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.

The association between diagonal earlobe crease and cardiovascular disease has been known for several decades. This review investigated whether there is a significant association between the presence of a diagonal earlobe crease and coronary artery disease independent of other confounding factors.

This study was a systematic review and meta-analysis of selected studies using the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist.

This study included 12 studies in the pooled analysis with 2415 cases and 2545 controls. The study found that patients with diagonal earlobe crease have an increased (four times) likelihood of having coronary artery disease. In addition, despite some previous studies suggesting that diagonal earlobe crease was simply a result of age, all 10 of the included studies that looked at this found that the relationship between diagonal earlobe crease and coronary artery disease was independent of both age and other known cardiovascular risk factors.

Patients with diagonal earlobe crease appear to have an increased risk of coronary artery disease, and this may be higher for patients with bilateral diagonal earlobe crease.

Drains are used post-parotidectomy to reduce seroma and haematoma formation. Tissue-derived thrombin sealant can enable a drainless procedure, allowing for an earlier discharge, less discomfort and a more cost-efficient method. This study aimed to assess whether tissue sealant improves wound-related outcomes in parotidectomy.

A systematic literature review was performed using a standardised published methodology and custom database search strategy. A fixed-effect meta-analysis of the combined complications was conducted.

Thirteen studies were identified relating to parotidectomy procedures using tissue sealants, of which nine were included in the quantitative synthesis. Our analysis suggested a reduction in the complication rates, including haematoma and seroma, with drainless parotidectomy procedures involving tissue sealant use when compared with conventional procedures with post-operative drain use.

Fibrin sealant in parotidectomy may be used to facilitate a drainless approach, expediting recovery and offering better comfort to patients.

The objective of this study was to evaluate graft success, hearing improvement, and complications following perichondrium–cartilage underlay myringoplasty without external auditory canal packing.

In this prospective study, we examined 37 ears of 37 patients with large perforations who underwent endoscopic perichondrium–cartilage underlay myringoplasty without external auditory canal packing. Patients were followed up for six months.

At one week after the surgery, the graft was in situ in 35 (94.6 per cent) ears. At 2–3 weeks post-surgery, among the 35 ears without infection, the graft was in situ in 29 (82.9 per cent) ears, and the graft was bulging in 6 (17.1 per cent) ears. At six months post-surgery, the graft success rate was 94.6 per cent (35 of 37 ears). No graft lateralisation or graft medialisation was encountered during the follow-up period.

The absence of external auditory canal packing did not affect the graft success or hearing improvement following underlay myringoplasty. Thus, external auditory canal packing does not appear to be necessary for underlay myringoplasty.

This study aimed to translate and validate the Attitude towards Loss of Hearing Questionnaire into the Arabic language and explore attitudes of working-age adults towards their hearing loss and hearing aids.

A cross-sectional investigation was conducted of 237 middle-aged Jordanians (18-65 years old) who have hearing loss using an online questionnaire during the period of October to December 2023.

The specialized experts in the field had an 88 per cent acceptance rate on all items of the Attitude towards Loss of Hearing Questionnaire. Five factors were loaded and explained a total of 58.37 per cent, confirming the validity of the Attitude towards Loss of Hearing Questionnaire Arabic version. All subscales of the Attitude towards Loss of Hearing Questionnaire surpass the normal values of Cronbach alpha. Several predictors of attitude towards loss of hearing were noted, including educational level, age, family members, income and marital status.

Addressing barriers to hearing aid use, such as psychosocial and economic, can improve hearing support and increase healthcare focus and collaboration among clinicians and stakeholders globally.

To assess the effects of intratympanic gentamicin on the recovery of patients with large vestibular schwannomas undergoing retrosigmoid resection.

We conducted a prospective case-control pilot study over 24 months, including 13 patients with large vestibular schwannomas (25–41 mm intracranial diameter); seven patients received intratympanic gentamicin pre-operatively, while six did not. Outcome measures were duration of stay (main), age, gender, vestibular schwannoma size, body mass index and financial costs.

Age had the highest association with longer inpatient stay. The non-gentamicin patients had longer hospital stays, were older, had lower body mass indices and larger vestibular schwannomas. A trend towards shorter stay was seen in patients receiving gentamicin with tumours less than 35 mm in size, but not in patients with larger tumours. Costs were lower for the gentamicin group.

Although not statistically significant, there was a positive trend in patients with vestibular schwannomas greater than 35 mm in size; thus, intratympanic gentamicin as prehabilitation could be considered.

This study aimed to describe outcomes of paediatric stapes surgery at an academic tertiary care centre.

Electronic medical records of patients younger than 21 years who underwent stapedotomy between September 2013 and July 2020 were reviewed.

A total of 17 patients (7 male, 10 female) were included in our study; 14 underwent surgery on one ear while 3 underwent surgery on both ears (20 ears total). Mean pre-operative air-bone gap was 34.5 dB (standard deviation, 11). At three months, the mean post-operative air-bone gap was 20.6 dB (standard deviation, 10.2), with a mean improvement of 17 dB (standard deviation, 12.1). Sixty-four per cent of patients had closure of their air-bone gap to 20 dB or less. A negative correlation between pre-operative body-mass index and post-operative air-bone gap was statistically significant (n = 14, p = 0.03, r = -0.57 [95% confidence interval -0.85, -0.04]).

Paediatric stapedotomy can be effective and safe. In this cohort, age was not correlated with improvement in air-bone gap; pre-operative body mass index was significantly correlated with post-operative air-bone gap.

