1.Clinical Analysis of Sinonasal Malignant Lymphoma: Treatment Modalities and Prognostic Factors
Seo Young KIM ; Jeong Kyou KIM ; Young Chul KIM ; Joonsik YOON ; Soo Min KIM ; Jeeyeon PARK ; Doo Hyun SONG ; Hyun Jik KIM
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(9):482-487
Background and Objectives:
Sinonasal malignant lymphoma is rare and aggressive. Its low incidence has made detailed studies on epidemiology, survival, and consensus treatment modalities a challenge, and also has limited developing standardized protocols for diagnosis and management. This study analyzes the clinical factors of patients diagnosed with sinonasal malignant lymphoma and their treatment modalities to understand therapeutic outcome and prognostic factors.Subjects and Method The medical records of patients diagnosed between 2011 and 2020 as sinonasal (SN) malignant lymphoma (extranodal NK/T cell lymphoma [ENKTL]/diffuse large B cell lymphoma [DLBCL]) in Seoul national university hospital were retrospectively reviewed.
Results:
A total 42 patients were included in the study. Of those, 30 patients were SN-ENKTL, 12 patients were SN-DLBCL. The mean age of SN-DLBCL and SN-DLBCL groups was 52.8±14.4, 60.8±12.4, respectively. The main chief complaint was nasal obstruction (54%). Approximately 75% were diagnosed as stage II (Ann-Arbor staging system) and most of the patients received multi-agent chemotherapy or chemoradiotherapy. The 3-year overall survival rate for SN-DLBCL and SN-DLBCL groups was roughly 90%, 88.9%, respectively and the average of disease-free survival period was approximately 41.1 and 22.1 months, respectively, after initiation of treatment.
Conclusion
We found that sinonasal malignant lymphoma is highly responsive to chemo or chemoradiotherapy. Early accurate diagnosis is important as early-stage patients receiving therapy may benefit from chemo or chemoradiotherapy. Our clinical data showed that in ambiguous situations, wide excision should be considered for diagnosis.
2.Clinical Analysis of Sinonasal Malignant Lymphoma: Treatment Modalities and Prognostic Factors
Seo Young KIM ; Jeong Kyou KIM ; Young Chul KIM ; Joonsik YOON ; Soo Min KIM ; Jeeyeon PARK ; Doo Hyun SONG ; Hyun Jik KIM
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(9):482-487
Background and Objectives:
Sinonasal malignant lymphoma is rare and aggressive. Its low incidence has made detailed studies on epidemiology, survival, and consensus treatment modalities a challenge, and also has limited developing standardized protocols for diagnosis and management. This study analyzes the clinical factors of patients diagnosed with sinonasal malignant lymphoma and their treatment modalities to understand therapeutic outcome and prognostic factors.Subjects and Method The medical records of patients diagnosed between 2011 and 2020 as sinonasal (SN) malignant lymphoma (extranodal NK/T cell lymphoma [ENKTL]/diffuse large B cell lymphoma [DLBCL]) in Seoul national university hospital were retrospectively reviewed.
Results:
A total 42 patients were included in the study. Of those, 30 patients were SN-ENKTL, 12 patients were SN-DLBCL. The mean age of SN-DLBCL and SN-DLBCL groups was 52.8±14.4, 60.8±12.4, respectively. The main chief complaint was nasal obstruction (54%). Approximately 75% were diagnosed as stage II (Ann-Arbor staging system) and most of the patients received multi-agent chemotherapy or chemoradiotherapy. The 3-year overall survival rate for SN-DLBCL and SN-DLBCL groups was roughly 90%, 88.9%, respectively and the average of disease-free survival period was approximately 41.1 and 22.1 months, respectively, after initiation of treatment.
Conclusion
We found that sinonasal malignant lymphoma is highly responsive to chemo or chemoradiotherapy. Early accurate diagnosis is important as early-stage patients receiving therapy may benefit from chemo or chemoradiotherapy. Our clinical data showed that in ambiguous situations, wide excision should be considered for diagnosis.
