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Diagnostics
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Clinical Diagnosis of Otorhinolaryngology
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Clinical Diagnosis of Otorhinolaryngology

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: closed (31 March 2025) | Viewed by 6105

Special Issue Editors

Prof. Dr. Nina Gale

E-Mail Website
Guest Editor
Institute of Pathology, Faculty of Medicine, Korytkova 2, 1000 Ljubljana, Slovenia.
Interests: head and neck tumors; narrow band imaging; oropharyngeal neoplasms
Prof. Dr. Primož Strojan

E-Mail Website
Guest Editor
Department of Radiation Oncology, Institute of Oncology, Zaloška 2, 1000 Ljubljana, Slovenia
Interests: head and neck cancer; neuroendocrine neoplasms of the head and neck; melanoma and non-melanoma skin cancer; radiochemotherapy; radiotherapy-related toxicities
Special Issues, Collections and Topics in MDPI journals
Dr. Robert Šifrer

E-Mail Website
Guest Editor
Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Zaloška 2, 1000 Ljubljana, Slovenia
Interests: head and neck cancer; otorhinolaryngology

Special Issue Information

Dear Colleagues,

Among all cancers, head and neck cancer (HNC) ranks sixth in frequency. Due to the complexity of the head and neck region, HNC might cause many symptoms and clinical signs. Curative organ-sparing procedures encompass various irradiation or chemoradiotherapy protocols. In contrast, curative surgical treatment ranges from conservative surgery (i.e., endoscopic or open partial laryngectomy, endoscopic resection of sinonasal cancer, sleeve resection of the external auditory canal) to extensive surgical procedures (i.e., total laryngectomy, pharyngectomy, radical maxillectomy, temporal bone resection, complex reconstruction). The type of treatment is always multidisciplinary and has to be accepted by hosting multi-board discussions. It depends on the tumor (histology, extension, disfunction) and patient factors (general conditions, previous treatments, personal preferences). Therefore, the decision is not always straightforward and easy, but it is complex and well thought out.

The importance of the diagnostics of HNC cannot be over emphasized. With the advent of modern endoscopes, surgical microscopes, advanced imaging, enhanced endoscopy, enhanced contact endoscopy, advances in anesthesiology in recent decades, and artificial intelligence in recent years, diagnostics has made an important advancement. All these improvements lead to a more thorough delineation of the extension of cancer and adequate planning of therapy. Nevertheless, they serve our patients the most, after all.

Authors are kindly invited and encouraged to upload their original manuscripts about their experiences and research in the field of diagnostics in otorhinolaryngology in regard to HNC for this Special Issue of Diagnostics.

Prof. Dr. Nina Gale
Prof. Dr. Primož Strojan
Dr. Robert Šifrer
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • head and neck cancer
  • otorhinolaryngology
  • symptoms and clinical signs

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Published Papers (4 papers)

