Pub Date : 2024-10-23DOI: 10.1177/01455613241292195
Mohammed Hazazi, Eman Almashharawi, Saleh Alamry, Meshael M Alkusayer, Alwaleed Altimyat, Yazeed Alsalamah
Background: Cerebrospinal fluid (CSF) gusher is a common complication experienced during cochlear implantation in patients with structural deformities in the inner ear. Objectives: This study aimed to investigate the incidence of CSF gusher, risk factors, and outcomes in patients during cochlear implantation. Methods: This systematic review and meta-analysis were guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses model. Studies used in the analysis were identified through a comprehensive search in Google Scholar and PubMed. Results: The analysis was performed using 13 retrospective studies. The incidence of CSF gusher was 5% (95% CI: 3%-9%). CSF gusher was more prevalent among patients with inner-ear malformation (IEM) than without IEM odds ratio = 63.01 (95% CI: 9.85-403.11, P < .00001, I2 = 88%). For incomplete partition (IP), CSF gusher in the IP-I group was 48% (95% CI: 25%-71%, I2 = 0%), 19% in IP-II, 86% in IP-III, 40% in the common cavity, 26% in cochlear hypoplasia, and 27% in patients with enlarged vestibula aqueduct. Conclusion: The CSF gusher incidences were determined to be 5%. Patients with IEM are at increased risk of experiencing CSF gusher during cochlear implant surgery. Therefore, precise scanning reports should be produced in preoperational phase to inform proper management techniques to reduce the chances of intraoperative complications, including CSF gusher.
{"title":"Retrospective Analysis of Cerebrospinal Gushers in Cochlear Implant Surgery: Incidence, Risk Factors, and Outcomes-A Systematic Review and Meta-analysis.","authors":"Mohammed Hazazi, Eman Almashharawi, Saleh Alamry, Meshael M Alkusayer, Alwaleed Altimyat, Yazeed Alsalamah","doi":"10.1177/01455613241292195","DOIUrl":"https://doi.org/10.1177/01455613241292195","url":null,"abstract":"<p><p><b>Background:</b> Cerebrospinal fluid (CSF) gusher is a common complication experienced during cochlear implantation in patients with structural deformities in the inner ear. <b>Objectives:</b> This study aimed to investigate the incidence of CSF gusher, risk factors, and outcomes in patients during cochlear implantation. <b>Methods:</b> This systematic review and meta-analysis were guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses model. Studies used in the analysis were identified through a comprehensive search in Google Scholar and PubMed. <b>Results:</b> The analysis was performed using 13 retrospective studies. The incidence of CSF gusher was 5% (95% CI: 3%-9%). CSF gusher was more prevalent among patients with inner-ear malformation (IEM) than without IEM odds ratio = 63.01 (95% CI: 9.85-403.11, <i>P</i> < .00001, <i>I</i><sup>2</sup> = 88%). For incomplete partition (IP), CSF gusher in the IP-I group was 48% (95% CI: 25%-71%, <i>I</i><sup>2</sup> = 0%), 19% in IP-II, 86% in IP-III, 40% in the common cavity, 26% in cochlear hypoplasia, and 27% in patients with enlarged vestibula aqueduct. <b>Conclusion:</b> The CSF gusher incidences were determined to be 5%. Patients with IEM are at increased risk of experiencing CSF gusher during cochlear implant surgery. Therefore, precise scanning reports should be produced in preoperational phase to inform proper management techniques to reduce the chances of intraoperative complications, including CSF gusher.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-23DOI: 10.1177/01455613241292734
Tarik Yagci, Zehra Gunay Yagci
Objective: This study evaluated patients' body perception, self-esteem, and personality traits during the preoperative and postoperative periods of septorhinoplasty. Based on these evaluations, we may provide patient selection recommendations for septorhinoplasty applicants. Methods: In this cross-sectional questionnaire study, 86 patients who underwent primary septorhinoplasty in the Department of Otolaryngology at Bilecik Training and Research Hospital were included between March 2023 and 2024. The same surgeon performed all operations. The preoperative Rhinoplasty Outcome Evaluation (ROE) Questionnaire, Rosenberg Self-Esteem Scale (RSES), Body Perception Scale (BPS), Toronto Alexithymia Scale (TAS), and TEMPS-A Temperament Scale in the preoperative period and ROE, RSES, and BPS in the postoperative period were applied. Results: Fifty-four female and 32 male patients participated in our study. The mean age was 24.0 ± 0.6 years. While there was no significant difference in the BPS and RSES scores between the preoperative and postoperative periods, the total ROE score was significantly higher in the postoperative than in the preoperative period. Postoperative ROE scores were positively correlated with RSES and hyperthymic temperament. In contrast, it was negatively correlated with depressive temperament, cyclothymic temperament, anxious temperament, BPS total score, TAS total score, and TAS emotion recognition and expression subscale scores. In the group with alexithymia features separated according to the TAS cutoff score, preoperative and postoperative ROE results were significantly lower, whereas depressive, cyclothymic, irritable, and anxious personality traits and total BPS scores were higher. However, the postoperative RSBE scores were lower in this group. Conclusion: This is the first study to evaluate self-esteem, body image, alexithymia, and personality traits in septorhinoplasty patients. Appropriate patient selection is essential for success and patient satisfaction in aesthetic operations such as septorhinoplasty. Performing BPS, TEMPS-A, and TAS may help evaluate psychological factors.
