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Introduction: Sinonasal organizing hematoma (OH) is a rare, nonneoplastic lesion that often presents with epistaxis, a reddish mass, and destruction of the involved sinonasal structures. Due to its rarity, the demographics, diagnostic modalities, treatment strategies, and outcomes have not yet been studied in a large, long‐term study. Materials and Methods: Retrospect cohort of 112 sinonasal OH patients treated between 1997 and 2020 in a tertiary, university hospital were evaluated. Demographics, systemic comorbidities, sinonasal surgery history, serum laboratory tests, radiological findings, and treatment results were collected. The present study aimed to assess the accuracy of preoperative computed tomography (CT), Gadolinum‐enhanced magnetic resonance (MR), and punch biopsies in detecting sinonasal OH as the most likely diagnosis. In addition, incidental differences by age and year of diagnosis were calculated using the Poisson log‐linear regression model. Results: The median age was 44, and 58% were male. Fewer than 20% of these cases had a chronic systemic comorbidity, bleeding tendency, or sinonasal surgery history. MR had the highest accuracy of (87%) to detect sinonasal OH as the most likely diagnosis, compared with contrast‐enhanced‐CT (53%), punch biopsy (49%), and non‐enhanced‐CT (16%) (all <0.05). Sinonasal OH incidence did not vary by age, but the yearly rate significantly increased by 1.05 times over 23 years (p < 0.05). Notably, 84% of 112 patients received surgical removal through the assistance of an endoscope, and none had substantial bleeding without preoperative embolization. Conclusion: Sinonasal OH was observed regardless of age, sex, systemic comorbidities, bleeding tendency, prior sinonasal surgery, or trauma. Preoperative MR gives the highest accuracy for detecting this disease. Sinonasal OH may be safely managed with endoscopic‐assisted surgery removal without embolization. Level of Evidence: 4 Laryngoscope, 134:1581–1590, 2024 [ABSTRACT FROM AUTHOR]

Objective: Total laryngectomy (TL) patients are good models in which to evaluate the effects of nasal airflow cessation on the sinonasal tract. Here, we evaluated changes in sinonasal structures and association with sinus opacification in the computed tomography (CT) images 3 years post‐TL. Methods: Patients who underwent TL from 2005 to 2017 in a teaching academic center were reviewed retrospectively. Patients with a final follow‐up CT taken less than 3 years after TL, tracheoesophageal puncture, inadequate CT image, or history of sinonasal surgery were excluded. The control group included patients who underwent a partial laryngectomy or hypopharyngectomy without requiring a tracheotomy for more than a month. Altogether, 45 TL patients and 38 controls were selected. The volume of all four paranasal sinuses, inferior turbinate soft tissue volume (ITSTV), maxillary sinus natural ostium (MSNO) mucosal width, and Lund–Mackay scores (LMS) were measured on preoperative and postoperative CT scans. Results: The mean duration between surgery and the final CT scan was 6.3 ± 2.4 and 5.5 ± 2.3 years for the TL and control groups, respectively. Neither group showed significant changes in the four paranasal sinuses' volume or MSNO mucosa width. The ITSTV decreased significantly, from 4.6 ± 1.3 to 2.8 ± 1.1 mL (p <.001), in the TL group, regardless of the presence of nasal septal deviation, showing ITSTV reduction on both concave and convex sides. By contrast, the control group showed no significant changes in ITSTV. Postoperative LMS changes in both groups were insignificant. The number of patients with LMS aggravation or alleviation was the same in both groups, regardless of preoperative sinus opacification. Conclusions: Paranasal sinus structures and sinus opacification are not affected significantly by nasal airflow cessation; however, the inferior turbinate mucosa is affected by long‐term discontinuation of nasal airflow. Level of Evidence: 4 (case–control study). [ABSTRACT FROM AUTHOR]