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11 pages, 1012 KiB  
Article
Accuracy of COuGH RefluX Score as a Predictor of Gastroesophageal Reflux Disease (GERD) in Mexican Patients with Chronic Laryngopharyngeal Symptoms: A Cross-Sectional Study
by Javier Ivanovychs Carrillo-Rojas, Salvador Zavala-Villegas, Guadalupe Morales-Osorio, Fausto Daniel García-García, Mauricio González-Navarro, Viridiana Montsserrat Mendoza-Martínez and Nallely Bueno-Hernández
Diagnostics 2025, 15(5), 636; https://doi.org/10.3390/diagnostics15050636 - 6 Mar 2025
Viewed by 667
Abstract
Background/Objectives: Gastroesophageal reflux disease (GERD) is associated with extraesophageal syndromes that require an objective assessment of abnormal acid exposure to establish the diagnosis. The COuGH RefluX score has been proposed as a diagnostic tool for GERD in patients with chronic laryngopharyngeal symptoms. The [...] Read more.
Background/Objectives: Gastroesophageal reflux disease (GERD) is associated with extraesophageal syndromes that require an objective assessment of abnormal acid exposure to establish the diagnosis. The COuGH RefluX score has been proposed as a diagnostic tool for GERD in patients with chronic laryngopharyngeal symptoms. The aim of the study was to evaluate the diagnostic performance of the COuGH RefluX score in the Mexican population. Methods: A cross-sectional study was conducted in patients with chronic laryngopharyngeal symptoms. Patients with cough, globus, sore throat, dysphonia, and/or throat clearing of ≥8 weeks duration, 24 h pH-impedance monitoring (pH-IM), and without objective evidence of GERD (defined as acid exposure time >6%) were included in the study. The COuGH RefluX score tool was applied and stratified as low probability with ≤2.5 points, intermediate probability with 3.0 to 4.5 points, and high probability with ≥5.0 points. The kappa test assessed the concordance between both tests; the area under the curve (AUR), sensitivity (S), specificity (E), positive predictive value (PPV), and negative predictive value (NPV) were calculated for each result. Results: 164 patients were included; the prevalence of GERD by pH-IM was 32% vs. 40.3% by COuGH RefluX score, the agreement was weak (κ = 0.34; p < 0.001), but the AUR was good (0.720 ± 0.17; p < 0.001). A score ≤ 2.5 had S = 49%, E = 88%, PPV = 89%, and NPV = 42% to rule out proven GERD, while a score ≥ 5 had S = 65%, E = 71%, PPV = 52%, and NPV = 82% for proven GERD. Conclusions: The COuGH RefluX score has low sensitivity but adequate specificity for GERD diagnosis in Mexican patients with chronic laryngopharyngeal symptoms. Full article
(This article belongs to the Special Issue Clinical Diagnosis of Otorhinolaryngology)
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11 pages, 1006 KiB  
Article
Cross-Cultural Adaptation and Validation of the Malayalam Version of the Vocal Tract Discomfort Scale
by Sunil Kumar Ravi, Srushti Shabnam, Saraswathi Thupakula, Vijaya Kumar Narne, Krishna Yerraguntla, Abdulaziz Almudhi, Irfana Madathodiyil, Feby Sajan and Kochette Ria Jacob
Diagnostics 2025, 15(3), 259; https://doi.org/10.3390/diagnostics15030259 - 23 Jan 2025
Viewed by 601
Abstract
Background: Voice disorders significantly impact individuals’ physical, functional, and emotional well-being, necessitating comprehensive assessment tools. The Vocal Tract Discomfort Scale (VTDS) assesses the frequency and severity of vocal discomfort symptoms. Despite its global adaptations, no validated Malayalam version has existed. This study aimed [...] Read more.
Background: Voice disorders significantly impact individuals’ physical, functional, and emotional well-being, necessitating comprehensive assessment tools. The Vocal Tract Discomfort Scale (VTDS) assesses the frequency and severity of vocal discomfort symptoms. Despite its global adaptations, no validated Malayalam version has existed. This study aimed to adapt and validate the VTDS for Malayalam speakers (VTDS-M). Method: The study was conducted in two phases: Phase I involved translation and cultural adaptation of VTDS into Malayalam, followed by content validation by native-speaking speech language pathologists; Phase II involved validation of VTDS-M on 150 professional voice users, categorized into normophonic (n = 105) and dysphonic (n = 45) groups based on otolaryngological and perceptual voice evaluations. Participants completed VTDS-M and VHI-M (Voice Handicap Index—Malayalam). Results: The results showed strong internal consistency (Cronbach’s α = 0.827 for frequency, 0.813 for severity). Significant differences were observed between groups for VTDS-M subscales and total scores, confirming its discriminatory capability. ROC analysis established a cut-off score of 11.5, with an AROC of 0.749, 64.4% sensitivity, and 79.0% specificity. Also, VTDS-M correlated positively with VHI-M, especially the physical and emotional subscales. Conclusions: VTDS-M demonstrated reliable psychometric properties and diagnostic accuracy, making it a valuable tool for assessing vocal discomfort in Malayalam-speaking populations specifically among the professional voice users. Future studies should explore its applicability to non-professional voice users with varied severity levels of dysphonia. Full article
