Tumors Of Ear Research Articles

Indications and outcomes of subtotal petrosectomy: our experience and review of literature

BackgroundSubtotal petrosectomy (STP) has attracted massive interest over last two decades. The aim is to present our experience of this uncommon surgery. The indications, outcomes, and our variation in surgical technique would be presented and literature reviewed.MethodsA retrospective observational study of all patients who underwent STP at a tertiary care center in India was analyzed.ResultsA total of 9 ears (in 8 patients) underwent STP over last 5 years at our center. The pathological conditions for which STP was done included chronic otitis media squamous (four ears), middle ear tumors (three ears), petrous apicitis (one ear), and traumatic cerebrospinal fluid (CSF) otorhinorrhea (one ear). The indication of STP included disease clearance (eight ears), unserviceable hearing (seven ears), hearing rehabilitation with otological implants (six ears), and intraoperative CSF gusher (one ear). Intraoperative indications included CSF gusher, large tegmen defect with erosion of apical turn of cochlea, and erosion of anterior bony wall of external auditory canal. The mean follow-up period was 36 months (range of 6 months to 60 months). None of the patients had any dehiscence of blind sac closure or secondary acquired cholesteatoma on imaging.ConclusionsSTP facilitates disease clearance by providing unmatchable exposure in difficult otological scenarios and additionally isolates middle ear cleft from external environment, thereby eliminating problems of mastoid cavity. Furthermore, it also prepares ear for second stage otological implants. It is a safe surgery with minimal complications.

Success and safety of endoscopic versus microscopic resection of temporal bone paraganglioma: a meta-analysis.

Temporal bone paraganglioma (TBP) are the most common tumors of the middle ear. They pose a challenge in otologic surgery due to their extensive vascularity and intricate location within the middle ear. This meta-analysis aimed to compare the safety and efficacy of two surgical approaches, microscopic middle ear surgery (MMES) and endoscopic middle ear surgery (EMES), in the resection of TBP. Eligible studies published after 1988 were identified through systematic searches of "PubMed", "Scopus" and "Google Scholar". Retrospective studies and randomized/non-randomized control trials reporting on surgical approaches for TBP with a minimum of five adult patients were included. A total of 595 records were initially identified. After removing 229 duplicates, 349 articles were excluded based upon article subject, title and abstract. Following the review of full texts, 13 articles were assessed for eligibility. The pooled analysis included a total of 529 ears, with a complication rate of 7.8% for EMES and 14.2% for MMES. Subgroup differences indicated no significant variation between the two methods (p = 0.2945). Both EMES and MMES demonstrated favorable surgical outcomes with low complication rates for TBP resection. These findings suggest that EMES is a safe and effective method for TBP resection and one that is comparable to MMES. Since the risk of bleeding is significant in these tumors, a third-hand technique, endoscopic bipolar cautery or laser-assisted hemostasis should be considered. Conversion to MMES is another option when visibility is critically affected by bleeding.

Rhein‐based Pickering emulsion for hepatocellular carcinoma: Shaping the metabolic signaling and immunoactivation in transarterial chemoembolization

AbstractThe efficacy of transarterial chemoembolization (TACE) has been limited by insufficient embolization and a high incidence of tumor recurrence. Herein, we identified that aberrant metabolic reprogramming and immunosuppression contribute to TACE refractoriness and Rhein, as a potential glycolytic metabolism inhibitor and immunoactivation inducer, was optimized to sensitize tumors to TACE therapy. To achieve efficient embolization, we developed an oil‐in‐water lipiodol embolic emulsion by stabilizing the self‐assembled Rhein nanogel. The assembled Rhein exhibited a nanofiber network, and its integration enhanced the mechanical stability and viscoelasticity of the lipiodol embolic agent. With the synergistic advantages of solid and liquid embolic agents, this carrier‐free Pickering emulsion exhibits efficient embolization and sustained drug release in models of unilateral renal artery embolization, rabbit ear tumor embolization, rabbit orthotopic liver cancer, and rat orthotopic liver cancer. Compared to conventional three‐way catheter mixing methods, multimodal imaging corroborates a marked enhancement in local drug retention and tumor suppression. Importantly, the incorporation of Rhein‐mediated synergistic immunoembolization in this strategy achieved efficient embolization while robustly activating anti‐tumor immune responses, including inducing immunogenic cell death, dendritic cell activation, and major histocompatibility complex class I presentation to CD8+ T cells for tumor killing. Together, these findings reveal a novel strategy for the application of self‐assembled Rhein nanofiber‐stabilized lipiodol emulsion to control metabolic signaling and immunoactivation in TACE.

