Phaeohyphomycosis caused by Corynespora cassiicola, a plant pathogen worldwide.

Although rare, trans-kingdom infection features an interesting infection biology concept, in which highly versatile pathogenic attributes allow successful infections in evolutionarily highly divergent species. Corynespora cassiicola is a phytopathogenic fungus and occasionally causes human infections. Herein, we report a phaeohyphomycosis case caused by C. cassiicola. Given that sporadic reports may contribute to a lack of awareness of the transmission route, clinical manifestations, and diagnostic and clinical management, we systematically reviewed the cases reported thus far. Nine patients were identified and included in the pooled analysis, 88.9% (8/9) of whom were reported after 2010. All patients were from Asian, African, and Latin American countries, among whom 77.8% (7/9) were farmers or lived in areas with active agriculture. Exposed body parts were the major affected infection area, and clinical manifestations were mainly non-specific inflammatory reactions. Although biochemical and morphological examinations confirmed the presence of fungal infection, molecular analysis was used for the final diagnosis, with 77.8% (7/9) being identified by internal transcribed spacer sequencing. Whereas voriconazole, terbinafine, and AmB, either alone or in combination, resulted in successful infection resolution in most cases (5/9; 55.5%), those suffering from invasive facial infections and CARD9 deficiency showed poor outcomes. Our patient is the third case of invasive facial infection caused by C. cassiicola and was successfully treated with intravenous LAmB followed by oral voriconazole combined with topical antifungal irrigation. Molecular identification of fungus and prompt antifungal treatment is pivotal in the clinical success of patients suspected to have phaeohyphomycosis. Moreover, as evidenced by our data, itraconazole treatment is not recommended.

A Comparison of Antifungal Drugs and Traditional Antiseptic Medication for Otomycosis Treatment: A Systematic Review and Meta-Analysis.

Objectives/Hypothesis: To perform a systematic review and meta-analysis to compare the efficacy of and complications associated with antifungal drugs and traditional antiseptic medication for the treatment of otomycosis. Data Sources: The PubMed, EMBASE, GeenMedical, Cochrane Library, CBM, CNKI, VIP and other databases were searched from January 1991 to January 2021. Methods: The systematic literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials (RCTs) and non-randomized studies (case-control, cohort, and case series) were included to assess the topical use of antifungal drugs and traditional antiseptic medication in patients with otomycosis. The research subjects were patients who were clinically diagnosed with otomycosis and whose external auditory canal secretions were positive for fungi. Funnel plots were used to detect bias, and the Q test was used to assess heterogeneity. The random-effects model was used for meta-analysis. The t-test was used to assess significance. Results: Of the 324 non-duplicate studies screened, 16 studies met the criteria for full-text review, and 7 were included in the meta-analysis. Four studies reported recovery conditions (P = 0.01). Six common complications after medication use were compared, and there were no significant differences. The authors further conducted subgroup analysis according to complications. The differences in the rates of ear distension (P = 0.007), earache (P = 0.03) and tinnitus (P = 0.003) were statistically significant. Conclusion: The results of this meta-analysis and literature review showed that antifungal drugs and traditional antiseptic medication were effective in relieving symptoms in patients with otomycosis, and the two treatments were associated with different complications. Otolaryngologists have the option to use one medication or a combination of two drugs on the basis of the condition. Future research in this area should include RCTs with long-term follow-up to guide the development of otomycosis guidelines to overcome some of the weaknesses found in the literature. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/#myprospero.

Efficacy and safety of semicircular canal occlusion for intractable horizontal semicircular benign paroxysmal positional vertigo.

BACKGROUND: Some studies have suggested that semicircular canal occlusion is effective and safe for treating intractable posterior semicircular benign paroxysmal positional vertigo (PSC-BPPV), and adverse effects of canal occlusions for intractable horizontal semicircular BPPV (HSC-BPPV) were rarely reported. The aim of this study was to retrospectively discuss the efficacy of semicircular canal occlusion for intractable HSC-BPPV with at least 2 years of follow-up. METHODS: From 2000 to 2011, 3 female patients (average age=60±6.9 years), with a diagnosis of HSC-BPPV refractory to head-shake and barbecue roll maneuver, underwent semicircular canal occlusion treatment in our hospital. The supine roll test was performed to diagnose HSC-BPPV and evaluate the treatment efficacy. RESULTS: All patients with intractable HSC-BPPV had complete resolution of their positional vertigo after semicircular canal occlusion with a negative supine roll test. All patients reported transient postoperative disequilibrium, nausea, and vomiting, which resolved within 2 weeks. In addition, 1 patient (33.3%) had transient tinnitus, which resolved after 4 months. There were no other significant long-term complications. CONCLUSION: Semicircular canal occlusion appears to be a safe and well-tolerated treatment modality for intractable HSC-BPPV. However, further studies with large sample sizes are needed to confirm our conclusion.

Botox transient treatment of tinnitus due to stapedius myoclonus: case report.

