Vascular mechanisms have been implicated in idiopathic acute unilateral audiovestibulopathy (iAUAV, also known as labyrinthitis), especially in older patients. We investigated the platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and white matter changes in patients with iAUAV/labyrinthitis to determine the potential vascular etiology in this disorder. We retrospectively analyzed complete blood count (CBC) data from patients aged over 50 years and diagnosed with iAUAV/labyrinthitis at a tertiary hospital in South Korea between March 2018 and June 2025. CBC data, Fazekas scores for white matter changes, video head-impulse tests (vHIT), and bithermal caloric test results were compared with those of patients with acute unilateral peripheral vestibulopathy (AUVP, i.e., vestibular neuritis [AUVP/VN]) and age- and sex-matched healthy controls. A total of 74 patients with iAUAV/labyrinthitis (mean age± standard deviation [SD] = 68± 9 years; 34 male), 84 with AUVP/VN (65± 9 years; 46 male), and 58 healthy controls (68± 10 years; 26 male) were included. Both NLR (p<0.001) and PLR (p=0.003) were higher in the iAUAV/labyrinthitis group than in the AUVP/VN or control groups. Patients with iAUAV/labyrinthitis had higher Fazekas scores than those with AUAV/VN (p=0.002). Compared to AUVP/VN, iAUAV/labyrinthitis was associated with a higher PLR (p=0.038), higher Fazekas score (p=0.011), increased VOR gain for the horizontal canal (p<0.001), and decreased VOR gain for the posterior canal (p=0.005). Elevated PLR and prominent white matter changes suggest a microvascular etiology of iAUAV/labyrinthitis in older adults. These serologic and imaging markers may complement standard neurotologic assessments in diagnosing iAUAV/labyrinthitis.

Obstructive sleep apnea (OSA) is a sleep-related breathing disorder caused by recurrent collapse of a structurally vulnerable upper airway during sleep. The nasal cavity, soft palate, lateral pharyngeal walls, tongue base, hyoid complex, and craniofacial skeleton each influence airway caliber and stability. A detailed knowledge of their anatomy is essential for surgical planning. This narrative review summarizes key anatomic features relevant to upper pharyngeal surgery, including the role of nasal obstruction and the internal nasal valve, palatal muscle and parapharyngeal fat, and the lateral palatal space as a target for reconstructive palatal and lateral wall procedures. We further outline lower pharyngeal strategies, such as genioglossus advancement, hyoid myotomy- suspension, and tongue base reduction, which address retroglossal collapse and adverse skeletal- soft tissue relationships. Maxillomandibular advancement and hypoglossal nerve stimulation are discussed as anatomy-driven multilevel and neuromodulatory options. Across these modalities, an anatomically grounded, phenotype-based approach is central to optimizing patient selection, minimizing complications, and improving long-term surgical outcomes in OSA.

Oropharyngeal squamous cell carcinoma (OPSCC) demonstrates distinct clinical behaviors depending on human papillomavirus (HPV) status. HPV-associated OPSCC typically shows a better prognosis and response to therapy compared to non-HPV-associated OPSCC; however, the underlying tumor microenvironment (TME) differences remain unclear. To investigate cellular and molecular factors linked to improved outcomes in HPVassociated OPSCC, we performed single-cell RNA sequencing and high-resolution spatial transcriptomics on samples from 2 non-HPV-associated OPSCCs, 5 HPVassociated OPSCCs, and 3 normal tonsils, focusing on fibroreticular cells (FRCs). We identified four distinct FRC subsets, with FBLN1+ FRCs significantly enriched in HPV-associated OPSCC. These FRCs expressed SLIT2, a molecule involved in immune cell recruitment. Spatial mapping revealed that FBLN1+ FRCs were closely associated with both tumor and immune cells, suggesting a role in promoting a more immunogenic TME. Moreover, HPV-associated OPSCC exhibited higher levels of proliferating epithelial cells and antigen-presentation gene expression compared to non-HPV-associated tumors. Our findings highlight the role of FBLN1+ FRCs in fostering immune activation within the TME of HPV-associated OPSCC. Enhanced antigen presentation and epithelial proliferation likely facilitate tumor-immune interactions, contributing to better clinical outcomes. This study advances the understanding of TME dynamics in OPSCC and may inform future therapeutic strategies.

The current settings of cochlear implants (CIs) do not respect specific cochlear tonotopy, resulting in tonotopic mismatch and potentially decreased auditory performance. The development of new implant settings adapted to individual tonotopy, called anatomybased fitting (ABF), could improve the auditory information coding, particularly by making surrounding sounds more recognizable. This study aimed to evaluate whether ABF allows better environmental sound recognition in new CI users compared to the conventional setting (CS); and to investigate the effect of ABF on speech recognition in quiet and noise. A prospective, randomized, double-blind, two-period cross-over study in 17 new CI users was performed between March 2022 and August 2024. Adult subjects were recruited from candidates selected for cochlear implantation within a single French university hospital. Newly implanted adult recipients of a MED-EL cochlear implant with an electrode array insertion angle greater than 540° were eligible. Subjects were randomized to receive either ABF or CS for 6 weeks, then switched to the other setting for the same duration. Audiometric testing, including Environmental Sound Identification Test (Test d'Identification des Sons de l'Environnement, TISE), speech audiometry in quiet using Fournier lists, and speech audiometry in noise (Vocale Rapide dans le Bruit, VRB) was performed at 6 and 12 weeks. Sixteen subjects (mean age 60 years [SD=15.1]) were analyzed. ABF showed a significant improvement in the TISE score (mean effect (ME)=1.2, 95% confidence interval (CI95%)=[0.3;2.0], standardized effect size (SES)=0.97, p=0.016). Speech recognition in quiet was statistically better with CS (ME=3.6, CI95%=[1.8;5.3], SES=1.4, p=0.001) while no statistically significant difference was found for speech recognition in noise (CI95%=[- 2.8;0.1], p=0.08). In newly implanted cochlear implant users, ABF improved environmental sound recognition, suggesting improved perceived sound naturalness in the first weeks after implantation. This benefit did not extend to speech recognition in quiet and remains inconclusive in noise due to floor effect.

