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Recurrent Ischemic Strokes in a 49-Year-Old Patient: Diagnosis and Management of Stylo-Carotid Syndrome (Eagle Syndrome).
Pub Date : 2025-01-26 DOI: 10.1177/01455613251316149
Carlos Miguel Chiesa-Estomba, Alfonso Rodriguez-Urzay, Jose Angel González-García
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引用次数: 0
Giant Solitary Fibrous Tumor of the Retropharyngeal Space: A Case Report and Review of the Literature. 咽后间隙巨型孤立纤维性肿瘤:病例报告和文献综述。
Pub Date : 2025-01-26 DOI: 10.1177/01455613251314606
Bingwan Dong, Enmin Zhao, Feng Wen

Solitary fibrous tumor (SFT) is an uncommon spindle cell neoplasm, which generally arises from the pleura. There have been documented a number of extrapleural origins including the head and neck in the literature. It is emphasized to make a diagnosis in a rare location such as the retropharyngeal space. We present a case of a 54-year-old man diagnosed with giant solitary retropharyngeal SFT. Clinical symptoms were pharyngeal foreign body sensation and dysphagia associated with dyspnea. Physical examination showed a sizable submucosal mass under the posterior pharyngeal wall, which partially obstructed the upper aerodigestive tract. With radiologic images to evaluate the dimension and relationship with surrounding structures, the tumor was surgically removed en bloc via a transcervical approach. The histology and immunohistochemistry play a crucial role in differential diagnosis. Complete surgical excision is an alternative and curative strategy.

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引用次数: 0
NUT Carcinoma of the Ethmoid Sinus: A Rare Case Report Highlighting Aggressive Behavior and Management Challenges. 乙状窦 NUT 癌:一份罕见病例报告,突显侵袭行为和管理难题。
Pub Date : 2025-01-26 DOI: 10.1177/01455613251316254
Tzu-Pai Chen, Heng-Jui Hsu

NUT carcinoma is a rare, aggressive malignancy characterized by chromosomal rearrangements involving the NUTM1 gene. We present the case of a 47-year-old male with a history of hypertension, diagnosed with NUT carcinoma originating in the ethmoid sinus and accompanied by extensive neck metastases. The patient underwent a left modified radical neck dissection and endoscopic nasal tumor excision, followed by concurrent chemoradiotherapy. Pathological examination confirmed NUT carcinoma with metastatic cancer cells in 41 out of 72 lymph nodes of left neck, along with extranodal extension. The patient remained alive at the 4-month follow-up. This case highlights the importance of early identification and including NUT carcinoma in the differential diagnosis to optimize treatment outcomes.

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引用次数: 0
A Case of Kimura Disease in the Left Postauricular and Neck Region. 左耳后和颈部木村氏病一例
Pub Date : 2025-01-26 DOI: 10.1177/01455613251316260
Yinghui Gao, Hao Yan, Yuan Zhong

This case involved a 21-year-old male patient who was admitted due to having a lump behind the left ear that had been present for 2 years and had gradually increased in size for over a year. This was accompanied by palpable hard masses on the same side of the neck. Laboratory tests indicated an elevated eosinophil count, and magnetic resonance imaging confirmed the "string-of-beads" sign in the left cervical lymph nodes. Fine-needle aspiration cytology prior to surgery revealed reactive lymphoid hyperplasia with eosinophils. Ultimately, surgical excision confirmed the diagnosis of Kimura's disease. Following glucocorticoid treatment, the patient was monitored, and no new masses were detected during 7-months follow-up period.

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引用次数: 0
A Rare Case of Tracheal Adenoid Cystic Carcinoma with Thyroid Invasion and Mimicking Thyroid Tumors.
Pub Date : 2025-01-23 DOI: 10.1177/01455613251315298
Mustafa Yeşilyurt, Cemile Altınkaya, Sevilay Özmen
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引用次数: 0
Cutaneous Involvement of the Ear as the Sole Presenting Symptom in Recurrent Chronic Lymphocytic Leukemia: A Case Report.
Pub Date : 2025-01-23 DOI: 10.1177/01455613241306010
Stephanie S Kim, Aravindhan Sriharan, Andrew Y Lee, Ryan R McCool

Cutaneous involvement of chronic lymphocytic leukemia (CLL) is rare but has been previously documented to involve the head and neck region. Generally, involvement to the ears is limited to the ear lobule; however, this study presents a unique case of recurrent CLL with cutaneous involvement overlying the auricular ear. The presentation was initially concerning for possible perichondritis but remained unresponsive to antibiotics and steroids. Eventual punch biopsy confirmed the recurrent CLL, although the lesion also presented with unique pathology, notably associated granulomata. This case demonstrates auricular involvement of CLL with unique pathology and highlights the importance of a widened differential and early, definitive tissue biopsy when evaluating refractory inflammation of the external ear.

