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Advances in the Diagnosis and Management of ENT Diseases

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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 25664

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Special Issue Editors

Dr. Wojciech Kukwa

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Guest Editor

Department of Otolaryngology, Medical University of Warsaw, Warsaw, Poland
Interests: OSA; sleep disorders and sleep medicine; treatment; tumors; cancer; oncology; otolaryngology; sleep medicine
Special Issues, Collections and Topics in MDPI journals

Dr. Mirosław J. Szczepański

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Guest Editor

Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
Interests: rhinosinusitis; Graves’ ophthalmopathy; scuba-diving medicine; treatment; otolaryngology; tumor immunology; exosomes
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

ENT specialists have the privilege of dealing with an extremely interesting body area with a complex anatomical structure and function. It is a wide specialty where rapid progress in diagnosis, treatment and management can be observed in rhinology, otology and upper aerodigestive tract disorders. Additionally, ENT continues progress in the diagnosis and therapy of head and neck cancers, and participates in the development of increasingly effective methods of diagnosing and treating sleep breathing disorders. The primary goal of this Special Issue is to advance the knowledge of ENT scientific progress and achievements. We invite all researchers in the field to contribute to this Issue in the form of systematic reviews, original research articles or short communications, as well as case reports.

Dr. Wojciech Kukwa
Dr. Mirosław J. Szczepański
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (10 papers)

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Research

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11 pages, 1732 KiB

Open AccessArticle

Influence of Age and Gender on Nasal Airway Patency as Measured by Active Anterior Rhinomanometry and Acoustic Rhinometry

by Jing-Jie Wang, Yi-Fang Chiang and Rong-San Jiang

Diagnostics 2023, 13(7), 1235; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13071235 - 24 Mar 2023

Cited by 3 | Viewed by 960

Abstract

In this study, we aimed to investigate the influences of age and gender on nasal airway patency, as measured by both active anterior rhinomanometry (AAR) and acoustic rhinometry (AR). The nasal airway patency of healthy subjects was evaluated using AAR and AR. In AAR, the subjects generated airflow actively through inspiration and expiration in repetitions of 10, while nasal patency was measured at an inspiratory and expiratory reference pressure of 75 Pa. In AR, we assessed the geometry of the nasal cavity through the analysis of sound waves reflected from the nasal cavities in order to measure both cross-sectional areas and nasal volumes. The subjects were divided by gender, with all males and females then grouped by ages of 20–39 years, 40–59 years and ≥60 years. There were 40 subjects in each group. The mean resistance measured by AAR and the cross-sectional areas and nasal volumes measured by AR were not different between the different age groups; however, the cross-sectional areas and nasal volumes were found to be lesser in females than in males. Our results showed that nasal airway patency was not affected by age, while females were shown to have wider nasal passages than males. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of ENT Diseases)

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12 pages, 1258 KiB

Open AccessArticle

The Impact of the Angular Head Movement’s Velocity during Diagnostic Maneuvers on Proper Benign Positional Paroxysmal Vertigo Diagnosis and Therapy

by Igor Anurin, Marlena Ziemska-Gorczyca, Dana Pavlovschi, Ireneusz Kantor and Karolina Dżaman

Diagnostics 2023, 13(4), 665; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13040665 - 10 Feb 2023

Cited by 1 | Viewed by 1350

Abstract

Based on the current state of the BPPV field, there are no guidelines that specify an angular head movement’s velocity (AHMV) during diagnostic maneuvers of BPPV. The aim of this study was to evaluate the impact of AHMV during diagnostic maneuvers on proper BPPV diagnosis and therapy. The analysis covered the results obtained in 91 patients with a positive result of the Dix-Hallpike (D-H) maneuver or the roll test. The patients were divided into four groups based on values of AHMV (high 100–200°/s and low 40–70°/s) and the BPPV type (posterior: PC-BPPV or horizontal: HC-BPPV). The parameters of the obtained nystagmuses were analyzed and compared to AHMV. There was a significant negative correlation between AHMV and latency of nystagmus in all study groups. Furthermore, there was a significant positive correlation between AHMV and both maximum slow phase velocity and average frequency of nystagmus in the PC-BPPV groups, whereas it was not observed in the HC-BPPV patients. Complete relief of symptoms was reported after 2 weeks and was better in patients diagnosed with maneuvers performed with high AHMV. High AHMV during the D-H maneuver allows the nystagmus to be more visible, increasing the sensitivity of diagnostic tests and is crucial for a proper diagnosis and therapy. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of ENT Diseases)

