This study aimed to evaluate physical simulation models for endoscopic ear surgery including model types, validation methodology and educational outcomes.

A Preferred Reporting Items for Systematic reviews and Meta-Analyses compliant search of PubMed, Embase and the Cochrane Library was conducted to June 2025. Studies describing physical endoscopic ear surgery simulators with reported validation or educational outcomes were included.

Fourteen studies met inclusion criteria. Simulators comprised cadaveric animal heads, synthetic task trainers and single- and multi-material three-dimensional-printed models. Face validity was consistently high. Construct validity, assessed using Objective Structured Assessment of Technical Skills scores or timed tasks, was demonstrated in five studies. Content validity was reported in three studies. No study evaluated transfer validity. Educational outcomes included improvements in confidence, anatomical knowledge and task completion time.

Physical endoscopic ear surgery simulators show strong face validity and emerging construct validity, but evidence is limited by small, single-centre studies and methodological variability. Standardised validation and assessment of clinical transfer are needed to support integration into training pathways.

This study aimed to evaluate the diagnostic and surveillance performance of circulating tumour human papillomavirus DNA for post-treatment monitoring of human papilloma virus–positive oropharyngeal squamous cell carcinoma.

Systematic review and meta-analysis of prospective studies (2019–2024) identified from PubMed, Web of Science and Scopus. Random-effects models were used to pool circulating tumour human papillomavirus DNA detectability and summarise lead-times to recurrence.

Fifteen studies (n=1,447) were included; 10 cohorts (n=731) entered the quantitative meta-analysis. Pooled baseline detectability was 85.5 per cent (95 per cent confidence interval 78.2–90.6). Circulating tumour human papillomavirus DNA positivity preceded clinical recurrence by a mean of 76.8 days (median 87.5). Specificity and negative predictive value were consistently high, whereas sensitivity varied by assay platform and sampling frequency.

Serial circulating tumour human papilloma virus DNA testing is a reliable adjunct to post-treatment surveillance in HPV-positive oropharyngeal squamous cell carcinoma, offering a clinically meaningful lead-time to recurrence. Standardised assays and multicentre validation are warranted.

This study aimed to systematically review the evidence on functional outcomes following dorsal preservation rhinoplasty, with a focus on nasal obstruction.

A systematic review was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. PubMed, Embase, Scopus and Cochrane databases were searched up to March 2025. Studies reporting nasal airway outcomes following dorsal preservation rhinoplasty using subjective or objective measures were included.

Six studies comprising 662 patients were included. Patient-reported outcomes (Nasal Obstruction Symptom Evaluation, Standardized Cosmesis and Health Nasal Outcomes Survey and Visual Analogue Scale) consistently demonstrated significant post-operative improvement. Objective measures (acoustic rhinometry, rhinomanometry and cone-beam computed tomography) showed maintained or improved airway dimensions. dorsal preservation rhinoplasty was functionally equivalent to traditional structural techniques, with low complication (<5 per cent) and revision rates (<2 per cent).

Dorsal preservation rhinoplasty maintains or improves nasal airway function while preserving structural integrity and reducing the need for grafting. It is a safe and effective alternative to traditional dorsal reduction techniques.

To evaluate the evidence for superior laryngeal nerve block in neurogenic cough and outline practical considerations for clinical use.

A systematic review was conducted in May 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible studies reported validated cough-specific quality-of-life outcomes and safety data.

Nine studies (1 randomised trial, 8 case series; n = 490) were included. All studies reported subjective improvement: eight conducted statistical testing and seven showed significant benefit, with the Leicester Cough Questionnaire exceeding the minimal clinically important difference and the Cough Severity Index showing reductions post treatment. Patients received an average of 2 to 3 injections, with follow-up of up to 22 months. Adverse effects were mild and transient. Neuromodulator use and behavioural therapy were inconsistently reported.

Superior laryngeal nerve block appears safe and effective as a short-term intervention, with long-term efficacy remaining uncertain. This review highlights procedural gaps and introduces a structured pathway to guide patient selection, injection and follow up. Robust multicentred trials and consensus guidelines are needed to define long-term benefit and standardise practice.

Button batteries are a common household item that are, unfortunately, attractive to young children. If ingested, they are corrosive and potentially fatal. Button battery ingestion is frequently unwitnessed, delaying the diagnosis. In the USA, approximately 6,000 accidental ingestions occur annually (2.2 deaths per year over a decade on average). Community awareness of this danger appears to be low.

