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Publications (10 of 54) Show all publications
Erlandsson, A., Lundahl, M., Holm, A. & Olofsson, K. (2025). A descriptive study on laryngotracheal stenosis in the Northern Sweden. Acta Oto-Laryngologica
Open this publication in new window or tab >>A descriptive study on laryngotracheal stenosis in the Northern Sweden
2025 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: We have in a retrospective design used laryngotracheal stenosis (LTS) classification to describe stenotic subsites and through international classification of disease (ICD-10) codes its diagnostic origins. The diagnostic challenge posed by varied etiologies can lead to treatment delays, in potentially life-threatening conditions.

Aims/objectives: The purpose of this study is to explore and ascertain the etiological and anatomical distribution of LTS to reduce misdiagnosis and as such delayed access to adequate treatment.

Material and methods: The included cases were consecutively recruited between 1999 and 2019, all labeled with relevant ICD-10 codes for the research question in combination with medical records for evaluation of its accuracy. The primary outcome was the causes, and anatomical locations of LTS.

Results: A total of 1441 records were screened, with 1071 cases meeting the inclusion criteria. The most common cause was unilateral vocal fold immobility, followed by glottic cancer. Benign causes were more prevalent than malignant ones, with glottic-level stenoses being most frequent.

Conclusion and significance: Unilateral vocal fold immobility is the most prevalent cause of LTS in our material. These findings can enhance diagnostic efficiency by increasing clinical awareness of common etiologies.

Place, publisher, year, edition, pages
Taylor & Francis, 2025
Keywords
diagnostic errors, Laryngotracheal stenosis, subglottic stenosis, unilateral vocal fold immobility
National Category
Oto-rhino-laryngology
Identifiers
urn:nbn:se:umu:diva-239172 (URN)10.1080/00016489.2025.2503000 (DOI)001487491700001 ()40358125 (PubMedID)2-s2.0-105005407761 (Scopus ID)
Funder
Cancerforskningsfonden i Norrland, AMP-19-973Cancerforskningsfonden i Norrland, AMP-211033Region Västerbotten, RVB 967352 (2022)Region Västerbotten, RVB 979607(2023)Region Västerbotten, RVB 992626 (2024)
Available from: 2025-06-16 Created: 2025-06-16 Last updated: 2025-06-16
Schindele, A., Holm, A., Kraft, S., Nylander, K., Allard, A. & Olofsson, K. (2025). Cross-evaluating Epstein-Barr virus, human papilloma virus, human cytomegalovirus and human adenovirus in nasal polyps and turbinate mucosa. Acta Oto-Laryngologica, 145(2), 164-167
Open this publication in new window or tab >>Cross-evaluating Epstein-Barr virus, human papilloma virus, human cytomegalovirus and human adenovirus in nasal polyps and turbinate mucosa
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2025 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 145, no 2, p. 164-167Article in journal (Refereed) Published
Abstract [en]

Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a common disease in which inflammatory responses to exogenic stressors, such as viral infections, has been recognised. The role of viruses in CRSwNP pathogenesis is unclear.

Aims/objectives: We aimed to characterise Epstein-Barr virus (EBV), human papillomavirus (HPV), human cytomegalovirus (HCMV), and human adenovirus (HAdV) in nasal polyps and adjacent paired healthy turbinate mucosa.

Materials and methods: We used real-time PCR for EBV, HCMV, and HAdV DNA detection, combined PCR/microarrays for HPV detection and genotyping, in samples from 45 patients with CRSwNP. Additionally, we used EBER in situ hybridisation for EBV detection.

Results: EBV detection with EBER-ISH was significantly higher in polyps (36%) versus turbinate mucosa (12%). None of the viral comparisons with PCR between polyps and turbinate mucosa for EBV-, HCMV- or HAdV-DNA showed statistically significant differences. All samples were HPV negative.