A Novel Coacervate Embolic Agent for Tumor Chemoembolization.

Transcatheter arterial chemoembolization (TACE) has proven effective in blocking tumor-supplied arteries and delivering localized chemotherapeutic treatment to combat tumors. However, traditional embolic TACE agents exhibit certain limitations, including insufficient chemotherapeutic drug-loading and sustained-release capabilities, non-biodegradability, susceptibility to aggregation, and unstable mechanical properties. This study introduces a novel approach to address these shortcomings by utilizing a complex coacervate as a liquid embolic agent for tumor chemoembolization. By mixing oppositely charged quaternized chitosan (QCS) and gum arabic (GA), a QCS/GA polymer complex coacervate with shear-thinning property is obtained. Furthermore, the incorporation of the contrast agent Iohexol (I) and the chemotherapeutic doxorubicin (DOX) into the coacervate leads to the development of an X-ray-opaque QCS/GA/I/DOX coacervate embolic agent capable of carrying drugs. This innovative formulation effectively embolizes the renal arteries without recanalization. More importantly, the QCS/GA/I/DOX coacervate can successfully embolize the supplying arteries of the VX2 tumors in rabbit ear and liver. Coacervates can locally release DOX to enhance its therapeutic effects, resulting in excellent antitumor efficacy. This coacervate embolic agent exhibits substantial potential for tumor chemoembolization due to its shear-thinning performance, excellent drug-loading and sustained-release capabilities, good biocompatibility, thrombogenicity, biodegradability, safe and effective embolic performance, and user-friendly application.

A Case of Middle Ear Adenomatous Neuroendocrine Tumors: Proposal of a Staging System

A 49-year-old man visited a local otolaryngology clinic with left hearing loss. He was diagnosed as left middle ear tumor and referred to us. The tumor was protruding from the left tympanic membrane. Computed tomography (CT) revealed thickening of the tympanic membrane, space-occupying lesions in the middle ear cavity and mastoid air cells, and no bone destruction in the left middle ear. Magnetic resonance imaging confirmed the CT findings, and the lesions were hyperintense on T1- and T2-weighted imaging. He was diagnosed as middle ear adenomatous neuroendocrine tumor (MEANT) with a pathological result. The patient underwent postauricular approach and canal wall-down mastoidectomy. The tumor occupied the mastoid air cells and extended into the middle ear mucosa. To prevent perilymphatic fistula, the tumor was excised as extensively as possible, while preserving the tumor around and adjacent to the stapes footplate. MEANT is extremely rare and long-term follow-up is necessary due to be potential for tumor regrowth or recurrence. Herein, we propose a new staging system for MEANT.

Microscopic Versus Endoscopic Ear Surgery for Early-Stage Glomus Tympanicum Tumors.

Purpose: Glomus tympanicum tumors are benign primary tumors of the middle ear that can be completely removed using modern surgery. We compared endoscopic ear surgery (EES) to traditional microscopic ear surgery (MES) in terms of the removal of early-stage glomus tympanicum tumors. Methods: We retrospectively reviewed 25 cases treated from 2003 to 2021 that were of Grade I or II based on the Glasscock-Jackson classification system. Overall, 18 cases underwent MES: 8 via trans-tympanic bone and 10 via canal-wall-down or canal-wall-up tympanomastoidectomy (CWDT or CWUT) and 7 underwent EES. We compared surgery durations, the lengths and costs of hospitalization, postoperative complications, and relapse rates between the two groups and among the three specific operation ways. Results: The postoperative follow-up period ranged from 1 to 19 years. There was no between-group difference in operative time or the length or cost of hospitalization. Operative time and cost of hospitalization did not show a statistically significant correlation to the three surgical procedures, whereas it was found that the group of MES via the trans-tympanic bone had shorter length of hospitalization when compared with CWUT or CWDT group. All tumors were completely resected; pulsatile tinnitus improved in all patients, and there was no major complication. Two patients who underwent CWUT or CWDT (one each) relapsed; no patient relapsed in the EES group. Conclusion: MES via the trans-tympanic bone and EES via the ear canal safely and reliably remove early-stage tumors without excessive patient discomfort.

