Low-Grade Papillary Schneiderian Carcinoma in the Nasal Cavity.

Only a limited number of documented low-grade papillary Schneiderian carcinoma (LGPSC) cases have been reported since its initial description in 2015. In this study, the authors present a case report involving a young female patient who presented with this rare condition localized in the nasal cavity. On the basis of histologic examination of a small tumor sample, the initial diagnosis pointed to squamous cell carcinoma. After the surgery, however, the final histologic diagnosis was confirmed as LGPSC. Finally, after surgical intervention, the histologic diagnosis was confirmed as LGPSC. Remarkably, over a period of 22 months, the patient showed no signs of recurrence or metastasis. To achieve an accurate diagnosis and implement appropriate treatment strategies for LGPSC, a comprehensive understanding of both its clinical and histologic characteristics is necessary.

Effect of house dust mite allergen on sleep parameters and sleep quality.

PURPOSE: The role of nasal problems such as allergic rhinitis in the development of obstructive sleep apnea (OSA) is controversial. The purpose of this study was to analyze the effects of house dust mite (HDM) allergen on sleep-related problems. METHODS: In a retrospective study patients were classified according to the house dust mite (HDM)-related specific immunoglobulin E (IgE) level into a low HDM-IgE group (group A) and a high HDM-IgE group (group B). Polysomnographic indices, OSA severity, and self-administered questionnaire results were compared between groups. Correlational analysis was used to identify associations between specific IgE values and sleep parameters related to respiratory events. RESULTS: A total of 327 patients were enrolled. N1 stage ratio, apnea index, and apnea-hypopnea index were significantly higher in group B (P = 0.010, 0.003, and 0.002 respectively) than in group A. N2 stage ratio, and lowest and mean oxygen saturation were significantly lower in group B (P = 0.001, 0.001, and < 0.001 respectively). After propensity score matching, the apnea index and lowest and mean oxygen saturation remained significantly different (P = 0.005, 0.005, and 0.001 respectively). Patients in group B were more likely to have severe OSA and worse subjective sleep quality. In correlational analysis, lowest and mean oxygen saturation were significantly negatively correlated with specific IgE values. CONCLUSION: A high HDM-specific IgE level was associated with the occurrence of respiratory events and oxygen desaturation during sleep, and with the presence of severe OSA, as well as poorer subjective sleep quality.

Metachronously Occurring Carcinomas of Different Histological Types in Bilateral Parotid Glands.

The occurrence of multiple malignant tumors with varying histological characteristics in bilateral parotid glands has never been documented previously in the literature. Here, the authors present a noteworthy case of a patient who exhibited the sequential development of primary carcinomas, each displaying distinct histologic types within the bilateral parotid glands. This case concerns a 57-year-old male patient who initially underwent surgery, followed by adjuvant radiotherapy, for squamous cell carcinoma diagnosed in the right parotid gland. Approximately 3 years after this treatment, a novel salivary duct carcinoma emerged within the left parotid gland, prompting a second round of surgical intervention, again followed by adjuvant radiotherapy. Subsequently, a recurrent tumor was identified within the left Stensen duct, necessitating additional surgical intervention. While monitoring for recurrence or metastases remains an important aspect of post-treatment care for salivary gland cancer, it is also imperative to consider the potential for developing a second primary salivary gland cancer.

Unusual Causes of Nasal Septal Abscess Including a COVID-19 Swab Test After Nasal Surgery.

A nasal septal abscess is a rare lesion that usually results from a nasal septal hematoma after nasal trauma or surgery, although it can occur unexpectedly. Nasal septal abscesses should be prevented and treated immediately. The authors describe 2 unusual cases: 1 caused by sudden loosening of the quilting suture of the nasal septum and the other by a nasopharyngeal swab test for coronavirus disease-2019. The authors also provide an intraoperative video and a literature review.

Diagnostic criteria for eosinophilic chronic rhinosinusitis: Comparative analysis and novel scoring system.

BACKGROUND: Accurate identification of eosinophilic chronic rhinosinusitis is essentialg because its treatment and prognosis substantially differ from other subtypes. METHODS: This retrospective observational study included 640 patients who underwent endoscopic sinus surgery for chronic rhinosinusitis in a single tertiary center from January 2021 to December 2022. Receiver operating characteristic curves were generated to compare accuracy, sensitivity, specificity of the novel scoring system, and previous diagnostic criteria (Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis, European Forum for Research and Education in Allergy and Airway Diseases, European Position Paper on Rhinosinusitis and Nasal Polyps, and Sakuma et al.) for predicting eosinophilic chronic rhinosinusitis (ECRS) by tissue eosinophil count ≥70 per high power field. RESULTS: Patients were randomly divided into estimation (n = 430) and validation (n = 210) groups. The area under the receiver operating characteristic curve for the novel score was 0.753 (95% confidence interval [CI], 0.670-0.835) in the estimation group, 0.729 (0.629-0.830) in the validation group, and 0.661 (0.584-0.738) in the 20-fold cross-validation with the entire dataset. CONCLUSIONS: We propose a novel scoring system that incorporates three key parameters: "novel score = blood eosinophil (%) + total Lund-Mackay score of anterior ethmoid sinuses + 2 if nasal polyp present" greater than 7 can be reliably used for diagnosing ECRS. This system can facilitate decision-making processes regarding the administration of oral steroids and biologics targeting type 2 inflammation prior to surgical intervention.

Impact of Aeroallergen Sensitization on Chronic Rhinosinusitis.

PURPOSE: This study investigated the impact of aeroallergens on the development and progression of chronic rhinosinusitis (CRS), with a focus on the specific associations between aeroallergens and CRS according to allergen type, number, and extent of sensitization. METHODS: The medical records of 256 CRS patients were retrospectively analyzed. All were divided into nonallergic, house dust mite (HDM)-allergic, pollen-allergic, and double allergic groups via specific immunoglobulin E (IgE) testing. Clinical characteristics, computed tomography (CT) scores, olfactory functions, and demographic data were compared. Correlation analysis was performed to explore the relationships between the extent of allergen sensitization and CRS severity. Binary logistic regression analysis was used to identify risk factors for hyposmia and anosmia. RESULTS: The allergic group exhibited higher total CT scores than the nonallergic group (P = 0.001). Sensitivity to HDM or pollen allergens alone was not significantly associated with increased CRS severity. No significant differences were observed between the effects of HDM and pollen allergens on CRS severity. However, the double allergic group exhibited significantly higher CT scores (P < 0.001, < 0.001, and 0.003) than the other groups. Although the prevalence rates of anosmia and hyposmia were notably higher in the double allergic group, the difference was not statistically significant. The maximum specific IgE levels to HDM and pollen allergens positively correlated with the CT scores (P = 0.001 and 0.001, respectively). CONCLUSIONS: Allergen sensitization, particularly to multiple common allergens, contributed to CRS severity. CRS patients sensitized to both HDM and pollen allergens tended to experience the diminished olfactory function. These findings underscore the importance of considering the allergen sensitization pattern when assessing CRS severity and its potential progression.