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13 pages, 3873 KiB

Open AccessArticle

A Role for Mast Cell-Mediated Antibodies in the Formation of Cholesteatoma and Cholesteatoma-Induced Bone Erosion

by Çiğdem Özdemir, Selçuk Kuzu, Yiğit Şenol, Tuba Yiğit, Erol Güldün, Abdulkadir Bucak, Şahin Ulu and Çiğdem Tokyol

Diagnostics 2023, 13(3), 455; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13030455 - 26 Jan 2023

Viewed by 1093

Abstract

The study aimed to evaluate the effects and relationships between mast cells in the matrix, mast cell enzymes tryptase and chymase, epithelial proliferation, microvascular density, and bone destruction in cholesteatoma. Thirty-five biopsies diagnosed with cholesteatoma and seven healthy skin tissues taken from the retro-auricular region for control were evaluated. Immunohistochemical studies were performed with CD117, CD34, Ki-67, chymase, and tryptase antibodies, in a single session for all cases and the control group. The relationship between erosion size and antibody load was determined. The mean cholesteatoma epithelium Ki-67 was higher than the control group (p < 0.001). CD117-positive mast cells, chymase-positive mast cells, tryptase-positive mast cells, and microvessel density were significantly higher in the cholesteatoma matrix compared to the control group (p < 0.002, p < 0.001, p < 0.005). In the group with bone erosion scores of two and above, immunohistochemical markers tended to be higher. A positive correlation was found between CD117 and chymase, tryptase, and microvessel density; between tryptase, chymase, and microvessel density; and between chymase and microvessel density. CD117-positive mast cells and chymase-positive mast cells stimulate angiogenesis, increase the epithelium’s proliferative capacity in the cholesteatoma matrix, and form cholesteatoma. The increased proliferation of cholesteatoma epithelium and increased vascular density in the matrix exacerbate bone erosion. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of ENT Diseases)

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9 pages, 653 KiB

Open AccessArticle

Nasal Mycology of Chronic Rhinosinusitis Revealed by Nanopore Sequencing

by Rong-San Jiang, Chien-Hung Shih, Yu-Han Jiang, Han-Hsueh Hsieh, Yi-Fang Chiang, Han-Ni Chuang and Tzu-Hung Hsiao

Diagnostics 2022, 12(11), 2735; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12112735 - 09 Nov 2022

Cited by 2 | Viewed by 1173

Abstract

Background: Nanopore sequencing (NS) is a third-generation sequencing technology capable of generating reads of long sequences. In this study, we used NS to investigate nasal mycology in patients with chronic rhinosinusitis (CRS). Methods: Nasal cavities of 13 CRS patients were individually irrigated with 20 mL of distilled water. The irrigant was forcefully blown by the patient into a basin. The collected fluid was placed into a centrifuge tube and processed using the method of Ponikau et al. The collected specimens were used for traditional fungal culture and sequenced for total DNA using NS. Results: Traditional fungal culture successfully grew fungi in the specimens of 11 (84.6%) patients. Aspergillus sp. and Penicillium sp. were found in four (30.8%) patients, Cladosporium sp. in three (23.1%) patients, and Candida albicans, Mucor sp. and Chaetomium sp. in one patient. NS revealed fungi abundance ranged from 81 to 2226, with the Shannon species diversity ranging from 1.094 to 1.683 at the genus level. Malassezia sp. was sequenced in 13 patients, Aspergillus sp. in 12 (92.3%) patients, Candida albicans in 11 (84.6%) patients, and Penicillium sp. in 10 (76.9%) patients. Conclusion: Our results showed that NS was sensitive and fast in detecting nasal fungi in CRS patients. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of ENT Diseases)

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14 pages, 1122 KiB

Open AccessArticle

Cancer Stem Cell Markers in Rhabdomyosarcoma in Children

by Joanna Radzikowska, Anna M. Czarnecka, Teresa Klepacka, Magdalena Rychłowska-Pruszyńska, Anna Raciborska, Bożenna Dembowska-Bagińska, Maciej Pronicki, Andrzej Kukwa, Wojciech Fendler, Urszula Smyczyńska, Wojciech Kukwa and Antoni Krzeski

Diagnostics 2022, 12(8), 1895; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12081895 - 04 Aug 2022