遗传预测血液代谢物与中耳、鼻腔及鼻窦良性肿瘤的因果关系——两样本双向孟德尔随机化研究

遗传预测血液代谢物与中耳、鼻腔及鼻窦良性肿瘤的因果关系——两样本双向孟德尔随机化研究

Unusual Benign Middle Ear Tumors: How Does the Presentation Differ from Otitis Media?

Introduction: Middle ear tumors represents a rare group of neoplasm that vary widely according to their pathology, anatomical involvements and clinical features. They mimic middle ear inflammatory pathologies intricately and hence early definitive diagnosis is a challenge. As these tumors are histologically benign, they are only locally destructive causing vestibular/facial dysfunction.
 Materials and Methods: In this case series, we have included 5 cases of rare middle ear tumors, who presented to our hospital in period of 2020-2023. All patients had a pre-operative examination with otoscope and microscope/otoendoscope. Pre-operative and post-operative hearing assessment done with tuning fork test and pure tone audiometry.Pre-operative radiological investigation done in all cases.Biopsy was usually taken pre-operatively, however in tumors suspected to be highly vascular an intra-operative sample was sent.
 Results: Mastoidectomy(canal wall up/canal wall down/radical) was performed as definite surgical treatment to achieve maximum clearance.
 Conclusion: Surgery is the treatment of the choice for benign middle ear tumors. High resolution computed tomography and magnetic resonance imaging are important to determine the extent and to help surgical planning in doubtful vascular tumour. Biopsy is helpful for the differential diagnosis.

Lisocabtagene Maraleucel as Second-Line Therapy for R/R Large B-Cell Lymphoma in Patients Not Intended for Hematopoietic Stem Cell Transplant: Final Analysis of the Phase 2 PILOT Study

Background: For the 30%-40% of patients with large B-cell lymphoma (LBCL) who are not cured after first-line therapy, traditional second-line therapy has been high-dose chemotherapy (HDCT) and hematopoietic stem cell transplantation (HSCT). Recent studies have challenged this paradigm, showing a PFS/OS benefit to CAR T cell therapy over HDCT/HSCT in patients with high-risk, transplant-intended disease at first relapse. Given the lack of effective therapeutic options, outcomes have been historically poor for patients not intended to receive HDCT/HSCT. Lisocabtagene maraleucel (liso-cel) is an autologous, CD19-directed, 4-1BB CAR T cell product administered at equal target doses of CD8 + and CD4 + CAR + T cells. The open-label phase 2 PILOT study (NCT03483103) evaluated the efficacy and safety of liso-cel in patients with R/R LBCL not intended for HSCT after 1 prior line of therapy. In the primary analysis, the primary endpoint was met with an ORR of 80%. Here, we report the final analysis results from PILOT after a median follow-up of 18.2 mo (range, 1.2-32.8). Methods: Adults with R/R LBCL were eligible if they had received 1 prior line of therapy with an anthracycline and CD20-targeted agent, were not intended for HSCT, and met ≥ 1 transplant not-intended criterion by investigator (age ≥ 70 years, ECOG PS of 2, diffusing capacity of the lung for carbon monoxide ≤ 60%, LVEF < 50%, CrCl < 60 mL/min, or alanine aminotransferase/aspartate transaminase > 2 × upper limit of normal). Patients received lymphodepleting chemotherapy (intravenous fludarabine 30 mg/m² and intravenous cyclophosphamide 300 mg/m² daily for 3 days) followed by liso-cel infusion 2-7 days later. The primary endpoint was ORR by independent review committee (IRC) per Lugano 2014 criteria; secondary endpoints included safety; CR rate, duration of response (DOR), and PFS by IRC; and OS. Results: A total of 61 patients were included in the liso-cel-treated analysis set. Median age was 74 years (range, 53‒84 years; ≥ 75 years, 46%), 39% were female, 26% had ECOG PS of 2, 25% had CrCl < 60 mL/min, 54% had diffuse LBCL not otherwise specified, 30% had high-grade lymphoma with diffuse LBCL histology (HGBCL), 33% had double-/triple-hit disease, and 54% had refractory disease. ORR was 80.3% (95% CI, 68.2-89.4),with 54.1% (95% CI, 40.8-66.9) achieving CR (Table). Responses were durable, with a median DOR of 23.3 mo (95% CI, 6.2-not reached [NR]) after a median follow-up of 23.1 mo (95% CI, 22.9-23.3); median DOR for those with CR was NR (95% CI, 21.65-NR) versus 2.1 mos (95% CI, 1.4-3.3) for those with PR. Median PFS was 9.0 mo (95% CI, 4.2-NR) and median OS was NR (95% CI, 16.3-NR). Twenty-four patients died, mostly because of disease progression (n = 20). During the treatment-emergent (TE) period (≤ 90 days after liso-cel administration), 96.7% of patients had TEAEs (grade ≥ 3, 78.7%), 37.7% had cytokine release syndrome (CRS; grade 3, 1.6%; no grade 4-5), 31.1% had neurological events (NE; grade 3, 4.9%; no grade 4-5), 8.2% had hypogammaglobulinemia, and 6.6% had grade ≥ 3 infections. A total of 57 patients were included in the post-TE period (starting from 91 days after liso-cel administration, initiation of subsequent anticancer therapy, or liso-cel retreatment before Day 91, whichever came first). Of those patients, 50.9% experienced AEs (grade ≥ 3, 17.5%; Table). The most common grade ≥ 3 AEs in the post-TE period were anemia (5.3%) and thrombocytopenia (5.3%). In the post-TE period, 1 (1.8%) patient had hypogammaglobulinemia, and 1 (1.8%) had grade ≥ 3 infections (bacteremia and sepsis). Overall, 2 (3.5%) patients had second primary malignancies (squamous cell carcinoma of skin and malignant external ear neoplasm [n = 1] and myelodysplastic syndrome [n = 1]). Cellular kinetics and B-cell aplasia data will be presented. Conclusions: After a median of 18.2 mo of follow-up, the final analysis of the PILOT study demonstrated a high CR rate and durable CRs with liso-cel treatment in patients with R/R LBCL for whom HSCT was not intended. Despite the high incidence of HGBCL, primary refractory disease, advanced age, and comorbidities in this population, the safety profile was consistent with previous reports, with no new or increased safety signals. These results continue to support liso-cel as second-line therapy for this underserved population of patients with R/R LBCL.

