Sriwijaya Journal of Otorhinolaryngology

Secondary Cross-Platform Transcriptomic Reanalysis of Laryngeal Squamous Cell Carcinoma Identifies Reproducible Tumor-Associated Programs but No Independently Validated Prognostic Biomarker

2026-07-31T04:10:35+00:00

Background: Public transcriptomes can reveal reproducible laryngeal squamous cell carcinoma (LSCC) programs, but differential expression alone does not establish prognosis.

Objective: To evaluate paired tumor-associated expression changes and test whether any gene met independent prognostic criteria.

Methods: Depositor-processed GSE127165 RNA-sequencing data from 57 paired LSCC and adjacent-mucosa specimens were analyzed with patient-blocked limma-trend after predefined filtering of log₂(FPKM + 1) values. Differentially expressed features required Benjamini–Hochberg false-discovery rate (FDR) <0.05 and absolute paired mean difference ≥1. Functional over-representation used g:Profiler. Expression replication used 23 paired TCGA larynx-labeled cases. Prognostic associations were assessed continuously in GSE27020 training (n=59) and validation (n=50) cohorts and 116 TCGA larynx-labeled tumors, with progression-free interval primary and overall survival secondary.

Results: Of 11,908 tested features, 230 were upregulated and 205 downregulated. Excluding three quality-control-associated pairs retained 418 primary calls; quantile normalization retained 396. Among 327 measurable discovery features in TCGA, 184 replicated at FDR <0.05 with the same direction; directional concordance was 89.0% and effect correlation was ρ=0.774. Keratinization, extracellular-matrix, adhesion, and inflammatory programs were over-represented. No gene satisfied the operational prognostic criterion. SERPINE1 was exploratory: training HR=2.09, validation HR=1.53, and TCGA progression-free interval HR=1.28; the modified Knapp–Hartung pooled inference was non-significant.

Conclusion: LSCC showed reproducible bulk-tissue expression programs, but no single differentially expressed gene qualified as an independently validated prognostic biomarker. These findings support biological prioritization, not clinical decision-making.

Concurrent Retropharyngeal and Cervical (Colli) Abscess in a Three-Year-Old Child: Diagnostic Challenges, Multidisciplinary Management, and Favourable Surgical Outcome

2026-07-31T08:35:38+00:00

Background: Retropharyngeal abscess is an uncommon but potentially life-threatening deep neck space infection of early childhood that may compromise the airway and, when it extends into adjacent compartments, endanger the great cervical vessels; its coexistence with a concurrent cervical (colli) abscess and carotid-space involvement in a toddler is rarely documented.

Objective: This report describes the diagnostic reasoning, the multidisciplinary airway-centred management, and the favourable outcome of such a case.

Case presentation: A three-year-old boy presented with a twenty-day history of a progressively enlarging, erythematous left neck swelling and a fourteen-day history of intermittent fever unresponsive to oral antibiotics, followed by vomiting of blood-stained pus. He was febrile with a muffled voice and a tender, warm, non-fluctuant left cervical mass. The leukocyte count was elevated and haemoglobin mildly reduced. Contrast-enhanced computed tomography showed a rim-enhancing retropharyngeal collection extending to the carotid space and left neck, abutting the left carotid artery and displacing the trachea, with cervical lymphadenopathy, pan-sinusitis, and pneumonia. After two negative SARS-CoV-2 tests, incision and drainage under general anaesthesia with a secured airway evacuated pus from the cervical component, supported by intravenous ceftriaxone and metronidazole; the child recovered fully.

Conclusion: Delayed recognition of paediatric deep neck infection permits dangerous multicompartment spread; integrated imaging-operative judgement and airway-focused multidisciplinary care are the decisive determinants of a favourable outcome.

Inferior Turbinate Hypertrophy and SFAR-Defined Allergic Rhinitis in Chronic Suppurative Otitis Media: A Cross-Sectional Study at Ngoerah Hospital, Bali

2026-07-31T08:35:50+00:00

Background: Allergic rhinitis (AR) is an IgE-mediated inflammatory disease of the nasal mucosa and a recognised risk factor for chronic suppurative otitis media (CSOM) through Eustachian tube dysfunction, yet Indonesian data on this comorbidity remain scarce.

Objective: To characterise Score for Allergic Rhinitis (SFAR)-defined AR and its association with inferior turbinate hypertrophy among CSOM patients at a tertiary ENT referral centre in Bali.

Methods: A descriptive cross-sectional study, reported in accordance with the STROBE statement, consecutively enrolled 26 CSOM patients attending the ENT outpatient clinic of Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, from November to December 2025. AR was screened using the validated SFAR questionnaire (cut-off ≥7). Data were analysed with Wilson 95% confidence intervals (CI), bivariate odds ratios (OR), multivariable logistic regression, and receiver-operating-characteristic (ROC) analysis.

Results: SFAR-defined AR was identified in 17 patients (65.4%; 95% CI 46.2–80.6). Most were female (65.4%) and aged 30–39 years (26.9%). Predominant symptoms were sneezing (42.3%), rhinorrhoea (34.6%) and nasal obstruction (23.1%); house dust was the leading trigger (94.1%). Inferior turbinate hypertrophy (80.8%) was strongly associated with AR (OR 12.8; 95% CI 1.15–142.6; p=0.034), and the SFAR score discriminated turbinate hypertrophy with an area under the curve of 0.776 (95% CI 0.527–1.00).

Conclusion: Comorbid AR is highly prevalent among CSOM patients. Routine SFAR screening, particularly when inferior turbinate hypertrophy is present, may enable earlier AR detection and more comprehensive middle-ear management in Indonesian ENT practice.