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

Rachmat Hidayat — 2026-07-31

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

Ketut Tadeus Max Nurcahya Pinatih — 2026-07-31

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

Ni Luh Sartika Sari — 2026-07-31

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.

Incidence, Mortality, Sex Differences, and Demographic Projections for Six Selected Head and Neck Cancer Site Groups in Indonesia: A Secondary Analysis of GLOBOCAN 2024 Modeled Estimates

Lisye Tiur Simanjuntak — 2026-08-05

Background: Nationally representative data on the heterogeneous malignancies managed in head and neck oncology remain limited in Indonesia.

Objective: To estimate incidence, mortality, sex differences, and demographic change for six selected head and neck cancer site groups in Indonesia.

Methods: We performed a descriptive secondary analysis of GLOBOCAN 2024 aggregate modeled estimates (version 08 July 2026). The definition included lip and oral cavity (C00–C06), salivary glands (C07–C08), oropharynx (C09–C10), nasopharynx (C11), hypopharynx (C12–C13), and larynx (C32). Counts and age-standardized rates were aggregated across mutually exclusive sites. Indonesia was compared descriptively with four reference populations. Constant-rate Cancer Tomorrow projections and two definitional sensitivity analyses were evaluated. Source uncertainty distributions were unavailable; therefore, confidence intervals were not constructed.

Results: An estimated 28,226 cases and 16,025 deaths occurred in 2024; summed ASIR and ASMR were 8.91 and 5.06 per 100,000. Nasopharyngeal cancer contributed 16,064 cases (56.9%) and 8,718 deaths (54.4%). Male rates exceeded female rates: ASIR 13.19 versus 5.18 and ASMR 7.73 versus 2.77. With 2024 rates held constant, annual cases increased to 46,895 (+66.1%) and deaths to 27,900 (+74.1%) by 2050. All 21 validation checks passed.

Conclusion: Indonesia's selected head and neck cancer burden is dominated by nasopharyngeal cancer and higher male rates. These modeled estimates support prevention, registry strengthening, and planning hypotheses but do not measure stage, utilization, treatment need, survival, cost, or causal effects.

Otitis Media and Upper Respiratory Infection Health Loss in 11 Current ASEAN Member States, 1990–2023

Imanuel Simbolon — 2026-08-06

Background: Otitis media and upper respiratory infections (URIs) are distinct Global Burden of Disease (GBD) causes but form a clinically relevant comparative pair for otorhinolaryngology.

Objective: To quantify their health loss in 11 current ASEAN member states.

Methods: We analysed GBD 2023 estimates for both sexes from 1990 to 2023. Outcomes were all-age disability-adjusted life-year (DALY) numbers, age-standardized DALY rates, and DALY numbers and rates at ages 0–14 years. Country-specific estimated annual percentage changes (EAPCs) used log-linear regression with Newey–West 95% confidence intervals. Analyses were descriptive and non-causal.

Results: The sum of 11 national URI DALY point estimates increased from 372,296 in 1990 to 476,741 in 2023 (+28.1%), while the unweighted cross-country median age-standardized rate fell 10.9% to 66.2 per 100,000. Otitis media DALYs increased from 175,399 to 191,971 (+9.4%), while the corresponding median rate fell 19.7% to 29.0 per 100,000. All 22 country-cause EAPC point estimates were negative. Thailand had the highest 2023 URI rate and Cambodia the highest otitis media rate. Ages 0–14 years accounted for 35.8% and 39.1% of summed URI and otitis media DALYs, respectively.

Conclusion: Declining standardized rates coexisted with increasing absolute health loss. DALYs provide a planning signal rather than measured clinical workload; translation into otolaryngology services requires local diagnostic, hearing, referral, and capacity data.