{"title":"Cutaneous Involvement of the Ear as the Sole Presenting Symptom in Recurrent Chronic Lymphocytic Leukemia: A Case Report.","authors":"Stephanie S Kim, Aravindhan Sriharan, Andrew Y Lee, Ryan R McCool","doi":"10.1177/01455613241306010","DOIUrl":"https://doi.org/10.1177/01455613241306010","url":null,"abstract":"<p><p>Cutaneous involvement of chronic lymphocytic leukemia (CLL) is rare but has been previously documented to involve the head and neck region. Generally, involvement to the ears is limited to the ear lobule; however, this study presents a unique case of recurrent CLL with cutaneous involvement overlying the auricular ear. The presentation was initially concerning for possible perichondritis but remained unresponsive to antibiotics and steroids. Eventual punch biopsy confirmed the recurrent CLL, although the lesion also presented with unique pathology, notably associated granulomata. This case demonstrates auricular involvement of CLL with unique pathology and highlights the importance of a widened differential and early, definitive tissue biopsy when evaluating refractory inflammation of the external ear.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613241306010"},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030519","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}
引用次数: 0
Correlation Between Preoperative Neutrophil-to-Lymphocyte Ratio and Clinicopathological Characteristics of Papillary Thyroid Carcinomas: Toward a Preoperative Biomarker. 术前中性粒细胞与淋巴细胞比值与甲状腺乳头状癌临床病理特征的相关性:一种术前生物标志物。
Pub Date : 2025-01-22 DOI: 10.1177/01455613251314708
Chaima Ben Ammar, Makram Tbini, Ines Riahi, Mamia Ben Salah

Introduction: Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, with considerable variability in its clinical presentation and prognosis. Recent studies have focused on the relationship between its clinicopathological characteristics and inflammatory biomarkers, particularly the preoperative neutrophil-to-lymphocyte ratio (NLR). Our aim was to investigate the correlation between NLR and the clinicopathological features of PTC. Methods: This was a retrospective study. We involved patients who underwent surgery for PTC over a 5-year period from January 2016 to December 2021. Based on the mean NLR value, the study population was divided into 2 groups, with Group 1 corresponding to patients with an elevated NLR. Results: Our study included 102 patients aged between 20 and 83 years. All patients were euthyroid. The mean preoperative NLR was 2.01 ± 0.62, with 53% of patients classified into Group 1. On ultrasound, most nodules were classified as EU-TIRADS 5, and 38% had a Bethesda category 6 cytology. Final histopathological analysis revealed microcarcinoma in the majority of cases. PTC was multifocal in 35 cases and bilateral in 38, with an aggressive histological variant observed in 45 cases. Multivariate analysis demonstrated a statistically significant correlation between NLR and extrathyroidal invasion, lymph node metastasis, aggressive histological subtypes, and multifocality. Conclusion: NLR is a readily accessible and cost-effective preoperative biomarker. Its use could improve risk stratification and support personalized therapeutic strategies. However, prospective studies with larger, multicenter cohorts are required to validate NLR as a reliable predictive biomarker.

简介:甲状腺乳头状癌(PTC)是最常见的甲状腺癌类型,其临床表现和预后具有相当大的差异。最近的研究集中在其临床病理特征与炎症生物标志物之间的关系,特别是术前中性粒细胞与淋巴细胞比率(NLR)。我们的目的是探讨NLR与PTC临床病理特征之间的关系。方法:回顾性研究。我们纳入了2016年1月至2021年12月5年期间接受PTC手术的患者。根据NLR平均值将研究人群分为2组,第一组对应NLR升高的患者。结果:本研究纳入102例患者,年龄在20 ~ 83岁之间。所有患者甲状腺功能正常。术前NLR平均值为2.01±0.62,53%的患者归为1组。在超声检查中,大多数结节被分类为EU-TIRADS 5, 38%的结节细胞学为Bethesda 6类。最终的组织病理学分析显示大多数病例为微癌。35例PTC为多灶性,38例为双侧,45例为侵袭性组织学变异。多变量分析显示NLR与甲状腺外浸润、淋巴结转移、侵袭性组织学亚型和多灶性之间具有统计学意义的相关性。结论:NLR是一种易于获得且具有成本效益的术前生物标志物。它的使用可以改善风险分层和支持个性化的治疗策略。然而,需要更大的、多中心队列的前瞻性研究来验证NLR作为可靠的预测性生物标志物。
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引用次数: 0
Influencing Factors for Residual Symptoms Following Canalith Repositioning Maneuver in Patients with Benign Paroxysmal Positional Vertigo. 良性阵发性体位性眩晕患者管根复位术后残留症状的影响因素
Pub Date : 2025-01-19 DOI: 10.1177/01455613241304913
Sen Yan, Zhengyue Li, Ping Chen, Wen Wu

