Objective: In this article we review the literature on the malignant sublingual gland tumors from a surgical perspective.Background: Sublingual gland tumors occur with a very low incidence and most are malignant tumors.The extent of treatment, clinical outcomes and prognosis of malignant sublingual gland tumors have not been well defined, due to the rarity of this disease.Methods: A database search using Web of Science (https://webofknowledge.com/) and PubMed (https:// pubmed.ncbi.nlm.nih.gov/) was conducted. The following keywords were used in the search: "sublingual gland tumor", AND "malignancy".Conclusions: Although the sublingual glands are among the major salivary glands, they share common anatomical characteristics with minor salivary gland tumors. Therefore, the tumors from the sublingual gland may have different clinical behaviors from the other major salivary gland tumors. The sublingual glands are small without a true surrounding capsule of the glands; the extra-parenchymal extension is very common in sublingual gland tumors. Furthermore, the sublingual glands are located in close proximity to the lingual nerve, the submandibular gland-duct system and the mandible. Thus, the surgical approach to the malignant sublingual gland tumor should include the adequate management of neighboring structures. In addition, adjuvant radiation therapy provides a survival benefit for patients with malignant sublingual gland tumors, which have adverse features. This article summarizes the clinical characteristics and unique features of malignant sublingual gland tumors based on previous reports, and provides clinical information regarding the sublingual gland tumors to increase awareness of primary physicians as well as patients.

Various chronic inflammatory airway diseases can be treated with low-dose, long-term (LDLT) macrolide therapy. LDLT macrolides can be one of the therapeutic options for chronic rhinosinusitis (CRS) due to their immunomodulatory and anti-inflammatory actions. Currently, various immunomodulatory mechanisms of the LDLT macrolide treatment have been reported, as well as their antimicrobial properties. Several mechanisms have already been identified in CRS, including reduced cytokines such as interleukin (IL)-8, IL-6, IL-1β, tumor necrosis factor-α, transforming growth factor-β, inhibition of neutrophil recruitment, decreased mucus secretion, and increased mucociliary transport. Although some evidence of effectiveness for CRS has been published, the efficacy of this therapy has been inconsistent across clinical studies. LDLT macrolides are generally believed to act on the non-type 2 inflammatory endotype of CRS. However, the effectiveness of LDLT macrolide treatment in CRS is still controversial. Here, we reviewed the immunological mechanisms related to CRS in LDLT macrolide therapy and the treatment effects according to the clinical situation of CRS.

This work is based on a part of the first author's master's thesis from Yongin University. Objectives: The purpose of this study is to investigate the characteristics of school age children's reading comprehension of expository texts based on different text structures and question types. Methods: A total of 54 children participated in this study. We presented assignments that tested children's comprehension of expository texts specifically designed with different text structures. Results: First, students in higher grades showed better performance across all text structures. However, significant differences in performance based on the text structures of scripts were only found between 2nd grade and 6th grade students and between 4th grade and 6th grade students. Students in every grade showed high performance on comprehension of process writings but low performance on comprehension of persuasive writings. Results from other text structures varied between grades, while the differences between grades were significant for comparison/contrast, listing, and persuasive text structures. Second, students in higher grades showed better performance on all question types; however, analogous to the previous result, significant differences in performance based on question types were only found between 2nd grade and 6th grade students and between 4th grade and 6th grade students. Students in every grade showed high performance on identification of details but low performance on identification of main topic. Results from other question types varied between grades, while the differences among grades pertaining to question types were significant for text structure and inference questions. Conclusion: These results demonstrate that children's strategy in identifying text structures and comprehending expository texts develop notably during later grades in elementary school.

