Microbiome means a holistic genomic information of microorganism which usually having symbiotic relationships confer benefits to human body. Breaches in the homeostasis between host and microorganism or alterations of the microbiome are well-known risk factors promoting human diseases. Oral cavity has hundreds of microbes and demonstrates chronic inflammatory conditions by interrelations among microorganisms, foreign bodies, alcohol, and smoking. Oral microbiome also demonstrates a growing evidence of its implication in the etiology of oral diseases including cancer and other systemic diseases. In this review paper, I would introduce to the associated human diseases with oral microbiome and the mechanism how changes in the oral microbiome with its microenvironment leads to the host diseases. And I would also suggest a new research field in otorhinolaryngology connected to oral microbiome.
Foreign Bodies ; Homeostasis ; Human Body ; Humans ; Microbiota* ; Mouth ; Otolaryngology ; Risk Factors ; Smoke ; Smoking ; Stomatitis

The locoregional recurrence rate after treatment of head and neck cancer (HNC) is known to be about 40%, and recurrence of cancer is the major factor directly related to the survival of patients. Recurrent HNC has different biological characteristics and tumor microenvironment from those of index cancer. And it subsequently exhibits pro-tumoral and treatment-resistant traits, which leads to difficulties in selecting salvage treatments and followed by dismal prognosis. Furthermore, since which salvage treatment can be selected and what the result of it will be determined by the prior treatment, there should be careful consideration in the initial therapeutic strategy. In this review, currently used treatment methods and results for locoregionally recurrent HNC are summarized, and considerations for each treatment based on the clinical and biomolecular characteristics of recurrent HNC are discussed. In addition, this review contains introductions of new therapeutic strategies including recent clinical trials and a perspective on the future direction for treatment of locoregionally recurrent HNC.

Background: The risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission during the endemic phase may vary from that during the previous pandemic phase. We evaluated the risk of infection in a general population with laboratory-confirmed coronavirus disease 2019 (COVID-19) in a community setting in Korea. Materials and Methods: This study included 1,286 individuals who had been in contact with an index COVID-19 case between January 24, 2020, and June 30, 2022. Variables such as age, sex, nationality, place of contact, level of contact, the status of exposed cases, period, and level of mask-wearing were assessed. Results: Among 1,286 participants, 132 (10.30%) were confirmed to have COVID-19. With increasing age, the risk of the exposed persons contracting COVID-19 from index cases tended to increase (P <0.001), especially for people in their 70s (odds ratio, 1.24; 95% confidence interval, 1.11–1.40; P <0.001). We found an increasing trend in the risk of a COVID-19 exposed case becoming a secondary infection case (P <0.001) in long-term care facilities where the attack rate was high. Conclusion The risk of COVID-19 transmission is high in long-term care facilities where many older adults reside. Intensive management of facilities at risk of infection and strict mask-wearing of confirmed COVID-19 cases are necessary to prevent the risk of COVID-19 infection.

OBJECTIVES: This study investigated the outcomes of uvula-preserving palatopharyngoplasty (UPPPP) in patients with obstructive sleep apnea syndrome (OSAS). METHODS: Twenty men with obstructive sleep apnea syndrome received the UPPPP operation at our institution. We measured symptom changes after UPPPP using a visual analog scale (VAS), and all patients were examined with polysomnography pre- and post-operatively. 'Surgical success' was defined as reduction in apnea-hypopnea index (AHI) to below 20 events per hour and more than 50% post-operative reduction. RESULTS: Snoring decreased significantly (6.7+/-2.3 to 3.7+/-2.9 on VAS, P=0.002) but the postoperative globus sense did not differ from that preoperatively (2.0+/-2.4 to 2.1+/-2.7 on VAS, P=0.79). Apnea and apnea-hypopnea indices were significantly reduced after UPPPP (34.7+/-20 to 24.2+/-17.2 events/hour, P=0.029). The surgical success rate was 40% regardless of Friedman stage. There was significant reduction in the AHI on supine sleep in both surgically successful and unsuccessful patient groups. CONCLUSION: UPPPP may minimize postoperative globus sense and other complications, with a success rate comparable to that of previously reported surgical methods in OSAS patients. In addition, it may reduce the apnea-hypopnea index in the supine sleep position.
Apnea ; Dependency (Psychology) ; Humans ; Male ; Polysomnography ; Sleep Apnea, Obstructive ; Snoring

A 56-year-old female presented with clinical features of acute tonsillitis with subsequent cervical lymphadenitis. After taking empirical antibiotics for 1 week, the acute infection symptoms and signs were resolved. However, an asymmetric enlargement of the left palatine tonsil with ipsilateral neck swelling remained. Subsequent tonsillectomy and lymph node excisional biopsy were performed due to the possibility of malignancy. The patient was eventually diagnosed as malignant lymphoma according to pathological confirmation. We demonstrate the diagnostic challenges in such a rare case and emphasize the importance of differentiating malignant lymphoma from an atypically presenting acute infectious disease.
Anti-Bacterial Agents ; Biopsy ; Communicable Diseases ; Female ; Humans ; Lymph Node Excision ; Lymphadenitis ; Lymphoma ; Middle Aged ; Neck ; Palatine Tonsil ; Tonsillectomy ; Tonsillitis