Cited by 1 | Viewed by 1659

Abstract

(1) Background: The aim of the present study was to assess the cancer stem cell (CSC) markers CD24, CD44, CD133, and ALDH1A1 in rhabdomyosarcoma (RMS) in children and to define their prognostic role in this group of patients. (2) Methods: The study material was archival tissue specimens collected from 49 patients under 18 years of age and who had been diagnosed with RMS. Immunohistochemistry (IHC) was used to evaluate the expression of the selected CSC markers in the tumor tissue. Expression was evaluated using a semiquantitative IRS scale based on the one developed by Remmele and Stenger and was correlated with the clinical and pathomorphological parameters of prognostic importance in RMS. (3) Results: Expression of the selected CSC markers CD24, CD44, CD133, and ALDH1A1 was demonstrated in 83.7%, 55.1%, 81.6%, and 100% of the RMS patients, respectively. The expression of all of the assessed CSC markers was statistically significantly higher in the study group versus the control group. No significant correlation was found between the expression of the selected CSC markers and clinical and pathological prognostic factors that were analyzed. The expression of the CSC markers did not have a significant influence on RMS survival rates. (4) Conclusions: The results of the conducted study confirm the expression of selected CSC markers in rhabdomyosarcoma tissue in children. The study did not support the prognostic relevance of the expression of any of the assessed CSC markers. However, further studies are needed to fully understand the relevance of the selected CSC markers in RMS carcinogenesis. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of ENT Diseases)

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9 pages, 961 KiB

Open AccessArticle

Analysis of Nasal Foreign Bodies in South Korea: Over 10-Year Experience

by Hahn Jin Jung, Sun Wook Kim, Joong Seob Lee, Hyo Geun Choi and Jee Hye Wee

Diagnostics 2022, 12(8), 1810; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12081810 - 28 Jul 2022

Cited by 1 | Viewed by 1288

Abstract

Foreign bodies (FBs) in the nasal cavity are commonly encountered in otorhinolaryngology. This retrospective study was conducted between January 2009 and December 2020. The nasal FB frequencies were investigated according to age and sex. The type, shape, and location of the FBs, onset, and clinical features were obtained. In a total of 1228 cases, the average age was 3.9 ± 5.7 years. We found a higher incidence in patients 2–4 years old. The most frequent nasal FBs were beads (24.0%), toys/plastics (17.8%), and beans/corn (15.8%). However, there were some differences in the nasal FB types according to the age group. There was no difference in the location of the nasal FBs according to age group, but nasal FBs were found more frequently in the right nasal cavity in the 1–3-years-old groups. Most patients (97.5%) visited the hospital the same day when the nasal FB insertion was suspected, and most were asymptomatic. After the removal of the nasal FBs, most patients were free of complications. Of the nine cases involving button batteries, septal perforation was observed in two patients who visited the hospital one or two days after the FB insertion. There were specific age-based characteristics of the nasal FBs that may serve as a basis for specific precautions. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of ENT Diseases)

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10 pages, 1556 KiB

Open AccessArticle

Isolated Sphenoid Sinusitis: Anatomical Features for Choosing a Method of Treatment, a Case-Control Study

by Sergei Karpishchenko, Olga Vereshchagina, Olga Stancheva, Tatiana Nagornykh, Alexander Krasichkov, Irina Serdiukova, Aleksandr Sinitca and Dmitry Kaplun

Diagnostics 2022, 12(5), 1284; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12051284 - 21 May 2022

Cited by 4 | Viewed by 3908

Abstract

Isolated sphenoid sinusitis (ISS) is a group of pathologies characterized by inflammation in one or both sphenoid sinuses. The gold standard for analyzing and diagnosing ISS is computer tomography. Many researchers have discussed the treatment of patients with ISS variants such as fully opacified sinus, mostly with surgery. A retrospective analysis of clinical data of 59 patients (21 male (35%), 38 female (65%)) with ISS, who were treated in the Otorhinolaryngological Department of Pavlov First Saint Petersburg State Medical University between January 2017 and January 2020, was conducted. All patients were in the first stage of the same medical therapy. In cases where there was no recovery, these patients were referred to surgery. For the control group, we analyzed patients without any disorders according to CT-scan examination. After analyzing the obtained clinical and radiological data, we found indicators that were common in patients who did not recover after medical therapy. According to the reverse regression method statistical model, in male patients with a diffuse headache and nasal discharge it was shown that medical therapy was highly effective (more than 78%). The presence of nasal septum deviation and adenoids in male and female patients leads to the highest risk of surgical treatment (83% probability of the logistic model). The detailed analysis of CT-scans and the complaints of patients with ISS can be the key to determining the preferred therapy choice. Not all cases need to have an endoscopic opening of the sphenoid sinus, according to our research. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of ENT Diseases)

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Review

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20 pages, 2573 KiB

Open AccessReview

Immunological Aspects of Chronic Rhinosinusitis

by Katarzyna Czerwaty, Katarzyna Piszczatowska, Jacek Brzost, Nils Ludwig, Mirosław J. Szczepański and Karolina Dżaman

