This study aimed to compare the efficacy of endoscopic type I tympanoplasty/myringoplasty with (ETMFE) or without tympanomeatal flap elevation (ETMFNE).

A thorough search of the PubMed, Embase and Cochrane Library databases was executed. The Review Manager 5.4 software was used for synthesising data, with forest plots illustrating the results for each outcome. Assessment of potential publication bias was conducted using funnel plots and Egger’s test.

The meta-analysis included data from seven studies with 839 patients. The results demonstrated no significant difference in graft success rates (risk ratio = 1.01; 95 per cent confidence interval: 0.98–1.04; p = 0.54) or air–bone gap improvement (mean difference = –0.08; 95 per cent confidence interval: –2.02–1.85; p = 0.93) between the ETMFE and ETMFNE groups. However, the ETMFE group showed a pronounced increase in operation time (mean difference = 19.50; 95 per cent confidence interval: 10.75–28.25; p < 0.0001).

ETMFNE could be a preferable option for tympanic membrane perforation, offering similar efficacy to ETMFE but with reduced surgical time, particularly in appropriately selected cases.

Although the role of computed tomography (CT) in vocal fold paralysis is well established, its utility in vocal fold motion impairment remains controversial. We aimed to examine the utility of CT in the aetiological assessment of patients with unexplained vocal fold motion impairment and to identify the underlying pathological causes.

We retrospectively reviewed the records of consecutive adults with vocal fold motion impairment who underwent neck CT between June 2010 and March 2023. The CT findings were correlated with management and final diagnoses.

Computed tomography helped to identify the cause of vocal fold motion impairment in 119 of 177 patients (diagnostic yield, 67.23 per cent). The accuracy, sensitivity and specificity of CT in detecting the underlying causes of vocal fold motion impairment were 96.05, 99.17 and 89.47 per cent, respectively. The leading cause of vocal fold motion impairment was malignancy, followed by idiopathic disease.

Computed tomography is highly recommended in patients with unexplained vocal fold motion impairment because of its high accuracy and high diagnostic yield.

We aimed to evaluate imaging modalities utilized in patients with vocal cord palsy (VCP) of unknown aetiology, emphasizing the significance of timing and diagnostic yield.

We conducted a retrospective review of medical records of patients diagnosed with VCP of unknown aetiology after their initial clinical examination between 2005 and 2016.

In our cohort, 46 out of 173 (27 per cent) patients were diagnosed with malignancies. All malignancies were identified during the initial imaging examination, except for one patient. Diagnostic imaging facilitated the diagnosis in 36 per cent of the patients. Computed tomography (CT) of the neck and chest and full-body positron emission tomography-CT (PET-CT) presented the highest overall diagnostic yield of 36 per cent and 35 per cent, respectively.

We recommend that patients with initial CT of the neck and upper chest or PET-CT combined with magnetic resonance imaging without pathological findings, are followed without additional imaging examinations, unless new relevant symptoms arise.

This study aimed to assess vaping prevalence, motivations and risk perceptions among adults attending ENT clinics in the East of England.

A survey was conducted with 284 adults (aged ≥18), gathering data on demographics, vaping habits, awareness of health risks and attitudes towards regulation.

A total of 24 per cent reported vaping, particularly among those aged 18–25 years and the unemployed (p = 0.027). The main motivation was smoking cessation (49 per cent), followed by stress relief and social factors. Vapers perceived vaping as less harmful, while 60 per cent of non-vapers considered it “very harmful.” Awareness of risks was low, especially among younger adults and the unemployed, with 83 per cent lacking sufficient information. Non-vapers (84 per cent) supported stricter regulations.

Vaping is currently a poorly defined health risk. There is a need for targeted education on vaping risks and enhanced regulation, particularly within ENT settings. Further research is required to explore vaping’s health impacts on ENT health.

The American Academy of Otolaryngology endorses using image-guided navigation systems in appropriately selected sinus and skull base cases. This study aimed to understand current practices, accessibility and use of image-guided navigation systems in otolaryngology departments across the UK.

A 13-point survey was distributed to UK otolaryngology consultants, with responses collated between May and December 2023.

A total of 154 responses were received. Whilst 28.6 per cent felt it should be mandatory for a department undertaking endoscopic sinus surgery to have image-guided navigation systems, 33.1 per cent reported a lack of access, with financial cost the primary barrier. Half of the respondents reported using image-guided navigation systems for surgery involving the sphenoid sinus and “full-house” functional endoscopic sinus surgery. Over three-quarters felt image-guided navigation systems should be utilised for frontal sinus pathology or expanded approaches.

