Head and Neck Diseases Conflux is an international, peer-reviewed, open-access journal focused on research and clinical practices in otolaryngology and head-neck diseases. The journal is committed to publishing high-quality basic and clinical research, covering innovative discoveries and technological advancements in otolaryngology, head-neck surgery, and related disciplines. Through rigorous peer review and an open-access platform, Head and Neck Diseases Conflux serves as a vital channel for researchers, clinicians, and healthcare professionals worldwide to share knowledge and exchange insights. The journal places special emphasis on the diagnosis, treatment, and prevention of otolaryngological and head-neck conditions, striving to bridge the gap between basic research and clinical application. Its scope includes hearing disorders, sinus diseases, throat pathologies, head-neck cancers, and the latest advancements in related fields. By publishing interdisciplinary research, Head and Neck Diseases Conflux fosters collaboration between otolaryngology and other areas such as immunology, genetics, and radiology, offering new approaches to addressing complex clinical challenges. Head and Neck Diseases Conflux not only provides the academic and medical communities with cutting-edge scientific information but also ensures the widespread dissemination of research findings through its open-access model, contributing to global public health initiatives. The journal’s mission is to drive innovation and progress in otolaryngology and head-neck diseases, ultimately improving patient outcomes and advancing healthcare standards worldwide.
Association of Bedtime Milk Consumption with Adenoid Sizeand Tissue Microbiota Profiles in Children with Adenoid Hypertrophy
Background: Adenoid hypertrophy is a common and frequently occurring disease in children, and the surgical rate is relatively high. Currently, the etiology is not yet clear, and it is of great significance to explore its pathogenesis and new treatment methods. To investigate the effect of milk consumption before bedtime on adenoid size and the tissue microbiota in children. Methods: A total of 104 children who underwent surgical treatment for adenoid hypertrophy (AH) at our hospital between March 2023 and January 2024 were divided into a bedtime milk consumption group (n = 42) and a control group (n = 62) according to their milk consumption before bedtime. The adenoid-nasopharyngeal (A/N) ratio was measured, and adenoid tissue samples from a randomly selected subset of 20 participants in each group were subjected to five-region (5R) 16S rRNA amplicon sequencing. Results: The average A/N ratio in the experimental group was 0.808 ± 0.070, vs 0.736 ± 0.037 in the control group, showing a significant difference (P < 0.001). There was no significant difference in total microbial diversity or dominant bacterial community distribution in adenoid tissue between the two groups. However, comparison revealed the experimental group's adenoid tissue was enriched in Ruminococcus, Dorea, and Lachnospiraceae, common in the gastrointestinal tract. Conclusions: Bedtime milk consumption was associated with a larger adenoid size and altered adenoid tissue microbiota profiles in children with AH. The enrichment of gastrointestinal-associated taxa suggests a potential link with reflux-related microbial exposure, which warrants further validation.
Benign Diseases of the Head, Neck, and Laryngopharynx: Basic Science and Clinical Practice
Copyright (c) 2026 Head and Neck Diseases Conflux https://creativecommons.org/licenses/by/4.0
Multilayered Regulation of SLC7A11 in Cancer: From Expression Control to Functional Ferroptosis Adaptation
SLC7A11, also known as xCT, is the functional light-chain subunit of system xc− and mediates extracellular cystine uptake in exchange for intracellular glutamate. By supplying cystine for glutathione (GSH) biosynthesis and sustaining glutathione peroxidase 4 (GPX4)-dependent detoxification of lipid peroxides, SLC7A11 occupies a central position in ferroptosis control. In cancer, SLC7A11 is not merely an amino acid transporter, but a stress-adaptive hub through which tumor cells convert hypoxia, oxidative stress, endoplasmic reticulum stress, nutrient limitation, and therapeutic pressure into antioxidant defense and ferroptosis resistance. This review summarizes the multilayered regulation of SLC7A11 expression in cancer. We first introduce the structural and functional basis of SLC7A11 and its biological significance in ferroptosis and tumor progression. We then discuss its epigenetic regulation, transcriptional regulatory network, post-transcriptional and translational control-including RNA modifications, RNA-binding proteins, and non-coding RNA networks-and protein homeostasis and post-translational regulation. Finally, we highlight therapeutic strategies centered on SLC7A11 and propose that effective ferroptosis-based cancer therapy may require simultaneous induction of lipid peroxidation stress and blockade of adaptive SLC7A11 upregulation or stabilization.
