Pub Date : 2025-12-11DOI: 10.1016/j.amjoto.2025.104769
Diana N. Kirke , Diana S. Shaari , Corina Din-Lovinescu , Andrew Blitzer , Marshall Strome
Objective
This longitudinal case series reports our ongoing experience with metformin, an oral antihyperglycemic drug, as a possible agent to halt the progression of dysplastic lesions to carcinoma, in those with previously treated head and neck squamous cell carcinoma (HNSCC).
Design
Case series.
Results
Three patients were included who had laryngeal dysplasia (age 66.67 ± 7.09; range 59–73 years; 3 male) with a follow up time of 17 to 88 months. The average dose of metformin was 500 mg twice daily. Two patients showed complete or partial regression of the dysplastic mucosa, while the third demonstrated a worsening of dysplasia after he halted treatment for six weeks.
Conclusion
Metformin is a safe agent that has the potential to prevent progression of laryngeal dysplasia in patients with a history of HNSCC. Further studies are needed to verify and expand on this limited case series.
{"title":"The role of metformin in dysplastic mucosa of the larynx: A follow up study","authors":"Diana N. Kirke , Diana S. Shaari , Corina Din-Lovinescu , Andrew Blitzer , Marshall Strome","doi":"10.1016/j.amjoto.2025.104769","DOIUrl":"10.1016/j.amjoto.2025.104769","url":null,"abstract":"<div><h3>Objective</h3><div>This longitudinal case series reports our ongoing experience with metformin, an oral antihyperglycemic drug, as a possible agent to halt the progression of dysplastic lesions to carcinoma, in those with previously treated head and neck squamous cell carcinoma (HNSCC).</div></div><div><h3>Design</h3><div>Case series.</div></div><div><h3>Results</h3><div>Three patients were included who had laryngeal dysplasia (age 66.67 ± 7.09; range 59–73 years; 3 male) with a follow up time of 17 to 88 months. The average dose of metformin was 500 mg twice daily. Two patients showed complete or partial regression of the dysplastic mucosa, while the third demonstrated a worsening of dysplasia after he halted treatment for six weeks.</div></div><div><h3>Conclusion</h3><div>Metformin is a safe agent that has the potential to prevent progression of laryngeal dysplasia in patients with a history of HNSCC. Further studies are needed to verify and expand on this limited case series.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 1","pages":"Article 104769"},"PeriodicalIF":1.7,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780012","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}
Pub Date : 2025-12-08DOI: 10.1016/j.amjoto.2025.104782
Haigang Zhang
{"title":"Preliminary study on classification and treatment of type I variant preauricular fistula","authors":"Haigang Zhang","doi":"10.1016/j.amjoto.2025.104782","DOIUrl":"10.1016/j.amjoto.2025.104782","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 1","pages":"Article 104782"},"PeriodicalIF":1.7,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766879","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}
Pub Date : 2025-12-08DOI: 10.1016/j.amjoto.2025.104781
Kanu Lal Saha
{"title":"Preliminary study on classification and treatment of type I variant preauricular fistula","authors":"Kanu Lal Saha","doi":"10.1016/j.amjoto.2025.104781","DOIUrl":"10.1016/j.amjoto.2025.104781","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 1","pages":"Article 104781"},"PeriodicalIF":1.7,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145748371","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}
Pub Date : 2025-12-06DOI: 10.1016/j.amjoto.2025.104758
Michael Xie , Han Zhang , Phillip Staibano , Zahra Abdallah , Michael K. Gupta , Nhu Tram Nguyen
Objective
To identify the prognostic value of sarcopenia in surgically treated HNC patients on postoperative morbidity.
Design
Systematic review and meta-analysis.
Information sources, study selection, and methods
EMBASE, MEDLINE, SCOPUS, and CINAHL databases were searched from January 1, 1946 to November 4, 2024. Published trials and observational studies reporting the association of sarcopenia and postoperative complications in surgically treated HNC patients were included. Two reviewers independently screened, extracted, and appraised studies using Covidence. Disagreements were resolved through consensus, and/or by consulting a third reviewer. Data were pooled using a random-effects model in RevMan 5.4.1.