The accumulation of misfolded and aggregated proteins is a hallmark of neurodegenerative proteinopathies. Although multiple genetic loci have been associated with specific neurodegenerative diseases (NDs), molecular mechanisms that may have a broader relevance for most or all proteinopathies remain poorly resolved. In this study, we developed a multi‐layered network expansion (MLnet) model to predict protein modifiers that are common to a group of diseases and, therefore, may have broader pathophysiological relevance for that group. When applied to the four NDs Alzheimer's disease (AD), Huntington's disease, and spinocerebellar ataxia types 1 and 3, we predicted multiple members of the insulin pathway, including PDK1, Akt1, InR, and sgg (GSK‐3β), as common modifiers. We validated these modifiers with the help of four Drosophila ND models. Further evaluation of Akt1 in human cell‐based ND models revealed that activation of Akt1 signaling by the small molecule SC79 increased cell viability in all models. Moreover, treatment of AD model mice with SC79 enhanced their long‐term memory and ameliorated dysregulated anxiety levels, which are commonly affected in AD patients. These findings validate MLnet as a valuable tool to uncover molecular pathways and proteins involved in the pathophysiology of entire disease groups and identify potential therapeutic targets that have relevance across disease boundaries. MLnet can be used for any group of diseases and is available as a web tool at http://ssbio.cau.ac.kr/software/mlnet. Synopsis: MLnet is a multi‐layered network expansion model that finds proteins with pathophysiological relevance for groups of diseases. Application to four neurodegenerative diseases predicts multiple members of the insulin pathway as common modifiers. MLnet uses data integration and a multi‐layered network expansion model to identify and prioritize for experimental testing proteins that affect pathophysiology across multiple diseases.When applied to Alzheimer's disease, Huntington's disease, and spinocerebellar ataxia types 1 and 3, MLnet identifies multiple members of the insulin pathway, proteostasis machinery and microtubule apparatus as common modifiers.The impact of the identified genes on neurodegenerative disease phenotypes is tested in Drosophila, human cell lines and mouse disease models.MLnet is available at http://ssbio.cau.ac.kr/software/mlnet and can be used for any group of diseases. [ABSTRACT FROM AUTHOR]

Introduction: Sinonasal inverted papillomas (IP) can undergo transformation into IP‐squamous cell carcinomas (IP‐SCC). More aggressive treatment plan should be established when IP‐SCC is suspected. Nevertheless, inaccuracy of the preoperative punch biopsy results to detect IP‐SCC from IP raises the need for an additional strategy. The present study aimed to investigate significant clinicoradiological remarks associated with IP‐SCC than IP. Material and Methods: Postoperative surgical specimens obtained from patients with confirmed IP or IP‐SCC at a single tertiary medical center from 1997 to 2018 were retrospectively evaluated. Patients' demographic and clinical characteristics, preoperative in‐office punch biopsy results, and preoperative computed tomography (CT) or magnetic resonance images were reviewed. Univariate and multivariate analyses were performed to assess the odds ratio (OR) associated with IP‐SCC. The area under the curve (AUC) in the receiver Operating Characteristic (ROC) curve was calculated in the prediction model to discriminate IP‐SCC from IP. Results: The study included 44 IP‐SCC and 301 patients with IP. The diagnostic sensitivity of in‐office punch biopsy to detect IP‐SCC was 70.7%. Multivariate analysis showed that factors significantly associated with IP‐SCC included tobacco smoking >10PY (adjusted‐OR [aOR]: 4.1), epistaxis (aOR: 3.4), facial pain (aOR: 4.2), bony destruction (aOR: 37.6), bony remodeling (aOR: 36.3), and invasion of adjacent structures (aOR: 31.6) (all p < 0.05). Combining all significantly related clinicoradiological features, the ability to discriminate IP‐SCC from IP reached an AUC of 0.974. Conclusion: IP patients with a history of tobacco smoking, facial pain, epistaxis, and bony destruction, remodeling, or invasion of an adjacent structure on preoperative images may be at higher risk for IP‐SCC. Level of Evidence: 3 Laryngoscope, 133:2502–2510, 2023 [ABSTRACT FROM AUTHOR]