3.Clinical Analysis of Sinonasal Malignant Lymphoma: Treatment Modalities and Prognostic Factors
Seo Young KIM ; Jeong Kyou KIM ; Young Chul KIM ; Joonsik YOON ; Soo Min KIM ; Jeeyeon PARK ; Doo Hyun SONG ; Hyun Jik KIM
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(9):482-487
Background and Objectives:
Sinonasal malignant lymphoma is rare and aggressive. Its low incidence has made detailed studies on epidemiology, survival, and consensus treatment modalities a challenge, and also has limited developing standardized protocols for diagnosis and management. This study analyzes the clinical factors of patients diagnosed with sinonasal malignant lymphoma and their treatment modalities to understand therapeutic outcome and prognostic factors.Subjects and Method The medical records of patients diagnosed between 2011 and 2020 as sinonasal (SN) malignant lymphoma (extranodal NK/T cell lymphoma [ENKTL]/diffuse large B cell lymphoma [DLBCL]) in Seoul national university hospital were retrospectively reviewed.
Results:
A total 42 patients were included in the study. Of those, 30 patients were SN-ENKTL, 12 patients were SN-DLBCL. The mean age of SN-DLBCL and SN-DLBCL groups was 52.8±14.4, 60.8±12.4, respectively. The main chief complaint was nasal obstruction (54%). Approximately 75% were diagnosed as stage II (Ann-Arbor staging system) and most of the patients received multi-agent chemotherapy or chemoradiotherapy. The 3-year overall survival rate for SN-DLBCL and SN-DLBCL groups was roughly 90%, 88.9%, respectively and the average of disease-free survival period was approximately 41.1 and 22.1 months, respectively, after initiation of treatment.
Conclusion
We found that sinonasal malignant lymphoma is highly responsive to chemo or chemoradiotherapy. Early accurate diagnosis is important as early-stage patients receiving therapy may benefit from chemo or chemoradiotherapy. Our clinical data showed that in ambiguous situations, wide excision should be considered for diagnosis.
4.Clinical Analysis of Sinonasal Malignant Lymphoma: Treatment Modalities and Prognostic Factors
Seo Young KIM ; Jeong Kyou KIM ; Young Chul KIM ; Joonsik YOON ; Soo Min KIM ; Jeeyeon PARK ; Doo Hyun SONG ; Hyun Jik KIM
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(9):482-487
Background and Objectives:
Sinonasal malignant lymphoma is rare and aggressive. Its low incidence has made detailed studies on epidemiology, survival, and consensus treatment modalities a challenge, and also has limited developing standardized protocols for diagnosis and management. This study analyzes the clinical factors of patients diagnosed with sinonasal malignant lymphoma and their treatment modalities to understand therapeutic outcome and prognostic factors.Subjects and Method The medical records of patients diagnosed between 2011 and 2020 as sinonasal (SN) malignant lymphoma (extranodal NK/T cell lymphoma [ENKTL]/diffuse large B cell lymphoma [DLBCL]) in Seoul national university hospital were retrospectively reviewed.
Results:
A total 42 patients were included in the study. Of those, 30 patients were SN-ENKTL, 12 patients were SN-DLBCL. The mean age of SN-DLBCL and SN-DLBCL groups was 52.8±14.4, 60.8±12.4, respectively. The main chief complaint was nasal obstruction (54%). Approximately 75% were diagnosed as stage II (Ann-Arbor staging system) and most of the patients received multi-agent chemotherapy or chemoradiotherapy. The 3-year overall survival rate for SN-DLBCL and SN-DLBCL groups was roughly 90%, 88.9%, respectively and the average of disease-free survival period was approximately 41.1 and 22.1 months, respectively, after initiation of treatment.
Conclusion
We found that sinonasal malignant lymphoma is highly responsive to chemo or chemoradiotherapy. Early accurate diagnosis is important as early-stage patients receiving therapy may benefit from chemo or chemoradiotherapy. Our clinical data showed that in ambiguous situations, wide excision should be considered for diagnosis.
5.Clinical Analysis of Sinonasal Malignant Lymphoma: Treatment Modalities and Prognostic Factors
Seo Young KIM ; Jeong Kyou KIM ; Young Chul KIM ; Joonsik YOON ; Soo Min KIM ; Jeeyeon PARK ; Doo Hyun SONG ; Hyun Jik KIM
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(9):482-487
Background and Objectives:
Sinonasal malignant lymphoma is rare and aggressive. Its low incidence has made detailed studies on epidemiology, survival, and consensus treatment modalities a challenge, and also has limited developing standardized protocols for diagnosis and management. This study analyzes the clinical factors of patients diagnosed with sinonasal malignant lymphoma and their treatment modalities to understand therapeutic outcome and prognostic factors.Subjects and Method The medical records of patients diagnosed between 2011 and 2020 as sinonasal (SN) malignant lymphoma (extranodal NK/T cell lymphoma [ENKTL]/diffuse large B cell lymphoma [DLBCL]) in Seoul national university hospital were retrospectively reviewed.