Our study highlights variations in access to image-guided navigation systems and a range of practices regarding its use for endoscopic sinus surgery amongst UK otolaryngologists.

This stidy aimed to identify factors influencing prognosis in severe full-frequency sudden sensorineural hearing loss and develop an early prognostic tool.

A total of 194 patients with severe full-frequency sudden sensorineural hearing loss were analyzed. Univariate analysis screened variables, followed by multivariate logistic regression to construct a nomogram prediction model. Model performance was evaluated using a receiver operating characteristics curve.

Significant differences (p < 0.05) were found between ineffective and effective treatment groups in gender, age, contralateral ear hearing, duration of hearing loss, dizziness/vertigo, hypertension, platelet count and fibrinogen levels (Fib1, Fib2, Fib3). The nomogram model, incorporating these factors, showed good calibration. The receiver operating characteristics curve analysis revealed an area under the curve of 0.880 (95 per cent confidence interval: 0.829–0.931), with sensitivity of 80.7 per cent and specificity of 87.5 per cent.

The nomogram model, integrating 11 factors, effectively predicts prognosis in severe full-frequency sudden sensorineural hearing loss.

This study evaluates the effectiveness of long-term, low-dose antibiotic treatment (macrolides and doxycycline) combined with intra-nasal corticosteroids in patients with chronic rhinosinusitis with nasal polyps.

A total of 72 patients diagnosed with chronic rhinosinusitis with nasal polyps, aged 18–65, were followed for at least six months. Patients were randomized into three treatment groups: group 1 (intra-nasal corticosteroids and nasal saline irrigation), group 2 (intra-nasal corticosteroids, saline irrigation and macrolides) and group 3 (intra-nasal corticosteroids, saline irrigation and doxycycline).

Of the 72 patients, 43 (59.7 per cent) were male, and 29 (40.3 per cent) were female, with an average age of 48.69 plus or minus 15.71 years. A significant reduction in polyp stages was observed bilaterally and unilaterally in group 3 (p < 0.05). Lund–Mackay Score showed significant improvement in group 2 and group 3.

Adding doxycycline to intra-nasal corticosteroids therapy led to significant reductions in polyp stages and Lund–Mackay Score, suggesting potential clinical and radiological benefits.

To explore methods for accurate diagnosis and effective treatment of otomycosis.

Using randomised stratification, eligible patients were split into a patient-applied medication group and a physician-applied medication group in order to compare the efficacy and recurrence rates of two treatment approaches.

The primary symptom of otomycosis was ear blockage (35.2 per cent), followed by pruritis (26.7 per cent) and otorrhea (13.6 per cent). Predominant fungi were Aspergillus terreus (50.5 per cent), Candida parapsilosis (15.5 per cent) and Aspergillus niger (12.5 per cent). The treatment efficacy was 44.7 per cent (34/76) for the patient-applied medication group and 98.6 per cent (71/72) for the physician-applied medication group, with the difference being statistically significant (χ2 = 52.061, p <0.01). The recurrence rate was 35.3 per cent (12/34) for the patient-applied group and 2.8 per cent (2/71) for the physician-applied medication group, also showing a statistically significant difference (p <0.01).

Triamcinolone acetonide econazole cream application by a physician every 2–3 days, three times, effectively cures otomycosis and lowers recurrence.

We report the surgical outcomes and functional results in a pediatric population following the use of the laryngotracheal LT-moldR prosthesis to treat complex glottic and subglottic stenosis.

A retrospective observational study in children following open and endoscopic surgical treatment for LT stenosis.

Among 46 patients, 91% received LT-mold during an open surgery and 9% had it following an endoscopic procedure. 93% patients were successfully decannulated and 80% needed stent placement for longer than 2 months. Mean time to decannulation was 229 days. Currently, 83% patients have normal breathing, 67% patients have normal voice or mild dysphonia and swallowing outcomes have remained similar in the pre- and post-operative period.

The LT-mold provided an adequate airway stenting, enabling decannulation in most patients with advanced grades of laryngotracheal stenosis. Duration of stenting and time to decannulation showed no correlation with the grade of stenosis or patient comorbidities. Functional results were optimal.

