Otolaryngology Commons^™

Extreme Wrinkling Of The Nuclear Lamina Is A Morphological Marker Of Cancer, Ting-Ching Wang, Christina R Dollahon, Sneha Mishra, Hailee Patel, Samere Abolghasemzade, Ishita Singh, Vilmos Thomazy, Daniel G Rosen, Vlad C Sandulache, Saptarshi Chakraborty, Tanmay P Lele

Faculty, Staff and Students Publications

Nuclear atypia is a hallmark of cancer. A recent model posits that excess surface area, visible as folds/wrinkles in the lamina of a rounded nucleus, allows the nucleus to take on diverse shapes with little mechanical resistance. Whether this model is applicable to normal and cancer nuclei in human tissues is unclear. We image nuclear lamins in patient tissues and find: (a) nuclear laminar wrinkles are present in control and cancer tissue but are obscured in hematoxylin and eosin (H&E) images, (b) nuclei rarely have a smooth lamina, and (c) wrinkled nuclei assume diverse shapes. Deep learning reveals the presence …

Predicting Operative Mortality In Patients Who Undergo Elective Open Thoracoabdominal Aortic Aneurysm Repair, Kyle W Blackburn, Susan Y Green, Allen Kuncheria, Meng Li, Adel M Hassan, Brittany Rhoades, Scott A Weldon, Subhasis Chatterjee, Marc R Moon, Scott A Lemaire, Joseph S Coselli

Faculty, Staff and Students Publications

Background

We have developed a model aimed at identifying preoperative predictors of operative mortality in patients who undergo elective, open thoracoabdominal aortic aneurysm (TAAA) repair. We converted this model into an intuitive nomogram to aid preoperative counseling.

Methods

We retrospectively analyzed data from 2884 elective, open TAAA repairs performed between 1986 and 2023 in a single practice. Using clinical and selected operative variables, we built 4 predictive models: multivariable logistic regression (MLR), random forest, support vector machine, and gradient boosting machine. Each model’s predictive effectiveness was evaluated with the C-statistic. Test C-statistics were computed using an 80:20 cross-validation scheme with …

Targeted Variant Assessments Of Human Endogenous Retroviral Regions In Whole Genome Sequencing Data Reveal Retroviral Variants Associated With Papillary Thyroid Cancer, Erik Stricker, Erin C Peckham-Gregory, Stephen Y Lai, Vlad C Sandulache, Michael E Scheurer

Faculty, Staff and Students Publications

Papillary thyroid cancer (PTC) is one of the fastest-growing cancers worldwide, lacking established causal factors or validated early diagnostics. Human endogenous retroviruses (HERVs), comprising 8% of human genomes, have potential as PTC biomarkers due to their comparably high baseline expression in healthy thyroid tissues, indicating homeostatic roles. However, HERV regions are often overlooked in genome-wide association studies because of their highly repetitive nature, low sequence coverage, and decreased sequencing quality. Using targeted whole-genome sequence analysis in conjunction with high sequencing depth to overcome methodological limitations, we identified associations of specific HERV variants with PTC. Analyzing WGS data from 138 patients …

Association Of Type 2 Diabetes Mellitus With Sensorineural Hearing Loss - A Population-Based Analysis, Marwin Li, Natalie Perlov, Jena Patel, Dev Amin, Ayan Kumar, Zachary D. Urdang, Thomas O. Willcox, Rebecca C. Chiffer

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVE: To test the hypothesis that patients with poorly controlled type 2 diabetes mellitus are more likely to develop sensorineural hearing loss (SNHL) than non-diabetic patients.

STUDY DESIGN: Retrospective cohort study.

SETTING: TriNetX US Collaborative Network (2003-2022).

METHODS: Electronic medical record data from the TriNetX US Collaborative Network was queried for subjects without prior hearing loss, defined using medical billing codes (ICD-10, CPT, etc.), who were diagnosed with type 2 diabetes mellitus after January 2003. Patients were stratified by most recent HbA1c (8.0-13.9% or ≥14.0%) and by age at diagnosis (21-30, 31-40, 41-50, 51-60, 61-70, ≥71 years). Primary outcome was …

The Relationship Between Spectral Signals And Retinal Sensitivity In Dendrobatid Frogs, Whitney G. Walkowski, Corinne L. Richards-Zawacki, William C. Gordon, Nicolas G. Bazan, Hamilton E. Farris