Results:
A total 42 patients were included in the study. Of those, 30 patients were SN-ENKTL, 12 patients were SN-DLBCL. The mean age of SN-DLBCL and SN-DLBCL groups was 52.8±14.4, 60.8±12.4, respectively. The main chief complaint was nasal obstruction (54%). Approximately 75% were diagnosed as stage II (Ann-Arbor staging system) and most of the patients received multi-agent chemotherapy or chemoradiotherapy. The 3-year overall survival rate for SN-DLBCL and SN-DLBCL groups was roughly 90%, 88.9%, respectively and the average of disease-free survival period was approximately 41.1 and 22.1 months, respectively, after initiation of treatment.
Conclusion
We found that sinonasal malignant lymphoma is highly responsive to chemo or chemoradiotherapy. Early accurate diagnosis is important as early-stage patients receiving therapy may benefit from chemo or chemoradiotherapy. Our clinical data showed that in ambiguous situations, wide excision should be considered for diagnosis.
6.The Search for an Ideal Definitive Treatment of Sinonasal Squamous Cell Carcinoma With Orbit Invasion
Seung Cheol HAN ; Jeon SEONG ; Sung-Woo CHO ; Hyun-Jik KIM ; Jeong-Whun KIM ; Dong-Young KIM ; Chae-Seo RHEE ; Tae-Bin WON
Clinical and Experimental Otorhinolaryngology 2024;17(3):253-262
Objectives:
. Sinonasal squamous cell carcinoma (SqCC) often invades the orbit. The treatment approach for sinonasal cancer that has spread to the orbit varies across medical centers and depends on the extent of the invasion. The decision to preserve the orbit in the treatment strategy is made on a case-by-case basis and results in varying outcomes. Currently, a multimodal treatment regimen, which may include surgery, chemotherapy, radiotherapy (RT), or concurrent chemoradiotherapy (CCRT), is commonly adopted for managing sinonasal cancers. This study aims to assess the prognosis of sinonasal SqCC with orbital invasion from various perspectives.
Methods:
. We conducted a retrospective review of patients with primary sinonasal SqCC invading the orbit who were treated at Seoul National University Hospital and Seoul National University Bundang Hospital between 2009 and 2018. The extent of the tumor, orbital invasion, treatment strategies, recurrence rates, and survival rates were analyzed.
Results:
. Overall survival and disease-free survival (DFS) rates showed no significant differences based on the grade of orbital invasion. When tumor resection with orbit preservation was employed as the definitive treatment, DFS was significantly extended compared to cases where surgery was not the definitive treatment (RT or CCRT). Additionally, there was no significant difference in DFS between patients who underwent orbit exenteration and those who underwent tumor resection with orbit preservation as the definitive treatment.
Conclusion
. Tumor resection with orbit preservation as the definitive treatment appears to be the preferred approach, prolonging DFS and increasing the likelihood of longer-term survival in cases of SqCC with orbital invasion.
7.Early Postoperative Benefits in Receptive and Expressive Language Development After Cochlear Implantation Under 9 Months of Age in Comparison to Implantation at Later Ages
Seung Jae LEE ; Heonjeong OH ; Kyu Ha SHIN ; Sung-Min PARK ; Yun Kyeong KIM ; Do Hyun JUNG ; Jiyeon YANG ; Yejun CHUN ; Min Young KIM ; Jin Hee HAN ; Ju Ang KIM ; Ngoc-Trinh TRAN ; Bong Jik KIM ; Byung Yoon CHOI
Clinical and Experimental Otorhinolaryngology 2024;17(1):46-55
Objectives:
. The recent expansion of eligibility for cochlear implantation (CI) by the U.S. Food and Drug Administration (FDA) to include infants as young as 9 months has reignited debates concerning the clinically appropriate cut-off age for pediatric CI. Our study compared the early postoperative trajectories of receptive and expressive language development in children who received CI before 9 months of age with those who received it between 9 and 12 months. This study involved a unique pediatric cohort with documented etiology, where the timing of CI was based on objective criteria and efforts were made to minimize the influence of parental socioeconomic status.
Methods:
. A retrospective review of 98 pediatric implantees recruited at a tertiary referral center was conducted. The timing of CI was based on auditory and language criteria focused on the extent of delay corresponding to the bottom 1st percentile of language development among age-matched controls, with patients categorized into very early (CI at <9 months), early (CI at 9–12 months) and delayed (CI at 12–18 months) CI groups. Postoperative receptive/expressive language development was assessed using the Sequenced Language Scale for Infants receptive and expressive standardized scores and percentiles.