Molecular Mechanisms and Translational Research in Oncology
Research Progress in Multimodal Guidance for Brain Tumor Surgeryand Preservation of Functional Brain Networks
The evolution of brain tumor surgery has progressed from "microsurgery" to "precision neurosurgery," currently entering a new stage characterized by the deep integration of multimodal technologies and the concept of preserving functional brain networks. This article systematically reviews the current state of research on preserving brain functional networks during brain tumor surgery. It summarizes the composition of brain functional networks, the impact of brain tumors on these networks, the classification of multimodal technologies, and the application progress of protecting key functional networks during brain tumor surgery. It emphasizes that precision surgical strategies based on preserving brain functional networks can significantly improve patient quality of life and provide a new paradigm for translational brain science research. Despite progress, key challenges remain, including interindividual functional variability, intraoperative brain shift, and the limited reproducibility of non-traditional network mapping. Future research should focus on dynamic monitoring of functional networks, long-term functional prognosis correlation analysis, and cross-modal data fusion integrated with artificial intelligence to establish new precision surgery standards guided by multimodal functional network preservation.
Digital, Endoscopic & Robotic Head and Neck Oncology
The Application of 3D Printing Technology in Otological Diagnosis and Treatment from Morphological Reconstruction to Functional Restoration
Through patient-specific design and precise anatomical fabrication, 3D printing is reshaping otology from experience-based surgery toward digital precision medicine. This review summarizes recent advances in the application of 3D printing in otology, focusing on technical platforms, morphological reconstruction, and functional restoration. At the technical level, stereolithography, selective laser melting, fused deposition modeling, and 3D bioprinting are suited to preoperative simulation, titanium-alloy implant fabrication, educational models, and tissue-engineered scaffolds, respectively. For morphological reconstruction, 3D printing enables precise replication of structures ranging from auricular frameworks and middle-ear ossicular chains to temporal-bone anatomical models. For functional restoration, patient-specific ossicular prostheses can optimize sound conduction, surgical guides can assist cochlear implantation and help preserve residual hearing, sustained-release devices may help overcome barriers to inner-ear drug delivery, and tissue-engineered scaffolds have opened new possibilities for inner-ear neural repair and regeneration. Although challenges related to material compatibility, regulatory approval, and cost-effectiveness remain, advances in multi-material printing and 4D printing may further expand the clinical potential of 3D printing in personalized otologic reconstruction that integrates anatomical form with functional recovery.
Reconstruction of Vertical Hemilaryngeal Defect using Vascularized Tracheal Cartilage with Pectoralis Major Flap
Objectives: This study aims to explore the feasibility of utilizing tracheal cartilage vascularized with a pectoralis major muscle flap for the reconstruction of vertical hemilaryngeal defects and to provide an experimental foundation for such reconstructions. Methods: Initially, the tracheal cartilages of nine Beagle canines were vascularized using pectoralis major muscle flaps. Subsequently, a defect model was established by vertically resecting the entire hemilarynx, and the vertical hemilaryngeal defect was reconstructed using the vascularized tracheal cartilage. Laryngeal computed tomography (CT) and video laryngoscopy were conducted at the following time points: pre-operation, immediately post-operation, and 28 days post-operation. At 28 days post-operation, the experimental dogs were euthanized after the completion of the examination. The reconstructed larynx was sectioned and subjected to hematoxylin and eosin (HE) staining. Results: Eight dogs were successfully extubated and could consume normal food. Immediate postoperative video laryngoscopy indicated a well-sutured trachea, mucosa with normal color, and a restored and unobstructed laryngeal airway. Twenty-eight days post-operation, video laryngoscopy revealed a slightly edematous tracheal mucosa, a well-supported laryngeal cavity without collapse, routine healing of the tracheal suture, half-reconstruction of the laryngeal defect, and no obvious granulosis. Additionally, laryngeal CT demonstrated that the reconstructed laryngeal cavity was unobstructed and that the transplanted tracheal cartilage had maintained its position. Hematoxylin and eosin (HE) staining showed favorable survival of the pectoralis major composite flap and the transplanted tracheal cartilage. Conclusion: This preliminary investigation demonstrates that short-term restoration of laryngeal structure and swallowing/respiratory function can be achieved through the reconstruction of vertical hemilaryngeal defects (including involvement of the unilateral cricoid cartilage) using tracheal cartilage vascularized with a pectoralis major flap.