School of Graduate Studies Faculty Publications

Research on visually driven behavior in anurans has often focused on Dendrobatoidea, a clade with extensive variation in skin reflectance, which is perceived to range from cryptic to conspicuous coloration. Because these skin patterns are important in intraspecific and interspecific communication, we hypothesized that the visual spectral sensitivity of dendrobatids should vary with conspecific skin spectrum. We predicted that the physiological response of frog retinas would be tuned to portions of the visible light spectrum that match their body reflectance. Using wavelength-specific electroretinograms (ERGs; from 350-650 nm), spectrometer measurements, and color-calibrated photography of the skin, we compared retinal sensitivity and …

Musical Hallucinations In An Elderly Female With Hearing Loss, Jacqueline Cavendish, Lynne J. Goebel

Internal Medicine

Musical hallucinations (MH) are rare auditory phenomena in which patients perceive music without a known source. Risk factors for MH include hearing loss, older age, female gender, epilepsy, and certain medications. This case report details the presentation, diagnosis, and treatment of an 82-year-old woman who developed MH following the onset of hearing loss. Despite treatment attempts with gabapentin, quetiapine, and donepezil, the symptoms persisted, demonstrating the difficulty in treating this condition.

Peak Nasal Inspiratory Flow Assessment Of Polyp Size And Response From Synapse, Amber U Luong, Joshua M Levy, Ludger Klimek, Richard J Harvey, Jared Silver, Steven G Smith, Abby Fuller, Robert Chan, Peter W Hellings

Faculty, Staff and Student Publications

Background: In the phase III SYNAPSE study, mepolizumab plus standard of care reduced total endoscopic nasal polyp score (NPS) versus that with placebo in patients with chronic rhinosinusitis with nasal polyps.

Objective: Our aim was to investigate relationships between NPS and (1) peak nasal inspiratory flow (PNIF) and (2) patient-reported outcomes.

Methods: In this post hoc analysis, patients randomized 1:1 received mepolizumab, 100 mg, or placebo subcutaneously every 4 weeks (plus standard of care). Changes from baseline in PNIF (week 52), visual analog scale scores (overall symptoms, nasal obstruction, and loss of smell [weeks 49-52]), and total 22-Item Sino-Nasal Outcome …

Endoscopic And Immunohistochemical Aspects In An Inverted Papilloma With Unilateral Total Obstruction Of The Nasal Fossa, Irina Enache, Florin Anghelina, Mircea -Sorin Ciolofan, Carmen Aurelia Mogoanta, Alex Emilian Stepan, Ioana-Cristina Vilcea, Cosmin Vasile Obleaga, Andrei Osman

Journal of Mind and Medical Sciences

An inverted papilloma is a medical condition in which epithelial cells placed on the surface grow in depth into the underlying supporting tissue. The case of a 68-year-old man with a 6-month history of right-sided complete nasal obstruction, who was referred to the ENT Department of our hospital, is presented. The associated symptoms were represented by repeated epistaxis, rhinorrhea and anosmia. From a clinical point of view, a polypous reddish-gray irregular mass, with cauliflower-like appearance, has been described. The formation was friable, richly vascularized, and with minor bleeding on light touch. The patient was diagnosed with inverted papilloma which was …

Challenges In Diagnosing Nasopharyngeal Tumors, Alexandru Aristide Alexe, Mihai Victor Lupascu, Haldun Septar, Anca Pantea Stoian, Andra Iulia Suceveanu, Viorel Gherghina, Iuliana Cindea, Alina Doina Nicoara, Laura Mazilu, Razvan Hainarosie, Felix Voinea, Adrian Paul Suceveanu

Journal of Mind and Medical Sciences

Malignant nasopharyngeal tumors account for approximately 4% of ENT malignant tumor pathology and 1% of all cancers. The diagnosis of nasopharyngeal tumors is often late, the reason being the location in a silent anatomical region in terms of symptomatology and accessibility. Thus, approximately 70% of newly diagnosed patients with nasopharyngeal carcinoma unfortunately present with the condition in an advanced local stage. The early signs and symptoms are varied (nasal obstruction, hearing loss, otalgia, headache) and are usually ignored by the patient and even by the doctor in the initial stage of nasopharyngeal tumor evolution. Approximately 5% of patients have systemic …

Multilevel Disparities Of Sex-Differentiated Human Papilloma Virus-Positive Oropharyngeal Cancers In The United States, Rhea Verma, David J. Fei-Zhang, Lily B. Fletcher, Sydney A. Fleishman, Daniel C. Chelius, Anthony M. Sheyn, Jeffrey C. Rastatter, Jill N. D’Souza