{"title":"Investigation of Body Perception, Alexithymic Characteristics, and Self-Esteem in Patients Underwent Septorhinoplasty.","authors":"Tarik Yagci, Zehra Gunay Yagci","doi":"10.1177/01455613241292734","DOIUrl":"https://doi.org/10.1177/01455613241292734","url":null,"abstract":"<p><p><b>Objective:</b> This study evaluated patients' body perception, self-esteem, and personality traits during the preoperative and postoperative periods of septorhinoplasty. Based on these evaluations, we may provide patient selection recommendations for septorhinoplasty applicants. <b>Methods:</b> In this cross-sectional questionnaire study, 86 patients who underwent primary septorhinoplasty in the Department of Otolaryngology at Bilecik Training and Research Hospital were included between March 2023 and 2024. The same surgeon performed all operations. The preoperative Rhinoplasty Outcome Evaluation (ROE) Questionnaire, Rosenberg Self-Esteem Scale (RSES), Body Perception Scale (BPS), Toronto Alexithymia Scale (TAS), and TEMPS-A Temperament Scale in the preoperative period and ROE, RSES, and BPS in the postoperative period were applied. <b>Results:</b> Fifty-four female and 32 male patients participated in our study. The mean age was 24.0 ± 0.6 years. While there was no significant difference in the BPS and RSES scores between the preoperative and postoperative periods, the total ROE score was significantly higher in the postoperative than in the preoperative period. Postoperative ROE scores were positively correlated with RSES and hyperthymic temperament. In contrast, it was negatively correlated with depressive temperament, cyclothymic temperament, anxious temperament, BPS total score, TAS total score, and TAS emotion recognition and expression subscale scores. In the group with alexithymia features separated according to the TAS cutoff score, preoperative and postoperative ROE results were significantly lower, whereas depressive, cyclothymic, irritable, and anxious personality traits and total BPS scores were higher. However, the postoperative RSBE scores were lower in this group. <b>Conclusion:</b> This is the first study to evaluate self-esteem, body image, alexithymia, and personality traits in septorhinoplasty patients. Appropriate patient selection is essential for success and patient satisfaction in aesthetic operations such as septorhinoplasty. Performing BPS, TEMPS-A, and TAS may help evaluate psychological factors.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-23DOI: 10.1177/01455613241291701
Dylan J Cooper, Camron Davies, Paul Putnam, James B Tansey, John Gleysteen, Eugene R Sansoni, David L Schwartz, Carey Burton Wood
Background: Optimal treatment of locally advanced cancer of the larynx is controversial. In this study, we aim to compare outcomes in patients with T3-4N0-1 cancer of the larynx who underwent surgery alone versus surgery followed by radiation therapy (RT). Materials and Methods: A total of 1820 patients with advanced laryngeal cancer were identified from the national Surveillance, Epidemiology, and End Results Database and stratified based on postoperative RT status, and clinical outcomes were compared between these 2 groups. Propensity score matching was conducted to balance baseline characteristics. Results: The majority of patients (53.4%) received adjuvant RT. N0 patients who received laryngectomy and who did not undergo adjuvant radiation had a 47% higher risk of cancer-specific death than patients receiving adjuvant RT (adj. HR 1.47, 95% CI 1.18-1.84). N1 patients who did not undergo adjuvant radiation had a 90% higher risk of cancer-specific death than patients receiving RT after surgery (adj. HR 1.90, 95% CI 1.27-2.84). After adjusting for propensity scores, adjuvant RT carried a significant overall survival benefit (HR 0.73, 95% CI 0.60-0.87). Conclusions: This study provides real-world support for adjuvant radiation in patients with T3-4N0-1 laryngeal carcinoma. Nearly half of patients did not receive RT, indicating a need for national provider education and process improvement strategies to improve utilization.