Results
Of 6345 screened studies, 17 out of the 23 included studies had outcomes which were incorporated in the meta-analysis (2884 patients from studies between 1996 and 2024). The meta-analysis revealed a statistically significant association between sarcopenia and all postoperative complications (odds ratio (OR) 2.26, 95 % CI [1.54, 3.33], p < 0.0001), postoperative complications grade 3 (OR 2.34, 95 % CI [1.80, 3.03], p < 0.00001), fistula (OR 2.64, 95 % CI [1.68, 4.16], p < 0.0001), and flap complications (OR 2.77, 95 % CI [1.58, 4.85], p = 0.0004). Subgroup analysis revealed the high risk of bias studies did not significantly bias the results (p = 0.76), but the different measurements of sarcopenia contributed significant heterogeneity (p < 0.00001). The level of evidence is moderate, primarily due to publication bias, for all outcomes, as per GRADE.
Conclusions
In patients undergoing curative surgery for HNC, preoperative sarcopenia is associated with higher odds of postoperative complications.
目的：探讨手术治疗的HNC患者肌肉减少症对术后发病率的预后价值。设计：系统回顾和荟萃分析。信息来源、研究选择和方法：检索1946年1月1日至2024年11月4日的EMBASE、MEDLINE、SCOPUS和CINAHL数据库。已发表的试验和观察性研究报告了手术治疗的HNC患者肌肉减少症与术后并发症的关系。两名审稿人独立筛选、提取和评价了使用covid - ence的研究。分歧通过协商一致和/或咨询第三方审稿人来解决。数据采用RevMan 5.4.1中的随机效应模型进行汇总。结果：在6345项筛选的研究中，23项纳入的研究中有17项的结果纳入了荟萃分析（来自1996年至2024年研究的2884名患者）。荟萃分析显示，肌肉减少症与所有术后并发症之间存在统计学意义上的相关性（优势比（OR） 2.26, 95% CI [1.54, 3.33], p）。结论：在接受根治性手术的HNC患者中，术前肌肉减少症与术后并发症的发生率较高相关。
{"title":"Sarcopenia and postoperative morbidity in head & neck cancer: A systematic review and meta-analysis","authors":"Michael Xie , Han Zhang , Phillip Staibano , Zahra Abdallah , Michael K. Gupta , Nhu Tram Nguyen","doi":"10.1016/j.amjoto.2025.104758","DOIUrl":"10.1016/j.amjoto.2025.104758","url":null,"abstract":"<div><h3>Objective</h3><div>To identify the prognostic value of sarcopenia in surgically treated HNC patients on postoperative morbidity.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Information sources, study selection, and methods</h3><div>EMBASE, MEDLINE, SCOPUS, and CINAHL databases were searched from January 1, 1946 to November 4, 2024. Published trials and observational studies reporting the association of sarcopenia and postoperative complications in surgically treated HNC patients were included. Two reviewers independently screened, extracted, and appraised studies using Covidence. Disagreements were resolved through consensus, and/or by consulting a third reviewer. Data were pooled using a random-effects model in RevMan 5.4.1.</div></div><div><h3>Results</h3><div>Of 6345 screened studies, 17 out of the 23 included studies had outcomes which were incorporated in the meta-analysis (2884 patients from studies between 1996 and 2024). The meta-analysis revealed a statistically significant association between sarcopenia and all postoperative complications (odds ratio (OR) 2.26, 95 % CI [1.54, 3.33], <em>p</em> < 0.0001), postoperative complications grade 3 (OR 2.34, 95 % CI [1.80, 3.03], <em>p</em> < 0.00001), fistula (OR 2.64, 95 % CI [1.68, 4.16], <em>p</em> < 0.0001), and flap complications (OR 2.77, 95 % CI [1.58, 4.85], <em>p</em> = 0.0004). Subgroup analysis revealed the high risk of bias studies did not significantly bias the results (<em>p</em> = 0.76), but the different measurements of sarcopenia contributed significant heterogeneity (<em>p</em> < 0.00001). The level of evidence is moderate, primarily due to publication bias, for all outcomes, as per GRADE.