Ear, nose, & throat journal最新文献

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.

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.

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.

Objective: Platelet-rich plasma (PRP) has been injected into the olfactory cleft to treat olfactory dysfunction related to coronavirus disease 2019. In this study, we aimed to evaluate the effect of PRP combined with hyaluronic acid (HA) nasal injection in the treatment of traumatic olfactory dysfunction. Methods: Patients who had lost olfactory function after experiencing head trauma and were willing to receive PRP and HA nasal injections for treatment were enrolled. Before nasal injection, 10 cc of blood was drawn from the patients. The drawn blood was injected into a centrifuge tube for processing, and finally, 5 cc of the PRP mixed with HA was drawn out using an empty syringe. The PRP mixed with HA was injected into the upper part of the middle nasal septum and the medial side of the middle turbinate of the patient's nasal cavity under a nasal endoscope. The olfactory function of each patient was evaluated by the phenyl ethyl alcohol (PEA) odor detection threshold test before and at both 1 and 3 months after nasal injection and the traditional Chinese version of the University of Pennsylvania Smell Identification Test at 3 months after nasal injection. Results: A total of 28 patients received PRP and HA nasal injections between August and December of 2023 and came back for evaluation of the effect. In all, 20 (71.4%) patients felt their olfactory function improved 1 month after injection, and 24 of 28 (85.7%) patients reported their olfactory function improved at 3 months after injection. The bilateral or unilateral PEA threshold decreased in 22 (78.6%) patients 1 month after injection, and decreased in 15 (53.6%) patients 3 months after injection. Conclusions: Our results show that PRP and HA nasal injections were associated with favored patient-reported outcomes and improved the olfactory threshold in the treatment of traumatic olfactory dysfunction.

For most cystic craniopharyngiomas, intracapsular debulking is a good strategy to get a large operation space and protect vital structures. However, this surgical strategy may lead to the residual and recurrence of the tumor capsule wall. Therefore, there is an urgent need for a new surgical strategy without residual capsule walls for the removal of cystic craniopharyngiomas. We reviewed a 45-year-old male with vision loss and visual field defects, whose head MRI revealed a suprasellar cystic lesion. The patient underwent extended endoscopic transsphenoidal surgery. The surgical strategy of total cystic wall decollement was adopted, which was that the lesion surrounded by the capsule was completely separated from the surrounding tissue without destroying the capsule and maintaining the tension of the capsule. The lesion was totally resected and pathological findings confirmed the diagnosis of craniopharyngioma. After the operation, both the visual acuity and pituitary function were significantly improved. In addition, he suffered from transient diabetes insipidus, which was subsequently relieved. During the 33-month follow-up, there was no tumor recurrence. Compared with the traditional surgical strategy of intracapsular debulking, the surgical strategy of total cystic wall decollement has the advantages of less residual tumor capsules, low tumor recurrence rates, etc. Therefore, for specific cystic craniopharyngiomas, the surgical strategy of total cystic wall decollement may be an effective surgical strategy to reduce tumor recurrence.

Background: Nasal bone fractures are pretty common. The most common causes include interpersonal violence, traffic accidents, sports injuries, and falls. This study aimed to assess patients presenting with nasal bone fractures not only for nasal trauma but also for personality disorders, impulsivity, and attention-deficit/hyperactivity disorder (ADHD) using psychiatric questionnaires. Methods: The study included 41 patients, and the control group consisted of 43 volunteers without nasal bone fracture; neither the patients nor the volunteers had previously been diagnosed with or treated for psychiatric disorders. The psychiatric questionnaires administered were the Eysenck Personality Questionnaire Revised-Short Form (EPQR-S), the Barratt Impulsivity Scale-Short Form (BIS-11-SF), and Turgay's Adult ADD/ADHD DSM-IV-based Scale. Results: The most common cause of nasal bone fractures in our study was violence (41.5%), followed by traffic accidents (29.3%), falls (17%), and sports injuries (12.2%). In the EPQR-S assessment, the nasal bone fracture (NBF) group had significantly-higher total scores than the control group (CG) (P < .001). In the subscales of the questionnaire, extroversion, psychoticism, and lie subscale scores were higher in the NBF group than in the CG. In the BIS-11-SF assessment, the NBF group had higher total scores than the CG (P < .001). Assessment using Turgay's adult ADD/ADHD DSM IV-based diagnostic screening and rating scale revealed no statistically-significant difference between the NBF group and the CG in terms of attention deficit and hyperactivity. Conclusion: We found that psychoticism patterns and impulsivity were more prevalent in the patient group, whereas ADD/ADHD was not. The results of our study suggest that performing a psychiatric assessment may be the right decision in patients presenting with NBFs caused by violence, whether they are the aggressor or the victim.