Recurrent respiratory papillomatosis is a benign disease caused by human papillomavirus that often requires frequent surgical intervention. In the UK, microdebridement is the most common technique compared to 3.3 per cent of procedures performed with coblation. This is the first study to compare the efficacy and safety profile of microdebriders versus coblation in children.

Demographic data and surgical outcomes were collected retrospectively for all children with recurrent respiratory papillomatosis over an eight-year period.

Seventeen children with recurrent respiratory papillomatosis underwent a total of three hundred operations, including 182 coblation (60.7 per cent) and 113 microdebrider procedures (37.7 per cent). The complication rate was 3.8 per cent for coblation and 7.1 per cent for microdebridement (p = 0.22). There was no significant difference in the time interval between coblation and microdebrider procedures (p = 0.21).

In children with recurrent respiratory papillomatosis, this study demonstrated a comparable efficacy and safety profile for surgical intervention with coblation versus the currently favoured microdebrider technique.

Mastoiditis commonly presents to ENT services. Following the UK introduction of the 13-valent conjugate pneumococcal vaccine in 2010, changes in the organisms of these infections were hypothesised. We aim to assess the microbiological profile of patients with acute mastoiditis in our centre.

Retrospective review of patients admitted to Alder Hey Children’s Hospital for mastoiditis between January 2017–September 2022. Data was collected from electronic patient records, microbiology and biochemistry reports.

A total of 108 patients were admitted: 61 males and 47 females with a median age of 2 years (with a range of 4 months–14 years). A total of 82 organisms were isolated from 50 (46 per cent) children. Streptococcus spp. (22 specimens; 27 per cent) and Staphylococcus spp. (13 specimens; 16 per cent) were most common. Other organisms included Pseudomonas aeruginosa (6; 7 per cent), anaerobes (4; 5 per cent), Haemophilus influenzae (4; 5 per cent), and Fusobacterium (4; 6 per cent).

Mastoiditis predominantly involves gram-positive, facultative anaerobic bacteria. Empirical cefotaxime and metronidazole provide adequate coverage. Culture and sensitivity testing is essential for antibiotic stewardship.

In recent years, there has been a significant disparity between workforce capacity and clinical demand in surgical specialities, including head and neck surgery (HNS). Our objective was to assess final-year medical student interest in pursuing a career in HNS.

An online survey was distributed via social media and was completed by 633 final-year medical students across seven United Kingdom (UK) universities.

A total of 66.7 per cent (n = 422) had 1–7 days of exposure to HNS. Complex surgery (24.2 per cent), interesting patient population (20.2 per cent) and complex pathology (16.7 per cent) were the main motivators to consider HNS. Work–life balance (23.8 per cent), lack of exposure (31.3 per cent) and length of training (6.5 per cent) were the most common deterrants. A total of 67.1 per cent of students reported inadequate exposure to the field during undergraduate training.

The undergraduate curriculum must place more emphasis on HNS to accommodate increasing disease burden amid a limited workforce capacity within the National Health Service.

The primary objective of our study was to survey ENT surgeons who perform functional endoscopic sinus surgery in the UK regarding their post-sinus surgery practices.

A 28-item questionnaire on post-functional endoscopic sinus surgery practices was distributed electronically to ENT UK members specialising in rhinology.

Ninety (90 per cent) surgeons prescribe saline nasal irrigation post-functional endoscopic sinus surgery but administration timing and methods vary. Following functional endoscopic sinus surgery, 17.7 per cent (n = 17) of respondents routinely prescribe antibiotics, whilst about a quarter (26.0 per cent, n = 25) do not prescribe antibiotics at all. The rest of the respondents only prescribe antibiotics in specific cases. Thirty-three (34.7 per cent) respondents do not prescribe oral steroids whilst most clinicians (83.9 per cent, n = 78) prescribe intranasal corticosteroids post-operatively.

Our study highlights homogeneous, evidence-based practices post-functional endoscopic sinus surgery from UK-based specialists, specifically in the use of saline irrigation and intranasal corticosteroids. However, our cohort displayed significant heterogeneity regarding oral antibiotics, oral steroids, and other specific aspects of post-operative care.

Laryngopharyngeal reflux disease can affect functioning of Eustachian tube which is responsible for maintenance of normal middle ear physiology. Our study aims to assess the effect of laryngopharyngeal reflux disease on middle ear physiology and whether any functional derangement can be reversed by anti-reflux therapy.