</div></div><div><h3>Conclusions</h3><div>In patients undergoing curative surgery for HNC, preoperative sarcopenia is associated with higher odds of postoperative complications.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 1","pages":"Article 104758"},"PeriodicalIF":1.7,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145713039","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}
Pub Date : 2025-12-05DOI: 10.1016/j.amjoto.2025.104783
Ziyu Chen , Hang Su , Juanjuan Hao , Fenghua Zhang
{"title":"Reply to the comment on “Clinicopathological features and prognostic value of CD276 expression in head and neck cancer: A meta-analysis”","authors":"Ziyu Chen , Hang Su , Juanjuan Hao , Fenghua Zhang","doi":"10.1016/j.amjoto.2025.104783","DOIUrl":"10.1016/j.amjoto.2025.104783","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 1","pages":"Article 104783"},"PeriodicalIF":1.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145740190","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}
Pub Date : 2025-12-05DOI: 10.1016/j.amjoto.2025.104776
Alec Kadrie , Jonathan Laredo , Evan Thomson , M. Boyd Gillespie
Objective
To compare short- and long-term clinical outcomes of continuous positive airway pressure versus palatal surgical interventions such as uvulopalatopharyngoplasty, including their impacts on sleep apnea-related cardiac, respiratory, and metabolic comorbidities.
Study design
Retrospective cohort study.
Setting
Database study using the TriNetX Network of Tennessee (2014–2024).
Methods
Adult patients diagnosed with obstructive sleep apnea and treated with either continuous positive airway pressure or palatal surgery were identified. Propensity score matching was performed to balance demographics and preexisting comorbidities between groups. Primary outcomes were cardiopulmonary events, and secondary outcomes were new-onset type 2 diabetes and weight change. Odds ratio with 95 % confidence intervals were computed across outcome measures.
Results
A total of 5030 continuous positive airway pressure and 220 palatal surgery patients met inclusion criteria. Following matching, 220 patients remained in each group. Patients treated with continuous positive airway pressure had significantly higher odds of post-treatment electronic medical record coding of acute respiratory failure (OR 4.67, [2.27, 9.60]), pulmonary hypertension (OR 20.0, [2.71, 147.7]), and new-onset atrial fibrillation/flutter (OR 3.32, [1.60, 6.96]) compared to the surgical cohort. No significant differences were observed in myocardial infarction, stroke, or new-onset type 2 diabetes.
Conclusion
Patients treated with continuous positive airway pressure had higher odds of post-treatment electronic medical recording coding of cardiorespiratory complications than those undergoing palatal surgery. These findings highlight potentially important differences between treatment modalities in long-term obstructive sleep apnea related comorbidities.