Diagnosis and management of bilateral lipoma of the middle ear.

Middle ear lipomas are rare, accounting for less than 1% of all middle ear tumours. To our knowledge there have been only 16 reported patients with middle ear lipoma. Only one of these had bilateral congenital middle ear lipomas. The aim of this review is to comprehensive overview the diagnosis and management of congenital lipomas of the middle ear. A literature review was performed searching multiple data bases, using the key words "middle ear", AND "lipoma", AND "congenital". A total of 116 articles were identified. One hundred were excluded on various criteria, leaving 16 articles for detailed review. Additionally, we report the second case of bilateral congenital middle ear lipoma. Based on this case report and literature review, the incidence of middle ear lipomas is greater in paediatric patients than in adult patients. Middle ear lipomas are distributed evenly between males and females. Three patients had recognised genetic syndromes, while five had prior ventilation tube placement. Clinically patients present with conductive hearing loss and middle ear effusions. In some cases, presence of a white or yellow mass behind the anterior aspect of the tympanic membrane is recognised. The most common location of the masses is in the anterosuperior quadrant of the middle ear, the site of predilection for small congenital cholesteatomas. An MRI scan is most useful in distinguishing between lipoma and cholesteatoma. All cases reported surgical excision of the middle ear lipoma. There was no evidence of recurrence noted up to 4 years follow up. Though rare, congenital lipomas of the middle ear should be a differential diagnosis of a middle ear masses. Early identification can allow surgical lipoma resection with minimal disruption to the ossicular chain. Though there is currently no consensus regarding management, surgical removal and appropriate reconstruction of the ossicular chain if needed, is appropriate.

Bilateral intracochlear schwannomas: histopathological confirmation and outcomes following tumour removal and cochlear implantation with lateral wall electrodes.

Intracochlear schwannomas (ICS) are very rare benign tumours of the inner ear. We present histopathological proof of the extremely rare bilateral occurrence of intracochlear schwannomas with negative blood genetic testing for neurofibromatosis type2 (NF2). Bilateral schwannomas are typically associated with the condition NF2 and this case is presumed to have either mosaicism for NF2 or sporadic development of bilateral tumours. For progressive bilateral tumour growth and associated profound hearing loss, surgical intervention via partial cochleoectomy, tumour removal, preservation of the modiolus, and simultaneous cochlear implantation with lateral wall electrode carrier with basal double electrode contacts was performed. The right side was operated on first with a14-month gap between each side. The hearing in aided speech recognition for consonant-nucleus-consonant (CNC) phonemes in quiet improved from 57% to 83% 12months after bilateral cochlear implantation (CI). Bilateral intracochlear schwannomas in non-NF2 patients are extremely rare but should be considered in cases of progressive bilateral hearing loss. Successful tumour removal and cochlear implantation utilizing alateral wall electrode is possible and can achieve good hearing outcomes.

