Chronic rhinosinusitis with nasal polyps (CRSwNP) is a clinically heterogeneous inflammatory disorder characterized by persistent sinonasal inflammation and a notable tendency for recurrence, even in patients receiving appropriate medical and surgical treatment. This heterogeneity largely reflects differences in underlying inflammatory endotypes, which in turn influence clinical presentation, risk of postoperative relapse, and response to therapy. In the majority of patients, type 2 (T2) inflammation represents the dominant immunologic profile, driven by cytokines such as interleukin (IL)-4, IL-5, IL-13, and thymic stromal lymphopoietin (TSLP). Targeting these pathways has become a central focus in recent therapeutic strategies. In this context, the introduction of biologic agents has substantially altered the management of patients with severe and difficult-to-control disease. Data from phase 3 randomized trials have consistently shown meaningful reductions in polyp burden and symptom severity, along with decreased reliance on systemic corticosteroids and a lower need for revision surgery. These findings are supported by real-world studies, which suggest that the benefits of biologic therapies extend to more heterogeneous patient populations, including those with comorbid asthma or aspirin-exacerbated respiratory disease. Despite these advances, several important questions remain unresolved. In particular, there is a need for more precise patient selection based on reliable biomarkers, as well as clearer guidance on long-term treatment strategies. Issues related to cost-effectiveness and the optimal timing of treatment discontinuation or switching also continue to represent areas of ongoing debate in clinical practice.
Africa has the highest global otitis media (OM) burden; however, regional trends and projections remain underexplored. We assessed the OM burden (incidence, prevalence, mortality, and disability-adjusted life years [DALYs]) across Africa (1992–2021) and forecasted 2037 trends. Data for this study were extracted from the Global Burden of Disease (GBD) database 1992 to 2021 and were analyzed using joinpoint regression, age-period-cohort (APC) analysis, decomposition analysis and Auto Regressive Integrated Moving Average (ARIMA) projections. Africa’s age-standardized incidence rate (ASIR) slightly increased (+0.02% average annual percentage change, AAPC), while the prevalence (−0.18%), mortality (−2.73%), and DALY rates (−0.39%) declined. In 2021, Eastern Africa had the highest ASIR/ age-standardized mortality rate (ASMR); Central Africa had the highest age-standardized prevalence rate (ASPR)/age-standardized DALY rate (ASDR). Children aged <9 years bore the greatest burden. The APC analysis shows that age and period were correlated with incidence rate. Decomposition analysis showed that population growth positively drove increases in disease burden, while aging negatively affected the growth. Projections estimate that ASIR will rise to 6,019.27 per 100,000 by 2037, while ASPR and ASDR will decline to 1,730.65 and 34.11 per 100,000. Reducing OM's disease burden necessitates strategies better aligned with African population needs and global collaboration.
Shear Wave Elastography (SWE) has emerged as a transformative ultrasound-based imaging modality for the quantitative assessment of tissue stiffness, providing valuable insights into the biomechanical properties of normal and diseased tissues. Unlike conventional ultrasonography, which primarily relies on morphological evaluation, SWE enables real-time, reproducible, and relatively operator-independent measurements of tissue elasticity. In recent years, its application has expanded considerably within head and neck imaging, where tissue stiffness serves as a potential biomarker for disease characterization, diagnosis, and treatment monitoring. This narrative review provides a comprehensive overview of the physical principles, quantitative parameters, technical considerations, and clinical applications of SWE in the head and neck region. Current evidence supporting its use in thyroid nodules, salivary gland disorders, cervical lymph node evaluation, oral soft tissue lesions, periodontal assessment, and temporomandibular joint and masticatory muscle disorders is discussed. The integration of SWE with conventional B-mode and Doppler ultrasonography has demonstrated improved diagnostic confidence, enhanced lesion characterization, and reduced reliance on invasive diagnostic procedures in selected clinical scenarios. Despite its promising clinical utility, several challenges remain, including variability in acquisition protocols, machine-dependent elasticity measurements, lack of universally accepted cutoff values, and limited standardization across institutions. Nevertheless, ongoing technological advancements and the growing interest in artificial intelligence, radiomics, and multiparametric ultrasound approaches are expected to further enhance the diagnostic and prognostic capabilities of SWE. Overall, SWE represents a valuable non-invasive adjunct to routine head and neck imaging and holds significant potential as a quantitative biomarker in precision medicine.