{"title":"Continuous positive airway pressure vs palatal surgery: Outcomes in obstructive sleep apnea treatment","authors":"Alec Kadrie , Jonathan Laredo , Evan Thomson , M. Boyd Gillespie","doi":"10.1016/j.amjoto.2025.104776","DOIUrl":"10.1016/j.amjoto.2025.104776","url":null,"abstract":"<div><h3>Objective</h3><div>To compare short- and long-term clinical outcomes of continuous positive airway pressure versus palatal surgical interventions such as uvulopalatopharyngoplasty, including their impacts on sleep apnea-related cardiac, respiratory, and metabolic comorbidities.</div></div><div><h3>Study design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Database study using the TriNetX Network of Tennessee (2014–2024).</div></div><div><h3>Methods</h3><div>Adult patients diagnosed with obstructive sleep apnea and treated with either continuous positive airway pressure or palatal surgery were identified. Propensity score matching was performed to balance demographics and preexisting comorbidities between groups. Primary outcomes were cardiopulmonary events, and secondary outcomes were new-onset type 2 diabetes and weight change. Odds ratio with 95 % confidence intervals were computed across outcome measures.</div></div><div><h3>Results</h3><div>A total of 5030 continuous positive airway pressure and 220 palatal surgery patients met inclusion criteria. Following matching, 220 patients remained in each group. Patients treated with continuous positive airway pressure had significantly higher odds of post-treatment electronic medical record coding of acute respiratory failure (OR 4.67, [2.27, 9.60]), pulmonary hypertension (OR 20.0, [2.71, 147.7]), and new-onset atrial fibrillation/flutter (OR 3.32, [1.60, 6.96]) compared to the surgical cohort. No significant differences were observed in myocardial infarction, stroke, or new-onset type 2 diabetes.</div></div><div><h3>Conclusion</h3><div>Patients treated with continuous positive airway pressure had higher odds of post-treatment electronic medical recording coding of cardiorespiratory complications than those undergoing palatal surgery. These findings highlight potentially important differences between treatment modalities in long-term obstructive sleep apnea related comorbidities.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 1","pages":"Article 104776"},"PeriodicalIF":1.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145691265","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}
Pub Date : 2025-12-04DOI: 10.1016/j.amjoto.2025.104768
Joo Hyun Kim
Purpose
To evaluate how stone location and size influence surgical approach selection in submandibular sialolithiasis, and to identify computed tomography (CT)-based imaging predictors to aid preoperative planning.
Methods
We retrospectively reviewed 428 consecutive surgeries (March 2020–December 2024). Preoperative non-contrast CT classified stones as distal duct, mid-duct, hilum, or intraglandular. Surgical approaches were transoral ductal incision, sialendoscopy-assisted removal, and external submandibular gland excision. Group comparisons used standard parametric/non-parametric tests. Receiver operating characteristic (ROC) analysis assessed size thresholds associated with selection of an invasive approach.
Results
Distal duct stones were most often treated by transoral incision (83.7 %), mid-duct stones by sialendoscopy-assisted removal (58.1 %), and intraglandular stones by external excision (71.0 %). Stones in the hilum/intraglandular regions were significantly larger than those in distal or mid-duct locations (p < 0.001). ROC analysis identified 5.5 mm as the optimal cutoff for predicting selection of an invasive approach (AUC = 0.83; sensitivity 74.2 %; specificity 78.9 %). Overall surgical success was 97.8 %. Complication rates varied by approach, lowest after sialendoscopy-assisted removal (4.4 %) and highest after external excision (15.2 %).
Conclusions
A simple CT-based framework incorporating stone location and size was associated with approach selection and outcomes in submandibular sialolithiasis. Using a 5.5 mm size threshold alongside anatomic zoning may help guide minimally invasive, gland-preserving strategies and reduce morbidity. Prospective validation is warranted.