The success of tympanoplasty is mainly defined by the post-operative integrity of the tympanic membrane, as well as the absence of any need for further operating. Among the factors affecting the outcome, the surgical grafting technique is still a matter of debate. Our aim is to report the results of the split two-layer cartilage–perichondrium technique.

We carried out a retrospective study of 108 consecutive adult patients undergoing myringoplasty, assessing both surgical and audiological outcomes of the split two-layer cartilage–perichondrium technique, including primary and revision cases.

Complete perforation closure was observed in 97/108 (89.7 per cent) of the cases; 101/108 (93.5 per cent) had no need for further intervention. Failures were observed only in cases with total perforations without any differences between primary and revision cases. The average air–bone gap improved from 29.75 dB pre-operatively to 5.8 dB post-operatively.

The results indicate high success rates of the technique with failures occurring only in total perforations.

In this study, the presence of dizziness in the late period was investigated in patients working in the Armed Forces who were exposed to blast trauma with a test battery consisting of cervical and ocular vestibular-evoked myogenic potentials and the Dizziness Handicap Inventory.

Twenty-two healthy adult volunteers (44 healthy ears) and 25 military personnel (43 patient ears) who had blast trauma were included in the study. The cervical and ocular vestibular-evoked myogenic potential tests were applied to the control and patient groups. The patient group also filled in the Dizziness Handicap Inventory.

The mean score of the Dizziness Handicap Inventory of the patient group was 14.80 ± 23.38. In cervical and ocular vestibular-evoked myogenic potential tests there was no significant difference in the comparison of P1 latency, N1 latency and P1N1 amplitude between control and patient groups.

It was observed that the functions of otolith organs were not affected in the late period after blast trauma.

The aim of this study was to compare the internet and social media use of teenagers with hearing loss with that of their normal hearing peers.

The study included 27 hearing-impaired and 27 normal-hearing peers (12–18 years). The Social Media Attitude Scale, the Internet Use Purposes Scale, University of California, Los Angeles Loneliness Scale and the Problematic Internet Use Scale were used to compare hearing-loss and normal-hearing groups.

The social isolation subscale and Social Media Attitude Scale total score differed between groups (p = 0.001 and p = 0.048, respectively). Internet Use Purposes Scale education subscale differences were statistically significant (p = 0.042). Negative consequences (p = 0.007), excessive use (p = 0.021) and Problematic Internet Use Scale total score (p = 0.005) differed significantly. The University of California, Los Angeles Loneliness Scale had a moderate negative connection with the Problematic Internet Use Scale's social benefit/comfort subscale and total score (r = 0.369, p = 0.006 and r = −0.309, p = 0.023, respectively).

While adolescents with hearing loss have limited online educational resources, problematic internet use is a concern. When overused, the internet can reduce loneliness, but it can also have harmful consequences.

Endoscopic endonasal surgery of the skull base carries the risk of meningitis. However, no consensus on the prophylactic antibiotic regimen exists.

A prospectively held database documenting endoscopic endonasal repair of cerebrospinal fluid (CSF) leaks in the anterior skull base was reviewed. Post-operative meningitis and antibiotic usage within 30 days of the index procedure were recorded.

A total of 285 consecutive cases were identified with a post-operative meningitis rate of 3.5 per cent. The post-operative confirmed bacterial meningitis rate was 2 per cent. All cases received a single dose of a single agent antibiotic peri-operatively.

The risk of developing post-operative meningitis was associated with a post-operative CSF leak in cases undergoing tumour resection of the anterior skull base.

A single dose, single agent peri-operative antibiotic regimen would appear to be adequate following an endoscopic endonasal approach to repair a CSF leak in the anterior skull base.

Nasal septal perforations are defects of the septum. Symptomatic patients failing conservative measures may be considered for surgery; however, the surgery is challenging. This study describes a technique involving mucosal advancement flaps and autologous or acellular porcine interposition grafts and assessed the long-term closure rate and symptom control.

This study looked at patients with symptomatic septal perforations who underwent surgery between 2005 and 2017. Symptoms were assessed pre- and post-operatively using a visual analogue scale. A literature search was performed for septal perforation repair techniques and outcomes.

A total of 95 per cent of patients had complete closure of their septal perforations, 90 per cent had complete symptom control. There were statistically significant differences between the pre- and post-operative mean visual analogue scale score for epistaxis (p < 0.001), crusting (p < 0.001), whistling (p < 0.001) and nasal obstruction (p < 0.001).

Surgical closure of nasal septal perforations with mucosal advancement flaps and an interposition graft is a reliable technique with excellent long-term outcomes.

The adipofascial anterolateral thigh (AF-ALT) free flap represents a versatile technique in head and neck reconstructions, with its applications increasingly broadening. The objective was to detail the novel utilization of the AF-ALT flap in orbital and skull base reconstruction, along with salvage laryngectomy onlay in our case series.

We conducted a retrospective analysis at Roswell Park Comprehensive Cancer Center, spanning from July 2019 to June 2023, focusing on patient demographics and reconstructive parameters data.

The AF-ALT flap was successfully employed in eight patients (average age 59, body mass index [BMI] 32.0) to repair various defects. Noteworthy outcomes were observed in skull base reconstructions, with no flap failures or major complications over an average 12-month follow-up. Donor sites typically healed well with minimal interventions.

Our series is the first to report the AF-ALT flap's efficacy in anterior skull base and orbital reconstructions, demonstrating an additional innovation in complex head and neck surgeries.