背景:局部晚期喉癌的最佳治疗方法尚存争议。本研究旨在比较 T3-4N0-1 喉癌患者单纯手术与手术后放疗(RT)的疗效。材料与方法:从国家监测、流行病学和最终结果数据库中确定了1820名晚期喉癌患者,并根据术后RT状态进行了分层,比较了两组患者的临床疗效。为平衡基线特征,进行了倾向评分匹配。结果:大多数患者(53.4%)接受了辅助 RT。与接受辅助 RT 的患者相比,接受喉切除术且未接受辅助放射治疗的 N0 患者的癌症特异性死亡风险高出 47%(辅助 HR 1.47,95% CI 1.18-1.84)。未接受辅助放射治疗的 N1 患者的癌症特异性死亡风险比术后接受 RT 的患者高 90%(adj. HR 1.90,95% CI 1.27-2.84)。在对倾向评分进行调整后,辅助 RT 可显著提高总生存率(HR 0.73,95% CI 0.60-0.87)。结论:这项研究为T3-4N0-1喉癌患者的辅助放射治疗提供了现实支持。近一半的患者没有接受RT治疗,这表明有必要在全国范围内开展医疗服务提供者教育并制定流程改进策略,以提高利用率。
{"title":"Real-World Survival Impact and Utilization of Adjuvant Radiation in Advanced Laryngeal Cancer.","authors":"Dylan J Cooper, Camron Davies, Paul Putnam, James B Tansey, John Gleysteen, Eugene R Sansoni, David L Schwartz, Carey Burton Wood","doi":"10.1177/01455613241291701","DOIUrl":"https://doi.org/10.1177/01455613241291701","url":null,"abstract":"<p><p><b>Background:</b> Optimal treatment of locally advanced cancer of the larynx is controversial. In this study, we aim to compare outcomes in patients with T3-4N0-1 cancer of the larynx who underwent surgery alone versus surgery followed by radiation therapy (RT). <b>Materials and Methods:</b> A total of 1820 patients with advanced laryngeal cancer were identified from the national Surveillance, Epidemiology, and End Results Database and stratified based on postoperative RT status, and clinical outcomes were compared between these 2 groups. Propensity score matching was conducted to balance baseline characteristics. <b>Results:</b> The majority of patients (53.4%) received adjuvant RT. N0 patients who received laryngectomy and who did not undergo adjuvant radiation had a 47% higher risk of cancer-specific death than patients receiving adjuvant RT (adj. HR 1.47, 95% CI 1.18-1.84). N1 patients who did not undergo adjuvant radiation had a 90% higher risk of cancer-specific death than patients receiving RT after surgery (adj. HR 1.90, 95% CI 1.27-2.84). After adjusting for propensity scores, adjuvant RT carried a significant overall survival benefit (HR 0.73, 95% CI 0.60-0.87). <b>Conclusions</b>: This study provides real-world support for adjuvant radiation in patients with T3-4N0-1 laryngeal carcinoma. Nearly half of patients did not receive RT, indicating a need for national provider education and process improvement strategies to improve utilization.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-23DOI: 10.1177/01455613241293868
Molham Alahmad, Lubna Kharita, Arige Alassaf
Introduction: Malignant peripheral nerve sheath tumors (MPNSTs) are rare tumors that develop from peripheral nerve sheath cells and they account for approximately 5% to 10% of all soft-tissue sarcomas. MPNSTs in the head and neck region represent approximately 2% to 6% of all head and neck sarcomas and account for 12% to 19% of all MPNSTs, and the infratemporal fossa is a rare site for MPNSTs. MPNSTs originating from the trigeminal nerve are extremely rare. Case presentation: A 19-year-old female presented with a 6-month history of left-sided facial pain and paresthesia on the same side. On examination, there was left-sided facial paresthesia at the third trigeminal nerve (V3) areas; computed tomography scanning and magnetic resonance imaging showed an infratemporal lesion and surgical resection was done. Histological examination and the immunostaining finding showed high-grade MPNST. Conclusion: MPNSTs in the head and neck region may manifest with nonspecific symptoms. The diagnosis often requires a combination of clinical, pathological, and immunohistochemistry studies. Treatment involves total surgical resection with adjuvant radiotherapy.