A Predictive Model for Lateral Cervical Lymph Node Metastasis in Thyroid Cancer
Objective: To investigate the predictive factors for lateral lymph node metastasis (LLNM) in patients with papillary thyroid carcinoma (PTC) and to develop an individualized prediction model. Methods: Clinical data from 241 PTC patients who underwent lateral neck dissection were analyzed. Logistic regression and machine learning methods were employed to identify predictive factors and construct a model. The predictive value of three-dimensional morphological parameters (total tumor surface area and total tumor volume) was also evaluated. Results: Maximum tumor diameter, central lymph node metastasis, preoperative Thyroid-Stimulating Hormone (TSH), and tumor location were identified as independent predictors of LLNM. A baseline combined model based on maximum tumor diameter showed good predictive performance (AUC 0.832). Furthermore, three-dimensional parameters (total surface area and total volume) demonstrated complementary predictive potential compared to the baseline model. Conclusion: An effective clinical prediction model for assessing LLNM risk was successfully developed. Three-dimensional morphological parameters represent promising predictive indicators with potential complementary value.
Management of Difficulty in Decannulation for Patients with Long-Term Tracheostomy Tubes Following Brain Diseases
Objective: To investigate the etiology of difficult decannulation in patients with long-term tracheostomy following brain-related diseases, and to explore the preoperative examination and assessment, selection of surgical indications, surgical and postoperative management methods. This aims to provide a scientific basis for facilitating successful decannulation, improving patients' quality of life, and guiding clinical practitioners in the management of such cases. Methods: A retrospective analysis was conducted on 27 patients who were hospitalized in our department from May to December 2025 and had experienced failed decannulation after long-term tracheostomy. Preoperative examination and assessment included electronic laryngoscopy and laryngotracheal CT three-dimensional reconstruction. Electronic laryngoscopy was simultaneously used to assess swallowing function, including the Penetration-Aspiration Scale score, Murray Secretion Scale score, vallecula and pyriform sinus residue grading, and swallowing disability grading and classification. The surgical procedure involved endoscopic-assisted resection of laryngeal and tracheal granulation tissue via a supporting laryngoscope under general anesthesia. Results: The primary cause of laryngotracheal stenosis leading to decannulation failure in patients with long-term tracheostomy due to brain diseases was obstruction from granulation tissue hyperplasia within the larynx and trachea, followed by restricted bilateral vocal cord abduction. Based on detailed preoperative examinations and assessments, all 27 patients in this group were deemed suitable candidates for surgery. They successfully underwent endoscopic-assisted resection of laryngeal and tracheal granulation tissue via a supporting laryngoscope under general anesthesia without any complications. Decannulation was successfully achieved in all patients within 7 to 10 days postoperatively. Conclusions: 1) Electronic fiberoptic laryngoscopy and laryngotracheal CT three-dimensional reconstruction are effective methods for preoperative examination and evaluation. 2) Appropriate surgical candidates can be selected based on these two examinations. 3) Endoscopic-assisted resection of laryngotracheal granulation lesions via a supporting laryngoscope under general anesthesia is a safe and effective method to resolve decannulation difficulties in such patients.
