(1) Background: No association between air pollution and periodontitis has yet been shown. Thus, we merged two nationwide databases to evaluate the risk of periodontitis in Taiwanese residents with long-term exposure to air pollution. (2) Methods: We conducted a nationwide retrospective cohort study using the Longitudinal Generation Tracking Database and the Taiwan Air Quality-Monitoring Database. The daily average air pollutant concentrations were categorized into quartiles (Q1, Q2, Q3, and Q4). We carried out Cox proportional hazards models to compute the hazard ratios of periodontitis, with 95% confidence intervals, in Q2–Q4 of the daily average air pollutant concentrations, compared with Q1. (3) Results: the adjusted HR (95 CI%) for periodontitis in Q2–Q4 increased with increased exposure to SO2, CO, NO, NO2, NOX, PM2.5, and PM10 from 1.72 (1.70, 1.76) to 4.86 (4.78–4.94); from 1.89 (1.85–1.93) to 2.64 (2.59–2.70); from 1.04 (1.02–1.06) to 1.52 (1.49–1.55); from 1.61 (1.58–1.64) to 2.51 (2.47–2.56); from 1.48 (1.45–1.51) to 2.11 (2.07–2.15); from 2.02 (1.98–2.06) to 22.9 (22.4–23.4, and from 2.71 (2.66–2.77) to 17.2 (16.8–17.6), respectively, compared to Q1. (4) Conclusions: Residents in Taiwan with long-term exposure to higher levels of air pollutants had a greater risk of periodontitis.

Air pollution triggers a tissue-specific inflammatory response. However, studies on the association between exposure to air pollutants and chronic rhinosinusitis (CRS) risk remain limited. Thus, we conducted this nationwide study to define the association between air pollution and CRS. We used the Longitudinal Health Insurance Database (LHID) and Taiwan Air Quality-Monitoring Database (TAQMD) to conduct a population-based cohort study. Study participants were recruited from the LHID, a data subset of the National Health Insurance Research Database that randomly sampled one million individuals. TAQMD has been an air pollutant database since 1998. In univariate and multivariate Cox proportional hazards regression models, adjusted hazard ratios (aHRs) and 95% CIs of CRS in five air pollutants were accounted. We adjusted for age, sex, urbanization level, insurance fee, comorbidities, and pollutant levels in the multivariate model. The total number of participants enrolled in this study was 160,504. The average age was 40.46 ± 14.62 years; males constituted 43.8% of the total participants. The percentages of alcoholism, tobacco dependence, and COPD were 1.5%, 2.8%, and 28.3%, respectively. After adjustment for age, sex, urbanization level, insurance fee, and comorbidities, the highest levels of air pollutants, including PM2.5 (aHR = 1.14, 95% CI = 1.06–1.22), NO2 (aHR = 1.07, 95% CI = 1.00–1.15), and PM10 (aHR = 1.13, 95% CI = 1.05–1.21) had a significantly greater CRS risk; we selected the lower concentration as the reference but did not correlate with CO. We found a significantly increased risk of CRS in residents with air pollutant exposure.

Background Post-pubertal teratomas, which mostly occur at 20 to 40 years old, are more likely to be found at a metastatic site in up to 20% of cases and may be inadvertently overlooked. We present a case of cervical malignant teratoma that masqueraded as a hematoma. Case presentation: A 24-year-old man presented to our institution with a 4-month history of a progressively relapsing painless mass in the neck, despite conservative treatments with oral medications. A huge space-occupying mass was identified with almost total occlusion of the left internal jugular vein. The likely diagnosis was an organized hematoma or congenital cystic tumor with internal hemorrhage. Surgical excisional biopsy of the mass lesion was conducted and a malignant teratoma was found. A whole-body positron emission tomography scan showed a left inguinal mass, bilateral intra-abdominal lymphadenopathies, and abdominal metastases. Histopathology further suggested the diagnosis of an immature testicular teratoma with multiple lymph node metastases. The patient received adjuvant chemotherapy with a bleomycin, etoposide, and cisplatin regimen. During follow-up, salvage second-line chemotherapy was required with a paclitaxel, ifosfamide, and cisplatin regimen. Conclusion Although uncommon, cervical teratoma should be taken into consideration once a painless and non-remitting mass lesion is found in a young adult.

Air pollutants as risk factors for benign brain tumor (BBT) remain unclear. Therefore, we conducted a nationwide retrospective cohort study by integrating the patients’ clinical data and daily air quality data to assess the environmental risk factors of BBT in Taiwan.Daily air quality data were categorized into quartiles (Q1 to Q4). The adjusted hazard ratio (aHR) was evaluated by comparing the BBT incidence rate of the subjects in Q2–Q4 with that of the subjects in Q1 (the lowest concentration of air pollutants). A total of 161,213 subjects were enrolled in the study. Among the air pollutants tested, the aHR of BBT was significantly higher in the subjects who were exposed to the highest level (Q4) of CO (aHR 1.37, 95% CI 1.08–1.74), NO2 (aHR 1.40, 95% CI 1.09–1.78), and PM2.5 (aHR 1.30, 95% CI 1.02–1.65) than that in the subjects who were exposed to the lowest level (Q1). No significant risk association of BBT with SO2 and PM10 exposure was observed. The results revealed that long-term exposure to air pollutants, particularly CO, NO2, and PM2.5, is associated with the risk of BBT.

Lymphatic malformations are rare benign malformations that predominantly occur in the head and neck region. The advent of surgical robots in head and neck surgery may provide beneficial outcomes for pediatric patients. Here, we describe our experiences with transhairline incisions for robot-assisted surgical resection of cervical lymphatic malformations in pediatric patients. In this prospective longitudinal cohort study, we recruited consecutive patients under 18 years of age who were diagnosed with congenital cervical lymphatic malformations and scheduled for transhairline approach robotic surgery at a single medical center. We documented the docking times, console times, surgical results, complications, and postoperative follow-up outcomes. The studied patients included 2 with mixed-type lymphatic malformations and 2 with macrocystic-type lymphatic malformations. In all 4 patients, the incision was hidden in the hairline; the incision length was <5 cm in 3 patients but was extended to 6 cm in 1 patient. Elevating the skin flap and securely positioning it with Yang retractor took <1 hour in all cases. The mean docking time was 5.5 minutes, and the mean console time was 1 hour and 46 minutes. All 4 surgeries were completed endoscopically with the robot. The average total drainage volume in the postoperative period was 21.75 mL. No patients required tracheotomy or nasogastric feeding tubes. Neither were adverse surgery-associated neurovascular sequelae observed. All 4 patients were successfully treated for their lymphatic malformations, primarily with robotic surgical excisions. Cervical lymphatic malformations in pediatric patients could be accessed, properly visualized, and safely resected with transhairline-approach robotic surgery. Transhairline-approach robotic surgery is an innovative method for meeting clinical needs and addressing esthetic concerns.