Ear, nose, & throat journal最新文献

Chondroid syringoma, a mixed tumor of the skin, is an acquired hamartoma that differentiates into hair follicles, sebaceous glands, and apocrine sweat glands. Chondroid syringoma in the ear region is exceptionally rare. However, we present 2 cases of ear chondroid syringoma: 1 involving multiple lesions in the external auditory canal and the other including a single lesion behind the auricle. We reviewed relevant literature to offer insights into the diagnosis and treatment of ear tumors in the future.

Background: Vitamin B12 is an essential nutrient crucial for overall health, and deficiencies can lead to hearing loss. Objective: The aim of the systematic review was to explore the intricate connection between vitamin B12 deficiency and hearing loss using a systematic literature review. Methods: A systematic literature search was carried out to identify the articles exploring the connection between vitamin B12 deficiency and hearing loss. Electronic databases such as PubMed, Scopus, and Cochrane databases were used to identify the relevant studies. Results: A total of 612 studies were identified from 3 databases, and after stepwise screening, 9 articles were found eligible for the data extraction and inclusion in the review. Most of the studies had observed statistically-significant differences in the hearing thresholds with low vitamin B12 levels. However, few studies found hearing loss in the low frequencies (250 and 500 Hz), and others have found elevated thresholds above 4 KHz. Factors such as age, gender, and treatment for vitamin B12 did not show any significant changes in the hearing thresholds. Conclusion: The systematic review revealed that individuals with lower vitamin B12 levels tended to have a higher prevalence of hearing impairment than those with normal or elevated levels. Vitamin B12 deficiency, coupled with high homocysteine levels and low folate concentrations, may contribute to different degrees of hearing loss, particularly in the elderly. Lower serum levels of vitamin B12 have been associated with slight to mild hearing loss, while cochlear dysfunction and poorer hearing thresholds have also been observed in individuals with vitamin B12 deficiency. These findings highlight the importance of maintaining optimal levels of vitamin B12 for preserving hearing health and warrant further investigation into potential interventions.

Objective: Secondhand smoke (SHS) is a major public health concern. In this study, we evaluated the global burden of otitis media (OM) due to SHS exposure during 1990-2019 and explored the impact of socioeconomic factors on it.

Methods: With reference to the 2019 Global Burden of Disease (GBD) data, we assessed the OM burden linked to SHS during 1990-2019, stratified by gender, GBD region, and country. Join-point regression models analyzed trends in OM burden by calculating the average annual percent change (AAPC). Spearman's correlation examined the relationship between the Socio-demographic Index (SDI), Healthcare Access and Quality (HAQ) index, and SHS-related OM burden.

Results: During 1990-2019, age-standardized disability-adjusted life years (ASDRs) and age-standardized mortality rates (ASMRs) for OM due to SHS declined globally, with AAPCs of -1.45 for ASDR and -7.97 for ASMR. Significant declines in ASMR were noted in low-to-middle SDI regions. Regionally, Eastern Sub-Saharan Africa had the highest OM-related deaths, while South Asia had the highest disability-adjusted life years. OM burden decreased with higher SDI and HAQ.

Conclusion: Despite global declines, significant regional and national disparities remained, which emphasizes the need for targeted interventions.

Objective: To compare the efficacy of surgical treatment in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) involving a standalone modified uvulopalatopharyngoplasty (mUPPP) and radiofrequency coblation inferior turbinoplasty with mUPPP. Methods: In this study, a retrospective analysis of 79 OSAHS patients with inferior turbinate hypertrophy and oropharyngeal obstruction undergoing surgical treatment was performed. According to the different surgical methods, the patients were divided into 2 groups (Group A and Group B). Group A included 36 patients treated with standalone mUPPP. Group B included 43 patients treated with mUPPP and bilateral radiofrequency coblation inferior turbinoplasty. Polysomnography (PSG), active anterior rhinomanometry, surgical success rate, and surgical complication were used to assess the patients in 2 groups. The successful surgical result was defined as a 50% or greater decrease in the apnea-hypopnea index (AHI) in postoperative PSG. Results: Before surgery, there were no significant differences in age, gender, neck circumference, body mass index, Friedman tongue position grade, tonsil size grade, Epworth sleepiness scale score, total inferior turbinate size grade, total nasal resistance (TNR), AHI and the lowest O₂ saturation (LSaO₂) between the 2 groups. After 6 months of follow-up visits, AHI, LSaO₂, and TNR in Group B showed a significant improvement compared to Group A. The surgical success rate was 76.74% in Group B compared to 52.78% in Group A (P = .025). There was no significant difference in the total surgical complication rate between the 2 groups (13.89% vs 23.26%, P = .290). Conclusion: For OSAHS patients with inferior turbinate hypertrophy and oropharyngeal obstruction, radiofrequency coblation inferior turbinoplasty with mUPPP appears to be a more effective surgical method than mUPPP alone.