Conclusions and significance: We report higher expression of EBV in nasal polyps (36%) than in adjacent healthy turbinate mucosa (12%), using a valid method; EBER-ISH in 45 patients with CRSwNP. EBV might be a possible stressor that can trigger polypoid inflammation.

Place, publisher, year, edition, pages
Taylor & Francis, 2025
Keywords
Chronic rhinosinusitis with nasal polyps, EBER-ISH, Epstein-Barr virus, HAdV, HCMV, HPV, nasal mucosa
National Category
Microbiology in the medical area Otorhinolaryngology
Identifiers
urn:nbn:se:umu:diva-233990 (URN)10.1080/00016489.2024.2445025 (DOI)001387611900001 ()39921355 (PubMedID)2-s2.0-85214259351 (Scopus ID)
Funder
Cancerforskningsfonden i NorrlandRegion Jämtland HärjedalenRegion Västerbotten
Available from: 2025-01-14 Created: 2025-01-14 Last updated: 2025-05-27Bibliographically approved
Koro, E., Ögren, E., Olofsson, K. & Werner, M. (2024). Evaluation of magnetic resonance imaging to detect cholesteatoma in clinical healthcare. Acta Oto-Laryngologica, 144(3), 193-197
Open this publication in new window or tab >>Evaluation of magnetic resonance imaging to detect cholesteatoma in clinical healthcare
2024 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 144, no 3, p. 193-197Article in journal (Refereed) Published
Abstract [en]

Background: Non-Echo-Planar Diffusion Weighed Magnetic Resonance Imaging (non-EPI DW MRI) plays a role in the planning of cholesteatoma surgery.

Objectives: To outline the usage of Non-EPI DW MRI in cholesteatoma diagnostics and to determine its accuracy, using otosurgery diagnostics as reference standard. Material and

Methods: A retrospective descriptive study. All subjects operated, with suspicion of cholesteatoma as indication, that had a preceding examination with non-EPI DW MRI, between October 2010 and March 2019. Calculating sensitivity, specificity, predicative values, and likelihood ratios, using non-EPI DW MRI as index test and diagnosis from otosurgery as reference standard.

Results: Fifty-two subject episodes were included. Non-EPI DW MRI had a sensitivity of 0.50, specificity of 0.75, positive and negative predictive values of 0.74 and 0.52 and, positive and negative likelihood ratios of 2.0 and 0.67 respectively.

Conclusions and Significance: There is a clear annual trend with increased numbers of executed examinations during the study period. The diagnostic accuracy of non-EPI DW MRI does not reach acceptable levels in the existing everyday routine practice conditions. The accuracy of the examination increases when interpreted by an experienced radiologist and when using the definition of cholesteatoma recommended by EAONO/JOS.

Place, publisher, year, edition, pages
Taylor & Francis, 2024
Keywords
Cholesteatoma, data accuracy, ear, magnetic resonance imaging, middle, non-epi diffusion weighted imaging, sensitivity and specificity, temporal bone
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-223954 (URN)10.1080/00016489.2024.2344820 (DOI)001208216000001 ()38662877 (PubMedID)2-s2.0-85191260879 (Scopus ID)
Funder
Region Västernorrland, LVNFOU92905The Kempe FoundationsUmeå University, FS 2.1.6-2408-18Umeå University, KV00-1.3-20-151
Available from: 2024-05-02 Created: 2024-05-02 Last updated: 2024-07-19Bibliographically approved
Schindele, A., Al-Sabtti, S. & Olofsson, K. (2024). Human papilloma virus (HPV) vaccination is associated with reduced number of surgical treatments, an observational study on recurrent respiratory papillomatosis in Northern Sweden. Acta Oto-Laryngologica, 144(1), 71-75
Open this publication in new window or tab >>Human papilloma virus (HPV) vaccination is associated with reduced number of surgical treatments, an observational study on recurrent respiratory papillomatosis in Northern Sweden
2024 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 144, no 1, p. 71-75Article in journal (Refereed) Published
Abstract [en]

Background: Recurrent respiratory papillomatosis (RRP) is a wart-like lesion mainly affecting the larynx, caused by human papillomavirus (HPV) genotypes 6 and 11. The disease affects both children and adults, and there is no cure. Surgery is the current symptom-relieving treatment; however, HPV vaccination is used as an adjuvant treatment.