Objectives: We aimed to analyze the influencing factors for residual symptoms following canalith repositioning maneuvers in patients with benign paroxysmal positional vertigo (BPPV). Methods: A total of 193 patients with BPPV who attended our hospital from July 2019 to December 2023 and were followed up in the outpatient clinic for 4 weeks after treatment were selected. The presence or absence of residual symptoms 4 weeks after repositioning was recorded, based on which the patients were assigned into a presence group (n = 72) and an absence group (n = 121). Their general data, incidence features, mental health, and sleep quality were compared. Results: After canalith repositioning maneuver and 4-week follow-up, the Dizziness Handicap Inventory (DHI) scores, Hospital Anxiety and Depression Scale (HADS) scores, and Pittsburgh Sleep Quality Index (PSQI) scores of the BPPV patients significantly decreased (P < .05). The presence of residual symptoms after repositioning in patients with BPPV had significant positive correlations with the time from onset to consultation, DHI score, HADS anxiety score, and PSQI score (P < .05). The area under the curve of the DHI score for predicting residual symptoms after repositioning in patients with BPPV was the largest (0.727), and the time from onset to consultation and the HADS anxiety score had the highest sensitivity (0.764) and specificity (0.801), respectively. Conclusions: Time from onset to consultation, DHI score, HADS anxiety score, and PSQI score are independent risk factors for and display significantly positive correlations with residual symptoms after canalith repositioning maneuver in patients with BPPV.

目的:分析良性阵发性体位性眩晕(BPPV)患者行导管复位术后残留症状的影响因素。方法:选择2019年7月至2023年12月在我院就诊的BPPV患者193例,治疗后在门诊随访4周。记录复位后4周是否存在残留症状,据此将患者分为存在组(n = 72)和不存在组(n = 121)。比较他们的一般资料、发病率特征、心理健康和睡眠质量。结果:BPPV患者经导管复位手法及4周随访后,头晕障碍量表(DHI)评分、医院焦虑抑郁量表(HADS)评分、匹兹堡睡眠质量指数(PSQI)评分均显著降低(P < 0.05)。BPPV患者复位后残留症状的存在与发病至会诊时间、DHI评分、HADS焦虑评分、PSQI评分呈正相关(P < 0.05)。DHI评分预测BPPV患者重新定位后残留症状的曲线下面积最大(0.727),发病至就诊时间和HADS焦虑评分的敏感性最高(0.764),特异性最高(0.801)。结论:发病至会诊时间、DHI评分、HADS焦虑评分、PSQI评分是BPPV患者导管复位后残留症状的独立危险因素,且与患者导管复位后残留症状呈显著正相关。
{"title":"Influencing Factors for Residual Symptoms Following Canalith Repositioning Maneuver in Patients with Benign Paroxysmal Positional Vertigo.","authors":"Sen Yan, Zhengyue Li, Ping Chen, Wen Wu","doi":"10.1177/01455613241304913","DOIUrl":"https://doi.org/10.1177/01455613241304913","url":null,"abstract":"<p><p><b>Objectives:</b> We aimed to analyze the influencing factors for residual symptoms following canalith repositioning maneuvers in patients with benign paroxysmal positional vertigo (BPPV). <b>Methods:</b> A total of 193 patients with BPPV who attended our hospital from July 2019 to December 2023 and were followed up in the outpatient clinic for 4 weeks after treatment were selected. The presence or absence of residual symptoms 4 weeks after repositioning was recorded, based on which the patients were assigned into a presence group (n = 72) and an absence group (n = 121). Their general data, incidence features, mental health, and sleep quality were compared. <b>Results:</b> After canalith repositioning maneuver and 4-week follow-up, the Dizziness Handicap Inventory (DHI) scores, Hospital Anxiety and Depression Scale (HADS) scores, and Pittsburgh Sleep Quality Index (PSQI) scores of the BPPV patients significantly decreased (<i>P</i> < .05). The presence of residual symptoms after repositioning in patients with BPPV had significant positive correlations with the time from onset to consultation, DHI score, HADS anxiety score, and PSQI score (<i>P</i> < .05). The area under the curve of the DHI score for predicting residual symptoms after repositioning in patients with BPPV was the largest (0.727), and the time from onset to consultation and the HADS anxiety score had the highest sensitivity (0.764) and specificity (0.801), respectively. <b>Conclusions:</b> Time from onset to consultation, DHI score, HADS anxiety score, and PSQI score are independent risk factors for and display significantly positive correlations with residual symptoms after canalith repositioning maneuver in patients with BPPV.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613241304913"},"PeriodicalIF":0.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018780","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}
引用次数: 0
Auricular Mucormycosis: Comprehensive Literature Review. 耳毛霉病:综合文献综述。
Pub Date : 2025-01-19 DOI: 10.1177/01455613251314604
Ahmad Alkheder, Adel Azar, Ghina Sukkar, Abdulmajeed Yousfan