Cavernous hemangiomas of the external auditory canal simultaneously affecting the tympanic membrane are extremely rare. Endoscopic otosurgery has been successfully used for resecting various ear lesions because of its wider surgical field of view and minimal trauma. We report the case of a 50-year-old male patient who presented with a 6-month history of left ear congestion. Otoendoscopic examination of the left ear revealed a dark red neoplasm blocking the bony external auditory canal. After admission, surgical contraindications were eliminated, and the patient underwent otoendoscopic resection of the canal tumor. Postoperatively, the patient's symptoms were relieved, and there was no reoccurrence during the 1-month follow-up. The tumor was successfully removed using otoendoscopy, followed by tympanoplasty.

Kaposi's sarcoma (KS) is a tumor involving blood vessels and lymphatic tissue. It is caused by human herpes virus-8, typically in HIV infection in individuals with AIDS. There are 4 major types of KS including classic, endemic, immunosuppression, and AIDS-related. Endemic KS is unique among the different types as it is associated with patients with HIV-seronegative and can present either as an indolent tumor or as a fast-growing mass. The authors discuss a unique presentation of metastatic, endemic KS in a patient with HIV-negative, non-immunosuppression, which has yet to be described in the United States. A 38-year-old male with a history of same-sex partners, presented with a new oral lesion that had appeared 6 weeks ago. He was negative for human papillomavirus or HIV infection. A computed tomography (CT) scan demonstrated destructive lesions of the hard palate. The specimens obtained from biopsy were consistent with endemic KS. A Positron Emission Tomography - computed tomography (PET-CT) scan showed widely-metastatic disease. Case reports have described a rare subtype of HIV-seronegative KS in men who have sex with men. However, these are typically-indolent tumors with exclusively-cutaneous manifestation. This is a unique case of aggressive, widely-metastatic endemic KS metastatic in a patient with HIV-negative.

Background: Infraorbital ethmoidal air cells (IOEAc) are ethmoidal cells that pneumatizes inferior to the orbital floor and lateral to a line parallel to the lamina papyracea. Studies have shown considerable anatomical variation with different extensions in humans. Objectives: To identify and categorize the anatomical variations of the IOEAc creating a new, comprehensive variation classification system. Patients and methods: All included 1260 computed tomography of the nose and paranasal sinuses were reviewed to detect the presence or absence of IOEAc. All cases with IOEAc were evaluated for bilaterality, multiplicity, and shape and categorized according to its extensions to the maxillary infundibulum and its relations to the entire length of the inferior orbital wall. Results: IOEAc were identified in 173 (13.7%) scans. Bilaterality was observed in 99 patients (57.2%), while 50 patients (28.9%) had unilateral air cells on the right and 24 patients (13.9%) had unilateral air cells on the left. They were classified into 5 categories that were subclassified into subtypes. With 173 cases distributed as 26%, 17.9%, 3.5%, 9.8%, 24.9%, 10.4%, 2.3%, 1.7%, and 3.5% among the 5 categories, respectively. Conclusions: The new classification system provides a comprehensive classification of the described anatomical variations of the IOEAc. It allows the description and categorization of variants identified in past and future studies. It is applicable to current clinical practice.

Introduction: Pleomorphic adenoma (PA) is the most common benign salivary gland tumor, primarily found in the parotid gland. Recurrences often extend into the parapharyngeal space (PPS), complicating management. This report presents a case of a recurrent giant PA in the PPS following a limited excision. Case Description: A 45-year-old male presented with a gradually enlarging neck mass, dysphagia, and mild dyspnea, having previously undergone limited excision of a PA. Clinical examination revealed a firm mass in the right parotid region. Magnetic resonance imaging (MRI) showed a large mass in the right parapharyngeal space. Surgical excision was performed using a cervical-transparotid and mandibular swing approach. The patient was discharged after 7 days and later received radiotherapy. Discussion: Parapharyngeal space tumors (PPT) are rare neoplasms, with 70% to 80% being benign, primarily PAs. Symptoms include neck masses, swallowing difficulties, and potential cranial nerve involvement. MRI is crucial for assessing tumor extent. A combined transparotid-transcervical approach was employed. Postoperative radiotherapy was recommended. Conclusions: PPTs present significant clinical challenges, highlighting the need for meticulous surgical planning and complete excision of PAs to minimize recurrence risk. The close proximity of vital neurovascular structures requires careful preoperative evaluation and strategic surgical approaches.