BackgroundThe prognostic role of neutrophil-to-lymphocyte ratio (NLR) has been proposed in head and neck squamous cell carcinoma (HNSCC). However, it is currently unclear which cutoff values of NLR could consistently and independently differentiate HNSCC patients to better and worse prognosis groups.MethodsWe performed a meta-analysis of prognostic significance of pretreatment NLR values, using data extracted from 24 relevant articles. Main outcomes were overall survival (OS) and disease-free survival (DFS) in HNSCC patients. Pooled hazard ratio (HR) and 95% confidence intervals (95%CI) were calculated using the random effect model for outcomes. Impacts of NLR cutoff values across the studies were assessed with a meta-regression analysis. Results were validated using an independent data set of patients (n = 540).ResultsPretreatment high NLR values above the cutoff were significantly associated with shorter OS (HR = 1.96, 95%CI = 1.66–2.31) and DFS (HR = 1.90, 95%CI = 1.41–2.54). Of note, NLR cutoffs ranging from 1.9 to 6.0 did not affect HR of OS or DFS in meta-regression analyses. In an independent cohort, any NLR cutoff between 2 and 6 produced significant HR of OS, similarly. Instead of binary cutoffs, three subgroups of NLR (< 2, 2 to 6, and ≥ 6) showed significant differences of OS in survival analyses.ConclusionsMeta-analyses confirmed that pretreatment NLR values above the cutoff were associated with shorter survival in HNSCC patients. However, the binary cutoffs of NLR values were variable across studies. Rather, pretreatment NLR values below 2 and above 6 using a three-tier classification (< 2, 2 to 6, and ≥ 6) could consistently imply better and worse prognosis in HNSCC patients, which could be readily translated to clinics.Electronic supplementary materialThe online version of this article (10.1186/s12885-018-4876-6) contains supplementary material, which is available to authorized users.

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Generally, a nasal septal abscess (NSA) is defined as a collection of pus between the cartilage and mucoperichondrium or bony septum and mucoperiosteum. It usually occurs after nasal trauma. It is commonly resolved without any complications, however, it can lead to serious complications including sepsis, cerebral spreading, and nasal deformities if not taken early diagnosis and proper management. Recently, we experienced a case of nasal septal abscess of 59 year-old female that developed after electrical cauterization for epistaxis. In this case, abscess pocket was located around Keystone area where the septum joins the nasal bones and the upper lateral cartilage. Incision and drainage was done and symptoms were improved. Any otorhinolaryngologist can encounter septal abscess at any time. This case was unusual because it was developed after electrical cauterization and localized in Keystone area. We report this case and discuss about disease and our thesis for this case.

<p class="abstract"><span lang="EN-US">A granular cell tumor (GCT) is a rare neoplasm. It grows slowly, presumably originates from a Schwann cell, and is typically benign. Histopathologically, GCTs are composed of loosely infiltrating sheets of large, pale, polyhedral cells with abundant granular eosinophilic cytoplasm and a pale, centrally situated nucleus. Immunohistochemically, GCTs express the S-100 protein and neuron-specific enolase. A GCT can occur anywhere in the body. Half of all GCTs occur in the head and neck regions, especially on the tongue, but they are rarely found in the nasal cavity. A GCT usually arises as a solitary tumor and can be confirmed only by a histologic examination. The appropriate treatment is excision of the lesion. </span>Here, we present a rare case of a GCT originating in the right posterior ethmoid sinus in the nasal cavity. A GCT originating in a posterior ethmoid sinus has not been reported thus far. In our case, a simple nasal polyp was found in the left ethmoid sinus of the patient. Thus, we initially misjudged the GCT in the right nasal cavity as a simple nasal polyp.</p>

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