Objectives: With the increase in dental implants for tooth loss, odontogenic sinusitis following maxillary dental implants is frequently encountered in otorhinolaryngology practice. The authors aimed to reveal the association between implant extrusion into maxillary sinus, along with implant‐related complications in patients diagnosed with implant‐related odontogenic sinusitis (IR‐ODS). Study Design: Case–control study. Methods: This study enrolled 60 patients who received functional endoscopic sinus surgery due to IR‐ODS. The preoperative sinus computed tomography was retrospectively reviewed. Among the 120 maxillary sinuses of the 60 patients, 68 sides were diagnosed with IR‐ODS sides, whereas 27 sides showed no clinical or radiological evidence of this condition after the implant insertion and were defined as the control sides. Statistical analysis between these two groups was conducted, in addition to odds ratio (OR) calculations for associations with IR‐ODS. Results: The mean age of the IR‐ODS subjects was 59.5 ± 19.1, with a male to female ratio of 32/28 (53.3%/46.7%). Implants extruding by more than 4 mm into the maxillary sinus, peri‐implantitis, bone graft disruption–extrusion were associated with a significantly higher incidence in the IR‐ODS (p = 0.035, p = 0.003, p = 0.011, respectively). The IR‐ODS sides showed an adjusted‐OR (95% confidence interval) of 27.4 (2.7–276.5) for extrusion length >4 mm, 11.8 (3.0–46.5) for peri‐implantitis, and 34.1 (3.3–347.8) for bone graft disruption (p = 0.005, p < 0.001, and p = 0.003, respectively). Conclusion: Maxillary dental implants extruding more than 4 mm into the maxillary sinus, peri‐implantitis, and disrupted–extruded bone grafts show significant association with IR‐ODS. Level of Evidence: 4 Laryngoscope, 133:237–243, 2023 [ABSTRACT FROM AUTHOR]

Objective: Given the conflicting evidence regarding adenotonsillectomy and the risk of upper airway infections (UAIs), including acute pharyngitis (APT), rhinosinusitis (ARS), and otitis media (AOM), we evaluated the risk of developing UAIs following adenotonsillectomy in a childhood population. Methods: In this population‐based follow‐up study, we used data from the National Health Insurance Service‐National Sample Cohort. The adenotonsillectomy group (n = 2,377) included patients aged <10 years who underwent an adenotonsillectomy. For every patient with APT (n = 2,309), ARS (n = 2,308), and AOM (n = 2,207) who had an adenotonsillectomy, four participants were randomly selected for the control groups (n = 9,204, n = 9,196, and n = 8,788, respectively) using propensity score matching. The number of postoperative hospital visits for UAIs was recorded for 1 to 9 years, and the equivalence test was used to compare the number of visits between the adenotonsillectomy and control groups. Results: There were no significant differences in the incidence of APT, ARS, or AOM at the margin of equivalence of difference (−0.5 < 95% confidence interval of difference < 0.5) between the two groups from postoperative year 1 to year 9. The hospital visits for these diseases gradually decreased over time in both groups. There was a significant decrease in the number of visits for APT, ARS, and AOM in the 5–9 years age group when compared with those in the <4 years age group (P <.01). Conclusion: Our results suggest that adenotonsillectomy does not alter the frequency of UAIs in children. Level of Evidence: NA Laryngoscope, 131:2376–2383, 2021 [ABSTRACT FROM AUTHOR]

Objective: To evaluate the risk of cardio-cerebrovascular disease (CCVD), such as ischemic stroke and acute myocardial infarction (AMI), in patients diagnosed with Bell palsy STUDY DESIGN: Population-based follow-up study.Methods: We used the National Sample Cohort 2002 to 2013 data from the Korea National Health Insurance Service. The Bell palsy group comprised all patients diagnosed with Bell palsy (n = 730). The comparison group comprised patients selected randomly using propensity score matching (n = 1,460). The Kaplan-Meier survival analysis, log-rank test, and Cox proportional-hazards regression models were used to calculate the disease-free survival rate and hazard ratio (HR) of CCVD for each group.Results: Of the total study population, ischemic stroke developed in 15.7% of patients with Bell palsy and 9% of patients in the comparison group during the 12-year follow-up period. After adjusting for other factors, the HR of ischemic stroke during the 12-year follow-up period was 1.84 times greater in the Bell palsy group than in the comparison group (95% confidence interval [CI], 1.43-2.36). However, the adjusted HR of developing ischemic stroke for patients with Bell palsy treated concurrently with antiviral agents and steroids was 1.12 (95% CI, 0.62.-2.04). There was no significant relationship between Bell palsy and risk of AMI development (HR, 1.13; 95% CI, 0.71-1.82).Conclusion: Bell palsy is linked with an increased incidence of ischemic stroke. Our data suggest that Bell palsy may be used as an indicator of increased stroke risk, and concurrent treatment with antiviral agents and steroids may be effective in preventing ischemic stroke.Level Of Evidence: NA Laryngoscope, 129:2371-2377, 2019. [ABSTRACT FROM AUTHOR]