Diagnostics 2022, 12(10), 2361; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12102361 - 29 Sep 2022

Cited by 5 | Viewed by 2443

Abstract

Chronic rhinosinusitis (CRS) is related to persistent inflammation with a dysfunctional relationship between environmental agents and the host immune system. Disturbances in the functioning of the sinus mucosa lead to common clinical symptoms. The major processes involved in the pathogenesis of CRS include airway epithelial dysfunctions that are influenced by external and host-derived factors which activate multiple immunological mechanisms. The molecular bases for CRS remain unclear, although some factors commonly correspond to the disease: bacterial, fungal and viral infections, comorbidity diseases, genetic dysfunctions, and immunodeficiency. Additionally, air pollution leads increased severity of symptoms. CRS is a heterogeneous group of sinus diseases with different clinical courses and response to treatment. Immunological pathways vary depending on the endotype or genotype of the patient. The recent knowledge expansion into mechanisms underlying the pathogenesis of CRS is leading to a steadily increasing significance of precision medicine in the treatment of CRS. The purpose of this review is to summarize the current state of knowledge regarding the immunological aspects of CRS, which are essential for ensuring more effective treatment strategies. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of ENT Diseases)

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12 pages, 2114 KiB

Open AccessReview

New Approaches and Technologies to Improve Accuracy of Acute Otitis Media Diagnosis

by Susanna Esposito, Sonia Bianchini, Alberto Argentiero, Riccardo Gobbi, Claudio Vicini and Nicola Principi

Diagnostics 2021, 11(12), 2392; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11122392 - 19 Dec 2021

Cited by 5 | Viewed by 7642

Abstract

Several studies have shown that in recent years incidence of acute otitis media (AOM) has declined worldwide. However, related medical, social, and economic problems for patients, their families, and society remain very high. Better knowledge of potential risk factors for AOM development and more effective preventive interventions, particularly in AOM-prone children, can further reduce disease incidence. However, a more accurate AOM diagnosis seems essential to achieve this goal. Diagnostic uncertainty is common, and to avoid risks related to a disease caused mainly by bacteria, several children without AOM are treated with antibiotics and followed as true AOM cases. The main objective of this manuscript is to discuss the most common difficulties that presently limit accurate AOM diagnosis and the new approaches and technologies that have been proposed to improve disease detection. We showed that misdiagnosis can be dangerous or lead to relevant therapeutic mistakes. The need to improve AOM diagnosis has allowed the identification of a long list of technologies to visualize and evaluate the tympanic membrane and to assess middle-ear effusion. Most of the new instruments, including light field otoscopy, optical coherence tomography, low-coherence interferometry, and Raman spectroscopy, are far from being introduced in clinical practice. Video-otoscopy can be effective, especially when it is used in association with telemedicine, parents’ cooperation, and artificial intelligence. Introduction of otologic telemedicine and use of artificial intelligence among pediatricians and ENT specialists must be strongly promoted in order to reduce mistakes in AOM diagnosis. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of ENT Diseases)

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Other

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22 pages, 902 KiB

Open AccessCase Report

Can EEG Correlates Predict Treatment Efficacy in Children with Overlapping ASD and SLI Symptoms: A Case Report

by Slavica Maksimović, Ljiljana Jeličić, Maša Marisavljević, Saška Fatić, Aleksandar Gavrilović and Miško Subotić

Diagnostics 2022, 12(5), 1110; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12051110 - 28 Apr 2022

Cited by 4 | Viewed by 1903

Abstract

Evaluation of the rehabilitation efficacy may be an essential indicator of its further implementation and planning. The research aim is to examine whether the estimation of EEG correlates of auditory-verbal processing in a child with overlapping autism spectrum disorder (ASD) and specific language impairment (SLI) symptoms may be a predictor of the treatment efficacy in conditions when behavioral tests do not show improvement during the time course. The prospective case report reports follow-up results in a child aged 36 to 66 months. During continuous integrative therapy, autism risk index, cognitive, speech–language, sensory, and EEG correlates of auditory-verbal information processing are recorded in six test periods, and their mutual interrelation was analyzed. The obtained results show a high statistically significant correlation of all observed functions with EEG correlates related to the difference between the average mean values of theta rhythm in the left (F1, F3, F7) and right (F2, F4, F8) frontal region. The temporal dynamics of the examined processes point to the consistency of the evaluated functions increasing with time flow. These findings indicate that EEG correlates of auditory-verbal processing may be used to diagnose treatment efficacy in children with overlapping ASD and SLI. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of ENT Diseases)

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