{"title":"Surgical strategy in submandibular sialolithiasis: Impact of stone location and size on approach selection and outcomes","authors":"Joo Hyun Kim","doi":"10.1016/j.amjoto.2025.104768","DOIUrl":"10.1016/j.amjoto.2025.104768","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate how stone location and size influence surgical approach selection in submandibular sialolithiasis, and to identify computed tomography (CT)-based imaging predictors to aid preoperative planning.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 428 consecutive surgeries (March 2020–December 2024). Preoperative non-contrast CT classified stones as distal duct, mid-duct, hilum, or intraglandular. Surgical approaches were transoral ductal incision, sialendoscopy-assisted removal, and external submandibular gland excision. Group comparisons used standard parametric/non-parametric tests. Receiver operating characteristic (ROC) analysis assessed size thresholds associated with selection of an invasive approach.</div></div><div><h3>Results</h3><div>Distal duct stones were most often treated by transoral incision (83.7 %), mid-duct stones by sialendoscopy-assisted removal (58.1 %), and intraglandular stones by external excision (71.0 %). Stones in the hilum/intraglandular regions were significantly larger than those in distal or mid-duct locations (<em>p</em> < 0.001). ROC analysis identified 5.5 mm as the optimal cutoff for predicting selection of an invasive approach (AUC = 0.83; sensitivity 74.2 %; specificity 78.9 %). Overall surgical success was 97.8 %. Complication rates varied by approach, lowest after sialendoscopy-assisted removal (4.4 %) and highest after external excision (15.2 %).</div></div><div><h3>Conclusions</h3><div>A simple CT-based framework incorporating stone location and size was associated with approach selection and outcomes in submandibular sialolithiasis. Using a 5.5 mm size threshold alongside anatomic zoning may help guide minimally invasive, gland-preserving strategies and reduce morbidity. Prospective validation is warranted.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 1","pages":"Article 104768"},"PeriodicalIF":1.7,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145713001","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}
Pub Date : 2025-12-04DOI: 10.1016/j.amjoto.2025.104766
Joong Ho Ahn
Dexamethasone palmitate (DXP) is a lipophilic, esterified corticosteroid with sustained-release properties that may provide advantages over conventional water-soluble dexamethasone in intratympanic therapy for sudden sensorineural hearing loss (SSNHL). We report the safety and clinical outcomes of intratympanic DXP injection in three patients with profound SSNHL. All patients also received systemic steroids and hyperbaric oxygen therapy, along with six sessions of intratympanic DXP. Two patients demonstrated substantial improvement in hearing thresholds and speech discrimination within 3 months, whereas one patient who presented late showed no recovery. No adverse effects, such as pain, inflammation, or tympanic membrane complications, were observed. The increased viscosity and lipophilicity of DXP likely enhance cochlear drug delivery and prolong therapeutic retention. These findings suggest that DXP is a safe and potentially effective intratympanic option for SSNHL, particularly when administered early.
{"title":"Dexamethasone palmitate: A promising intratympanic treatment option for severe sudden hearing loss","authors":"Joong Ho Ahn","doi":"10.1016/j.amjoto.2025.104766","DOIUrl":"10.1016/j.amjoto.2025.104766","url":null,"abstract":"<div><div>Dexamethasone palmitate (DXP) is a lipophilic, esterified corticosteroid with sustained-release properties that may provide advantages over conventional water-soluble dexamethasone in intratympanic therapy for sudden sensorineural hearing loss (SSNHL). We report the safety and clinical outcomes of intratympanic DXP injection in three patients with profound SSNHL. All patients also received systemic steroids and hyperbaric oxygen therapy, along with six sessions of intratympanic DXP. Two patients demonstrated substantial improvement in hearing thresholds and speech discrimination within 3 months, whereas one patient who presented late showed no recovery. No adverse effects, such as pain, inflammation, or tympanic membrane complications, were observed. The increased viscosity and lipophilicity of DXP likely enhance cochlear drug delivery and prolong therapeutic retention. These findings suggest that DXP is a safe and potentially effective intratympanic option for SSNHL, particularly when administered early.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 1","pages":"Article 104766"},"PeriodicalIF":1.7,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145773166","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}
Pub Date : 2025-12-04DOI: 10.1016/j.amjoto.2025.104779
Iris Lee , Sonam Verma , John S. Schneider , Nyssa F. Farrell , Peggy L. Kendall , Lauren T. Roland
Background
Invasive Fungal Sinusitis (IFS) is a deadly and morbid disease of the paranasal sinuses. Immunocompromised patients are at risk of developing IFS, and survival at 6 months is approximately 50%. Previously studied treatments such as granulocyte stimulating factor have not improved survival. Thus, the immune cells responsible for survival in this vulnerable population are not well defined.
Objective
The goal of this study was to immunophenotype cells associated with IFS survival.
Methods
Blood samples from consenting patients were collected at the time of surgery for IFS between April 2022 and December 2023. Peripheral blood mononuclear cells (PBMCs) were evaluated for major lymphoid and myeloid subsets using mass Cytometry by Time of Flight (CyTOF) between IFS survivors and non-survivors, defined by vital status 6 months after the time of diagnosis. Data were analyzed using the dimensionality reduction algorithm optimized t-distributed stochastic neighbor embedding (opt-SNE).