Purpose: Cochlear implant (CI) surgery is conventionally done under general anesthesia (GA). However, many patients are unable to undergo GA due to various reasons, raising the need for an alternative safe option. CI under local anesthesia is feasible and safely done in patients who can't tolerate GA. This approach allows for device fitting immediately after surgery. This study aims to evaluate simultaneous bilateral cochlear implant (BiCI) surgery performed under local anesthesia with sedation in adults. To our knowledge, this is the largest cohort of patients who underwent this approach. Methods: This is a retrospective chart review in a tertiary center. We included all adult patients who underwent simultaneous BiCI under local anesthesia with sedation from 2018 to 2024. The feasibility of BiCI under local anesthesia with sedation was assessed through clinical, surgical, audiological, and patient questionnaire data. Results: Six patients underwent simultaneous BiCI with local anesthetic and sedation. Mean age was 41.7 ± 16.0, comprising 66.7% male and 33.3% female. No intraoperative problems were encountered. All woke up from sedation without any agitation or difficulties. Their recovery was uneventful. No dizziness, nausea, or vomiting were reported. The device was activated immediately postoperatively. Pure tone audiometry, speech reception threshold, and word recognition score were significantly improved. Positive experiences were reported in all patients. Conclusion: Bilateral simultaneous cochlear implantation under local anesthesia in adults is achievable, through a multidisciplinary approach. This approach is a potential alternative option for some patients and could optimize their hearing rehabilitation.

Background: Sphenoid sinus mucocele (SSM) represents a relatively rare disease among pediatric population as compared to adults, with a 1% to 3% incidence of all paranasal sinus mucoceles. Since the initial symptoms varied often, SSM caused blindness was scarcely seen. Case Presentation: Here we described an unusual case of small, isolated SSM causing acute visual loss in a 9-year-old girl. The patient first consulted an ophthalmologist for her right blindness. A diagnosis of SSM was suspected indicated by an orbital MRI scan. Thereafter the patient was referred to our department and an endoscopic sphenoidotomy and optic nerve decompression was performed. Surprisingly, her vision was relieved immediately after surgery, followed by dramatic improvement during the postoperative 20-month follow-up period. Conclusion: To our knowledge, a better understanding of SSM in pediatrics is essential for clinicians, including neurologists, ophthalmologists, and otolaryngologists to make early diagnoses and correct treatment by MRI and CT scan. Prompt surgical intervention of endoscopic transnasal sphenoidectomy is a quite safe, effective, and minimally invasive method for patients.

Keratocystoma of the parotid gland is a rare benign salivary gland tumor. In 2022, the World Health Organization added keratocystoma to the classification of benign parotid tumors. Recently, our hospital encountered a case involving a 2-year-old child, making this the youngest patient reported to date. We excised part of the parotid gland and lesion under general anesthesia while preserving the facial nerve. There was no local recurrence during the 1-year follow-up period after surgery. Despite its rarity, it is essential to consider the possibility of keratocystoma and distinguish it from other benign neoplastic lesions of the parotid gland.