{"title":"A Rare Case Report of Malignant Peripheral Nerve Sheath Tumor in the Infratemporal Fossa.","authors":"Molham Alahmad, Lubna Kharita, Arige Alassaf","doi":"10.1177/01455613241293868","DOIUrl":"https://doi.org/10.1177/01455613241293868","url":null,"abstract":"<p><p><b>Introduction:</b> Malignant peripheral nerve sheath tumors (MPNSTs) are rare tumors that develop from peripheral nerve sheath cells and they account for approximately 5% to 10% of all soft-tissue sarcomas. MPNSTs in the head and neck region represent approximately 2% to 6% of all head and neck sarcomas and account for 12% to 19% of all MPNSTs, and the infratemporal fossa is a rare site for MPNSTs. MPNSTs originating from the trigeminal nerve are extremely rare. <b>Case presentation:</b> A 19-year-old female presented with a 6-month history of left-sided facial pain and paresthesia on the same side. On examination, there was left-sided facial paresthesia at the third trigeminal nerve (V3) areas; computed tomography scanning and magnetic resonance imaging showed an infratemporal lesion and surgical resection was done. Histological examination and the immunostaining finding showed high-grade MPNST. <b>Conclusion:</b> MPNSTs in the head and neck region may manifest with nonspecific symptoms. The diagnosis often requires a combination of clinical, pathological, and immunohistochemistry studies. Treatment involves total surgical resection with adjuvant radiotherapy.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-16DOI: 10.1177/01455613241272656
Xionghui Hu, Fang-Luo Md, Di-He Md, Wenlong Jiang
Objective: To evaluate the outcomes and complications of the endoscopic cartilage slice reinforcement technique used on anterior margins for anterior perforation repair with anterior canal wall protrusion. Material and Methods: We conducted a prospective study on 38 cases of anterior perforation with anterior canal wall protrusion, treated using the endoscopic cartilage slice reinforcement technique from February 1, 2017 to August 29, 2023. The follow-up period was 6 months. Results: Of the 38 patients, medium perforations were present in 28.9%, large in 65.8%, and subtotal in 5.3%. The cause was mucosal chronic otitis media in 92.1%, traumatic perforation in 5.3%, and ventilation tube removal in 2.6%. The average operation time was 27.2 ± 4.6 minutes. The graft success rate was 94.7% (36/38) at 6 months postoperative. The average preoperative air-bone gap (ABG) was 19.8 ± 4.2 dB, and postoperative ABG was 8.6 ± 2.9 dB; this improvement was statistically significant (P < .001; paired-sample t-test). The ABG gain was 11.8 ± 5.1 dB, and the rate of successful surgery (postoperative ABG ≤ 20 dB) was 97.4% (37/38). No complications such as altered taste, vertigo, or tinnitus were reported, and no cases involved graft lateralization, significant blunting, graft atelectasis, graft adhesions, or effusion. However, myringitis was observed in 4 (10.5%) patients. Conclusion: The endoscopic cartilage slice reinforcement technique for anterior margins is a simple and effective method for repairing anterior perforations with anterior canal wall protrusion, achieving a high graft success rate, improved hearing, and minimal complications.