Lymphatic endothelial cells (LECs) have long been viewed as passive conduits that merely maintain tissue fluid homeostasis. But that picture has changed dramatically. Recent advances in single-cell transcriptome sequencing (scRNA-seq) and spatial transcriptomics (ST) have revealed that LECs are highly heterogeneous and remarkably plastic in their functions. This review summarizes the new research results of LECs based on the above two technologies. LECs in normal tissues have multiple types of subpopulations. In the lymph node, there are further sub-regions, such as the subcapsular sinus ceiling/floor LECs, medullary sinus LECs, valve LECs and other special subsets. Each subpopulation performs distinct functions depending on its anatomical location, ranging from lymph drainage and barrier formation to immune regulation, etc. Under pathological conditions such as cancer, chronic inflammation, cardiovascular disease, obesity, and tissue repair, LECs undergo profound transcriptional reprogramming and phenotypic remodeling. They express immune checkpoint molecules, secrete chemokines, and build ligand-receptor interaction networks. In other words, LECs transform from passive structural pipes into active signaling integration centers and immune regulatory hubs. They participate directly in immune response modulation, metastasis promotion or suppression, tissue repair, and fibrosis. These findings have fundamentally redefined the biological role of LECs in the microenvironment. Targeting LECs heterogeneity and their bidirectional cell-cell interaction networks may offer novel stromal-targeted strategies for intervening in tumor lymphatic metastasis, reversing chronic inflammation, and treating cardiovascular diseases.
Olfaction is one of the primitive sensory functions in humans, and olfactory dysfunction often leads to a decline in patients' quality of life. However, clinical research on the treatment of olfactory dysfunction still faces certain challenges. This article reviews the global research progress in the treatment of olfactory dysfunction in recent years. The main approaches include pharmacotherapy, such as corticosteroids and biologics; olfactory training; surgical treatment; and several novel therapies, including intranasal platelet-rich plasma injection, electrical stimulation of the olfactory system, and olfactory mucosa transplantation. Among the various administration routes, oral, ultrasonic nebulized inhalation, and nasal irrigation therapies have demonstrated superior efficacy compared to intranasal corticosteroids. The researchers compared the efficacy and safety of eight monoclonal antibodies in the treatment of chronic rhinosinusitis with nasal polyps. In terms of improving the olfactory function: Dupilumab ranks first. Olfactory training is applicable for the treatment of post-infectious, post-traumatic, neurodegenerative, and idiopathic olfactory disorders. Compared with traditional training, the novel nasal plug-based olfactory training is more convenient, discreet, and diversified in scent selection, effectively reducing olfactory fatigue and significantly improving patient compliance and therapeutic outcomes. Although its short-term advantages have been demonstrated, further studies are required to validate its long-term efficacy and generalizability. Surgery is a double-edged sword: it can enhance olfactory function, but it may also lead to iatrogenic olfactory impairment. Currently, its main application is still in conductive olfactory disorders, especially for olfactory improvement in individuals with chronic rhinosinusitis accompanied by nasal polyps.
Mastoiditis, a serious complication of acute otitis media, primarily affects the pediatric population and requires prompt diagnosis and treatment to prevent severe complications. This review explores the pathophysiology, clinical presentation, diagnostic techniques, and therapeutic approaches for mastoiditis, focusing on the role of amoxicillin in its management. The anatomical connection between the middle ear and mastoid air cells facilitates the spread of infection, which is further influenced by inflammatory processes, bacterial biofilms, and host immune responses. Diagnosis involves a combination of clinical findings, imaging studies such as computed tomography and magnetic resonance imaging, and microbiological cultures to guide targeted antibiotic therapy. Amoxicillin remains the first-line treatment for non-resistant cases owing to its effectiveness against common pathogens, safety profile, and cost efficiency. However, the increasing prevalence of β-lactamase-producing bacteria necessitates the use of amoxicillin-clavulanate in resistant cases. Antibiotic selection should be based on local resistance patterns and patient-specific factors, such as allergies and comorbidities. Surgical interventions, including mastoidectomy, are required in advanced or refractory cases. Future research should focus on developing novel diagnostic tools, optimizing antibiotic regimens, and implementing antimicrobial stewardship programs to combat drug resistance. Global collaboration is essential for establishing standardized guidelines and improving access to high-quality care in resource-limited settings.