Results
Seven patients had PBMCs viable for analysis (3 survivors and 4 non-survivors). Total white blood cell counts were lower in non-survivors. Total T cell and B cell counts were decreased in non-survivors as compared to survivors, but there were no differences in other immune cell populations, such as NK cells or monocytes. Percentage differences were identified as deficiencies in CD4 T cells, particularly memory cells, in the IFS non-survivors.
Conclusion
Future work includes the investigation of CD4 T cells as a biomarker for IFS survival and the study of T cell manipulation or stimulation in IFS patients.
{"title":"Preservation of adaptive immunity is associated with survival in invasive fungal sinusitis","authors":"Iris Lee , Sonam Verma , John S. Schneider , Nyssa F. Farrell , Peggy L. Kendall , Lauren T. Roland","doi":"10.1016/j.amjoto.2025.104779","DOIUrl":"10.1016/j.amjoto.2025.104779","url":null,"abstract":"<div><h3>Background</h3><div>Invasive Fungal Sinusitis (IFS) is a deadly and morbid disease of the paranasal sinuses. Immunocompromised patients are at risk of developing IFS, and survival at 6 months is approximately 50%. Previously studied treatments such as granulocyte stimulating factor have not improved survival. Thus, the immune cells responsible for survival in this vulnerable population are not well defined.</div></div><div><h3>Objective</h3><div>The goal of this study was to immunophenotype cells associated with IFS survival.</div></div><div><h3>Methods</h3><div>Blood samples from consenting patients were collected at the time of surgery for IFS between April 2022 and December 2023. Peripheral blood mononuclear cells (PBMCs) were evaluated for major lymphoid and myeloid subsets using mass Cytometry by Time of Flight (CyTOF) between IFS survivors and non-survivors, defined by vital status 6 months after the time of diagnosis. Data were analyzed using the dimensionality reduction algorithm optimized t-distributed stochastic neighbor embedding (opt-SNE).</div></div><div><h3>Results</h3><div>Seven patients had PBMCs viable for analysis (3 survivors and 4 non-survivors). Total white blood cell counts were lower in non-survivors. Total T cell and B cell counts were decreased in non-survivors as compared to survivors, but there were no differences in other immune cell populations, such as NK cells or monocytes. Percentage differences were identified as deficiencies in CD4 T cells, particularly memory cells, in the IFS non-survivors.</div></div><div><h3>Conclusion</h3><div>Future work includes the investigation of CD4 T cells as a biomarker for IFS survival and the study of T cell manipulation or stimulation in IFS patients.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 1","pages":"Article 104779"},"PeriodicalIF":1.7,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712990","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}
To evaluate the incidence, diagnostic accuracy, surgical outcomes, complications, and patient-reported aesthetic satisfaction among patients with surgically treated Warthin's tumor (WT) over a 14-year period in a single tertiary center.
Methods
A retrospective review of 150 patients undergoing parotidectomy (2009–2022) was performed. Fifty-four patients with histopathologically confirmed WT comprised the primary analysis group. Demographics, smoking history, preoperative diagnostics [fine-needle aspiration cytology (FNAC), ultrasonography (US), magnetic resonance imaging (MRI)], surgical technique, and outcomes were recorded. Aesthetic satisfaction was assessed in a prospective subgroup (n = 37) using a 5-point Likert scale. Statistical analyses were applied with significance at p < 0.05.