Metastatic Renal Clear Cell Carcinoma First Presenting As a Head-and-Neck Mass: two case reports
Background: Clear cell renal cell carcinoma (ccRCC) is a prevalent malignant tumor within the urinary system, characterized by a high metastatic potential. However, instances of ccRCC metastasizing to the head and neck are exceedingly rare. Case presentation: This article presents two patients who were admitted to the Department of Otorhinolaryngology Head and Neck Surgery. Case 1: A 61-year-old East Asian male patient presented with a painless, progressive enlargement of the left neck. Imaging revealed a 3.6 × 2.3 cm enhancing solid lesion with cystic components in the deep lobe. After surgical resection, histopathology with immunohistochemistry (CD10+, vimentin+) suggested metastatic clear cell carcinoma of renal origin. Subsequent Positron Emission Tomography-Computed Tomography (PET CT) confirmed a left renal mass (11.4 × 10.1 cm, SUVmax 5.86) with ipsilateral lung nodules, establishing the diagnosis of ccRCC with parotid and pulmonary metastases. Case 2: Another 69-year-old East Asian male patient presented to the hospital with a complaint of foreign body sensation in the pharynx. This individual had previously undergone laparoscopic left nephrectomy for left renal cell carcinoma 14 years prior. Subsequent electronic laryngoscopy identified a new growth on the right side of the pharyngeal wall, leading to laryngoscopic resection of the lesion. Postoperative pathology indicated metastatic clear cell carcinoma originating from the renal site. Conclusion: Both cases involved metastatic lesions of ccRCC in the head and neck region, underscoring the critical importance of promptly conducting PET-CT scans and relevant pathological assessments when encountering head and neck masses with unidentified primary origins to ascertain whether they represent metastatic clear cell renal cell carcinoma(mCCRCC). The vague initial clinical manifestations of mCCRCC pose significant obstacles to its early clinical detection, necessitating multidisciplinary consultations, prolonged patient monitoring, and the administration of postoperative radiotherapy, chemotherapy, immunotherapy, and other interventions to enhance patient survival rates.
Developmental Outcomes Following Early Cochlear Implantation in Infants and Toddlers: a Comparative Study with Normal-hearing Peers
Objective: To evaluate whether early cochlear implant (CI) use can significantly and positively change hearing and speech abilities during a child’s development. Methods: The present study included 42 children with bilateral CIs (8–36 months) and 40 age-matched children with normal hearing (NH) (6–48 months). Ages & Stages Questionnaires, Third Edition (ASQ-3); Categories of Auditory Performance (CAP); Speech Intelligibility Rate (SIR) were used. Results: Twelve months after receiving bilateral CIs, the hearing status of the infants (1–12 months) and toddlers (13–36 months) had improved significantly. Infants using CIs were comparable to those with NH in all ASQ-3 aspects (p > 0.05). For toddlers, there was a post-implantation improvement in the gross motor, problem solving, and personal social domains (p > 0.05). However, there were still gaps in the communication domain (p < 0.001). Multivariate analysis revealed that pre-implantation hearing aid usage duration, schooling, SIR score, communication, and caregiver education level significantly influenced post implantation outcomes. Conclusions: With CI use, infants and toddlers with congenital sensorineural hearing loss showed improvements in auditory perception, speech production, and developmental abilities. Infant implant recipients performed better in all areas of development than toddlers, comparable to with NH children. Hearing aid use, language rehabilitation training, caregivers’ education level, and communication method were all highly correlated with the overall development of the children.
Gene Therapy for Non-Syndromic Hearing Loss
Hereditary hearing loss accounts for over 60% of congenital deafness cases, with non-syndromic hearing loss (NSHL) representing the most common subtype. Typically caused by monogenic mutations, NSHL presents a promising candidate for gene therapy. Recent advances in deciphering the genetic underpinnings of deafness and developing gene delivery systems have greatly accelerated the progress of inner ear gene therapy, leading to a number of breakthrough achievements. This review provides an overview of the latest developments in gene therapy for NSHL. After outlining the genetic basis of NSHL, we summarize the preclinical progress made during the first decade of hereditary deafness gene therapy. Special emphasis is placed on gene replacement strategies for DFNB9, an autosomal recessive form of hearing loss caused by mutations in the OTOF gene. We highlight the remarkable journey of OTOF gene therapy and discuss future directions in this transformative field.
