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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]

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]

Purpose We determined the relationship between apnea severity and depressive symptoms in a large sample of the newly diagnosed male patients with severe obstructive sleep apnea (OSA). Methods Data were collected from patients who received polysomnography due to suspected OSA. The questionnaires included the Beck Depression Inventory (BDI), Epworth Sleepiness Scale (ESS), and Medical Outcomes Study (MOS)-Sleep Scale, for which Sleep Problems Index-1 (SPI-1) was calculated. The apnea-hypopnea index (AHI) and respiratory distress index (RDI) were used to measure apnea severity. The mediational model, which states that OSA severity affects depression through a mediator, was tested here. Results In total, 302 male patients with severe OSA participated. The mean patient age was 48.4 years (SD = 11.3 years). The BDI was [greater than or equal to]10 in 118 patients (39 %) and was significantly associated with body mass index (r = 0.114; p = 0.048), ESS (r = 0.164; p = 0.004), SPI-1 (r = 0.453; p < 0.001), and RDI (r = 0.126; p = 0.029). According to the linear regression analyses, the RDI is not independently associated with the BDI. The strongest predictor of BDI was sleep quality (SPI-1; [beta] = 0.425; p < 0.001). The bootstrap method confirmed that the depressive effects of RDI are significantly mediated by poor sleep quality (bootstrapped 95 % CI 0.0113-0.0632). Conclusions There is evidence of a mediational role of subjective sleep quality on the relationship between apnea severity and depressive symptoms in male patients with severe OSA., Author(s): Wonhee Lee[sup.1] [sup.2] , Sang-Ahm Lee[sup.1] , Yoo-Sam Chung[sup.3] , Woo Sung Kim[sup.4] Author Affiliations: (1) Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 86 [...]

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  Orbital invasion is associated with a poor prognosis in cases of sinonasal malignancy. This study aimed to analyze the oncological outcomes of sinonasal malignancies involving the orbit. Patients and Methods  We reviewed the medical records of 116 patients with a sinonasal malignancy who had orbital invasion at initial diagnosis and followed up at least 6 months between June 1991 and October 2017 at a single institute. The overall survival (OS), disease-specific survival (DSS), and progression-free survival (PFS) rates according to the clinicopathological factors, extent to orbit, and treatment modality were compared. Results  Patients were mainly treated with surgery and postoperative radiation (n  = 39, 33.6%) and concurrent chemoradiation (n  = 72, 62.1%). Only five patients (5.1%) underwent orbital exenteration. The OS, DSS, and PFS rates significantly decreased in patients older than 60 years of age and in patients with a higher Charlson Comorbidity Index Score (each p  < 0.001). The OS and DSS rates were higher in patients at clinical T3 and N0 stage than in patients at clinical T4 and N1–2 stage (each p  < 0.05). There were no significant differences in survival and local control rates according to the extent of orbital invasion, treatment modalities, and orbital preservation. However, neoadjuvant chemotherapy and adjuvant radiation or concurrent chemoradiation increased survival rates in the patients treated with surgery. Conclusion  Orbit preservation and relatively successful oncological outcome could be obtained with surgery and adjuvant radiation or concurrent chemoradiation. [ABSTRACT FROM AUTHOR]