Mixed Medullary and Follicular Cell Carcinoma (MMFCC) is a rare thyroid cancer combining medullary and follicular (often papillary) elements. The lack of standard clinical signs and imaging characteristics makes it difficult to diagnose before surgery. At present, the main approach to treatment is surgical removal, and the outlook for patients is primarily influenced by how advanced the medullary carcinoma is. We report two cases of MMFCC confirmed by postoperative pathology. Case 1 involved a 46-year-old woman with bilateral thyroid nodules and left cervical lymph node metastasis. Preoperative ultrasound classified the nodules as TI-RADS 4c, and fine-needle aspiration cytology suggested papillary thyroid carcinoma. Total thyroidectomy with bilateral neck lymph node dissection was performed. Postoperative pathology revealed MMFCC, with a medullary component accounting for approximately 95% and extensive lymph node metastasis. Six weeks postoperatively, serum calcitonin was 73.00 pg/mL. Case 2 involved a 54-year-old man presenting with neck pain. Ultrasound showed a hypoechoic left thyroid nodule (TI-RADS 4b) with bilateral cervical lymphadenopathy. Fine-needle aspiration suggested medullary thyroid carcinoma, and serum calcitonin and carcinoembryonic antigen levels were markedly elevated. Following total thyroidectomy with bilateral neck lymph node dissection, pathology confirmed MMFCC with an approximately 80% medullary component. Postoperative tumor markers decreased significantly, and long-term follow-up was initiated. MMFCC is a rare thyroid carcinoma with considerable diagnostic difficulty. Fine-needle aspiration alone may be insufficient for accurate diagnosis, whereas preoperative serum calcitonin testing provides important diagnostic clues. Total thyroidectomy with systematic lymph node dissection is advised, plus long-term monitoring per both carcinoma guidelines.
Laryngotracheal stenosis (LTS) is a refractory airway disorder characterised by pathological scar formation and airway luminal narrowing, which severely impairs respiratory function and quality of life. This review systematically summarises the pathological mechanisms, anatomical characteristics and latest therapeutic progress of LTS, including iatrogenic and idiopathic subtypes. The core pathogenesis of LTS lies in disordered wound healing, persistent chronic inflammation and excessive extracellular matrix deposition, driven by key fibrotic mediators such as transforming growth factor-β1. Current interventions cover endoscopic techniques such as laser and cold-knife resection, balloon dilation, as well as open procedures including tracheal resection and anastomosis, and graft reconstruction. For lesions beyond the safe limits of conventional resection (> 6 cm), graft-based reconstruction using autologous tissues, allografts, or tissue-engineered constructs becomes necessary. Each therapy has distinct indications, curative effects and limitations. Multimodal therapy, individualised regimens and multidisciplinary collaboration have become the core principles to improve clinical outcomes. Adjunctive pharmacologic therapies, including topical mitomycin C and corticosteroids, are increasingly integrated to modulate wound healing and reduce recurrence risk. For refractory long-segment stenosis and recurrent cases, biomaterials, tissue engineering and precision medicine represent the key research directions for future LTS treatment.
