Immunoglobulin G4-related disease (IgG4-RD) is a chronic inflammatory disease involving multiple organs. Some studies have reported otological manifestations of IgG4-RD, although most studies describe involvement of the middle ear, and reports on inner ear manifestations are limited. Here, we describe a case of a 30-year-old man with IgG4-RD involving the inner ear. This case demonstrated that IgG4-RD affected the inner ear and caused cochlear ossification. Cochlear implants may be considered for milder cases, and hormone and immunosuppressive therapy may control disease progression.
Stapediovestibular dislocation is a rare disorder as a result of traumatic injury to the structures in the middle ear. We described a case of a 60-year-old female with stapediovestibular dislocation with associated perilymph fistula. She presented with symptoms including hearing loss, vertigo, and tinnitus after a penetrating injury by an ear pick. After 4 months of conservative management, her symptoms failed to improve. Therefore, she underwent surgery which resolved completely her vestibular symptoms and her hearing loss had partially improved. The restoration of the stapes to its normal anatomical position coupled with ossiculoplasty and closure of the tympanic membrane are effective in patients with stapediovestibular dislocation.
Nasopharyngeal Hodgkin’s lymphoma is a rare disorder. We describe a case of a 24-year-old male with Hodgkin’s lymphoma (HL) primarily originating from the nasopharynx. He presented with symptoms including snoring and bilateral nasal congestion. After evaluation, endoscopic surgery was performed. Surprisingly, the pathological result proved to be classic HL. Postoperative MRI showed that the tumor was completely resected, and PET-CT was further examined. No lesions were found in other places. Shortly thereafter, the patient was transferred to the hematology department for chemotherapy, and the patient was followed up for 5 months without tumor recurrence. As new problems have been detected in medical management, it is vital to put the HL of the nasopharynx into a new perspective.
As a relatively uncommon disease in clinical practice, Hodgkin's lymphoma of the nasopharynx is particularly susceptible to misdiagnosis, which might delay treatment. Clinical dilemmas are regularly faced in the attempt to forecast this disease. With the aim of developing a flawless prediction system in the future to raise the rate of early diagnosis and enhance patient prognosis, we primarily highlight several dilemmas about tumor microenvironment, comparison of biopsy and surgery, and the usage of fluoro-2deoxy-D-glucose positron emission tomography in this study. We summarized the predictive biomarkers in the Hodgkin's lymphoma microenvironment, including both routine and specific biomarkers such as mast cells, tumor related macrophages and so on. Fluoro-2-deoxy-D-glucose positron emission tomography is a highly useful method for the early diagnosis of Hodgkin's lymphoma. It can increase the accuracy and sensitivity of diagnosis and is also a valuable tool for therapy evaluation. Additionally, for pathological procedures, surgery is more dangerous but produces more accurate findings, whereas biopsy is less risky but produces less accurate results.
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