Objective: To analyze the etiology, diagnosis, and treatment of unexplained conductive hearing loss (UCHL) with intact tympanic membrane. Methods: A systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 642 articles were retrieved from databases such as PubMed, Embase, Web of Science, and Cochrane. Fifty-four research articles and 21 case reports were screened out according to the inclusion and exclusion criteria for analysis of the etiology of UCHL. Seven research articles with UCHL who underwent exploratory tympanotomy were selected for data extraction and analysis of clinical characteristics. Results: UCHL is a common manifestation of various diseases, including congenital ossicular anomalies (COA), otosclerosis (OTS), congenital middle ear cholesteatoma (CMEC), oval window atresia, superior semicircular-canal dehiscence, congenital stapedial footplate fixation, middle ear osteoma or adenoma, congenital ossification of stapedial tendon, and so on. A total of 522 patients were included in the 7 articles; among whom OTS showed a tendency to increase with age. The main symptoms were hearing loss, followed by tinnitus, dizziness, ear fullness, ear pain, facial paralysis. A total of 87.5% to 93.0% patients with COA manifested as nonprogressive deafness that occurred since childhood, with tinnitus incidence of 15.6% to 30.2%, and 86.4% to 96.4% patients with OTS presented with progressive hearing loss, with tinnitus incidence of 60.1% to 90.9%. The diagnosis positive rate of high-resolution computed tomography (HRCT) was 33.8% to 87.1%, and CMEC was higher than that of COA (83.3%-100% vs 28.6%-64%). All the articles reported good hearing recovery. The most common surgical complications included taste abnormalities, tinnitus, and dizziness. Conclusion: UCHL presents with similar clinical manifestations and poses challenges in preoperative diagnosis. Exploratory tympanotomy is the primary method for diagnosis and treatment, with good prognosis after removing the lesion and reconstructing hearing during the operation. Children can also safely undergo the surgery.

Non-syndromic sensorineural hearing loss (NSHL) significantly affects quality of life and is often associated with the MT-RNR1 A1555G variant. This meta-analysis investigated the global prevalence of the A1555G variant, considering factors such as age of onset and aminoglycoside exposure. A systematic review of 97 studies published between 2000 and the present included 31,013 participants. The overall prevalence of the A1555G variant was 3.37 %, with higher rates in East Asia. Subgroup analysis revealed variant frequencies of 7.24 % in postlingual deafness cases and 1.45 % in prelingual cases. Familial cases and those with aminoglycoside exposure showed significantly higher prevalence rates (9.2 % vs. 1.9 %). These findings underscore the variant's critical role in NSHL etiology and the necessity of incorporating genetic screening into clinical practices, especially for patients with aminoglycoside exposure.

Objectives: Clinical pharmacists are increasingly recognized as essential members of multidisciplinary palliative care teams, yet their specific roles and impact have not been comprehensively summarized. This scoping review aimed to systematically map and synthesize published evidence on the clinical roles, interventions, and professional contributions of pharmacists within multidisciplinary palliative care services for patients with non-communicable diseases. Methods: A scoping review was conducted by searching PubMed, Embase, Web of Science, and Scopus from January 2000 to May 2024. Eligible studies reported clinical pharmacist interventions in palliative care. Data were extracted on study characteristics, pharmacist activities, and clinical outcomes. Results: Twelve studies were included, predominantly from the United States. Pharmacist-led interventions encompassed medication reconciliation (91.7%), symptom management (83.3%), adverse drug event prevention (75.0%), patient and caregiver education (58.3%), and policy-level contributions (33.3%). High physician acceptance rates (≥90%) were consistently reported. Outcomes included improved symptom control, reduced drug-related problems, and enhanced patient-reported quality of life. Significance of results: This scoping review synthesizes current evidence on the roles of clinical pharmacists in palliative care teams. The findings highlight their essential contributions to medication safety, symptom management, deprescribing, and opioid stewardship, reinforcing the need for pharmacist integration into multidisciplinary palliative care models to improve patient-centered outcomes. Future research should focus on implementation models, cost-effectiveness analyses, and service expansion in community-based settings.