{"title":"Endoscopic Cartilage Slice Reinforcement Technique for Anterior Perforation Repair with Anterior Canal Wall Protrusion.","authors":"Xionghui Hu, Fang-Luo Md, Di-He Md, Wenlong Jiang","doi":"10.1177/01455613241272656","DOIUrl":"https://doi.org/10.1177/01455613241272656","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the outcomes and complications of the endoscopic cartilage slice reinforcement technique used on anterior margins for anterior perforation repair with anterior canal wall protrusion. <b>Material and Methods:</b> We conducted a prospective study on 38 cases of anterior perforation with anterior canal wall protrusion, treated using the endoscopic cartilage slice reinforcement technique from February 1, 2017 to August 29, 2023. The follow-up period was 6 months. <b>Results:</b> Of the 38 patients, medium perforations were present in 28.9%, large in 65.8%, and subtotal in 5.3%. The cause was mucosal chronic otitis media in 92.1%, traumatic perforation in 5.3%, and ventilation tube removal in 2.6%. The average operation time was 27.2 ± 4.6 minutes. The graft success rate was 94.7% (36/38) at 6 months postoperative. The average preoperative air-bone gap (ABG) was 19.8 ± 4.2 dB, and postoperative ABG was 8.6 ± 2.9 dB; this improvement was statistically significant (<i>P</i> < .001; paired-sample <i>t</i>-test). The ABG gain was 11.8 ± 5.1 dB, and the rate of successful surgery (postoperative ABG ≤ 20 dB) was 97.4% (37/38). No complications such as altered taste, vertigo, or tinnitus were reported, and no cases involved graft lateralization, significant blunting, graft atelectasis, graft adhesions, or effusion. However, myringitis was observed in 4 (10.5%) patients. <b>Conclusion:</b> The endoscopic cartilage slice reinforcement technique for anterior margins is a simple and effective method for repairing anterior perforations with anterior canal wall protrusion, achieving a high graft success rate, improved hearing, and minimal complications.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-16DOI: 10.1177/01455613241288486
Badi Aldosari
Objective: Rhinoplasty aims to create a nose in harmony with an ideal face, help patients with specific aesthetic concerns, and improve the nose's function. So, learning all types of deformities and rhinoplasty procedures is essential to solving that particular problem. So, we aimed to point at a neglected nasal deformity to serve as a guide in short nose rhinoplasty. Methods: Hereditary factors usually determine the length of a nose, such as cephalo-caudal patterning. Nowadays, individuals who want a change on their nose neglect whether it suits their face. Therefore, a considerable change may cause a paradox and lead to losing the operated nose and face harmony. As a general rule, it should be remembered that short nose elongation sounds more complicated than reduction rhinoplasty. Indeed, multiple soft tissues, mucosa, and structures exist, and short noses may get fibrotic, thickened, and inflamed skin for various reasons. Results: Dorsal augmentation through autologous cartilage grafts or implants is often used in patients with short noses. This demands a primary focus on lengthening the short nasal base. The simplest method of lengthening the short nose is dorsal onlay or radix implants. Silicone implants with a reported non-negligible tendency of infection are no longer used. Autologous cartilage grafts can be harvested from the septum, auricular cartilage, or rib. In the case of short noses, the surgeon can remove the septum as a graft and increase the nasal dorsum or undertake dorsal augmentation through septal cartilage grafts. Conclusion: Dorsal augmentation through autologous cartilage grafts or implants remains valuable for patients with short noses. Surgeons can achieve the desired length and proportional rotation by employing various methods, such as dorsal onlay or radix implants, septal cartilage grafts, and careful tip rotation. Through skillful execution and a patient-centered approach, surgeons can help patients with short noses achieve improved facial harmony and self-confidence.
{"title":"Lengthening Short Noses in Rhinoplasty.","authors":"Badi Aldosari","doi":"10.1177/01455613241288486","DOIUrl":"https://doi.org/10.1177/01455613241288486","url":null,"abstract":"<p><p><b>Objective:</b> Rhinoplasty aims to create a nose in harmony with an ideal face, help patients with specific aesthetic concerns, and improve the nose's function. So, learning all types of deformities and rhinoplasty procedures is essential to solving that particular problem. So, we aimed to point at a neglected nasal deformity to serve as a guide in short nose rhinoplasty. <b>Methods:</b> Hereditary factors usually determine the length of a nose, such as cephalo-caudal patterning. Nowadays, individuals who want a change on their nose neglect whether it suits their face. Therefore, a considerable change may cause a paradox and lead to losing the operated nose and face harmony. As a general rule, it should be remembered that short nose elongation sounds more complicated than reduction rhinoplasty. Indeed, multiple soft tissues, mucosa, and structures exist, and short noses may get fibrotic, thickened, and inflamed skin for various reasons. <b>Results:</b> Dorsal augmentation through autologous