Firecrackers are still popular among the general public of various populations worldwide. This study investigated inner ear damage in patients with firecracker trauma and analyzed noise levels in 6 kinds of commercially available firecrackers. During the past 20 years, we have experienced 30 patients with firecracker trauma. An inner ear test battery comprising audiometry, cervical and ocular vestibular-evoked myogenic potential (cVEMP and oVEMP) tests and a caloric test was performed. The real-time noise levels were measured outdoors at a distance of 2, 4 and 6 m away from a lighting firecracker to mimic a noise event. Mean hearing levels at high frequencies (4,000 and 8,000 Hz) were significantly higher than those at the low and middle frequencies, indicating that firecrackers mostly cause high-tone hearing loss. For the vestibular damage, abnormality percentages were higher in the results of cVEMP (80%) and oVEMP (60%) tests, but not in the caloric test (8%). In conclusion, most firecrackers exhibited noise levels > 110 dB SPL even at a distance of 6 m. This blast injury simultaneously damaged the cochlea, saccule and utricle, but spared the semicircular canals, indicating that blast exposure potentiates the adverse effect of noise exposure on both cochlear and vestibular partitions.

Background: Oral cancer causes significant morbidity and mortality. Chemoprevention utilizes medication or natural compounds to reverse oral premalignant lesions and to prevent second primary tumors. Methods: A comprehensive PubMed database and Cochrane Library search from 1980 to 2021 was performed using the keywords "leukoplakia," "oral premalignant lesion," and "chemoprevention."Results: Chemopreventive agents included retinoids, carotenoids, cyclooxygenase inhibitor, herbal extracts, bleomycin, tyrosine kinase inhibitors, metformin, and immune checkpoint inhibitors. Although some agents demonstrated effect in reducing premalignant lesions and preventing second primary tumors, the results among different studies were highly variable. Conclusions:The results of different trials, albeit inconsistent, provided substantial information for future studies. In the era of personalized medicine, future studies will focus on identifying specific biomarkers and molecular profile to monitor and to prevent malignant transformation. Larger trials are warranted to validate the effect of chemopreventive agents.

Background Radiation‐induced sarcoma of the head and neck (RISHN) is a rare yet devastating potential complication of radiotherapy treatment. We aimed to evaluate the clinicopathological characteristics and molecular signatures of RISHN in patients who underwent radiotherapy for head and neck cancer (HNC) to identify high‐risk patients and enable earlier cancer detection. Methods This study retrospectively evaluated 24 sarcoma patients who received radiotherapy for HNC between 1994 and 2019. Patients were divided into two groups based on RISHN latency period. Patient demographics, initial tumor staging, risk factors, and survival between groups were analyzed, and whole‐exome sequencing (WES) of selected samples was performed. Results The median age at diagnosis of RISHN was 54 years, and the male‐to‐female ratio was 2:1. The latency period ranged from 0.8 to 64.4 years (median 6.5 years), with a median survival of 21.5 months. Primary cancer in the oral cavity, treatment with alkylating agents, alcohol consumption, betel nut chewing, and smoking were identified as risk factors for short (<5 years) latency periods. The majority of RISHN cases occurred in the oral cavity (58.3%). WES analysis showed that tumor necrosis factor and cell cycle checkpoint pathways were differentially involved in both patient groups. Conclusions Although case numbers were small, our cohort represents the largest case series of RISHN from a single institution to date. Clinicians must be aware of factors affecting RISHN development and latency, and risk factor identification may lead to earlier detection and prevention in the future.

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