Background: Helicobacter pylori (H. pylori) has definite or possible associations with multiple local and distant manifestations. H. pylori has been isolated from multiple sites throughout the body, including the nose. Clinical non-randomized studies with H. pylori report discrepant data regarding the association between H. pylori infection and nasal polyps. The aim of this first systematic review and meta-analysis was the assessment of the strength of the association between H. pylori infection and incidence of nasal polyps. Methods: We performed an electronic search in the three major medical databases, namely PubMed, EMBASE and Cochrane, to extract and analyze data as per PRISMA guidelines. Results: Out of 57 articles, 12 studies were graded as good quality for analysis. Male-to-female ratio was 2:1, and age ranged between 17–78 years. The cumulative pooled rate of H. pylori infection in the nasal polyp group was 32.3% (controls 17.8%). The comparison between the two groups revealed a more significant incidence of H. pylori infection among the nasal polyp group (OR 4.12), though with high heterogeneity I2 = 66%. Subgroup analysis demonstrated that in European studies, the prevalence of H. pylori infection among the nasal polyp group was significantly higher than in controls, yielding null heterogeneity. Subgroup analysis based on immunohistochemistry resulted in null heterogeneity with preserving a statistically significant difference in H. pylori infection prevalence between the groups. Conclusion: The present study revealed a positive association between H. pylori infection and nasal polyps.
4 September 2021 in Laryngoscope Investigative Otolaryngology
Objectives The COVID-19 pandemic bears the risk of delayed cancer diagnoses. Methods Study on the diagnostic pathway of sinonasal malignancies during the COVID-19 pandemic. Results Median time from first symptom to treatment initiation was not increased during the pandemic: 137 days (interquartile range [IQR] 104-193) vs 139 days (IQR 103-219) (P = .60). Median time from first appointment at our institution to treatment initiation was even reduced in 2020: 18 days (IQR 11-25) vs 11 days (IQR 7-17) (P = .02). A trend toward advanced tumor stages during the pandemic was seen: 11/30 patients (36.7%) ≥ stage 4 in 2018 to 2019 vs 12/19 patients (63.2%) ≥ stage 4 in 2020 (P = .064). Conclusion Both, time to diagnosis and time to treatment initiation were similar during the pandemic. However, a higher proportion of advanced tumors stages was observed. Despite the pandemic, we provided a swift diagnostic workflow, including a virtual tumor board decision and a prompt treatment initiation. Level of Evidence: 4.
Key Clinical Message: Fourth branchial arch anomalies are extremely rare. The anatomic course of the fourth branchial arch fistula usually determines the delay in diagnosis. High clinical suspicion should be given to reoccurring neck infections in infants and young adults. Diagnosis is obtained by direct laryngoscopy.
Background: In the clinical management of advanced stage head and neck squamous cell carcinoma, the use of hybrid [18F]FDG‐PET imaging is well established. However, there is ongoing debate regarding the optimal frequency of hybrid PET scans to be included in follow‐up protocols, particularly if the initial post‐therapeutic scan is negative.Methods: We conducted a single‐center 10‐year retrospective study involving all patients who underwent hybrid PET scans for the follow‐up of advanced stage head and neck cancer. A total of 285 patients were included.Results: Out of 199 patients with a negative 3‐month hybrid PET, 15% subsequently developed a recurrence during further follow‐up. Notably, 90% of these recurrences were detected by hybrid PET.Conclusion: Fifteen percent of patients with a negative 3‐month hybrid PET experienced a recurrence. Given that the majority of recurrences were detected by hybrid PET scans, there is a compelling argument for incorporating regular repetitive scans during follow‐up.