Aims and Objectives: The aims were to study effects of HPV vaccination in RRP cases and to compare juvenile-onset to adult-onset disease and high treatment frequency (TF) to low TF cases.

Material and Methods: Medical records of RRP patients were studied from May 2006 to January 2023. Eighty-five RRP cases, tested for HPV genotypes with PapilloCheck®, were included. Vaccination- onset- and treatment analysis were performed.

Results: Twelve percent of the cases were vaccinated. The number of surgeries decreased from 2.0 to 0.8/year after HPV vaccination. Most cases had an adult-onset and less than one treatment per year. Juvenile-onset cases had a higher vaccination treatment ratio compared to adult-onset.

Conclusions: HPV vaccination was associated with a lower number of treatments per year, supporting the use of vaccination as an adjuvant treatment.

Significance: Vaccination as adjuvant treatment to surgery may lead to increased quality of life for RRP patients and saved healthcare resources.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2024
Keywords
human papillomavirus viruses, papillomavirus vaccines, Recurrent respiratory papillomatosis
National Category
Otorhinolaryngology
Identifiers
urn:nbn:se:umu:diva-222345 (URN)10.1080/00016489.2024.2316264 (DOI)001177976800001 ()2-s2.0-85186863889 (Scopus ID)
Available from: 2024-03-18 Created: 2024-03-18 Last updated: 2025-04-24Bibliographically approved
Erlandsson, A., Lundquist, A. & Olofsson, K. (2024). Mapping quality of life after balloon dilatation in subglottic stenosis using dyspnea index and short form health survey-36. European Archives of Oto-Rhino-Laryngology, 281(7), 3701-3706
Open this publication in new window or tab >>Mapping quality of life after balloon dilatation in subglottic stenosis using dyspnea index and short form health survey-36
2024 (English)In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 281, no 7, p. 3701-3706Article in journal (Refereed) Published
Abstract [en]

Purpose: An accurate diagnosis and proper treatment plan are required to restore an adequate patent airway in fibrotic subglottic stenosis (SGS). Currently, the definitive treatment entails single-stage balloon dilatation with steroid injections. The primary aim was to evaluate successful airway restoration and general quality of life in cases with SGS in northern Sweden using robust patient reported outcomes.

Methods: All participants with need of surgical treatment due to SGS that had been referred to the department of otorhinolaryngology, University Hospital of Umeå from September 2020 to August 2023 was included. Exclusion criteria included malignant, extrathoracic or cartilaginous cause, age < 18 years, or incompetent to sign consent documents. We assessed the patient-reported outcome measures pre- as well as 3 months postoperatively.

Results: Of the 40 cases fulfilling the eligibility criteria’s, 33 cases completed the Dyspnea index (DI) and the short form health survey (SF-36) pre- as well as 3 months post-operatively. Receiver operating characteristics showed significant improvement in DI as well as in SF 36 scores post-operatively.

Conclusions: Evaluation of balloon dilatation in SGS in this cohort follow-up analysis shows clear improvement in patient quality of life using robust PROM 3 months postoperatively, ensuring the use of a safe and well-tolerated procedure.