Applications of Tumor Organoids in Head and Neck Diseases
Head and neck cancers (HNC) constitute a highly heterogeneous group of malignancies with complex pathogenesis; effective clinical management remains challenging. Organoids, an emerging three-dimensional culture system, recapitulate key structural and functional features of the tissues of origin and offer distinctive advantages for studying head and neck cancer. Structured around four major head and neck cancer entities (head and neck squamous cell carcinoma, thyroid cancer, nasopharyngeal carcinoma, and malignant salivary gland tumors), this Review systematically outlines approaches for constructing head and neck cancer organoids, summarises common modelling methods and authentication strategies, and defines an integrated pipeline spanning acquisition, culture, validation and application. At the application level, we review five areas: basic tumor biology; drug screening and new drug development; immune-related studies; biobanking and biomarker discovery; and regenerative medicine with functional reconstruction. The goal is to inform subsequent research and clinical translation, and to highlight the broad prospects of this approach for addressing heterogeneity, therapy resistance and recurrence in head and neck cancer.
Copyright (c) 2025 Head and Neck Diseases Conflux https://creativecommons.org/licenses/by/4.0
TEAS: Integrating Personalized TCM with Standardized Western Protocols in Otolaryngology–Head and Neck Surgery
In order to treat diseases in the field of otolaryngology-head and neck surgery (OHNS), our research methodically investigates an integrative therapy model that blends Western medical techniques with Traditional Chinese Medicine (TCM). Our study demonstrates applications across multiple sub-specialties, including otology (sudden sensorineural hearing loss, chronic tinnitus), rhinology (allergic rhinitis, chronic cough), laryngology (refractory hiccups), and postoperative care. The key innovation lies in the systematic development and application of transcutaneous electrical acupoint stimulation (TEAS), which modernizes traditional acupuncture through non-invasive electrical stimulation, enhancing patient compliance and enabling home-based management. This integrative approach demonstrates significant practical value by synergizing Western medicine's targeted efficacy with TCM's holistic regulation, leading to improved clinical outcomes, reduced recurrence rates, and decreased reliance on pharmaceutical interventions. Future research should focus on standardizing TEAS parameters through multicenter randomized controlled trials and elucidating the underlying mechanisms using multi-omics technologies. Our research represents a paradigm shift toward personalized, evidence-based integrative medicine in OHNS, offering a comprehensive framework for enhancing patient care across acute and chronic conditions.
Transcutaneous Electrical Acupoint Stimulation
Evaluation of the Efficacy of Neoadjuvant Combined Therapy in Patients with Locally Advanced Head and Neck Squamous Cell Carcinoma
Objective: Our study aimed to assess the effectiveness and safety of neoadjuvant therapy involving the immune checkpoint inhibitor Nimotuzumab and programmed cell death ligand 1 (PD-L1) inhibitors, along with platinum and paclitaxel chemotherapy in individuals diagnosed with the head and neck squamous cell carcinoma (HNSCC). Method: Over the course of 2024 and 2025, a cohort of 33 patients with locally advanced HNSCC admitted to our institution was included in the investigation. Stratification into three groups was based on the expression levels of epidermal growth factor receptor (EGFR) and PD-L1 in tumour tissues. The patients were treated with Nimotuzumab and PD-L1 inhibitors along with platinum and paclitaxel chemotherapy for three cycles. After three cycles of neoadjuvant therapy, some patients were given surgical treatment. The primary metrics for evaluating treatment success were the objective response rate (ORR) and the disease control rate (DCR). Secondary endpoints included pathological complete response rate, laryngeal preservation rate, and incidence of chemotherapy-related toxicities. Results: The study results revealed promising tumour response among the 33 patients, with an objective response rate of 75.8%. One patient achieved a complete radiographic response. Twenty patients achieved radiologic response, with T-stage downstaging observed in 60.6% and N-stage downstaging in 27.3% of these cases. Seven patients underwent surgery following neoadjuvant therapy, with five of these patients successfully undergoing larynx-preserving hypopharyngeal cancer radical resections. Regarding adverse events, 21.2% of patients experienced leukopenia; 42.4% experienced anemia; 3.0%, hepatic impairment; and 9.1%, gastrointestinal reactions. Conclusion: Neoadjuvant combination therapy significantly enhances tumour response rates in HNSCC, with most patients with laryngeal cancer retaining laryngeal function. Adverse reactions remain clinically manageable, and the majority of patients tolerate the treatment well.
