Background and Objectives: Extramedullary plasmacytoma (EMP) is a rare monoclonal B-cell neoplasm that typically affects the head and neck region, with a predilection for the sinonasal tract. Clinical presentation is often nonspecific, leading to delayed diagnosis. This study aims to improve our understanding of sinonasal EMP by reviewing the recent literature and presenting a case series from our clinical experience. Materials and Methods: A systematic review of published cases of sinonasal EMP from 2000 to 2023 was conducted using the PubMed database, yielding 28 eligible cases. Additionally, we retrospectively analyzed three patients diagnosed and treated at our institutions. Inclusion criteria included histologically and immunohistochemically confirmed EMP without evidence of systemic multiple myeloma. Data on demographics, tumor location, symptoms, treatment, and outcomes were collected and analyzed descriptively. Results: Sinonasal EMP most commonly presented with unilateral nasal obstruction and epistaxis. Tumors were primarily located in the nasal cavity and paranasal sinuses, often extending beyond a single anatomical site. In the literature cohort, the most frequent treatment was combined surgery and radiotherapy (35.71%), followed by radiotherapy alone (17.86%). Recurrence was reported in 10.71% of cases, and 7.14% of patients died due to disease progression. All three patients in our case series underwent surgical excision; two received postoperative radiotherapy. No recurrences or progression to multiple myeloma were observed during follow-up (12–24 months). Conclusions: Sinonasal EMP is a rare but radiosensitive tumor with a favorable prognosis when treated with surgery and/or radiotherapy. Early diagnosis, histopathological confirmation, and exclusion of systemic disease are essential. Multidisciplinary management and long-term follow-up are critical due to the risk of recurrence and transformation into multiple myeloma.

(1) Background: Extrapulmonary tuberculosis (EPTB) of the head and neck is a rare but difficult diagnosis due to mostly absent pulmonary involvement and high clinical resemblance to neoplastic or chronic inflammatory conditions. This diagnosis still poses a challenge for otorhinolaryngologists, due to non-specific symptoms and the low index of suspicion in non-endemic regions. (2) Methods: This study presents a retrospective review of nine cases of head and neck EPTB diagnosed at two regional hospitals in southern Romania. Patients presented with pharyngeal, laryngeal, or cervical lymph node involvement. All cases underwent surgical biopsies for histopathological and microbiological confirmation, followed by standard anti-tubercular therapy. (3) Results: In all nine cases, surgical biopsies were essential for the accurate diagnosis and excluded malignancy or other granulomatous diseases. Diagnostic delays were observed due to atypical clinical presentations. Integration of biopsy findings with anti-tubercular treatment resulted in favorable disease control and clinical recovery. (4) Conclusions: Head and neck EPTB requires a high index of suspicion and clinical discernment. Surgical biopsy remains a critical diagnostic tool in practice and should be considered early in the diagnostic process when encountering atypical lesions. A timely use improves diagnostic accuracy, may eliminate delays, ensures patient safety, and improves therapeutic outcomes.

Sinonasal inverted papillomas (IPs) are rare benign tumors with ~15% postoperative recurrence and a ~8% risk of malignant transformation, with human papillomavirus (HPV) reported as a risk factor in IP malignant transformation. To evaluate clinical, molecular and immunohistochemical factors associated with recurrence and malignant transformation in IPs. We retrospectively analyzed 73 patients with histologically confirmed IPs that were treated at three tertiary ENT centers, including radiologic data, HPV DNA detection and p16 immunohistochemistry. Univariate analysis was used to identify factors associated with recurrence and malignant transformation, and restricted exploratory multivariable logistic regression models were used to assess recurrence while minimizing overfitting. Fourteen recurrences (19%) were associated with longer symptom duration (p = 0.003), smoking (p = 0.03), advanced Krouse stage (III–IV) (p < 0.001), frontal sinus origin (p = 0.02), HPV+ DNA (50% vs. 22%, p = 0.048), and p16 loss/reduced expression (p = 0.006). Nine recurrences transformed into carcinoma (12%) and were associated with smoking (p = 0.01). HPV+ was not associated with malignancy (p = 1.00). Recurrence was associated with the advanced stage of the IP, tobacco use, longer symptom duration, frontal sinus origin, HPV+, and p16 loss/reduced expression.