Place, publisher, year, edition, pages
Springer Nature, 2024
Keywords
Balloon dilatation, Dyspnea index, Short form healthy survey, Subglottic stenosis
National Category
Otorhinolaryngology
Identifiers
urn:nbn:se:umu:diva-224264 (URN)10.1007/s00405-024-08667-0 (DOI)001214210400002 ()38705896 (PubMedID)2-s2.0-85192082165 (Scopus ID)
Funder
Cancerforskningsfonden i Norrland, AMP-19-973Cancerforskningsfonden i Norrland, AMP-21 1033Region Västerbotten, 967352Region Västerbotten, 979607
Available from: 2024-05-14 Created: 2024-05-14 Last updated: 2024-07-26Bibliographically approved
Erlandsson, A., Werner, M., Holm, A., Schindele, A. & Olofsson, K. (2023). Balloon dilatation versus CO2 laser surgery in subglottic stenosis: a retrospective analysis of therapeutic approaches. Acta Oto-Laryngologica, 143(6), 528-535
Open this publication in new window or tab >>Balloon dilatation versus CO2 laser surgery in subglottic stenosis: a retrospective analysis of therapeutic approaches
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2023 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 143, no 6, p. 528-535Article in journal (Refereed) Published
Abstract [en]

Background: Subglottic stenosis (SGS) is a narrowing of the airway just below the vocal folds. The cause of SGS and the optimal care for these patients, have remained elusive. Endoscopic surgery of SGS using either balloon or CO2 laser is associated with recurrence.

Aims and objectives: Our aim is to compare surgery free intervals (SFI) between these two methods applied in two different timeframes. The knowledge gained from this project can support decision-making regarding surgical method choice.

Material and methods: Participants were retrospectively identified using medical records between 1999–2021. We used pre-defined broad inclusion criteria to identify cases using the International Classification of Disease (ICD-10). Primary outcome was surgery free intervals.

Results: 141 patients were identified, 63 met the criteria for SGS, and were included in the analysis. Results show no significant difference in SFI, comparing balloon dilatation and CO2 laser.

Conclusion: These findings demonstrate no detected difference in treatment intervals (SFI) when comparing these two commonly used surgical alternatives for SGS.

Significance: The outcome of this report supports surgical freedom of choice based on the surgeon’s experience and skill and ushes for further studies on patient experience regarding these two therapeutic approaches.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
balloon dilatation, CO2 laser, idiopathic subglottic stenosis, Subglottic stenosis, surgery free intervals
National Category
Otorhinolaryngology Surgery
Identifiers
urn:nbn:se:umu:diva-212260 (URN)10.1080/00016489.2023.2222756 (DOI)001011786800001 ()37343275 (PubMedID)2-s2.0-85164105528 (Scopus ID)
Funder
Cancerforskningsfonden i Norrland, AMP 18-925Cancerforskningsfonden i Norrland, AMP-19-973Region Västerbotten, RV 967352Region Västerbotten, RV 979607
Available from: 2023-07-20 Created: 2023-07-20 Last updated: 2023-07-20Bibliographically approved
Schindele, A., Holm, A., Nylander, K., Allard, A. & Olofsson, K. (2022). Mapping human papillomavirus, Epstein–Barr virus, cytomegalovirus, adenovirus, and p16 in laryngeal cancer. Discover Oncology, 13(1), Article ID 18.
Open this publication in new window or tab >>Mapping human papillomavirus, Epstein–Barr virus, cytomegalovirus, adenovirus, and p16 in laryngeal cancer
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2022 (English)In: Discover Oncology, E-ISSN 2730-6011, Vol. 13, no 1, article id 18Article in journal (Refereed) Published
Abstract [en]

Purpose: Apart from tobacco and alcohol, viral infections are proposed as risk factors for laryngeal cancer. The occurrence of oncogenic viruses including human papilloma virus (HPV) and Epstein–Barr virus (EBV), in laryngeal squamous cell carcinoma (LSCC) varies in the world. Carcinogenesis is a multi-step process, and the role of viruses in LSCC progression has not been clarified. We aimed to analyze the presence and co-expression of HPV, EBV, human cytomegalovirus (HCMV) and human adenovirus (HAdV) in LSCC. We also investigated if p16 can act as surrogate marker for HPV in LSCC.

Methods: Combined PCR/microarrays (PapilloCheck®) were used for detection and genotyping of HPV DNA, real-time PCR for EBV, HCMV and HAdV DNA detection, and EBER in situ hybridization (EBER-ISH) for EBV detection in tissue from 78 LSCC patients. Additionally, we analyzed p16 expression with immunohistochemistry.