OBJECT: To explore the feasibility of using botulinum toxin type A (BTXA) to treat tinnitus due to stapedius myoclonus. METHOD: A piece of gelfoam containing BTXA (25 U/ml) was placed, through a perforation in tympanic membrane, into the middle ear cavity of a patient suffering from tinnitus due to stapedius myoclonus. RESULTS: The tinnitus disappeared on the second day after the BTXA treatment. The patient was free of symptoms during a 3-month follow-up period. Tinnitus reappeared at 4 months, and disappeared after second BTXA local treatment. CONCLUSION: Local BTXA treatment may be considered as a treatment for tinnitus caused by stapedius myoclonus.

[Ectopic parathyroid gland hyperplasia in the pyriform sinus].

OBJECTIVE: To explore the diagnosis and treatment of the ectopic parathyroid gland in the pyriform sinus. METHOD: Retrospectively analysis of 1 case with ectopic parathyroid gland in the pyriform sinus and retrospectively review the past literatures. RESULT: The cases with the ectopic parathyroid gland in the pyriform sinus reported in the past literatures included: 2 with parathyroid gland tissues, 3 with hyperplasia, the other 1 with adenoma. The case reported by us was with adenoma. CONCLUSION: The ectopic parathyroid gland hyperplasia in the pyriform sinus is rarely reported before and it usually causes misdiagnosis. Better knowledge of the different position of the ectopic parathyroid gland hyperplasia in the pyriform sinus will help diagnosing and treating it.

[Imaging analysis of the ethmoid roof].

OBJECTIVE: To discuss the image anatomy characters in the height and contour of the ethmoid roof. METHOD: Retrospective review of direct coronal sinus computed tomography (CT) scans in 160 patients. The height and contour of the fovea ethmoidalis, and the connection modes between ethmoidal roof and cribriform plate were examined. When an asymmetry in the height of the fovea ethmoidalis existed, this difference was quantified, and the difference between ethmoidal roof and cribriform plate was quantified in high type, too. RESULT: In 25 scans (15.63%), there was an asymmetry between the height of the fovea ethmoidalis on the right and left sides. Of these 25, 13 (52.00%) were lower on the right side. The difference between left and right was 2.35 mm. Sixty-two patients (38.75%) demonstrated a contour asymmetry with "flattening" of the ethmoid roof on one side. Horizontal type was 116 sides (36.25%), and high type was 204 sides (63.75%) in the connection modes between ethmoidal roof and cribriform plate. The difference was 2.80 mm in the high type. CONCLUSION: There were asymmetries in the height and contour of the right and left fovea ethmoidalis. The asymmetry was most often the result of a difference in contour with flattening of the fovea on one side. The high type was the most connection modes between ethmoidal roof and cribriform plate. This underscores the importance of careful preoperative and intraoperative review of paranasal sinus CT scans in patients undergoing endoscopoic sinus surgery.

[The expression of CD44 and it's significance in human laryngeal carcinoma].

OBJECTIVE: To explore the CD44 expression in different laryngeal carcinoma tissues and their clinical significance. METHOD: Using immunohistochemistry methods to study 261 cases of archived paraffin-embedded laryngeal tissue. RESULT: The results turned out to be as follows: 1. A high level of CD44 expression was more frequently found in laryngeal carcinoma than in precarcinoma lesions and normal tissues. 2. CD44 expression correlated well with histological grades, the higher grade the lower the CD44 expression. 3. The third and fourth stages laryngeal carcinoma had stronger CD44 positive than those of the first and second stages. 4. CD44 expression in laryngeal carcinoma with cervical metastasis were higher than those without cervical metastasis. 5. To 3 and 5 years survival, CD44 positive cases had lower chance than CD44 negative cases. CONCLUSION: These results implicates that the occurrence, development and prognosis of laryngeal carcinoma may be closely related to CD44 expression.

[The pathogenesis and treatment exploration of vocal cord paralysis].

OBJECTIVE: To investigate the causes and effective treatment of vocal cord paralysis(VCP). METHOD: Sixty-five patients with VCP in our hospital in recent 10 years were analyzed. All the patients underwent examination by indirect laryngoscope, stroboscopy or electrolaryngostroboscopy, of which, 31 cases were operated by stiring arytenoid cartilage. RESULT: Fourteen cases with VCP were caused by neck and thoracic tumor; Nine cases were caused by infectations; sixteen cases were caused by neck, thoracic, abdominal openations; twelve cases were caused by trachea intubation; Three cases were caused by gastric intubation; Eleven cases were caused without obvious reason. All the symptoms of VCP were cured after treatment in 37 cases. The improvement rate of hoarseness was 58.46%. CONCLUSION: Patients with hoarseness should be routinely examinated by indirect laryngoscope, stroboscopy or electrolaryngostroboscopy. Arytenoid cartilage of patients with VCP should be stired by indirect laryngoscope or direct laryngoscope or self-retaining laryngoscope as early as possible.