Nicotine is a stimulant that affects the ganglia. Similar to capsaicin, it also activates sensory nerves in the airways, which leads to secretion and coughing in human subjects. The nasal mucosa can be exposed to the drug through either nasal or oral administration. The study investigated the effects of nicotine on electrically stimulated contractions of human nasal mucosa, resting tension of human nasal mucosa, and contractions induced by 10-6 M norepinephrine (NE) or 10-6 M methoxamine, a sympathetic mimetic. The purpose was to assess the direct im- pact of nicotine on human nasal mucosa in an in vitro laboratory setting. The findings demonstrated that the nasal mucosa contracted in a dose-dependent manner upon the addition of methoxamine to the incubation medium. Ad- dition of nicotine at doses of 10-4 M elicited a significant relaxation response to 10-6 M methoxamine-induced mucosal strip contraction. Nicotine could inhibit electrical field stimulation-induced spike contraction and had a negligible effect on the basal tension of the nasal mucosa as the concentration increased. Adding 10-6 M nicotine to the 10-6 M NE-induced contraction, it initially induced a small reduction of the contraction, then it potentiated the contractions. This study demonstrated that high nicotine concentrations had a significant spasmolytic effect via an- tagonistically binding to alpha-adrenoceptors. Moreover, people with nasal allergies and stuffy noses who additionally utilize an alpha-adrenergic agonist nasal spray, oral or smoked nicotine, or both concurrently may not get relief from nasal obstruction.
Asthma is a chronic respiratory condition affecting millions globally, causing significant morbidity and economic burden. Despite advances in treatment, many patients experience uncontrolled symptoms and exacerbations, particularly those with corticosteroid resistance or neutrophilic inflammation. Roflumilast, an oral phosphodiesterase-4 inhibitor, may offer additional benefits by targeting inflammatory pathways that are not fully controlled by standard therapy. This systematic review and meta-analysis aimed to assess the efficacy and safety of roflumilast in patients with asthma. A comprehensive literature search was conducted using the PubMed, Scopus, and Web of Science databases from January 2015 to August 2025. We included randomized controlled trials and pooled analyses evaluating roflumilast in patients with asthma. The primary outcome was the mean difference in the forced expiratory volume in one second between the intervention and control groups. Secondary outcomes included risk of exacerbation, symptom control, and adverse events. Six studies met the inclusion criteria, with 2845 participants. Roflumilast showed a modest improvement in forced expiratory volume in one second (Mean difference: +0.04 L; 95% confidence interval: −0.01 to +0.09; heterogeneity = 41%), which was not statistically significant. Exacerbation risk reduction was inconsistent across studies (Risk ratio: 0.96; 95% confidence interval: 0.83–1.12; heterogeneity = 35%). Adverse events, particularly gastrointestinal issues and weight loss, were more frequent with roflumilast, leading to higher rates of discontinuation. Subgroup analysis suggested potential benefits in patients with persistent airway inflammation or corticosteroid resistance, whereas harm was observed in obese patients. The limited number of trials and heterogeneity among studies restricted the conclusiveness of our findings.
Benralizumab is an interleukin-5 receptor α-directed monoclonal antibody that depletes eosinophils via antibody-dependent cell-mediated cytotoxicity. This systematic review and meta-analysis evaluated the efficacy and safety of benralizumab in patients with severe eosinophilic asthma (SEA) using evidence from randomized controlled trials, post hoc analyses, and real-world studies. Eight studies comprising 1600 patients were included in this review. Benralizumab significantly reduced the risk of severe exacerbations by 52% (Risk Ratio [RR] = 0.48, 95% confidence interval [CI]: 0.44–0.52) and decreased the maintenance oral corticosteroid (OCS) dose by 11.6 mg/day (95% CI: −13.07 to −10.13). Lung function improved, with a mean increase of 0.22 L in pre-bronchodilator forced expiratory volume in one second (95% CI: 0.18 to 0.26). The asthma control test scores increased by 4.33 points (95% CI: 3.69 to 4.98), surpassing the minimal clinically important difference. These benefits were observed in both randomized controlled trial extensions and real-world studies and were maintained for up to five years, with a favorable safety profile. Subgroup analyses revealed greater improvements in patients with chronic rhinosinusitis with nasal polyps and those receiving maintenance OCS. Benralizumab efficacy was maintained in obese patients, although improvements in lung function were attenuated. These results support the use of benralizumab as a long-term treatment for SEA, particularly in patients with comorbidities or those requiring maintenance OCS. The integration of benralizumab into personalized management plans based on biomarkers and clinical phenotypes can optimize outcomes in SEA.