Auricular mucormycosis is an exceptionally rare and aggressive fungal infection primarily affecting immunocompromised individuals, particularly those with poorly controlled diabetes. This report presents the case of a 54-year-old diabetic woman with isolated auricular mucormycosis and facial nerve palsy. The patient developed right auricular edema, necrosis, and severe pain, progressing over 10 days, with no history of trauma. Initial management included broad-spectrum antibiotics and intravenous liposomal amphotericin B, followed by surgical debridement and partial auricular resection. Despite extensive soft tissue involvement, imaging revealed no bony erosion or significant compression of the facial nerve. Facial nerve function gradually improved from House-Brackmann grade IV to grade II within 38 days. The patient's condition stabilized after sequential surgical interventions and prolonged antifungal therapy, culminating in recovery by day 61. A comprehensive literature review identified 6 documented cases of auricular mucormycosis, all involving diabetic patients, with a mortality rate of 33.3%. Facial nerve paralysis, observed in 4 cases, often persisted despite infection resolution. This case underscores the importance of early diagnosis, aggressive antifungal therapy, surgical debridement, and meticulous management of underlying conditions to optimize outcomes in auricular mucormycosis, a condition with significant diagnostic and therapeutic challenges.

耳毛霉菌病是一种罕见的侵袭性真菌感染,主要影响免疫功能低下的个体,特别是糖尿病控制不佳的患者。本文报告一例54岁女性糖尿病患者,并发孤立性耳廓毛霉菌病和面神经麻痹。患者出现右耳水肿、坏死和剧烈疼痛,进展超过10天,无外伤史。最初的治疗包括广谱抗生素和静脉注射两性霉素B脂质体,随后进行手术清创和部分耳廓切除术。尽管广泛的软组织受累,影像学显示没有骨侵蚀或明显压迫面神经。面部神经功能在38天内由House-Brackmann分级IV级逐渐改善至II级。经过连续的手术干预和长期的抗真菌治疗,患者的病情稳定下来,最终在第61天恢复。综合文献综述确定了6例耳廓毛霉菌病的记录病例,均涉及糖尿病患者,死亡率为33.3%。面神经麻痹4例,感染消退后仍持续存在。该病例强调了早期诊断、积极抗真菌治疗、手术清创和对潜在疾病细致管理的重要性,以优化耳毛霉菌病的预后,耳毛霉菌病是一种具有重大诊断和治疗挑战的疾病。
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引用次数: 0
Prediction Model for Early Subacute Phase Tracheostomy Decannulation in Patients with Stroke. 脑卒中患者早期亚急性期气管切开脱管的预测模型。
Pub Date : 2025-01-16 DOI: 10.1177/01455613241312788
Hui-Min Qin, Xi-Yan Huang, Rui-Yun Xu, Qiu-You Xie, Dan-Zhe Tang