(This article belongs to the Special Issue Clinical Diagnosis of Otorhinolaryngology)
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13 pages, 2449 KiB  
Article
Incidence of Carotid Blowout Syndrome in Patients with Head and Neck Cancer after Radiation Therapy: A Cohort Study
by Jian-Lin Jiang, Joseph Tung-Chieh Chang, Chih-Hua Yeh, Ting-Yu Chang, Bing-Shen Huang, Pi-Shan Sung, Chien-Yu Lin, Kang-Hsing Fan, Yi-Chia Wei and Chi-Hung Liu
Diagnostics 2024, 14(12), 1222; https://doi.org/10.3390/diagnostics14121222 - 9 Jun 2024
Cited by 1 | Viewed by 1838
Abstract
Carotid blowout syndrome (CBS) is a rare yet life-threatening complication that occurs after radiation therapy (RT). This study aimed to determine the incidence of CBS in patients with head and neck cancer (HNC) undergoing contemporary RT and to explore potential discrepancies in the [...] Read more.
Carotid blowout syndrome (CBS) is a rare yet life-threatening complication that occurs after radiation therapy (RT). This study aimed to determine the incidence of CBS in patients with head and neck cancer (HNC) undergoing contemporary RT and to explore potential discrepancies in the risk of CBS between nasopharyngeal cancer (NPC) and non-NPC patients. A total of 1084 patients with HNC who underwent RT between 2013 and 2023 were included in the study. All patients were under regular follow-ups at the radio-oncology department, and underwent annual contrast-enhanced computed tomography and/or magnetic resonance imaging for cancer recurrence surveillance. Experienced neuroradiologists and vascular neurologists reviewed the recruited patients’ images. Patients were further referred to the neurology department for radiation vasculopathy evaluation. The primary outcome of this study was CBS. Patients were categorized into NPC and non-NPC groups and survival analysis was employed to compare the CBS risk between the two groups. A review of the literature on CBS incidence was also conducted. Among the enrolled patients, the incidence of CBS in the HNC, NPC, and non-NPC groups was 0.8%, 0.9%, and 0.7%, respectively. Kaplan–Meier analysis revealed no significant difference between the NPC and non-NPC groups (p = 0.34). Combining the findings for our cohort with those of previous studies revealed that the cumulative incidence of CBS in patients with HNC is 5% (95% CI = 3–7%) after both surgery and RT, 4% (95% CI = 2–6%) after surgery alone, and 5% (95% CI = 3–7%) after RT alone. Our findings indicate a low incidence of CBS in patients with HNC undergoing contemporary RT. Patients with NPC may have a CBS risk close to that of non-NPC patients. However, the low incidence of CBS could be a potentially cause of selection bias and underestimation bias. Full article
(This article belongs to the Special Issue Clinical Diagnosis of Otorhinolaryngology)
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6 pages, 1510 KiB  
Case Report
The Thyrohyoid Syndrome: Promoting Awareness with a Case Report and Systematic Review of the Literature
by Raphael Jeker, Linda März and Lukas Horvath
Diagnostics 2024, 14(12), 1227; https://doi.org/10.3390/diagnostics14121227 - 12 Jun 2024
Viewed by 2292
Abstract
Objective: Neck pain is commonly referred to an ENT specialist and can be caused by the little-known inflammatory condition of the lateral thyrohyoid ligament. The pathophysiology of this condition is believed to be inflammation subsequent to over-exertion or cervical trauma. Typically, patients present [...] Read more.
Objective: Neck pain is commonly referred to an ENT specialist and can be caused by the little-known inflammatory condition of the lateral thyrohyoid ligament. The pathophysiology of this condition is believed to be inflammation subsequent to over-exertion or cervical trauma. Typically, patients present with chronic unilateral neck pain. Elicitation of localized tenderness over the axis of the lateral thyrohyoid ligament on palpation is a key finding for its diagnosis. We present an unusual case with an acute course and subcutaneous inflammation and discuss its management in an effort to raise awareness for this often-misdiagnosed syndrome. Methods: A systematic literature research on PubMed was performed selecting patients with a definitive diagnosis of thyrohyoid syndrome or lateral thyrohyoid ligament syndrome. Results: We collected 54 cases from three studies. This condition is an important differential diagnosis for acute or chronic antero-lateral or unilateral neck pain. Conclusion: No specific radiological findings are defined and a CT scan is therefore not necessary for its diagnosis, but ultrasound is a useful tool to primarily assess any neck lesion. Once the diagnosis is made, a local infiltration of steroids is the most sustainable treatment option and relapse prevention. Full article
(This article belongs to the Special Issue Clinical Diagnosis of Otorhinolaryngology)
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