This brief review summarises the efficacy of the treatments for post-irradiation otitis media with effusion.

Literature review.

Studies suggest that tympanocentesis is recommended for patients with post-irradiation otitis media with effusion The efficacy of balloon dilatation Eustachian tube for post-irradiation otitis media with effusion remains unclear.

The efficacy of different treatments for post-irradiation otitis media with effusion is unclear. Therefore, there are no recognised clinical guidelines, and long-term clinical research with a large sample size is needed.

There is limited evidence on the optimal management of nasal septal haematoma and abscess. This systemic review aims to summarise the management and outcomes and identify gaps in the literature.

A systematic search of Embase, PubMed, Cochrane Central Register of Controlled Trials (CENTRAL) and CINAHL was done. We included all studies on management of paediatric and adult patients with nasal septal haematoma or nasal septal abscess.

Seventeen articles were included (15 retrospective and 2 prospective) totalling 503 patients. Prophylactic antibiotics generally are used in nasal septal haematoma. Most septal collections were drained under general anaesthetic, and incision and drainage used in all. Quilting sutures, drains, nasal packing or a combination of these surgical techniques were described. Re-collection occurred in 18 of the 503 (3.6 per cent) patients.

Low rates of re-collection following incision and drainage are reported. There is a lack of well-designed studies that stratify outcomes and morbidity of nasal septal abscess and nasal septal haematoma based on mode of treatment.

Sublingual ranulas present diagnostic and therapeutic challenges due to their heterogenous clinical presentations. This systematic review and meta-analysis aims to synthesise treatment outcomes and proposes a new classification for this condition.

Following PRISMA guidelines, a thorough literature search identified studies on patients with sublingual ranulas receiving medical or surgical treatment. Proportion meta-analysis compared success rates among studies using a random-effects model.

Forty-two studies were included, covering 686 endoral ranulas, 429 plunging ranulas, and 16 ranulas extending into the parapharyngeal space. Sublingual sialoadenectomy with or without pseudocyst wall excision showed low heterogeneity and the highest success rates. Consequently, a new classification system is proposed categorising ranulas by intraoral (Type 1), cervical (Type 2) or parapharyngeal space (Type 3) extension.

This study confirms the role of sublingual gland resection as standard of care and highlights the need for a revised classification to improve patient outcomes.

Congenital hearing loss is a chronic condition which occurs worldwide. In the past, investigations focused on testing the most common genes associated with hearing loss (such as Connexin 26-related hearing loss). Targeted testing of specific genes was requested only when a particular syndrome was suspected. Recent advances have led to the development of a large gene panel which utilises next-generation sequencing to simultaneously test for pathogenic variants in many genes associated with hearing loss.

This review article aims to highlight the changes in the approach to congenital hearing loss in the context of the R67 gene panel, and how its use may increase the efficiency of the diagnosis and management of this condition.

The use of this large gene panel has revolutionised the approach to hearing loss. Uptake of this large gene panel has resulted in prompter diagnosis and therefore more appropriate clinical management.

Sudden onset sensorineural hearing loss has been associated with infection by severe acute respiratory syndrome coronavirus-2. However, little is known regarding how this differs from sudden onset sensorineural hearing loss of other aetiologies. This systematic review summarises existing literature on severe acute respiratory syndrome coronavirus-2 associated sudden onset sensorineural hearing loss treatment and outcomes.

A literature search using Ovid was performed for studies which evaluated treatments and outcomes of patients with sudden onset sensorineural hearing loss associated with severe acute respiratory syndrome coronavirus-2 infection.

A total of 99 studies were identified, from which 14 studies were selected for inclusion - collectively including 154 patients. Nine of these studies were single participant case reports and five were larger case series. Corticosteroid treatment varied between studies in terms of administration route, dose, and duration. Only 63/154 patients in this review achieved complete resolution of their symptoms following steroid treatment.

Oral, intravenous, and intratympanic steroids demonstrate a good safety profile. However, the majority of patients are left with unresolved hearing loss.