cartilage grafts or implants is often used in patients with short noses. This demands a primary focus on lengthening the short nasal base. The simplest method of lengthening the short nose is dorsal onlay or radix implants. Silicone implants with a reported non-negligible tendency of infection are no longer used. Autologous cartilage grafts can be harvested from the septum, auricular cartilage, or rib. In the case of short noses, the surgeon can remove the septum as a graft and increase the nasal dorsum or undertake dorsal augmentation through septal cartilage grafts. <b>Conclusion:</b> Dorsal augmentation through autologous cartilage grafts or implants remains valuable for patients with short noses. Surgeons can achieve the desired length and proportional rotation by employing various methods, such as dorsal onlay or radix implants, septal cartilage grafts, and careful tip rotation. Through skillful execution and a patient-centered approach, surgeons can help patients with short noses achieve improved facial harmony and self-confidence.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-16DOI: 10.1177/01455613241272494
Yuelin Qin, Ningning Hu, Runze Zhang, Xuecai Yang, Junwei Wang
Hamartoma is a congenital benign lesion commonly found in the lungs, kidneys, colon, and other regions, but it is seldom seen in the oral cavity. Multiple hamartoma occurrences in the tongue are particularly rare. This article describes a 7-day-old female infant with multiple tongue tumors and a cleft palate, who had difficulty feeding and subsequently underwent tumor removal under general anesthesia. Nine months later, a cleft palate repair was performed. No genetic abnormalities were detected in the genetic testing. After the tumor removal, follow-ups were conducted every year to observe any recurrence of the tumors, the morphology and function of the tongue, and any systemic abnormalities. After 7 years of follow-up, there was no recurrence of the tumors, and the morphology and function of the tongue were normal, with no systemic diseases found. It is crucial to conduct multidisciplinary consultations for children diagnosed with multiple tongue hamartomas and to monitor their overall development while addressing oral lesions.
{"title":"A Case of Multiple Tongue Hamartomas with Cleft Palate: 7 Years of Follow-Up.","authors":"Yuelin Qin, Ningning Hu, Runze Zhang, Xuecai Yang, Junwei Wang","doi":"10.1177/01455613241272494","DOIUrl":"https://doi.org/10.1177/01455613241272494","url":null,"abstract":"<p><p>Hamartoma is a congenital benign lesion commonly found in the lungs, kidneys, colon, and other regions, but it is seldom seen in the oral cavity. Multiple hamartoma occurrences in the tongue are particularly rare. This article describes a 7-day-old female infant with multiple tongue tumors and a cleft palate, who had difficulty feeding and subsequently underwent tumor removal under general anesthesia. Nine months later, a cleft palate repair was performed. No genetic abnormalities were detected in the genetic testing. After the tumor removal, follow-ups were conducted every year to observe any recurrence of the tumors, the morphology and function of the tongue, and any systemic abnormalities. After 7 years of follow-up, there was no recurrence of the tumors, and the morphology and function of the tongue were normal, with no systemic diseases found. It is crucial to conduct multidisciplinary consultations for children diagnosed with multiple tongue hamartomas and to monitor their overall development while addressing oral lesions.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Despite the ever-expanding scope of telemedicine, studies regarding its application in the field of otorhinolaryngology-head and neck surgery (ORL-HNS) in remote parts of the world are lacking. This pilot study aims to bridge the research gap and to assess the efficacy of our tailored telemedicine clinic model, operating in an "asynchronous" mode, in diagnosing various ORL-HNS diseases. Methods: This is a cross-sectional study conducted at a tertiary care center of Nepal. An asynchronous telemedicine portal was used with a store and share approach to telecast the pen endoscopic camera findings to the consultant in order to formulate a diagnosis and a management plan. Interobserver reliability was assessed using SPSS version 26 based on Cohen's kappa. The association between the results of the Mimi Hearing App (v. 5.0) and pure tone audiometry were performed using chi-square test. Results: The overall diagnostic agreement in our study was substantial to almost perfect with kappa values of .843, .784, .737, and .764 for rhinology, head and neck, otology, and pediatric cases. Chronic otitis media was the predominant diagnosis across all age groups. Various head and neck swellings, symptomatic deviated nasal septum and chronic rhinosinusitis with polyposis followed closely. Discussion: The future of telemedicine in otorhinolaryngology can be gauged to be effective in reducing cost and human resource use in the limited setting of Nepal with the model allowing for remote but effective communication between the concerned patients and the expert doctor in clarifying doubts and making diagnosis, early recognition of diseases and preventing or decreasing complications of those diseases.