Results
WT accounted for 41.2 % of benign parotid tumors, nearly equal to pleomorphic adenoma (42.0 %). Mean age was 59.5 ± 8.9 years; 75.9 % were male. Mean smoking exposure was 42 ± 12.5 pack-years, and all patients with metachronous contralateral tumors continued smoking. FNAC sensitivity was 77.8 % overall and 91.3 % for adequate samples (PPV 94.4 %). US suggested WT in 5/43 (11.6 %) of reported examinations; MRI suggested WT in 34/39 (87.2 %) of US/MRI reports available. Superficial parotidectomy was performed in 70.4 % and partial superficial parotidectomy in 29.6 %. The most common complication was great auricular nerve sensory deficit (35.2 %); permanent facial nerve paralysis occurred in 1.9 %. In the aesthetic subgroup, 8.1 % rated contour deformity as “Poor/Very Poor,” and 10.8 % reported similar dissatisfaction with scarring.
Conclusion
Our 14-year analysis confirms that WT now constitutes a substantial proportion of benign parotid tumors, approaching the incidence of pleomorphic adenoma, with a strong association with smoking. FNAC and MRI demonstrated high diagnostic accuracy, supporting their role in reliable preoperative evaluation. While surgical treatment remains safe, postoperative sensory deficits and aesthetic concerns are not uncommon and may meaningfully affect patient satisfaction, even after limited surgery. Individualized management—particularly active surveillance for small, asymptomatic tumors in elderly or comorbid patients—may help balance oncologic safety with quality-of-life considerations.
{"title":"Warthin's tumor of the parotid gland: A 14-year retrospective review of surgical outcomes, diagnostic accuracy and patient-reported aesthetic satisfaction","authors":"Ethem İlhan , Melek Uyar , Sibel Bektaş , Çağla Arukan","doi":"10.1016/j.amjoto.2025.104775","DOIUrl":"10.1016/j.amjoto.2025.104775","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the incidence, diagnostic accuracy, surgical outcomes, complications, and patient-reported aesthetic satisfaction among patients with surgically treated Warthin's tumor (WT) over a 14-year period in a single tertiary center.</div></div><div><h3>Methods</h3><div>A retrospective review of 150 patients undergoing parotidectomy (2009–2022) was performed. Fifty-four patients with histopathologically confirmed WT comprised the primary analysis group. Demographics, smoking history, preoperative diagnostics [fine-needle aspiration cytology (FNAC), ultrasonography (US), magnetic resonance imaging (MRI)], surgical technique, and outcomes were recorded. Aesthetic satisfaction was assessed in a prospective subgroup (<em>n</em> = 37) using a 5-point Likert scale. Statistical analyses were applied with significance at <em>p</em> < 0.05.</div></div><div><h3>Results</h3><div>WT accounted for 41.2 % of benign parotid tumors, nearly equal to pleomorphic adenoma (42.0 %). Mean age was 59.5 ± 8.9 years; 75.9 % were male. Mean smoking exposure was 42 ± 12.5 pack-years, and all patients with metachronous contralateral tumors continued smoking. FNAC sensitivity was 77.8 % overall and 91.3 % for adequate samples (PPV 94.4 %). US suggested WT in 5/43 (11.6 %) of reported examinations; MRI suggested WT in 34/39 (87.2 %) of US/MRI reports available. Superficial parotidectomy was performed in 70.4 % and partial superficial parotidectomy in 29.6 %. The most common complication was great auricular nerve sensory deficit (35.2 %); permanent facial nerve paralysis occurred in 1.9 %. In the aesthetic subgroup, 8.1 % rated contour deformity as “Poor/Very Poor,” and 10.8 % reported similar dissatisfaction with scarring.</div></div><div><h3>Conclusion</h3><div>Our 14-year analysis confirms that WT now constitutes a substantial proportion of benign parotid tumors, approaching the incidence of pleomorphic adenoma, with a strong association with smoking. FNAC and MRI demonstrated high diagnostic accuracy, supporting their role in reliable preoperative evaluation. While surgical treatment remains safe, postoperative sensory deficits and aesthetic concerns are not uncommon and may meaningfully affect patient satisfaction, even after limited surgery. Individualized management—particularly active surveillance for small, asymptomatic tumors in elderly or comorbid patients—may help balance oncologic safety with quality-of-life considerations.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 1","pages":"Article 104775"},"PeriodicalIF":1.7,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145720103","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号