Objective: This study aims to identify the factors influencing decannulation in patients with stroke who underwent tracheostomy during the early subacute phase. Methods: A retrospective analysis was conducted on 219 patients with stroke who underwent a tracheostomy at a tertiary hospital between January 2020 and December 2023. Among them, there were 155 males and 64 females. The age distribution ranged from 13 to 90 years old (average, 54.32 ± 14.96). There were 189 patients diagnosed with cerebral hemorrhage and 30 patients diagnosed with cerebral infarction. The patients were categorized into 2 groups: Those who achieved decannulation during the early subacute phase and those who did not. The decannulation group comprised 69 individuals, while the non-decannulation group comprised 150 individuals. Data collected included general patient demographics, stroke types, levels of consciousness, the presence of airway polyps, and outcomes of the modified Evan's blue dye test (MEBDT). Multivariate logistic regression analysis was employed to identify independent factors influencing early decannulation. The predictive value of these factors was further evaluated using the area under the curve (AUC) from the receiver operating characteristic (ROC) curve analysis. Results: Logistic regression analysis identified Glasgow Coma Scale scores, MEBDT results, and cough ability as independent factors influencing decannulation. ROC curve analysis demonstrated that a predictive model incorporating these 3 factors had a high predictive accuracy, with an AUC of 0.975 (P < .001, 95% CI 0.958-0.993). The model's cut-off value of 0.19 yielded a sensitivity of 95.6% and a specificity of 87.3%. Conclusion: The Glasgow Coma Scale score, MEBDT results, and cough ability are independent determinants of early decannulation is patients with stroke. The combined assessment of these factors offers strong predictive accuracy for early decannulation.

目的:探讨亚急性期行气管切开术的脑卒中患者脱管的影响因素。方法:对2020年1月至2023年12月在某三级医院行气管切开术的219例脑卒中患者进行回顾性分析。其中,男性155人,女性64人。年龄分布13 ~ 90岁,平均54.32±14.96岁。189例诊断为脑出血,30例诊断为脑梗死。将患者分为两组:在亚急性期早期实现脱管的患者和未实现脱管的患者。脱管组有69人,而非脱管组有150人。收集的数据包括一般患者人口统计数据、卒中类型、意识水平、气道息肉的存在以及改进的埃文蓝染色试验(MEBDT)的结果。采用多因素logistic回归分析确定影响早期拔管的独立因素。使用受试者工作特征曲线分析的曲线下面积(AUC)进一步评估这些因素的预测价值。结果:Logistic回归分析发现格拉斯哥昏迷量表评分、MEBDT结果和咳嗽能力是影响去管术的独立因素。ROC曲线分析表明,纳入这3个因素的预测模型具有较高的预测准确率,AUC为0.975 (P < 0.001, 95% CI 0.958 ~ 0.993)。该模型的临界值为0.19,敏感性为95.6%,特异性为87.3%。结论:格拉斯哥昏迷量表评分、MEBDT结果和咳嗽能力是脑卒中患者早期脱管的独立决定因素。这些因素的综合评估为早期脱管提供了强有力的预测准确性。
{"title":"Prediction Model for Early Subacute Phase Tracheostomy Decannulation in Patients with Stroke.","authors":"Hui-Min Qin, Xi-Yan Huang, Rui-Yun Xu, Qiu-You Xie, Dan-Zhe Tang","doi":"10.1177/01455613241312788","DOIUrl":"https://doi.org/10.1177/01455613241312788","url":null,"abstract":"<p><p><b>Objective:</b> This study aims to identify the factors influencing decannulation in patients with stroke who underwent tracheostomy during the early subacute phase. <b>Methods:</b> A retrospective analysis was conducted on 219 patients with stroke who underwent a tracheostomy at a tertiary hospital between January 2020 and December 2023. Among them, there were 155 males and 64 females. The age distribution ranged from 13 to 90 years old (average, 54.32 ± 14.96). There were 189 patients diagnosed with cerebral hemorrhage and 30 patients diagnosed with cerebral infarction. The patients were categorized into 2 groups: Those who achieved decannulation during the early subacute phase and those who did not. The decannulation group comprised 69 individuals, while the non-decannulation group comprised 150 individuals. Data collected included general patient demographics, stroke types, levels of consciousness, the presence of airway polyps, and outcomes of the modified Evan's blue dye test (MEBDT). Multivariate logistic regression analysis was employed to identify independent factors influencing early decannulation. The predictive value of these factors was further evaluated using the area under the curve (AUC) from the receiver operating characteristic (ROC) curve analysis. <b>Results:</b> Logistic regression analysis identified Glasgow Coma Scale scores, MEBDT results, and cough ability as independent factors influencing decannulation. ROC curve analysis demonstrated that a predictive model incorporating these 3 factors had a high predictive accuracy, with an AUC of 0.975 (<i>P</i> < .001, 95% CI 0.958-0.993). The model's cut-off value of 0.19 yielded a sensitivity of 95.6% and a specificity of 87.3%. <b>Conclusion:</b> The Glasgow Coma Scale score, MEBDT results, and cough ability are independent determinants of early decannulation is patients with stroke. The combined assessment of these factors offers strong predictive accuracy for early decannulation.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613241312788"},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018785","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}
引用次数: 0
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Ear, nose, & throat journal
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