School of Medicine Faculty Publications

Objectives: This study used multilevel social determinants of health (SDoH) models to determine how SDoH influence different sexes of patients diagnosed with HPV-positive oropharyngeal squamous cell cancers (OPSCC) across the US. Methods: This was a retrospective cohort study assessing HPV-confirmed patients with oropharyngeal squamous cell cancers from 2010 to 2018 using census-level Yost Index socioeconomic status (SES) score and rurality–urbanicity measures alongside individual-level race–ethnicity while stratifying by biological sex. Age-adjusted multivariate regressions were performed for survival, treatment receipt, and delay of treatment initiation (of 3+ months). Results: Across 14,076 OPSCC-HPV-positive patients, delay of treatment uniquely featured positive predictors for males …

Institutional Experience Of Lymphoproliferative Disorders With Initial Diagnosis Made Via Fine Needle Aspiration At Otolaryngology Clinic, Alaa S. Hrizat, Jerald Gong, Stacey M. Gargano

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

BACKGROUND: This study characterizes lymphomas presenting as palpable head and neck masses and evaluates the role of fine needle aspiration (FNA) and flow cytometry (FC) in diagnosis.

DESIGN: A 5-year retrospective review of FNAs performed by pathologists in an ENT clinic identified cases with a predominant lymphoid population that lacked an epithelial component. Cytology, FC, and subsequent surgical pathology diagnoses were correlated.

RESULTS: Of 821 FNAs, 154 (19%) met selection criteria. Reactive lymph nodes accounted for 43% (67/154), with most diagnosed as 'negative for malignancy,' except one 'atypical' (ATY) case. Lymphoma was confirmed in 57% (87/154) of cases, categorized as …

Diagnostic Overshadowing: A Delayed Diagnosis Of Autism Spectrum Disorder In A Deaf Child, Quynh-Chi Dang, Michael Hoffman, Rachel St. John

Journal of Early Hearing Detection and Intervention

Diagnostic overshadowing occurs when a patient with a pre-existing diagnosis presents with symptoms that are attributed to the diagnosis, but actually reflect a separate issue. This diagnostic overshadowing can lead to delays in diagnosis, as well as disparities in health care and outcomes. The following case will provide an example in which diagnostic overshadowing contributed to the delay of an autism diagnosis in a child who is deaf. With at least 40 to 50% of children who are deaf or hard of hearing having at least one co-existing medical/developmental condition, and the current prevalence of autism at 1 in 36 …

Does Bimodal Stimulation Improve Or Interfere With Consonant Perception?, Courtney J. Austin, Rose Dumont, Alexander Kain, Holden Sanders, Lina Reiss

Research Colloquium

Bimodal stimulation, the usage of both a cochlear implant and a hearing aid in the contralateral ear, is noted for improving speech perception in noisy backgrounds for some hearing-impaired individuals. However, the usage of both devices provides a range of variability in benefit that relate to difference in pitch fusion range. Hearing impaired populations are noted to have broad binaural fusion ranges compared to normal hearing population, effecting the ability to perceive certain syllables. In studies involving vowels classification and fusion, bimodal CI users showed significant difference in both CI-only conditions and HA-only conditions, compared to the bimodal conditions (Reiss …

The Impact Of Digital Inequities On Salivary Gland Cancer Disparities In The United States, David M. Bruss, David J. Fei-Zhang, Helena Kim, Daniel C. Chelius, Anthony M. Sheyn, John P. Maddalozzo, Jeffrey C. Rastatter, Jill N. D'Souza

School of Medicine Faculty Publications

Introduction: Technology and internet access have become increasingly integrated into healthcare as the primary platform for health-related information and provider-patient communication. Disparities in access to digital resources exist in the United States and have been shown to impact health outcomes in various head and neck malignancies. Our objective is to evaluate the associations of digital inequity on health outcomes in patients with salivary gland cancer (SGC). Methods: The Digital Inequity Index (DII) was developed using 17 census-tract level variables obtained from the American Community Survey and Federal Communications Commission. Variables were categorized as digital infrastructure or sociodemographic (e.g., non-digital) and …

Tumor-Infiltrating Nerves Functionally Alter Brain Circuits And Modulate Behavior In A Mouse Model Of Head-And-Neck Cancer, Jeffrey Barr, Austin Walz, Anthony C Restaino, Moran Amit, Sarah M Barclay, Elisabeth G Vichaya, William C Spanos, Robert Dantzer, Sebastien Talbot, Paola D Vermeer