Surgical Outcomes and Complications of Adult Thalamic Gliomas:A Systematic Review and Meta-Analysis
Objective: This systematic review and meta-analysis evaluated surgical outcomes, complications, and survival in adult thalamic glioma patients to inform optimal surgical and adjuvant treatment strategies. Methods: We searched PubMed, Web of Science, and Embase up to July 10, 2025, analyzing 15 studies with 695 adults. Data included patient characteristics, surgical approaches (lateral, medial, posterior), extent of resection (EOR, gross total/subtotal resection [GTR/STR]), or partial resection [PR]), complications, and overall survival (OS). Cox proportional hazards models assessed survival factors (p<0.05). Results: High-grade gliomas (HGGs) accounted for the majority (77.8%), and GTR/STR was achieved in 86.1% of cases, primarily through a lateral-related surgical approach (51.8%). Common postoperative complications were movement disorders (29%), infection/fever (25%), and sensory disorders (13%). In the pooled cohort consisting of 103 patients, median OS was 16 months for HGGs and 23 months for low-grade gliomas (LGGs). Multivariate Cox analysis confirmed prolonged OS in LGGs (hazard ratios [HRs]: 0.34, p = 0.005) and with adjuvant therapies (chemotherapy: HR 0.19, p=0.025; radiotherapy: HR 0.10, p=0.002; radiochemotherapy: HR 0.13, p=0.003). Conclusion: Maximal safe resection with adjuvant therapies enhances survival in thalamic gliomas, despite high complication rates. Tailored surgical strategies and molecular profiling, are essential to optimize outcomes and guide targeted therapies.
Efficacy of Transcutaneous Auricular Vagus Nerve StimulationCombined with Retroauricular Glucocorticoid Injectionin the Treatment of Chronic Tinnitus
Objective: To evaluate the efficacy of transcutaneous auricular vagus nerve stimulation (taVNS) in combination with retroauricular glucocorticoid injection for the treatment of chronic tinnitus. Methods: This prospective, single-arm study enrolled a total of 34 patients with chronic tinnitus. All participants received combined therapy consisting of taVNS and subcutaneous triamcinolone acetonide injection at the retroauricular mastoid sieve area. The interventions were administered over a one-month period, with taVNS delivered twice daily. Assessments were performed at three time points: baseline (T0), immediately post-treatment (T1), and one month after treatment completion (T2). The primary outcome was tinnitus severity, measured using the Tinnitus Functional Index (TFI). Secondary outcomes included sleep quality (Insomnia Severity Index, ISI), anxiety (Generalized Anxiety Disorder-7, GAD-7), and depression (Patient Health Questionnaire-9, PHQ-9). Results: Significant improvements in tinnitus severity were observed, as reflected by a reduction in TFI scores from baseline to T1 (P = 0.002), with sustained improvement at T2 (P = 0.054). ISI scores also showed significant improvement from T0 to T1 (P = 0.033), with further improvement at T2 (P = 0.011). Although GAD-7 and PHQ-9 scores did not show immediate improvement post-treatment, both decreased significantly by T2 compared with baseline (GAD-7: P = 0.001; PHQ-9: P = 0.004), indicating delayed but meaningful reductions in anxiety and depressive symptoms. Conclusion: The combined application of taVNS and retroauricular glucocorticoid injection yielded significant reductions in tinnitus severity. While additional controlled studies are warranted, these results offer preliminary evidence that this non-invasive approach may represent a promising therapeutic strategy for chronic tinnitus.