Radical surgery on the middle ear in the treatment of cholesteatoma: history or reality? A review

Radical surgery on the middle ear is primarily associated with such pathology as cholesteatoma and ear neoplasms. And if in the case of tumors radicalism in ear surgery is justified, then in the surgery of the cholesteatomic process there is a need to discuss this issue. The existence of acquired cholesteatoma was recognized more than three centuries ago. Without timely detection and intervention, cholesteatomas can increase to gigantic sizes and lead to numerous intracranial and extracranial complications. Due to its aggressive growth, invasive nature and potentially fatal consequences of intracranial complications, acquired cholesteatoma remains the cause of morbidity and death in those who do not have access to advanced medical care. Currently, there are no effective non-surgical methods of treatment. The article provides a brief overview of the main issues related to acquired middle ear cholesteatoma, and discusses the practical

Critical Analysis of Malignancies in Ayurveda WSR to ENT Cancer

Cancer is one of the major causes of death across the globe accounting for nearly 10 million deaths in 2020. The commonest cancers are breast (11.6%), Lung (11.6%), colorectal (6.1%), and prostate cancer (7.1%). Every 6th death in the world is due to the cancer. According to the International Agency for Research on Cancer (ARC), by 2040, the global burden of Cancer is expected to grow by 27.5 million new cases. And it’s going to increase further due to faulty dietary and lifestyle practices. Therefore, it is necessary to look for every possible solution including the ancient medical sciences such as in Ayurveda. Ayurveda is an ancient Indian medical science. There are references to various malignancies in Ayurveda. The tumour is referred as ‘Arbuda’ or ‘Gulma’ in Ayurveda. All the characteristics of tumour are very well mentioned in Ayurveda. Ayurvedic acharyas while suggesting the operation for these tumours, said that these tumours should be excised completely along with surrounding healthy tissue otherwise it recures soon indicating the malignant nature of the tumour. Most of the tumours are mentioned as incurable again indicating its malignant nature. In Ayurveda, tumour is classified based on doshas and structural appearance. There are references to Liver tumour, Nasal tumour, Ear tumour, Throat tumours, head tumour, muscle tumour. Liposarcoma and hemangiosarcoma. But there is no reference to breast malignancy which is common today. The less prevalence of breast malignancy during ancient time could be due to better infant feeding practices as compared to today’s era or it could be have been included under Mansarbuda. Among the treatment modality for Cancer, apart from medicine and surgery, cauterization and application of Alkali is also suggested in Ayurveda to avoid the recurrence. It is observed and concluded that Cancers are very well documented in Ayurveda and the treatment suggested for treating the tumours need to be reexplored.

Glomus tympanicum removal using transcanal endoscopic assisted surgery: An experience with six cases.

To evaluate an endoscopic approach in the management of glomus tumor, and also to investigate and evaluate its appropriateness and feasibility. Glomus tumors, also known as paragangliomas, are benign primary tumors of the middle ear. The advent of endoscopic ear surgery has provided new dimensions to the management of this highly vascular tumor. Retrospective analysis of six patients of glomus tympanicum, operated between July 2014 and June 2019, with modified Fisch classification Type A and B1, who were managed by a retroauricular transcanal endoscopic approach. Preoperative and postoperative analysis was done for these patients. The chief complaint was pulsatile tinnitus, which disappeared in five cases and reduced in severity in one of them. Hearing was improved with reduction in air-bone gap in all the cases. No major complications or recurrence were observed in any of the patients after 12 months of follow-up. This endoscopic approach serves as a safe and reliable technique for tumor removal. It thus provides postoperative comfort for most of the patients.