Patients with both laryngopharyngeal reflux disease and asymptomatic middle ear dysfunction (n = 50) were prescribed anti-reflux therapy and followed up for eight weeks. Audiometric evaluations were done routinely to assess changes.

Post-intervention, 72 per cent of affected ears had improved thresholds with reduction in mean and median over each serial evaluation (p = 0.003). Tympanograms showed reversal to normal in 38 per cent of cases with increasing compliance over each successive visit (p < 0.001).

Laryngopharyngeal reflux disease can result in middle ear dysfunction. Early detection and treatment is crucial for restoration of normalcy and prevention of progression to other complications.

The presence of nodal disease at presentation of a head and neck mucosal-based squamous cell carcinoma has a significant impact upon outcomes.

This is a retrospective, ethics-approved study in which patients with squamous cell carcinoma of the larynx, oropharynx, hypopharynx and oral cavity were reviewed and compared with respect to nodal disease (N0 vs N1–N2 vs N3). Patient, disease and treatment parameters were evaluated with ultimate local control, regional control, cancer-specific survival and overall survival investigated.

In the cohort of 1265 patients, 764 presented with nodal disease (N3 = 60). The majority of the N3 group had oropharynx squamous cell carcinoma (52%) and experienced worse ultimate local control (63%; p < 0.001), regional control (67%; p < 0.001) and both squamous cell carcinoma and overall survival (log rank p < 0.001).

Patients presenting with N3 nodal disease had poor regional control, a lower cancer-specific survival and a worse overall survival compared to patients with lesser to no nodal disease.

The virtues of the scapular tip free flap for reconstruction of complex midface oncologic defects have been claimed by many. To obtain optimal functional and aesthetic results, precise positioning of the free flap used for reconstruction is paramount.

Four cases illustrate our approach to midface reconstruction with angular branch-based scapular tip flaps. A standard surgical navigation device was used both to plan bone cuts for the oncologic resection and to optimise the positioning of the flap.

Case 1 illustrates the usefulness of navigation for reconstruction of total palato-septectomy defects, using a horizontally positioned flap. Optimal neo-palate height, alignment of the anterior nasal spine and nasal projection were obtained. For cases 2–4, vertical inset of the flap yielded optimal midface projection and orbital floor position.

Surgical navigation systems are useful adjuncts for midface reconstruction.

To investigate the association between Healthy Eating Index 2015 scores and hearing loss.

This study used cross-sectional data from individuals aged over 20 years (n = 5171) who participated in the National Health and Nutrition Examination Survey from 1999 to 2012 and from 2015 to 2018. Information was collected on their hearing, Healthy Eating Index 2015 scores, and several other important covariates using multivariate regression analyses.

After adjusting for potential confounders, when hearing loss was defined as ≥20 dB, the odds ratios for low-frequency and high-frequency hearing loss were 0.99 (95 per cent confidence interval (CI) = 0.98−0.99, p < 0.001) and 0.99 (95 per cent CI = 0.98−1, p = 0.006), respectively. When hearing loss was defined as >25 dB, the odds ratios for low-frequency hearing loss and speech-frequency band hearing loss were 0.98 (95 per cent CI = 0.98−0.99, p < 0.001) and 0.99 (95 per cent CI = 0.98−1, p = 0.008), respectively.

In U.S. adults, the Healthy Eating Index 2015 is associated with hearing loss.

The aim of this study was to investigate the association between the Healthy Eating Index 2015 scores and hearing loss.

This study utilized cross-sectional data from individuals aged over 20 years (n = 5171) who participated in the National Health and Nutrition Examination Survey from 1999 to 2012 and 2015 to 2018. We collected information on their hearing, Healthy Eating Index 2015 scores and several other important covariates using multivariate regression analyses.

After adjusting for potential confounders, when hearing loss was defined as greater than or equal to 20 dB, the odds ratio for low-frequency hearing loss and high-frequency hearing loss was 0.99 (95 per cent confidence interval: 0.98–0.99; p < 0.001) and 0.99 (95 per cent confidence interval: 0.98–1; p = 0.006), respectively. When hearing loss was defined as greater than 25 dB, the odds ratio for low-frequency hearing loss and speech-frequency band hearing loss was 0.98 (95 per cent confidence interval: 0.98–0.99; p < 0.001) and 0.99 (95 per cent confidence interval: 0.98–1; p = 0.008), respectively.

In American adults, Healthy Eating Index scores are associated with hearing loss.