Cochlear Implantation in Patients with Age-Related Hearing Loss:A Bibliometric Analysis
Background: The prevalence of age-related hearing loss has become increasingly prominent, with a year-on-year rise in the number of elderly patients with presbycusis undergoing cochlear implantation. Nevertheless, there remains a scarcity of systematic, chronologically oriented comprehensive research on this topic. The present study employs bibliometric analysis to identify research trends and current hotspots pertinent to this theme. Methods: Relevant studies on cochlear implantation for presbycusis indexed in the Web of Science Core Collection database were retrieved, covering the period from January 1, 2005, to December 31, 2024. Employing bibliometric tools including Vosviewer, CiteSpace, and Bibliometrix R, systematic bibliometric statistical and visual analyses were conducted on the included research literature. Results: A total of 2,331 documents were included in this analysis, reflecting a growing volume of scientific research on this topic alongside increasingly significant scholarly contributions. The United States maintains a leading position with 759 publications, while the University of Toronto System tops institutional rankings with 173 publications. At the author level, CARLSON MATTHEW L. leads with 40 publications, and MOBERLY AARON C. exhibits notable growth potential. In terms of research evolution, the field has progressively shifted from early investigations into etiological mechanisms toward a focus on clinical phenotypes, intervention strategies, and prognostic evaluation. Conclusions: As publications focusing on cochlear implantation research for presbycusis continue to proliferate, bibliometric analysis serves as a valuable tool to help researchers delineate international academic collaborations and discern trending themes within this specialized research domain.
INAUGURAL EDITORIAL OF HEAD AND NECK DISEASES CONFLUX
Head and Neck Diseases Conflux is a pioneering international journal dedicated to catalyzing interdisciplinary research and clinical innovation in head and neck medicine. Central to our mission is the integration of diverse medical specialties and fostering global academic collaboration as cornerstones of scientific advancement. The intricate anatomy of the head and neck region, encompassing complex sensory, neurological, and vascular systems, necessitates seamless collaboration among ophthalmologists, otolaryngologists, neurosurgeons, and allied specialists. The journal champions the full spectrum of translational research, bridging fundamental molecular discoveries with cutting-edge clinical applications including minimally invasive endoscopic techniques, artificial intelligence-enhanced diagnostics, novel cold plasma therapeutics, robotic-assisted surgical precision, and personalized 3D-printed implants. Through our commitment to cultivating future medical leaders and upholding the highest standards of academic rigor, we aim to accelerate transformative technologies in precision medicine, tissue engineering, regenerative therapeutics, and gene-editing applications. By promoting global partnerships and scientific discourse, Head and Neck Diseases Conflux aspires to make substantial contributions to advancing healthcare through evidence-based innovation and clinical excellence.
Use of Autologous hematopoietic stem cell transplantation for a patient with primary nasal NK/T-cell lymphoma combined with hemophagocytic syndrome
Extranodal NK/T-cell lymphoma, nasal type (ENKTCL-NT) is a type of primary nasal peripheral T-cell lymphoma, which is a rare type of non-Hodgkin's lymphoma, especially with hemophagocytic syndrome (HPS), and can easily lead to clinical misdiagnosis. The disease is dangerous, it progresses rapidly, and the treatment is ineffective. This article reports a case of ENKTCL-NT with HPS, which involves the primary nasal cavity invading the oral cavity. Patients attain improved remission outcomes with autologous hematopoietic stem cell transplantation (ASCT) in combination with chemotherapy. This paper reviews current domestic and international research and summarizes diagnostic and therapeutic approaches to enhance clinicians' comprehension of the disease.
autologous hematopoietic stem cell transplantation
Skull Base Lesions Extending Towards Multiple Compartments: The Role of Maxillary Swing Approach in the Endoscopic Era
Objective: Although advances in endoscopic techniques, resection of complex lesions that occupying multiple compartments in the skull base still represents significant challenges, since surgical outcomes may be compromised by insufficient exposure and inappropriate techniques. The question of whether to perform endoscopic surgery or to use open craniofacial approach remains unresolved. Nevertheless, careful assessment of lesion characteristics must be carried out in selection of the appropriate trajectory. Methods: Between May 2006 and November 2016, 16 patients experienced resection of extensive lesions in the skull base via maxillary swing approach. Data regarding clinical findings and technical considerations as shown in case illustrations were discussed. Results: Complete resection was achieved in all patients. Pathological findings were diverse, while the majority were schwannomas (10 cases, 62.5%) followed by meningiomas (3 cases, 18.75%). The complications were managed as shown in case illustrations, and symptoms improved with time. The follow-up duration ranged from 49 to 177 months (median, 102 months), while 2 patients were lost. There was no postoperative mortality, and 1 patient who experienced a relapse of meningioma 72 months after surgery is still under observation due to asymptomatic status. Conclusions: Our preliminary results suggest that the maxillary swing approach can be an alternative option in management of extensive, recurrent, and hypervascularized masses with fibrous or calcified consistency in the skull base, which may represent challenges for the endoscopic procedure. Future studies are required to demonstrate the surgical indications and efficiency.