This study investigates the effects of various clinical data on rapid recurrence (recurrence within 3months) of oral tongue squamous cell carcinoma (OTSCC) and develops prediction models using various combinations of data. We divided 944 OTSCC patients into two groups based on timing of recurrence: the rapid recurrence group (RRG, N=89) and the non-rapid or no-recurrence group (NRRG, N=855). Treatment-related data were collected and analyzed to identify risk factors for overall survival (OS) and rapid recurrence. A logistic regression-based prediction model was developed to identify the likelihood of rapid recurrence, and validation was performed using 10-fold cross-validation, leave-group-out cross-validation, and a calibration plot. Significantly lower OS rates were identified with increasing age, the T3-4 and N1-3 stages, a higher maximum preoperative positron emission tomography standardized uptake value (PET SUVmax), and rapid recurrence. Among the 89 RRG patients, T2-4 and N3 stages, a positive resection margin, and higher PET SUVmax were significant predictors of rapid recurrence, and postoperative chemoradiation was a preventive factor. A nomogram was developed to facilitate easy prediction of rapid recurrence in real-world clinical practice by risk-stratifying each clinical variable. Rapid recurrence strongly predicts poor oncologic outcomes in OTSCC. Our validated prediction model, incorporating imaging and pathological factors, might help identify high-risk patients and support more tailored treatment and follow-up strategies.

Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder strongly influenced by obesity, the most significant modifiable risk factor. Effective weight management is therefore essential for optimal OSA care. This guideline aims to provide updated, evidence-based recommendations for the evaluation and management of obesity in adults with obstructive sleep apnea (OSA), incorporating recent advances in lifestyle, pharmacologic, and surgical interventions. The Korean Society of Sleep and Breathing convened a multidisciplinary panel. A systematic literature search was performed across major databases through 2025. Evidence was appraised using GRADE, and recommendations were formulated through consensus using the Evidence-to-Decision framework. Eight statements were developed. Key recommendations include recognizing obesity as a major risk factor, routinely assessing overweight and obesity, and implementing structured weight reduction through diet, exercise, and behavioral therapy. Glucagon-like peptide-1 receptor agonists are recommended when lifestyle interventions are insufficient, and bariatric/metabolic surgery is advised for severe obesity unresponsive to nonsurgical treatment. Weight loss improves apnea-hypopnea index, symptoms, and cardiometabolic markers and may reduce positive airway pressure needs. Continued follow-up is recommended even after clinical improvement. Weight management is a core component of OSA treatment. This guideline offers practical, evidence-based strategies to support clinicians in delivering effective obesity-focused care for adults with OSA.

Rhinosinusitis disrupts the neuroepithelium, promotes inflammatory cell infiltration, and ultimately leads to olfactory dysfunction. Celecoxib, a selective cyclooxygenase 2 (COX-2) inhibitor, reduces neuroinflammation through its antiinflammatory effects. We hypothesize that celecoxib can mitigate sensorineural olfactory impairment by reducing inflammation, preserving neuroepithelial structure, and exerting neuroprotective effects. Male C57BL/6 mice were intranasally administered lipopolysaccharide (LPS) for three weeks to induce rhinosinusitis. Celecoxib treatment was also administered via subcutaneous injection. The mice then underwent histological staining in sinonasal tissue, olfactory function test, and quantitative genomic expression patterns in the olfactory bulb. Following intranasal administration of LPS, mice exhibited impaired olfactory function, increased neutrophil infiltration, an elevated number of goblet cells in the sinonasal mucosa, and upregulated mRNA expression of inflammatory markers indicative of neuroinflammation in the olfactory bulb. Celecoxib treatment resulted in improved olfactory function, reduced neutrophil infiltration, decreased goblet cells number, and attenuated neuroinflammation in the olfactory bulb. These findings suggest that celecoxib alleviates sensorineural olfactory dysfunction by reducing sinonasal neuroinflammation, highlighting its therapeutic potential in rhinosinusitis-associated olfactory loss.

Particulate matter (PM) is well established as an environmental hazard linked to an increased risk of disease. Although numerous studies have explored PM-induced cellular responses, a comprehensive understanding of PM toxicity requires integrating advanced imaging techniques with quantitative biochemical assays. Herein, we address this gap by combining these techniques with quantitative and functional assays to investigate the cellular effects of PM. PM collected from South Korea was used to assess toxicity in macrophages exposed to PM-containing medium. Three-dimensional (3D) holotomography revealed PM distribution and microstructural changes in cells following exposure. Cell viability and inflammation analyses across PM concentrations highlighted its harmful effects. Lipid metabolism and mitochondrial dysfunction assays helped elucidate the underlying mechanisms, whereas a comparative study of oxidative potential between PM and gold nanoparticles (AuNPs) further demonstrates PM-induced hazards. Oxidative stress drove PM-induced physicochemical changes in macrophages. The oxidative potential of PM is a measurable factor that determines its oxidative stress properties. In addition, PM contains several components including transition metals and organic chemicals. Metallic components in PM particularly exhibited redox activity associated with oxidative stress and inflammation. Overall, our findings advance the mechanistic understanding of PM-cell interactions and introduce a novel methodological paradigm for studying the toxicological effects of environmental pollutants.