Topical drug applications to the external auditory canal (EAC) are one of the most important applications in Ear, Nose, and Throat (ENT) practice. In this study, we aimed to evaluate the histopathological, biochemical, and microbiological effects of oxygen-boric acid drops in the EAC. Eighteen albino Wistar rats were divided into three groups. The left ear was designated as the drop-treated ear, and the right ear was the control ear in each rat. Group 1 rats were treated with Oxygen-boric acid drops, group 2 with ciprofloxacin drops, and group 3 with hydrogen peroxide drops for two weeks. For biochemical evaluation, the pH of the EAC was measured. Microbiological analysis was performed by culturing samples from both EACs. Finally, both EACs underwent histopathological examination. Histopathologically, oxygen-boric acid ear drops had no adverse effect on the EAC mucosa. There was also no statistically significant difference amongst the groups in histopathological findings and bacterial growth. While there was a statistically significant difference in pH was observed between the groups during the first week of treatment, no significant difference was found between the groups during the second week of treatment. Topical oxygen-boric acid, ciprofloxacin, and hydrogen peroxide can be used safely for EAC diseases due to their topical efficacy and fewer side effects. Topical drops should be chosen according to the disease, the patient's comorbidities, and the cost-effectiveness of ear drops.
Ciprofloxacin, a fluoroquinolone antibiotic, plays a crucial role in treating otitis externa, which is a common inflammatory disorder of the outer ear canal. This review examines the effectiveness and safety of ciprofloxacin in managing otitis externa, with a focus on its pharmacological properties, antibacterial effects, and outcomes. This review highlights the potent activity of ciprofloxacin against the primary pathogens Pseudomonas aeruginosa and Staphylococcus aureus and its ability to penetrate the auditory canal, making it ideal for treating ear infections. The use of oral ciprofloxacin in severe cases, particularly in malignant otitis externa, is also discussed. This review explores the benefits and drawbacks of topical and oral ciprofloxacin formulations and the rationale for combining these routes in complex cases. Special attention should be given to prescribing ciprofloxacin to vulnerable populations, such as children, the elderly, and pregnant women. The increasing prevalence of ciprofloxacin-resistant bacteria and the importance of antimicrobial stewardship programs in combating resistance are emphasized. This review addresses drug interactions and monitoring strategies. Future directions in otitis externa treatment are discussed, including the development of safer quinolones, advancements in targeted drug delivery systems, and progress in diagnostic tools for antibiotic selection. This review underscores the significance of ciprofloxacin in managing otitis externa while highlighting the need for judicious use and research to optimize outcomes and mitigate resistance risk.
Bronchopulmonary dysplasia (BPD) is a complex chronic lung disorder that affects extremely premature infants, particularly those born before 30 weeks of gestation or weighing less than 1500 g at birth. This systematic review aimed to evaluate the effectiveness of pharmacological interventions for BPD and to explore otolaryngologic manifestations and management strategies. A comprehensive literature search was conducted in the PubMed, Scopus, and Web of Science databases, yielding five studies that met the inclusion criteria. The studies investigated the effects of corticosteroids (prednisolone, hydrocortisone, and dexamethasone), erythropoietin, and diuretics on BPD outcomes. Prednisolone showed minimal short-term benefits, whereas hydrocortisone did not significantly reduce the incidence of BPD. However, extended dexamethasone regimens have been shown to improve survival rates without increasing complications. Early erythropoietin treatment reduced the incidence of BPD but did not affect hospital readmission rates. Diuretic use varied widely across centers, without clear survival or discharge benefits. Preterm infants with severe BPD requiring prolonged mechanical ventilation are at a high risk of subglottic stenosis, tracheomalacia, and vocal cord paralysis. Early diagnosis through airway endoscopy and multidisciplinary management, including tracheostomy for severe cases, are crucial for optimizing outcomes. BPD survivors may experience long-term respiratory impairment, exercise intolerance, and developmental delays, necessitating close monitoring and intervention. Future research should focus on developing standardized, evidence-based management protocols and exploring novel therapies to improve long-term respiratory and neurodevelopmental outcomes in this vulnerable population group.