Background and Objectives: Carotid body paraganglioma is the common type of carotid body tumor for which angiography, carotid artery balloon occlusion test (BOT) and tumor embolization could be considered before the surgery. We analyzed cases in a single institute and reviewed related literature to investigate the necessity of these preoperative examinations.Subjects and Method Medical records of patients who were diagnosed with paraganglioma were retrospectively analyzed from 2000 to 2019. Results: Sixteen patients were identified. Of the total, 14 patients underwent surgery at this institute, and 13 underwent angiography. Of the 13 patients who underwent angiography, 6 patients underwent carotid artery BOT, and 12 patients underwent tumor embolization. The average tumor size of 6 patients who underwent carotid artery BOT was 28.7 mm, and 8 patients who did not undergo carotid artery BOT was 30.1 mm. The average tumor size of 12 patients who underwent tumor embolization was 29.4 mm. Two patients did not undergo tumor embolization, and their average tumor size was 30 mm. In 1 patient, both preoperative angiography and carotid artery BOT were performed, but tumor embolization was not performed due to spasm of tumor vessels. Conclusion Preoperative carotid artery BOT can be performed to reduce side effects in patients with the potential for carotid resection. In addition, tumor embolization is performed regardless of tumor size. By reducing the amount of bleeding during surgery and reducing the size of the tumor, it is possible to secure an appropriate surgical field of view to facilitate operation during surgery; however, its effectiveness needs to be clearly identified.

The use of cardiac implantable electronic devices (CIEDs) has increased significantly in recent years. Consequently, more patients with CIEDs will undergo surgery during their lifetime, and thus the involvement of anesthesiologists in the perioperative management of CIEDs is increasing. With ongoing advancements in technology, many types of CIEDs have been developed, including permanent pacemakers, leadless pacemakers, implantable cardioverter defibrillators, cardiac resynchronization therapy-pacemakers/defibrillators, and implantable loop recorders. The functioning of CIEDs exposed to an electromagnetic field can be affected by electromagnetic interference, potential sources of which can be found in the operating room. Thus, to prevent potential adverse events caused by electromagnetic interference in the operating room, anesthesiologists must have knowledge of CIEDs and be able to identify each type. This review focuses on the perioperative management of patients with CIEDs, including indications for CIED implantation to determine the baseline cardiovascular status of patients; concerns associated with CIEDs before and during surgery; perioperative management of CIEDs, including magnet application and device reprogramming; and additional perioperative provisions for patients with CIEDs. As issues such as variations in programming capabilities and responses to magnet application according to device can be challenging, this review provides essential information for the safe perioperative management of patients with CIEDs.

PURPOSE: This retrospective cohort study aimed to determine the clinical outcomes of staged bilateral carotid endarterectomy (CEA) for bilateral internal carotid artery (ICA) stenosis performed with a short interval between the primary and secondary CEA procedures. METHODS: In our institution, 574 consecutive patients underwent CEA between September 2007 and August 2014. Bilateral significant ICA stenosis was identified in 43 patients (7.5%) who underwent staged bilateral CEA within 30 days or less. Patients with unilateral CEA and staged bilateral CEA were compared in terms of CEA outcomes. The primary endpoint was the composite of any stroke, myocardial infarction, or death during the periprocedural period or ipsilateral stroke within 3 years after the CEA. RESULTS: Staged bilateral CEA was not associated with ipsilateral stroke (P = 0.178) during postoperative follow-up. The two groups did not differ in terms of estimated 3-year primary endpoint rates (2.8% vs. 4.7%, P = 0.456) or ipsilateral stroke-free (P = 0.225), any stroke-free (P = 0.326), or overall (P = 0.739) survival rates. CONCLUSION: Patients with bilateral significant ICA stenosis can undergo staged bilateral CEA within 30 days or less with outcomes that compare favorably with those of patients undergoing unilateral CEA.
Carotid Arteries* ; Carotid Artery, Internal ; Carotid Stenosis* ; Cohort Studies ; Constriction, Pathologic ; Endarterectomy, Carotid* ; Follow-Up Studies ; Humans ; Myocardial Infarction ; Retrospective Studies ; Stroke ; Survival Rate ; Treatment Outcome

BACKGROUND AND OBJECTIVES: This study examined the expressions of p16 and the programmed cell death 1 ligand (PD-L1) in patients with oropharyngeal cancer (OPC) treated with radiotherapy (RT) to identify the correlation between p16 and PD-L1 expression, and to examine the prognostic significance of these markers for OPC patients receiving RT.SUBJECTS AND METHOD: Forty-eight OPC patients diagnosed and treated at a tertiary referral hospital were enrolled in this retrospective analysis. Patients were initially treated with RT or chemoradiotherapy (CRT) with curative intent and completed the planned schedule. Expression of p16 and PD-L1 by primary tumors was evaluated by immunohistochemistry, and results were interpreted separately and dichotomized according to outcome analyses. RESULTS: Of the 48 patients, 25 (52.1%) expressed p16 and 15 (31.3%) expressed PD-L1. Expression of these markers showed a mutual positive correlation (p=0.046). Positive PD-L1 expression was associated with poor complete remission (CR) rates after RT (p=0.040). Positive p16 expression was associated with better recurrence-free survival (RFS) (p=0.004) but not overall survival (OS) (p=0.192). PD-L1 expression showed no independent association with survival (p>0.05); however, PD-L1 expression tended toward poorer RFS, even in p16-positive individuals. CONCLUSION There was a positive correlation between the expression of p16 and PD-L1 in OPCs. PD-L1 expression was associated with poorer CR rates after RT or CRT. PD-L1 alone did not show an association with RFS or OS, but when combined with p16, it tended toward poorer RFS, even in p16-positive cases.