The discovery of a cervical mass in children is a situation quite frequently encountered and often represents a diagnostic or therapeutic challenge for the practicing physician. Although approximately 12% to 15% of all neck masses (NMs) in children may be malignant, most commonly these masses are benign. This study included 137 patients aged between 14 months and 18 years old, with the majority (54.01%) of patients being less than five years old. A total of 83 (60.58%) patients were presented with a single NM, with 64 (59.12%) patients having mass located on the midline of the neck. Preoperatively, in addition to laboratory tests, imaging examinations played an important role in diagnostic orientation and determining the therapeutic plan. Among the imaging examinations, ultrasound was the most commonly used, performed in 87 (63.5%) of the patients. The definitive diagnosis was established based on the histopathological examination of the excised specimens. Midline NMs were most frequently thyroglossal duct cysts or dermoid cysts, while lateral NMs were often lymphadenitis or branchial cysts. The aim of this study was to present the experience of 10 years in evaluating cervical masses in the neck area that appeared in children, their possible causes, the methods of investigation (considering the contribution and limitations of each diagnostic method), and the therapeutic approach (since there is no clear standardization of treatment in the literature).

Purpose: This review aims to analyze the diagnostic methods used to evaluate inferior vestibular nerve neuritis. Methods: We performed an electronic search on the PubMed database for clinical studies investigating the diagnostic techniques used for inferior vestibular nerve neuritis. Results: We initially identified 114 records in our search. After applying the inclusion and exclusion criteria, we narrowed it down to 12 studies. These studies collectively examined a total of 642 patients diagnosed with vestibular nerve neuritis, 64 of whom had inferior vestibular neuritis. Conclusions: The inferior vestibular neuritis is an unfrequent form of vestibular neuritis, often misdiagnosed. The diagnosis of inferior vestibular neuritis (IVN) is based on clinical history and vestibular testing, specifically reduced posterior canal gain on video head impulse test (vHIT), absent cervical VEMP (cVEMP), normal caloric responses, and preserved ocular VEMP (oVEMP). This review highlights the gaps in current diagnostic strategies and emphasizes the need for integrating advanced vestibular testing methods to enhance diagnostic accuracy for inferior vestibular nerve neuritis. Future studies should address the standardization of diagnostic protocols to facilitate broader clinical application.

Objective: To evaluate the safety and efficacy of irreversible electroporation for non‐thermal ablation of tonsils in adults. Study Design: Prospective interventional case series of 24 adult patients referred for tonsillectomy that were followed for 3 months. Setting: Academic medical center. Methods: The procedures were performed under general anesthesia or sedation. Irreversible electroporation was applied to the tonsils using the ENTire ^TM system. Pain was assessed daily using a pain scale for the first postoperative week. Tonsil sizes were assessed at baseline and 1 and 3 months postoperatively. The Tonsil and Adenoid Health Status Instrument and the Snore‐Visual Analog Scale (VAS) questionnaires were administered at baseline and at 3 months. Results: In total, 23 adult patients (mean age: 36.5 ± 14.0; mean body mass index [BMI]: 25.5 ± 4.1) completed the study. No bleeding was observed intra‐ or postoperatively. Procedural time was 7.98 ± 2.62 minutes. A pain scale score below 2 was reported 4.5 ± 1.7 days after intervention. Reduction in tonsillar size was observed from 2.4 ± 0.9 pre‐intervention to 1.3 ± 1.0 at 3 months post‐intervention ( P < .001). Tonsil and Adenoid Health Status scores decreased from 17.7 ± 13.0 to 0.96 ± 1.7 ( P < .001). The Snore‐ VAS score decreased by 72%. Conclusion: This is the first clinical study to investigate the use of irreversible electroporation for tonsillar ablation. Irreversible electroporation shows promise as a minimally invasive procedure for reducing the size of tonsillar hypertrophy and alleviating symptoms, with negligible bleeding and significantly less pain. Multicenter studies are in progress to evaluate long‐term efficacy including in children.