Cancers rares de la tête et du cou sous l’égide du REFCOR, partie 2

Among the 16,000 new cases of malignant tumors of the head and neck diagnosed in France each year, 10% are not conventional squamous cell carcinomas. These so-called rare cancers are distinguished by their presentation and patterns of failure, which is important to recognize in order to offer specific adapted management and maximize the chances of tumor control. These cancers can be rare by their histology as well as their anatomical location when arising from the paranasal sinuses, salivary glands and ear. The management of these heterogeneous rare diseases of complex treatment has considerably been structured over the last 15years, in particular via the French ENT Cancer Expertise Network (REFCOR) and international networks and registries (EURACAN, etc.). Structuration also favors research with identification of new entities and setting up of specific therapeutic trials. A first article (part 1) discusses the diagnostic and therapeutic specificities of these rare cancers, and develops the recommendations of the REFCOR concerning rare epithelial tumors, i.e., salivary tumors, sinonasal tumors, variants of conventional squamous cell carcinomas, neuroendocrine carcinomas, malignant odontogenic tumors, and ear tumors. This second article (part 2) is focused on non-epithelial tumors (sarcomas, mucosal melanomas, lymphomas, tumors of uncertain or undetermined malignancy) and describes the organization and missions of the REFCOR.

Cancers rares de la tête et du cou sous l’égide du REFCOR, partie 1

Among the 16,000 new cases of malignant tumors of the head and neck diagnosed in France each year, 10% are not conventional squamous cell carcinomas. These so-called rare cancers are distinguished by their presentation and patterns of failure, which is important to recognize in order to offer specific adapted management and maximize the chances of tumor control. These cancers can be rare by their histology, which determines their local invasiveness, and their hematogenous/nodal spread. Their diagnosis can be difficult and often requires comprehensive immunohistochemistry and genomic techniques. Expert pathology review is recommended in the cases of undifferentiated tumors, sarcomas and at the slightest diagnostic doubt. These rare cancers can also be rare by their anatomical location when arising from the paranasal sinuses, salivary glands and ear. Their location requires knowledge of their specific extension routes, and may call for a specific surgical technique (skull base endoscopic sinus surgery, extended total parotidectomy, etc.) and adapted radiotherapy to spare healthy organs surrounding the tumor. This article (part 1) discusses the diagnostic and therapeutic specificities of these rare cancers, and develops the recommendations of the French ENT Cancer Expertise Network (REFCOR) concerning rare epithelial tumors, i.e., salivary tumors, sinonasal tumors, variants of conventional squamous cell carcinomas, neuroendocrine carcinomas, malignant odontogenic tumors, and ear tumors. A second article (part 2) is focused on non-epithelial tumors (sarcomas, mucosal melanomas, lymphomas, tumors of uncertain or undetermined malignancy) and describes the organization and missions of the REFCOR.

Dual-modality imaging particle size monodisperse poly (ethylene glycol) diacrylate drug-loaded embolic microspheres for tumor therapy

Transcatheter arterial chemoembolization (TACE) is one of the common methods of treating tumors and usually requires an accompanying injection of an exogenous contrast agent, but the exogenous contrast agent is highly susceptible to removal by blood flow, which greatly reduces the efficiency of the operation. Here, we developed a uniformly sized Ag2S/BaSO4/DOX@PEGDAMS that integrates embolization, drug loading, and visualization with a microfluidic device. The microspheres can be imaged stably under NIR-II/X-ray for a long time, and the luminescence of NIR-II is better than that of X-ray. This breaks the limitations of conventional X-ray-only imaging of embolic microspheres. The microscope images and scanning electron microscope EDS results showed that the microspheres were regularly spherical with uniform particle size, and the signature elements such as Ag, S, and Ba were uniformly distributed in the microspheres. In vitro cytotoxicity assays and apoptosis assays have demonstrated that the microspheres have good biocompatibility and can effectively inhibit tumor cell growth due to the presence of DOX. The ability of microspheres to aggregate in blood vessels and block blood flow was verified by modeling and embolizing in rabbit ear tumors. In conclusion, Ag2S/BaSO4/DOX@PEGDAMS shows excellent embolization, drug loading, and imaging capabilities, and has the potential to be used for TACE and other diseases requiring interventional embolization therapy.