Otitis media is a common childhood condition that affects public health because of its frequency, recur- rence, and potential long-term consequences. This systematic review and meta-analysis assessed the efficacy and safety of systemic corticosteroids (SCS) in children with acute otitis media and otitis media with an effusion. A com- prehensive search of PubMed, Scopus, and Web of Science identified relevant studies published between January 2018 and August 2025. The primary outcomes were effusion resolution, hearing loss, and otitis media recurrence. Secondary outcomes included pain relief, tympanostomy tube placement, speech and language development, qual- ity of life, and adverse events. Four studies, including two Cochrane reviews, one randomized controlled trial, and one meta-analysis, were analyzed. The results showed that SCS provided short-term improvements in effusion clearance and hearing, with risk ratios from 1.08 to 1.20. However, these benefits were temporary, with no sig- nificant long-term effects on recurrence rates, persistent effusion, or developmental outcomes. Safety data were limited, with most adverse events being mild and self-resolving. The studies had moderate heterogeneity due to differences in population characteristics, intervention protocols, and outcome definitions. Results suggest that SCS may offer short-term symptom relief in certain cases but cannot be recommended for routine management of pe- diatric otitis media. Future research should prioritize large-scale multicenter trials with standardized outcomes, extended follow-up periods, and thorough safety assessments to identify the subgroups that might benefit the most from SCS treatment.
Head and Neck Squamous Cell Carcinoma (HNSCC) poses a major global health challenge, highlighting the demand for reliable biomarkers to enable earlier detection and improve patient survival. This study sought to evaluate the diagnostic and prognostic significance of RAD54-like Protein 2 (RAD54L2) in HNSCC. RAD54L2 ex- pression was assessed across multiple cancer types, including HNSCC, using data sourced from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO). Through R-based analysis of RNA-seq data from TCGA-HNSCC, differentially expressed genes (DEGs) were identified between tumors with high and low RAD54L2 expression. RAD54L2 may be a useful diagnostic and prognostic biomarker in HNSCC. Using various statistical methods, we explored the relationship between RAD54L2 levels and immune cell infiltration, DNA methylation patterns and ge- netic alterations in RAD54L2, RAD54L2 expression with clinicopathological features of HNSCC patients, and the diagnostic and prognostic utility of RAD54L2. Its expression was markedly upregulated in tumor tissues versus controls. RAD54L2 expression exhibited significant correlations with immune infiltration, cell cycle genes, and an- drogen receptor (AR) in HNSCC. DNA methylation levels at three CpG sites within the RAD54L2 gene were linked to patient prognosis. Furthermore, RAD54L2 expression was associated with multiple clinicopathological variables, including M, N, and T stages, age, gender, race, tumor status, and overall stage. ROC analysis and nomogram model indicated that RAD54L2 effectively discriminated HNSCC from non-tumor tissues. These findings underscore the potential diagnostic and prognostic utility of RAD54L2, supporting its promise as a therapeutic target in HNSCC.