Background and Objective Endoscopic airway dilation is the primary treatment for pediatric subglottic stenosis (SGS) due to its feasibility and non-invasiveness. The aim of this study is to evaluate the risk factors for the failure of endoscopic airway dilation in pediatric patients with SGS. Materials and Methods This study reviewed medical records of 38 pediatric patients had endoscopic dilation from a single and tertiary referral center, retrospectively. The success of the endoscopic dilation procedure was defined as no dyspneic symptom without tracheostomy or laryngotracheal reconstruction. Demographic profiles, underlying disease, and Myer-Cotton SGS severity grade were recorded. Success rates and risk factors for the failure of treatment were analyzed. Results The SGS patients with severity grade I was most common. After mean 1.8 numbers of procedures, there were 23 patients (60.5%) in the success group and 15 patients (39.5%) in the failure group. Age, sex, underlying diseases, and SGS severity grade were not significantly different between two groups. In patients who had multiple endoscopic procedures, the failure group showed SGS deteriorated after procedures in 66.7%, compared to 11.1% of the success group. In multivariable analysis, a long-term intubation (≥1 month) was identified as an independent risk factor for failure of endoscopic dilation procedure. Conclusion Although endoscopic dilation procedure is safe and effective for the management, repetitive endoscopic dilation may not give clinical benefit in patient with long-term intubation. Other airway procedures must be considered in those group of patients.

Digital twins were initially introduced in the aerospace industry, but they have been applied to the medical field in the 2020s. The development of the Internet of Things, sensor technology, cloud computing, big data analysis, and simulation technology has made this idea feasible. Essentially, digital twins are virtual representations of real-world data that can generate virtual outcomes related to a patient based on their actual data. With this technology, doctors can predict treatment outcomes, plan surgery, and monitor patients’ medical conditions in real time. While digital twins have endless potential, challenges include the need to deal with vast amounts of data and ensure the security of personal information. In the field of rhinology, which deals with complex anatomy from the sinus to the skull base, the adoption of digital twins is just beginning. Digital twins have begun to be incorporated into surgical navigation and the management of chronic diseases such as chronic rhinosinusitis. Despite the limitless potential of digital twins, challenges related to dealing with vast amounts of data and enhancing the security of personal data need to be surmounted for this method to be more widely applied.

Perilymph fistula (PLF) is defined as an abnormal communication between the middle ear cavity and perilymphatic space of the inner ear. Most cases of PLF are responsible for pressure change caused by internal trauma or external trauma. However, spontaneous PLF might occur without an obvious history of barotrauma. We report two cases of possible spontaneous PLF in the postpartum period: both cases involved progressive sensorineural hearing loss with positional dizziness. Although the leakage of perilymph was not found during exploration, both hearing loss and dizziness improved immediately after PLF repair. It is necessary to consider the possibility of PLF in patients who have sudden or progressive sensorineural hearing loss with positional nystagmus. Early surgical exploration is recommended even if the history of barotrauma is not clear.

Objective: This study aimed to evaluate the procedural outcomes and learning curve of type I endoscopic tympanoplasty (ET) performed by a single surgeon.Methods: This was a retrospective study of 376 patients who underwent type I ET performed by a single surgeon over 7 years. We evaluated the pre/post air-bone gap (ABG), time required for surgery, changes in pain after surgery, success, and failure rate of type I ET.Results: Hearing results indicated an ABG of approximately 17.8 dB before surgery but decreased significantly to 9.8 dB at 6 months after surgery. The time required for the operation gradually decreased. In particular, the time required for the procedure was 67.6 min in the first year and decreased to 31.5 minutes in the fifth year, a drastic reduction. The graft failure rate up to 6 months after surgery was 13.0% and was the same for both primary and revision surgeries. Graft failure was significantly greater with increasing size of the preoperative tympanic perforation. The success rate varied depending on graft material, and the group with only acellular allogenic dermal matrix showed the lowest success rate. Postoperative pain significantly decreased from 2.01 immediately after surgery to 0.78 points the next day, and there were no severe complications during surgery.Conclusions: ET produces superior cosmetic results with minimal pain and is associated with stable hearing improvement and high success rate. The operation time decreased with surgeon experience and continued to decrease until the fifth and final year of this analysis.