Results: Thirty-three percent (26/78) of LSCC tumor samples were EBV positive, 9% (7/78) HCMV positive and 4% (3/78) HAdV positive. Due to DNA fragmentation, 45 samples could not be analyzed with PapilloCheck®; 9% of the remaining (3/33) were high-risk HPV16 positive and also over-expressed p16. A total of 14% (11/78) of the samples over-expressed p16.

Conclusion: These findings present a mapping of HPV, EBV, HCMV and HAdV, including the HPV surrogate marker p16, in LSCC in this cohort. Except for EBV, which was detected in a third of the samples, data show viral infection to be uncommon, and that p16 does not appear to be a specific surrogate marker for high-risk HPV infection in LSCC.

Place, publisher, year, edition, pages
Springer, 2022
National Category
Cancer and Oncology Otorhinolaryngology
Research subject
Oncology
Identifiers
urn:nbn:se:umu:diva-193581 (URN)10.1007/s12672-022-00475-4 (DOI)000771496000002 ()35312853 (PubMedID)2-s2.0-85126886934 (Scopus ID)
Available from: 2022-04-19 Created: 2022-04-19 Last updated: 2022-10-12Bibliographically approved
Sobti, A., Sakellariou, C., Nilsson, M., Schwartz, S., Olofsson, K., Rydell, R., . . . Forslund, O. (2021). Immune delineation of laryngeal papilloma reveals enhanced neutrophil associated gene profile [Letter to the editor]. European Journal of Immunology, 51(10), 2535-2539
Open this publication in new window or tab >>Immune delineation of laryngeal papilloma reveals enhanced neutrophil associated gene profile
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2021 (English)In: European Journal of Immunology, ISSN 0014-2980, E-ISSN 1521-4141, Vol. 51, no 10, p. 2535-2539Article in journal, Letter (Refereed) Published
Abstract [en]

Laryngeal papilloma (LP) is a rare benign disease, caused by recurrent multisite papillomas that are referred to as recurrent respiratory papillomatosis (RRP). RRP is caused primarily by two types of human papillomavirus (HPV): HPV6 and HPV11. The immune dysregulation within the microenvironment of the lesions has been shown to likely play a role in the development of RRP. The present study aimed at analyzing the transcriptional profile of immune response genes and cancer-related genes in the LP microenvironment. We used the NanoString® nCounter® analysis system to study expression of 730 genes among seven paired samples of LP and healthy laryngeal (HL) tissue. qRT-PCR and flow cytometric analysis was performed to confirm identified transcripts and follow-up scores of infiltrating immune cells, respectively. In total, 113 differentially expressed transcripts were detected of which 37 showed increased expression levels and 76 decreased expression levels in the LP samples compared to the HL samples (fold change ≥ 2). Transcripts with increased expression levels included S100As (A7, A8, and A12), CEACAM1, neutrophil activation associated cytokines (IL8), chemokines (CXCL6), and IL receptors, e.g., IL4R. Transcripts with decreased expression in LP were associated with innate and adaptive immunity. Overall, HPV6 and 11 were present in 67% and 33% of the patients, respectively. There was a significant increase in neutrophils and a significant decrease in CD8+ T cells in LP. LP samples display an immune profile characterized by enhanced expression of neutrophilic markers and significantly reduced T cell-associated markers.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
B cells, CD8 T cells, immune profile, laryngeal papilloma, neutrophils
National Category
Immunology in the medical area
Identifiers
urn:nbn:se:umu:diva-186918 (URN)10.1002/eji.202149202 (DOI)000685708500001 ()34337750 (PubMedID)2-s2.0-85112438146 (Scopus ID)
Available from: 2021-08-26 Created: 2021-08-26 Last updated: 2021-12-30Bibliographically approved
Olofsson, K. (2021). Nya nationella rekommendationer för trakeotomi och trakeostomivård. Svensk ÖNH-tidskrift, 3, 20-21
Open this publication in new window or tab >>Nya nationella rekommendationer för trakeotomi och trakeostomivård
2021 (Swedish)In: Svensk ÖNH-tidskrift, ISSN 1400-0121, Vol. 3, p. 20-21Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
Taylor & Francis, 2021
National Category
Otorhinolaryngology
Research subject
Oto-Rhino-Laryngology
Identifiers
urn:nbn:se:umu:diva-196197 (URN)
Available from: 2022-06-09 Created: 2022-06-09 Last updated: 2022-06-30Bibliographically approved
Holm, A., Allard, A., Eriksson, I., Laurell, G., Nylander, K. & Olofsson, K. (2020). Absence de papillomavirus humain à risque élevé dans le papillome inversé naso-sinusien p16 positif: [Absence of high-risk human papillomavirus in p16 positive inverted sinonasal papilloma]. Annales Francaises d'Oto-Rhino-Laryngologie et de Pathologie Cervico-Faciale, 137(3), 186-191
Open this publication in new window or tab >>Absence de papillomavirus humain à risque élevé dans le papillome inversé naso-sinusien p16 positif: [Absence of high-risk human papillomavirus in p16 positive inverted sinonasal papilloma]
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2020 (French)In: Annales Francaises d'Oto-Rhino-Laryngologie et de Pathologie Cervico-Faciale, ISSN 1879-7261, Vol. 137, no 3, p. 186-191Article in journal (Refereed) Published
Abstract [fr]