Drop attacks are described as an instantaneous fall to the ground, occurring without warning and without loss of consciousness, a consequence of abrupt deformation of the otolithic membrane due to high endolymphatic pressure. Drop attacks present significant injury risk, therefore effective treatment is imperative. This review is the first to examine all evidence for the management of drop attacks in Ménière’s disease, and make recommendations.

We conducted a systematic literature review. Inclusion criteria consisted of all published English language examining treatments of drop attacks in Ménière’s disease.

One hundred and five articles were identified, 19 met criteria (case series and/or cohort studies). Two articles identified conservative treatments, eight examined intratympanic gentamicin, seven examined surgery, one examined all three and one examined intratympanic dexamethasone.

Evidence for the management of drop attacks in Ménière’s disease is limited due to small studies. Some surgical approaches have limited effect. Intratympanic dexamethasone remains a promising treatment; further research is recommended.

The aim of this study is to identify risk factors for residual dizziness in benign paroxysmal positional vertigo patients after repositioning manoeuvres and explore the mediation role of lipid indicators.

In all, 110 benign paroxysmal positional vertigo patients treated from January 2019 to February 2022 were studied. Data on demographics, diseases, behaviours, and lipids were collected. Multivariate logistic regression assessed risk factors, and mediation analyses explored effects via lipid indicators. Odds ratios and 95 per cent confidence intervals are reported.

Differences between groups with and without residual dizziness included limb weakness, hypertension, nausea, arteriosclerosis, medication, dizziness handicap inventory scores, hospital anxiety and depression scale scores, and lipid distributions (p < 0.05). Significant risk factors were sleep disorders, medication, hypertension, triglycerides, and total cholesterol (p < 0.05). Total cholesterol mediated 9.1 per cent of the effect of sleep disorders on residual dizziness.

Managing lipid levels and sleep disorders is crucial in treating residual dizziness in benign paroxysmal positional vertigo patients after repositioning.

To evaluate the predictive value of peripheral blood eosinophil levels for eosinophilic chronic rhinosinusitis.

Electronic searches were conducted in PubMed, Embase and the Cochrane Library. Data were analysed using Stata 16.0.

In total, 23 studies that fulfilled the inclusion criteria were analysed. For peripheral blood eosinophil percentage in identifying eosinophilic chronic rhinosinusitis, the pooled sensitivity was 0.77 (95 per cent confidence interval (CI) = 0.69–0.83) and specificity was 0.74 (95 per cent CI = 0.68–0.80), with a positive likelihood ratio of 2.97 (95 per cent CI = 2.38–3.72) and a negative likelihood ratio of 0.31 (95 per cent CI = 0.24–0.42). Similarly, for peripheral blood eosinophil count, the pooled sensitivity was 0.78 (95 per cent CI = 0.73–0.82) and specificity was 0.73 (95 per cent CI = 0.69–0.77), with a positive likelihood ratio of 2.93 (95 per cent CI = 2.45–3.50) and a negative likelihood ratio of 0.30 (95 per cent CI = 0.24–0.37).

There is not sufficient evidence to support peripheral eosinophilia as a good predictor of eosinophilic chronic rhinosinusitis.

This study analyses the current literature to evaluate the effectiveness of dabrafenib and trametinib in the multi-modal treatment of anaplastic thyroid cancer (ATC).

A systematic review and meta-analysis of the literature were undertaken. The primary endpoint measured was overall response rate (ORR) defined by the RECIST v1.1 guidelines. Secondary endpoints were 12-month overall survival (OS), median OS and progression-free survival (PFS).

Of 656 identified reports, 8 studies were included which featured 95 patients (median age 68.5 years, 46 per cent male). Median follow-up period was 11.8 months with a 12-month OS of 51 per cent. Median OS was 10.4 months. Progression-free survival (PFS) was 6.5 months. The ORR was 71 per cent. A total of 65 patients exhibited a partial or complete response in radiological tumour size. Side effects compared favourably to other kinase inhibitors.