This case report aims to highlight the importance of considering lymphoma as a potential differential diagnosis in patients presenting with laryngeal mass and associated cervical lymphadenopathy, particularly those with a history of chronic tonsillitis. A case of a 63-year-old male patient who underwent bilateral tonsillectomy for tumor in the left tonsil was presented. Two months after the procedure, he developed throat discomfort, dysphagia, neck swelling, and other symptoms. The patient was initially diagnosed with “tongue base mass” and chronic lymphadenitis. Partial excision of the tongue base mass was performed twice in another hospital, revealing chronic inflammation of the epithelial mucosa. Further evaluations, including electron laryngoscopy and imaging studies, were conducted to investigate the condition. A computed tomography (CT) scan showed irregular soft tissue density in the oropharyngeal region, along with multiple lymph nodes in the neck. Subsequent histopathological examination of the lingual base biopsy revealed peripheral T-cell lymphoma with a follicular T-helper cell phenotype. Immunohistochemical staining confirmed specific markers while ruling out other markers. In situ hybridization testing demonstrated positivity for Epstein–Barr virus-encoded RNA, and TCRG clonality was confirmed. The duration from symptom onset to diagnosis was 2 months. This case emphasizes the importance of considering lymphoma in patients with laryngeal mass and associated cervical lymphadenopathy, especially when a history of chronic tonsillitis is present. Accurate diagnosis and early intervention are crucial for effective management and improved patient outcomes.

Middle ear meningiomas (MEMs) are rare tumors that can present with nonspecific symptoms, posing challenges in diagnosis and management. This case report focuses on a middle-aged female patient who was misdiagnosed with secretory otitis media for 5 years. However, further evaluation through computed tomography imaging and subsequent pathologic biopsy revealed the presence of a MEM. The patient underwent surgical and gamma knife resection of the tumor and follow-up examination after 1 year showed no signs of recurrence. This case report highlights the importance of considering meningiomas in the differential diagnosis of middle ear pathologies and the need for careful preoperative planning for optimal outcomes. Overall, this case demonstrates that correct diagnosis and appropriate treatment can lead to successful management of MEMs.

Well-differentiated liposarcoma (WDLPS), also termed atypical lipomatous tumor, is a low-grade malignant adipocytic neoplasm characterized by indolent growth, limited metastatic potential, and a propensity for local recurrence. Primary WDLPS arising in the hypopharyngeal region is exceptionally rare, particularly in young adults, and may clinically mimic benign submucosal lesions. We report the case of a 24-year-old man who presented with a one-month history of persistent foreign body sensation in the throat. Flexible laryngoscopy revealed a smooth submucosal mass arising from the left hypopharyngeal region, and contrast-enhanced magnetic resonance imaging demonstrated a well-circumscribed enhancing lesion without cervical lymphadenopathy. The mass was excised transorally under general anesthesia. Histopathological examination showed mature adipocytic proliferation with atypical stromal cells, and immunohistochemistry demonstrated positivity for MDM2, CDK4, CD34, and p16. Fluorescence in situ hybridization confirmed MDM2 gene amplification, establishing the diagnosis of WDLPS. Although the early postoperative course was uneventful and initial follow-up showed satisfactory mucosal healing, serial laryngoscopic examinations at 2, 2.5, and 4 months after surgery revealed early local recurrence at the surgical site. This case highlights that hypopharyngeal WDLPS can occur in young adults and may recur early even after apparently complete transoral excision. Accurate diagnosis requires integration of histopathology, MDM2/CDK4 immunohistochemistry, and molecular confirmation of MDM2 amplification. Close endoscopic and radiological surveillance is essential for early detection of local recurrence.