{"title":"Reliability of a Tailored Tele-Medicine Model for Otorhinolaryngology-Head and Neck Surgery (ORL-HNS) Clinical Practice in Remote Areas of Nepal: A Pilot Study from Tertiary Referral Center.","authors":"Bigyan Raj Gyawali, Obaidullah, Saurav Ghimire, Ashutosh Kashyap, Umesh Jang Rai, Prashant Tripathi, Kunjan Acharya","doi":"10.1177/01455613241291168","DOIUrl":"https://doi.org/10.1177/01455613241291168","url":null,"abstract":"<p><p><b>Introduction:</b> Despite the ever-expanding scope of telemedicine, studies regarding its application in the field of otorhinolaryngology-head and neck surgery (ORL-HNS) in remote parts of the world are lacking. This pilot study aims to bridge the research gap and to assess the efficacy of our tailored telemedicine clinic model, operating in an \"asynchronous\" mode, in diagnosing various ORL-HNS diseases. <b>Methods:</b> This is a cross-sectional study conducted at a tertiary care center of Nepal. An asynchronous telemedicine portal was used with a store and share approach to telecast the pen endoscopic camera findings to the consultant in order to formulate a diagnosis and a management plan. Interobserver reliability was assessed using SPSS version 26 based on Cohen's kappa. The association between the results of the Mimi Hearing App (v. 5.0) and pure tone audiometry were performed using chi-square test. <b>Results:</b> The overall diagnostic agreement in our study was substantial to almost perfect with kappa values of .843, .784, .737, and .764 for rhinology, head and neck, otology, and pediatric cases. Chronic otitis media was the predominant diagnosis across all age groups. Various head and neck swellings, symptomatic deviated nasal septum and chronic rhinosinusitis with polyposis followed closely. <b>Discussion:</b> The future of telemedicine in otorhinolaryngology can be gauged to be effective in reducing cost and human resource use in the limited setting of Nepal with the model allowing for remote but effective communication between the concerned patients and the expert doctor in clarifying doubts and making diagnosis, early recognition of diseases and preventing or decreasing complications of those diseases.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-15DOI: 10.1177/01455613241290178
Amin Khbou, Samia Meherzi, Ons Mnif, Oumaima Beldi, Afifa Charfi
Schwannomas are generally known to be benign tumors that arise from Schwann cells. The most frequently encountered tumors of this type in ENT are vestibular schwannomas or acoustic neuromas. However, head and neck localization, although rare, has been documented in the literature. We present the case of a 13-year-old girl who presented with chronic swelling of the left cheek, leading to aesthetic discomfort. Clinical examination objectified a palpable swelling on both the external and internal sides of the left cheek. No other abnormalities were detected during the clinical examination. Ultrasound of the soft tissues identified the left cheek swelling as corresponding to a subcutaneous cyst. No further investigations were indicated for this patient. The treatment consisted of surgical excision via an intraoral approach with an internal buccal incision. Histological analysis confirmed the diagnosis of schwannoma. Schwannoma, a benign neurologic tumor, is rarely located in the face, particularly in the jaw. Its diagnosis is confirmed through histopathological examination, and treatment typically involves complete surgical removal when feasible.
{"title":"Benign Solitary Schwannoma of the Cheek: A Case Report and a Review of the Literature.","authors":"Amin Khbou, Samia Meherzi, Ons Mnif, Oumaima Beldi, Afifa Charfi","doi":"10.1177/01455613241290178","DOIUrl":"https://doi.org/10.1177/01455613241290178","url":null,"abstract":"<p><p>Schwannomas are generally known to be benign tumors that arise from Schwann cells. The most frequently encountered tumors of this type in ENT are vestibular schwannomas or acoustic neuromas. However, head and neck localization, although rare, has been documented in the literature. We present the case of a 13-year-old girl who presented with chronic swelling of the left cheek, leading to aesthetic discomfort. Clinical examination objectified a palpable swelling on both the external and internal sides of the left cheek. No other abnormalities were detected during the clinical examination. Ultrasound of the soft tissues identified the left cheek swelling as corresponding to a subcutaneous cyst. No further investigations were indicated for this patient. The treatment consisted of surgical excision via an intraoral approach with an internal buccal incision. Histological analysis confirmed the diagnosis of schwannoma. Schwannoma, a benign neurologic tumor, is rarely located in the face, particularly in the jaw. Its diagnosis is confirmed through histopathological examination, and treatment typically involves complete surgical removal when feasible.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}