Ear, nose, & throat journal最新文献

Objective: To determine the risk factor for developing complications in patients undergoing removal procedures for foreign bodies (FBs) in the external auditory canal (EAC) in the otolaryngology (ENT) emergency unit. Methods: Cases involving patients with EAC FBs treated at the ENT emergency unit of a tertiary medical center were retrospectively recruited. Patients were classified into the age < 10 years and ≥10 years groups. Univariate analyses of the complication rates were performed in all patients and the two age groups. Results: The mean age of the 457 patients was 29.9 ± 19.9 (range, 1.0-89.0) years; 42.7% (n = 195) were under 10 years of age, and 57.1% (n = 261) were male. Complications following FB removal occurred in 40 cases (8.8%), with EAC laceration being the most common (4.4%). Patients under 10 years of age had a higher risk of developing complications than those over 10 years (13.8% vs 5.0%, P = .001), with the younger group also showing an increased risk of EAC laceration (6.7% vs 2.7%, P = .039). Conclusion: Patients under 10 years of age had a significantly-higher rate of complications after EAC FB removal in the ENT emergency unit. Sedation or surgical removal under general anesthesia should be considered to minimize the risk of complications after a failed removal under direct vision in this patient group. Further studies are warranted to verify this implication for clinical practice.

Keratoacanthoma (KA) is a self-regressing cutaneous tumor sharing clinical and histopathological similarities with squamous cell carcinoma. It is relatively uncommon and presents diagnostic challenges, particularly in pediatric patients. This paper presents a case study of KA affecting the upper lip keratosis in a 6-year-old girl. Through a comprehensive analysis of the pathogenesis, differential diagnosis, and treatment approaches of KA in children based on existing literature, we aim to offer clinical insights and guidance for practice.

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.

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.

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.

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.

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.

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.