Faculty, Staff and Student Publications

Cancer patients often experience changes in mental health, prompting an exploration into whether nerves infiltrating tumors contribute to these alterations by impacting brain functions. Using a mouse model for head and neck cancer and neuronal tracing, we show that tumor-infiltrating nerves connect to distinct brain areas. The activation of this neuronal circuitry altered behaviors (decreased nest-building, increased latency to eat a cookie, and reduced wheel running). Tumor-infiltrating nociceptor neurons exhibited heightened calcium activity and brain regions receiving these neural projections showed elevated Fos as well as increased calcium responses compared to non-tumor-bearing counterparts. The genetic elimination of nociceptor neurons decreased …

Bezold’S Abscess In A Middle-Aged Man, Mohammed Ansari, Cheyenne Rahimi, Jagan D. Gupta, Neel D. Gupta, Triet M. Do, Enrique Palacios

School of Medicine Faculty Publications

No abstract provided.

Head And Neck Metastasis Of Colorectal Adenocarcinoma: A Case Report And Literature Review, Taha Al Hassan, Jessica Flores, Adam Bender-Heine, Rachel A. Giese

Research Colloquium

Introduction/Background: Colorectal Adenocarcinoma (CRC) metastasis is found in approximately 1 in 5 patients diagnosed with CRC and frequently spreads to the liver, lungs, peritoneum, bone, and nervous system. There are several subtypes of adenocarcinoma but the single most associated with distant metastasis, multiple sites of metastasis, and poorer survival is the signet-ring cell carcinoma variant. We present an unusual case of a head and neck mass demonstrating immunohistochemical staining specific for colorectal origin in a patient with a history of mucinous adenocarcinoma of the colon.

Case Presentation: A 53-year-old female was referred for a left cervical neck mass associated with …

Potentially Functional Variants Of Chmp4a And Panx1 In The Pyroptosis-Related Pathway Predict Survival Of Patients With Non-Oropharyngeal Head And Neck Squamous Cell Carcinoma, Xiaozhun Tang, Huiling Wang, Hongliang Liu, Guojun Li, Erich M Sturgis, Sanjay Shete, Qingyi Wei

Faculty, Staff and Students Publications

Background: Pyroptosis has been implicated in the advancement of various cancers. Triggering pyroptosis within tumors amplifies the immune response, thereby fostering an antitumor immune environment. Nonetheless, few published studies have evaluated associations between functional variants in the pyroptosis-related genes and clinical outcomes of patients with non-oropharyngeal head and neck squamous cell carcinoma (NON-ORO HNSCC).

Methods: We conducted an association study of 985 NON-ORO HNSCC patients who were randomly divided into two groups: the discovery group of 492 patients and the replication group of 493 patients. We used Cox proportional hazards regression analysis to examine associations between genetic variants of the …

Comparing Cadaveric And 3d-Printed Laryngeal Models In Transcutaneous Injection Laryngoplasty, Megha Chandna, Sana Siddiqui, Dylan Bertoni, Marah Sakkal, Sara Belko, Maurits Boon, Joseph Spiegel

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

BACKGROUND: There is increasing focus on the development of high-quality simulation models for medical education. Cadaveric models, although considered more realistic, may be difficult to obtain and costly. The advent of three-dimensional (3D) printing has offered a low-cost, reliable, and reproducible alternative. This study sought to compare the utility of 3D-printed to cadaveric models for training in transcutaneous injection laryngoplasty (TIL).

METHODS: A simulation course with a cross-over design was employed. Video laryngoscopes were utilized for both the 3D and cadaveric models to assess the accuracy of injection into the vocal fold. Pre-procedure and post-procedure surveys were administered to evaluate …

Case Report Of Unilateral Dysphagia In The Context Of A Classical Type Of Eagle Syndrome, Ryan Tam, Stephen D. Howard, Timothy Ehmann, Bryan Scott

Advances in Clinical Medical Research and Healthcare Delivery

A patient presents with unilateral, right-sided dysphagia and generalized facial symptoms following past surgical history of tonsillectomy that is consistent with an underdiagnosis of Eagle Syndrome. The elongation of the styloid process likely impinged on the glossopharyngeal and vagus nerves resulting in symptoms. Given the lack of recognition of the disease, this case report describes the presentation of Eagle Syndrome to encourage physicians to consider this disease as part of a broader differential diagnosis.