Le papillome inversé naso-sinusien (PINS) est une tumeur relativement rare dont l’étiologie est mal connue. Elle se caractérise par une agressivité locale et un fort potentiel de récidive en dépit d’une histologie bénigne.

Objectif: L’objectif de cette étude était d’identifier la présence du papillomavirus humain (HPV) et de son marqueur de substitution, la protéine p16, dans des prélèvements tissulaires de PINS issus d’une cohorte régionale.

Matériels et méthodes: À partir de notre cohorte régionale de 88 patients atteints de PINS traités entre 1984 et 2014, 54 sujets ont été sélectionnés et inclus dans cette étude. La technologie PCR a été réalisée sur 53 prélèvements et la coloration immunohistochimique pour recherche de p16 a été réalisée sur 54 prélèvements. L’ADN a été extrait après confirmation histopathologique du PINS. Un génotypage pour 13 types de HPV à risque élevé, 5 types de HPV à risque oncogène et 6 types de HPV à faible risque a été réalisé à l’aide du test de dépistage HPV PapilloCheck®.

Résultats: L’analyse HPV a été réalisable sur 38 des 53 prélèvements. Sur ces 38 prélèvements, seuls 2 étaient positifs pour HPV 11. L’analyse immunohistochimique a montré que p16 était présent dans l’épithélium de tous les prélèvements, et dans les régions papillomateuses de 37 prélèvements.

Conclusion: Étant donné que seuls 2 sur 38 PINS étaient positifs pour HPV (type 11) et que, dans le même temps, p16 était positif dans l’épithélium de tous les prélèvements et dans 37 des 38 régions papillomateuses, nous avons conclu que p16 ne peut pas être utilisé comme marqueur de substitution pour l’infection HPV à risque élevé dans le PINS. Nous préparons actuellement une étude multicentrique prospective afin d’augmenter la puissance de l’étude et de pouvoir mieux évaluer les implications cliniques de HPV et de p16 dans le PINS.

Place, publisher, year, edition, pages
Elsevier, 2020
National Category
Ophthalmology
Identifiers
urn:nbn:se:umu:diva-197931 (URN)10.1016/j.aforl.2019.10.004 (DOI)2-s2.0-85075428840 (Scopus ID)
Available from: 2022-07-08 Created: 2022-07-08 Last updated: 2022-07-08Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-0649-3825

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