Dabrafenib and trametinib exhibit a promising tumour response with a tolerable side profile. BRAF/MEK inhibitors continue to provide robust responses in BRAF-mutated ATC. The heterogeneity and lack of controls in included studies limits the confidence in the conclusions drawn.

This study evaluates the safety and utility of Eustachian tube balloon dilatation in treating Eustachian tube dysfunction symptoms in adults without middle-ear disease.

A prospective cohort study was performed. Adults with dilatory Eustachian tube dysfunction symptoms and no middle-ear disease underwent Eustachian tube balloon dilatation. A clinical assessment including tympanometry, pure tone audiometry, otoscopy, ability to Valsalva, and Eustachian Tube Dysfunction Questionnaire-7 was performed pre-operatively and repeated during a 12-month follow-up period.

Fifteen participants were enrolled. The mean pre-operative Eustachian Tube Dysfunction Questionnaire-7 score of 4.6 reduced to 2.5 at six weeks (P < 0.01), 3.0 at six months (P = 0.02) and 2.6 at 12 months (P < 0.01) post-operatively. All patients without evidence of negative middle-ear pressure had Eustachian Tube Dysfunction Questionnaire-7 score improvements. There were no post-operative complications.

Eustachian tube balloon dilatation is safe and effective at treating Eustachian tube dysfunction in patients with no middle-ear disease or evidence of negative middle-ear pressure.

The aim of this study is to investigate hearing outcomes in patients who have undergone cerebrospinal fluid (CSF) leak repair via a middle cranial fossa (MCF) approach and to identify any variables that influence post-operative hearing outcomes.

This is a multi-centre study. A total of 65 patients who underwent an MCF approach CSF leak repair were included. Retrospective case review was conducted to collect patient demographic and clinical data including pre- and post-operative audiometry.

A total of 65 patients were included: 9 patients (9.2per cent) had an encephalocele confirmed on magnetic resonance (MR) imaging, whilst the remaining patients had biochemically confirmed, beta-trace protein positive CSF leaks. Post-operatively, there was a statistically significant improvement in both bone conduction (Z = -3.71, p < 0.001) and air conduction thresholds (Z = -5.82, p < 0.001). None of the studied variables were found to be associated with the degree of hearing improvement.

The MCF approach for CSF leak repair yields favorable audiological outcomes.

The BiZact device offers precise and versatile functionality for tonsillectomies. The objective of this study is to assess the efficacy and safety of the BiZact instrument for tonsillectomies.

The researchers used the PRISMA guidelines to retrieve relevant articles from PubMed, Embase and Web of Science. Eight articles were aggregated and examined for this systematic review.

The BiZact device shortens operative time when compared to cold dissection and bipolar electrocautery, where no difference was found when compared to coblation. Intra-operative bleeding was decreased with BiZact tonsillectomy compared to cold dissection and electrocautery, although bleeding was slightly increased when compared to coblation.

The BiZact instrument is an alternative tonsillectomy device that may shorten surgical time as well as reduce intra-operative blood loss. More studies are needed to conduct a meta-analysis directly comparing surgical outcomes of the BiZact device to other techniques.

The father of Czech music, Bedřich Smetana was a brilliant, patriotic Romantic composer who spent his last decade completely deaf. He became progressively ill in his final years and passed away prematurely at 60 years old. Since then, there have been two main propositions for the etiology of his neurological symptoms, in particular his hearing loss: neurosyphilis or osteomyelitis of the temporal bone.

This article compares the clinical presentation and pathology of neurosyphilis and osteomyelitis.

This article infers which one is arguably the most likely cause based on Smetana’s own medical history, signs and symptoms and autopsy findings.

Smetana’s clinical presentation and pathological results grant us a clearer picture of his neurological condition and allows us to diagnose his final neurological deterioration as complications of neurosyphilis and not osteomyelitis of the temporal bone.