Objective Septal body hypertrophy, like inferior turbinate hypertrophy, can result in changes to the nasal cross-sectional area and resistance to airflow. The aim of this study is to evaluate the efficacy of septal body volume reduction (SBVR) for the treatment of septal body hypertrophy in patients with nasal obstruction. Study Design Prospective randomized study. Methods The study was conducted on two groups (51 patients) with symptoms and signs of nasal obstruction associated with septal body and inferior turbinate hypertrophy that were refractory to medical therapy. In the turbinoplasty only (ITR) group (n = 25), conventional turbinoplasty was only performed on the inferior turbinate. In the septal body reduction (SBR) group (n = 26), concurrent bilateral microdebrider-assisted SBVR was performed during the turbinate surgery. Results The nasal symptoms, including nasal obstruction, rhinorrhea, itching, and sneezing, had significantly improved at 3 months after treatment in both groups ( P < 0.001). Improvement of nasal obstruction in the SBR group was greater than that in the ITR group at 3 months ( P < 0.05). Acoustic rhinometry demonstrated a significant increase in the cross-sectional area and nasal volume in both groups 3 months after surgery. The postoperative change in nasal volume was higher in the SBR group ( P < 0.05). No adverse reactions such as bleeding, infection, adhesions, or olfactory changes were encountered in the SBR group. Conclusions Combined SBVR and turbinoplasty appears to be more effective than turbinoplasty alone for the treatment of nasal obstruction in patients with inferior turbinate and septal body hypertrophy. Level of Evidence 1b. Laryngoscope, 125:1523-1528, 2015 [ABSTRACT FROM AUTHOR]

The article discusses a study on the changes of Tutoplast-processed fascia lata (TPFL) during rhinoplasty in rabbit. It informs that autologous fascia lata (FL) and Tutoplast-processed fascia lata (TPFL) are commercially available homografts that are used as graft tissue for rhinoplasty. The TPFL grafts exhibited negligible resorptionrates and favorable tissue reactions in the rhinoplasty of rabbit.

Objectives. Control of perioperative infection can increase the success rate of organ transplant. The incidence, clinical features, and optimal management of chronic otitis media (COM) in solid organ transplant recipients have not been adequately evaluated. We therefore assessed the incidence and clinical course of COM in solid-organ transplant recipients.Design. Case series with chart review.Setting. Tertiary referral center.Subjects and Methods. We reviewed the medical records of 3278 patients who underwent solid organ transplantations between February 1995 and December 2007 to identify those diagnosed with COM before and after transplant. We analyzed the long-term clinical course and management of COM in these patients.Results. Of 3278 solid organ transplant recipients, 65 (2.0%) were diagnosed with pretransplant COM with a perforated ear drum, including 31 liver, 28 renal, and 6 heart transplant recipients. The primary symptom was otorrhea, followed by hearing disturbance, otalgia, and tinnitus. Middle ear swab culture showed bacterial growth in 17 of the 40 patients (42.5%) with suppurative COM. Of these 40 patients, 14 underwent tympanomastoid surgery (operation group) and 26 were prescribed antibiotics (medication group). The remaining 25 patients, with dry perforated ear drums and well-pneumatized mastoids, were observed without treatment (observation group). After transplantation, the incidence of otorrhea was significantly lower in the operation group (11.1%) than in either the medication (26.9%) or observation (26.7%) group (P = .040, .048, respectively).Conclusions. Precise diagnosis and proper surgical intervention for COM may reduce the rate of otorrhea and exacerbation of COM in solid organ transplant recipients. [ABSTRACT FROM PUBLISHER]