The article titled “Relationship between Carotid Body Tumor and Thyroid Papillary Cancer” has been formally retracted. Following its publication, the publisher received a complaint indicating that the article had significant problems regarding the accuracy of the reported clinical case details and inconsistencies in author contribution attribution. In accordance with our complaints procedure, the editorial office and the Editorial Board conducted an investigation, which confirmed that these problems make the research results unreliable. Consequently, the Editorial Board has decided to retract the article. This retraction has been approved by the Editor-in-Chief of ENT Updates. All authors have agreed to the retraction. Original Article DOI: https://doi.org/10.54963/entu.v15i1.889 Retraction Date: 5 December 2025
Ferroptosis, an iron-dependent form of regulated cell death, is driven by the accumulation of lipid peroxides and shaped by mitochondrial metabolism. However, the role of BCL2L10 (B-cell lymphoma 2-like 10)-a gene previously implicated in ferroptosis-in affecting the immune microenvironment and clinical progression of head and neck squamous cell carcinoma (HNSCC) remains unclear. Using RNA-seq data from The Cancer Genome Atlas (TCGA), we compared BCL2L10 expression in HNSCC tumors and matched normal tissues and corroborated the results with immunohistochemistry images from the Human Protein Atlas (HPA). Logistic regression and Kaplan-Meier analyses were then applied to assess the relationship between BCL2L10 levels and clinical outcomes. The protein-protein interaction network centered on BCL2L10 was constructed with the STRING database, and the immunological relevance of BCL2L10 was explored through three complementary approaches: Gene Ontology (GO) annotation, gene set enrichment analysis (GSEA), and single-sample GSEA (ssGSEA). BCL2L10 mRNA levels were markedly higher in HNSCC tumors than in adjacent normal tissues. Nevertheless, univariate survival analysis revealed no significant difference in overall survival between patients with high versus low BCL2L10 expression (p > 0.05). Mechanistically, BCL2L11 emerged as a key interactor of BCL2L10, and tumors overexpressing BCL2L10 exhibited reduced infiltration by immune cells. Overall, elevated BCL2L10 expression in HNSCC is associated with an unfavorable prognosis and an immunosuppressive tumor microenvironment.
Ingesting caustic substances can cause severe esophageal strictures, particularly in young adults. Thoraco- laparoscopic esophagectomy (TLE) is a minimally invasive surgical treatment for complex strictures when conser- vative methods fail. However, dense fibrosis and altered anatomy pose challenges for conventional laparoscopic surgical systems. This prospective comparative study evaluated the effectiveness of three-dimensional (3D) la- paroscopic visualization in TLE for post-burn esophageal strictures. Twenty-eight patients aged 18-40 years with caustic-induced strictures were divided into two groups: Full High-Definition (HD) laparoscopy (n = 14) and 3D laparoscopy (n = 14). Intraoperative and postoperative outcomes were compared between the two groups. The 3D group had significantly shorter operative times (200 +/- 10 min vs. 230 +/- 20 min; p < 0.05), reduced blood loss (40 +/- 8 ml vs. 60 +/- 10 ml; p < 0.05), and lower anastomotic failure rates (7.1% vs. 21.4%; p < 0.05) than the Full HD group. Postoperative complications and hospital stay were lower in the 3D group, although the difference was not statistically significant. Surgeon feedback indicated better depth perception and precision with 3D systems. Macroscopic examination of the resected specimens confirmed severe fibrotic strictures, whereas postoperative imaging showed patent anastomoses. The results suggest that 3D laparoscopy enhances surgical efficiency and safety in TLE for post-caustic strictures by improving visualization of the fibrotic planes. Incorporating 3D systems into surgical practice and training can potentially improve outcomes and expand minimally invasive techniques for complex esophageal surgeries, particularly in resource-limited settings.
Erosive and ulcerative oral diseases, such as recurrent aphthous stomatitis and herpetiform ulcers, are common in children and significantly affect their quality of life. This observational study investigated the relation- ship between oral and intestinal microbiocenosis and the onset of these conditions in 648 children aged 1-16 years. Microbiological examination revealed dysbiotic changes in the oral and gut microbiota of affected children com- pared to controls, with a significant decrease in beneficial commensal bacteria, particularly Bifidobacterium and Lactobacillus species, and an increase in opportunistic pathogens, such as Staphylococcus and Candida spp. The reduction in Bifidobacteria and Lactobacilli in both oral and stool samples supports the concept of a gut-oral mi- crobial axis in the manifestation of these diseases. These findings suggest that systemic factors, such as intestinal microbial imbalance, may contribute to the development of recurrent oral lesions in children. Incorporating mi- crobiota analysis into the diagnostic process and considering targeted treatments, such as probiotics and dietary adjustments, could improve clinical outcomes. This study emphasizes the importance of a multidisciplinary ap- proach involving collaboration among ENT specialists, pediatric dentists, gastroenterologists, and microbiologists to comprehensively evaluate and manage these conditions in children. Further research is needed to elucidate the causal relationships between microbial shifts and disease flares and to develop personalized microbiota-based in- terventions for pediatric patients with erosive and ulcerative oral diseases.