The use of radio wave scalpel "Surgitron" in the surgical treatment of the outer ear neoplasms

The number of ENT organs diseases continues to grow, and therefore the problem of combating these diseases has been and remains relevant in otorhinolaryngology. The least studied of all the ENT organs neoplasm are ear tumors. Aims: to increase the efficiency of surgical treatment of neoplasms of the outer ear using a radio wave scalpel "Surgitron". Patients and Methods. The work is based on the results of treatment of 230 patients (146 in the main and 84 in the control groups) with tumor-like formations, benign and malignantouter ear tumors. Results. The first place in the structure of ear neoplasms in the main group was occupied by tumor-like formations - 58 patients (40%), benign tumors were somewhat less common - 48 patients (33%), and even less often - malignant neoplasms (40 patients, 27%). Most often, the auricle neoplasms were removed without the underlying cartilage (in 60 patients; 56.6%). Limited tumors (I-II stage) were removed under local anesthesia with 1% solution of novocaine with the addition, in the absence of contraindications, 5 drops of 0.1% solution of adrenaline per 10 ml of novocaine. After detachment of the tumor with skin and perichondrium from the underlying cartilage, an incision was made using a Surgitron radio wave scalpel, after which the tumor was removed within healthy tissues without cartilage resection. A strip of healthy skin around a benign tumor should be at least 3 mm. The surface of the cartilage at the bottom of the wound was examined under an operating microscope. The cartilage undamaged by the tumor had a smooth, shiny surface. Bleeding during the operation was minimal, stopped with the help of Surgitron, in the coagulation mode. In 1 patient with senile keratosis, in which the neoplasm was localized on the anterior surface of the auricle, the tumor was removed with a section of cartilage tissue. Conclusion. The use of the radio wave scalpel "Surgitron" in surgical interventions for outer ear neoplasms can reduce the time of the operation, reduce blood loss to a minimum, the time of wound epithelialization and the length of the patient's stay in the hospital. Comparison of the number of recurrences according to the result of using a radio wave scalpel and the classical surgical method (for tumor-like formations - 12% and 24.2%, respectively, for benign tumors - 8.3% and 40%, for malignant tumors - 30% and 70%) indicates a high effectiveness of surgical treatment using "Surgitron".

Top Ten Oncocytic Head and Neck Lesions to Contemplate.

Oncocytes are a component of many metaplastic and neoplastic lesions throughout the head and neck area, primarily originating in salivary/seromucinous glands and the thyroid gland. In addition, other lesions can contain cells that mimic oncocytes (pseudo-oncocytes); these can be of epithelial or non-epithelial origin. Review article. Oncocytic metaplasia is common in seromucinous glands throughout the upper aerodigestive tract, most notable in the oral cavity, nasopharynx and larynx. The main oncocytic salivary gland neoplasms are Warthin tumor and oncocytoma. Infarction of Warthin tumor may lead to recognition difficulties. Oncocytic subtypes of mucoepidermoid carcinoma and intraductal carcinoma have morphologic and immunohistochemical features that allow distinction from major oncocytic entities. Oncocytic thyroid tumors include adenoma, carcinoma (follicular, papillary and medullary), along with poorly differentiated tumors. Oncocytic papillary sinonasal and middle ear tumors must be distinguished from low grade adenocarcinomas. Pseudo-oncocytic entities include paraganglioma, Langerhans cell histiocytosis, giant cell tumor, rhabdomyoma, and metastatic tumors. Correct diagnosis of oncocytic head and neck lesions requires a knowledge of the spectrum of possible entities, their characteristic sites of occurrence, architecture, histomorphology, and immunohistochemistry. Oncocytic subtypes of several newly described entities are now recognized. Both epithelial and non-epithelial mimics of oncocytes exist. The molecular features of oncocytic tumors can be helpful in their diagnosis and understanding their pathogenesis.

Wideband Acoustic Immittance in Children.

As wideband absorbance (WBA) gains popularity, it is essential to understand the impact of different middle ear pathologies on the absorbance patterns as a function of frequency in children with various middle ear pathologies. More recently, the use of wideband tympanometry has enabled clinicians to conduct WBA at ambient pressure (WBA amb ) as well as the pressurized mode (WBA TPP ). This article reviews evidence for the ability of WBA measurements to accurately characterize the normal middle ear function across a wide range of frequencies and to aid in differential diagnosis of common middle ear disorders in children. Absorbance results in cases of otitis media with effusion, negative middle ear pressure, Eustachian tube malfunction, middle ear tumors, and pressure equalization tubes will be compared to age-appropriate normative data. Where applicable, WBA amb as well as WBA TPP will be reviewed in these conditions. The main objectives of this article are to identify, assess, and interpret WBA amb and WBA TPP outcomes from various middle ear conditions in children between the ages of 3 and 12 years.