Research on the Incidence of High Jugular Bulb in the Lateral Position among Otitis Media Patients
Objective: This study aims to analyze the incidence of high jugular bulb (HJB), an anatomical variation, in patients with otitis media using high-resolution CT imaging in the lateral position. Methods: A retrospective analysis was performed on high-resolution CT scans of the middle ear from 965 patients clinically diagnosed with otitis media between October 2018 and October 2023. The age range was 6 to 81 years, with a mean age of 47.11 years. The cohort included 387 male and 578 female patients. HJB was defined as the superior border of the jugular bulb extending beyond the inferior border of the basal turn of the cochlea. Using the lateral wall of the cochlear basal turn as the reference line, HJB was classified into medial and lateral types. In the lateral type, the jugular bulb was in proximity to the tympanic membrane, ossicular chain, or round window; in the medial type, it was adjacent to the cochlear aqueduct, vestibular aqueduct, or internal auditory canal. The presence of HJB was recorded, and gender and side distribution were analyzed. Results: Among the 965 patients with chronic otitis media, 176 cases exhibited HJB, representing an incidence rate of 18.23%. Of these, 103 were female (58.52%) and 73 were male (41.48%), indicating a higher prevalence in females. Right-sided HJB occurred in 115 cases (65.34%), compared to 61 cases on the left (34.66%), suggesting a predominance on the right side. Lateral HJB was observed in 125 cases (71.02%), including five cases with direct exposure, whereas medial HJB was found in 51 cases (28.98%), demonstrating a significantly higher frequency of the lateral variant. Conclusions: The findings indicate that HJB is more prevalent in females than males and more common on the right side than the left. Additionally, the lateral type occurs more frequently than the medial type. Given its anatomical significance, lateral HJB must be carefully evaluated during otoscopic tympanic surgery to prevent potentially serious complications. Special attention should be paid to identifying this variation preoperatively.
Clinical Effect of Partial Tonsillectomy in Preschool Children with OSAHS
Background: To explore the optimal surgical approach for preschool children with obstructive sleep apnea (OSA) by comparing changes in venous hematological parameters, Faces Pain Scale Revision (FPS-R) pain scale scores, and OSA-18 scale scores following two different surgical treatments. Methods: A total of 83 preschool children with OSA were enrolled, with 42 assigned to the control group (total tonsillectomy with adenoidectomy) and 41 to the experimental group (partial tonsillectomy with adenoidectomy). Preoperative and postoperative (3-day) measurements included cardiovascular disease risk factors, immune-related indicators, perioperative blood loss, postoperative FPS-R pain scale scores, and OSA-18 scale scores. Results: Comparison between the two groups revealed no significant differences in intraoperative blood loss, primary bleeding, pre- and post-treatment OSA-18 scale scores, C-reactive protein (CRP) levels, cardiovascular disease risk factors, or immune-related indicators (all P > 0.05). However, significant differences were observed in secondary bleeding (P < 0.05) and postoperative FPS-R pain scale grades (P < 0.05). In the control group, pre- and post-treatment antistreptolysin O (ASO) levels showed no significant difference (P> 0.05), whereas in the experimental group, ASO levels decreased significantly (P < 0.05). Conclusion: Partial tonsillectomy demonstrated comparable efficacy to total tonsillectomy in terms of intraoperative blood loss, reduction of snoring symptoms, and improvement of airway patency, with both procedures achieving stable therapeutic outcomes. No significant differences were observed between partial and total tonsillectomy regarding short-term effects on cardiovascular disease risk factors or immune function. For preschool children with OSA, partial tonsillectomy was superior to total tonsillectomy in reducing postoperative pain, secondary bleeding, and ASO levels.
Pathophysiology and Complications of Obstructive Sleep Apnea