Abstract: Objective: Conventional bilateral same-day tympanoplasty or myringoplasty has been rarely performed because of the risk of postoperative complications. Inlay butterfly cartilage myringoplasty (IBCM) has been shown effective for same-day closure of bilateral tympanic membrane perforations and is a quicker and more comfortable procedure for the patient. Immediate postoperative hearing is not compromised by packing materials because no external canal packing or middle ear support is required. We assessed the efficacy and safety of bilateral same day IBCM. Study Design: Case series with chart review. Setting: Tertiary referral center. Subjects and Methods: Of the 81 patients (age range, 9-64 years) who underwent conventional tympanoplasty/mastoidectomy for bilateral perforated chronic otitis media between June 2005 and September 2009, 17 with small-to-medium perforations and no history of otorrhea underwent same-day cartilage IBCM on the contralateral ear. Median follow-up duration was 13.0 months. Results: The graft take rate was 100 percent, with no retraction pockets or displaced grafts observed during follow-up. Mean air−bone gap was improved from 15.8 to 8.4 dB. Twelve patients had an average air−bone gap between 0 and 10 dB, three between 11 and 20 dB, and two between 21 and 30 dB. Two patients had myringitis postoperatively, but it improved with antibiotic treatment. Conclusion: Bilateral same-day IBCM offers favorable outcomes in selected patients. [Copyright &y& Elsevier]

Objectives/Hypothesis: Vertical dome division (VDD) is a useful nasal tip surgery technique. However, it is associated with postoperative complications and has never been studied in Asian patients. This study examined results following application of our modified VDD approach in Asian patients requiring nasal tip surgery. Study Design: A retrospective clinical chart review. Methods: We retrospectively studied 37 patients who underwent rhinoplasty using our modified VDD procedure. The indications were thick tip skin and relatively strong and well-developed lower lateral cartilages. Outcome measurements were made using preoperative and postoperative photographs. Doctors and patients separately indicated satisfaction using a visual analogue scale (from 1 = satisfied, to 4 = dissatisfied). Results: Following surgery, the mean tip projection increment across the population was 15.8%, and the nasofrontal and nasolabial angle increments were 1.4° and 5.5°, respectively. Doctor and patient satisfaction scores were 1.54 ± 0.76 and 1.61 ± 0.81, respectively. Most patients showed prominent tip projection and good cosmetic results. Two patients (5.4%) were dissatisfied, one due to a narrow tip and the other due to nostril asymmetry. Conclusions: The modified VDD was an effective method for nasal tip projection and rotation in selected Asian patients. Laryngoscope, 2010 [ABSTRACT FROM AUTHOR]

Abstract: Objective: To evaluate changes in vertigo and hearing from patients with Ménière''s disease managed by endolymphatic mastoid shunt (EMS). Study Design: Case series with chart review. Setting: Tertiary referral center. Subjects and Methods: Data from 16 patients were analyzed using 1995 AAO–HNS criteria. Results: Among 16 patients, six had class A vertigo control two years after treatment, five had class B, one class C, three class D, and one class F. At four years after surgery, seven patients had class A, four class B, three class C, and two class F. The mean functional level before surgery was 4.8 and improved to 2.9 and 2.6 at two years and four years after surgery, respectively. The bone conduction pure-tone averages (four frequencies) were 43.3 before surgery and improved to 33.5 dB HL and 35.5 dB HL at three and six months after surgery, respectively. At two years of follow-up, the hearing level was 38.6 dB HL and was not different from the preoperative hearing level. Two years after surgery, the hearing level gradually decreased and was 42.0 dB HL at five years of follow-up. Conclusion: EMS appears to be beneficial in the short term for the symptomatic patients. [Copyright &y& Elsevier]