Results:
. Only the very early CI group showed significant improvements in receptive language starting at 3 months post-CI, aligning with normal-hearing peers by 9 months and maintaining this level until age 2 years. During this period (<2 years), all improvements were more pronounced in receptive language than in expressive language.
Conclusion
. CI before 9 months of age significantly improved receptive language development compared to later CI, with improvements sustained at least up to the age of 2. This study supports the consideration of earlier CI, beyond pediatric Food and Drug Administration labeling criteria (>9 months), in children with profound deafness who have a clear deafness etiology and language development delays (<1st percentile).
8.Isolated Myeloid Sarcoma in the Nasal Cavity Without Bone Marrow Involvement in a 5-Year-Old Child
Jeong Kyou KIM ; Soo Min KIM ; Won Jun NOH ; Hyun Jik KIM
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(5):295-295
Isolated myeloid sarcoma is a rare extramedullary manifestation, characterized by the presence of myeloid blasts in the body and occurring without bone marrow involvement. While the isolated myeloid sarcoma involvement in the nasal cavity of adults has been reported sparsely, there have been no documented cases involving children in South Korea. Given its rarity, diagnosing isolated myeloid sarcoma is challenging without resorting to a biopsy accompanied by a comprehensive panel of immunohistochemistry. In this context, we present a case of a 5-yearold child diagnosed with isolated myeloid sarcoma situated within the right nasal cavity. Notably, this case is unique as there is no evidence of bone marrow invasion or underlying hematological disorders.
9.A Case of Complete Remission of Nasal Cavity Poorly Differentiated Carcinoma With Targeted Therapy, to Which Surgery and Concurrent Chemoradiotherapy Was Ineffective
Hyun Tae RYU ; Hyung Dong JO ; Suyeon PYO ; Hyun Jik KIM
Korean Journal of Otolaryngology - Head and Neck Surgery 2023;66(3):192-197
Nasal cavity and paranasal sinus cancers comprise about 1% of all malignancies, and 5% of head and neck malignancy. Squamous cell carcinoma comprises more than half of nasal cavity cancers. Treatment is determined by considering tumor size, location, staging, age, general condition, purpose of treatment, etc. Conventional therapy includes surgery, radiotherapy, and chemotherapy; however, for the locally advanced, recurrent, or metastatic cancer after conventional therapy, immunotherapy or targeted therapy are taken into consideration. Target therapy attacks specific cancer cells directly, such as cancer cells with certain gene mutation, whereas immunotherapy attacks cancer cells indirectly, stimulating our own immune system, such as T-cell activity. Histologically poorly differentiated carcinomas are treated with surgery, radiotherapy, and sometimes chemotherapy, but 5-year survival rate is low due to frequent recurrence. Here, we present a case of successful targeted therapy applied to recurrent nasal cavity cancer after serial application of conventional therapies.
10.A Moonlighting Protein Secreted by aNasal Microbiome Fortifies the Innate Host Defense Against Bacterial and Viral Infections
Gwanghee KIM ; Yoojin LEE ; Jin Sun YOU ; Wontae HWANG ; Jeewon HWANG ; Hwa Young KIM ; Jieun KIM ; Ara JO ; In ho PARK ; Mohammed ALI ; Jongsun KIM ; Jeon-Soo SHIN ; Ho-Keun KWON ; Hyun Jik KIM ; Sang Sun YOON
Immune Network 2023;23(4):e31-
Evidence suggests that the human respiratory tract, as with the gastrointestinal tract, has evolved to its current state in association with commensal microbes. However, little is known about how the airway microbiome affects the development of airway immune system. Here, we uncover a previously unidentified mode of interaction between host airway immunity and a unique strain (AIT01) of Staphylococcus epidermidis, a predominant species of the nasal microbiome. Intranasal administration of AIT01 increased the population of neutrophils and monocytes in mouse lungs. The recruitment of these immune cells resulted in the protection of the murine host against infection by Pseudomonas aeruginosa, a pathogenic bacterium.Interestingly, an AIT01-secreted protein identified as GAPDH, a well-known bacterial moonlighting protein, mediated this protective effect. Intranasal delivery of the purified GAPDH conferred significant resistance against other Gram-negative pathogens (Klebsiella pneumoniae and Acinetobacter baumannii) and influenza A virus. Our findings demonstrate the potential of a native nasal microbe and its secretory protein to enhance innate immune defense against airway infections. These results offer a promising preventive measure, particularly relevant in the context of global pandemics.

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