progression-free survival (PFS) were evaluated using Kaplan–Meier estimates, and prognostic factors were identified through Cox regression analysis.</div></div><div><h3>Results</h3><div>Among the 179 patients, 98 (54.7%) were classified as sarcopenic. These patients had significantly shorter median OS compared to non-sarcopenic patients (12.1 vs. 39.8 months; p &lt; 0.001). Univariate analysis identified sarcopenia, BMI, NLR, and PLR as significant predictors of OS. However, multivariate Cox analysis revealed that only sarcopenia remained an independent prognostic factor for both OS (HR 1.94; 95% CI: 1.15–3.27; p = 0.013) and PFS (HR 1.92; 95% CI: 1.33–2.75; p &lt; 0.001). Inflammatory markers and their composite indices failed to retain prognostic significance in adjusted models.</div></div><div><h3>Conclusion</h3><div>Sarcopenia independently predicts poor survival outcomes in patients with R/M HNC undergoing ICI therapy, whereas conventional inflammatory markers such as NLR, PLR, and LMR, alone or in combination with sarcopenia, lack independent prognostic value. Routine pre-treatment evaluation of skeletal muscle mass using CT imaging may offer a practical and effective tool for patient risk stratification.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"53 1","pages":"Pages 1-6"},"PeriodicalIF":1.5,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}