We conducted a 22-question online questionnaire-based study to assess and raise awareness of this exceptional childhood risk.

A total of 561 survey responses were analysed; 77 per cent were female, and 60 per cent were aged 30–50. Despite 87 per cent using button batteries, 65 per cent did not consider their safety, and 68 per cent found existing packaging warnings inadequate. Notably, 80 per cent recognised the potential for fatality, but 88 per cent were unaware that a spoonful of honey could delay this corrosive process.

Challenges persist regarding the design and marketing of button batteries and public awareness of their ingestion. Action is required to prevent further tragedies.

This study aimed to estimate the prevalence of Eustachian tube dysfunction and identify associated risk factors in a consecutive cohort of children undergoing adenotonsillectomy for sleep-disordered breathing.

This was a retrospective study of children with sleep-disordered breathing admitted for adenotonsillectomy in two tertiary public hospitals in South China from January 2019 to November 2023. The prevalence of Eustachian tube dysfunction was assessed based on tympanograms. Demographic information and clinical characteristics were collected for risk factors analysis.

A total of 1,044 children aged 3 to 14 years were enrolled in the present study, 375 (35.92%) of whom had Eustachian tube dysfunction. Risk factors for Eustachian tube dysfunction included age less than or equal to six years, allergic rhinitis, sinusitis, adenoid hypertrophy and hypoxemia. No significant association was found between Eustachian tube dysfunction and gender, disease duration, tonsillar hypertrophy, obesity or obstructive sleep apnoea.

Eustachian tube dysfunction is highly prevalent in children undergoing adenotonsillectomy for sleep-disordered breathing and, therefore, warrants further attention and intervention.

Eustachian tube balloon dilation is increasingly recognised as a minimally invasive option for middle ear effusion. However, its role in children with cleft lip and palate remains under-explored.

We prospectively evaluated 14 cleft lip and palate children (28 ears) with middle ear effusion. Group 1 (intervention) comprised 14 ears that underwent Eustachian tube balloon dilation with intranasal corticosteroids, while Group 2 (control) included 14 ears treated with intranasal corticosteroids alone. Tympanometry, pure-tone audiometry and Eustachian Tube Dysfunction Questionnaire-7 were administered before and six weeks after intervention.

Eustachian tube balloon dilation significantly improved hearing thresholds (p = 0.03) and air-bone gap (p = 0.04), with favourable tympanometric changes (p < 0.05) and a significant reduction in Eustachian Tube Dysfunction Questionnaire-7 scores, indicating symptom improvement. No major complications occurred.

Eustachian tube balloon dilation is a safe, well-tolerated and potentially effective adjunctive procedure for cleft lip and palate children with middle ear effusion. Larger randomised controlled trials are needed to validate these findings.

Artificial intelligence (AI) has the potential to revolutionise medical communication. Our aim was to investigate whether AI can be used to adapt patient information leaflets and compare their acceptability with human-generated patient information leaflets.

ChatGPT was instructed to refine four ENT-related patient information leaflets originally written by clinicians. Pairs of human-generated and AI-adapted patient information leaflets were distributed to patients alongside a questionnaire asking them to assess presentation, condition explanation, ease of understanding, and when to seek medical attention and overall preference. Readability was evaluated using the Flesch–Kincaid Readability Ease Score and Grade Level.

Of 111 responses, 39.6 per cent expressed no overall preference between the AI-adapted and human-generated patient information leaflets, 27.9 per cent preferred the AI-adapted leaflet and 32.4 per cent preferred the human-generated patient information leaflet. There was a slight reduction in the readability of the AI-adapted patient information leaflets.

Artificial intelligence- and human-generated patient information leaflets were broadly comparable in their acceptability to patients. However, clinician oversight is essential to safeguard the quality and readability of AI-produced materials.

To assess the relationship between vitamin D and post-operative hypocalcaemia in patients undergoing total thyroidectomy in our population.

A prospective cohort of 210 patients meeting inclusion criteria from March 2020 to September 2023 at Sultan Qaboos University Hospital was analysed. Pre-operative serum 25-hydroxy vitamin D was measured, with calcium and parathyroid hormone assessed post-operatively, and symptoms recorded.

Univariate and logistic regression analyses showed no significant association between pre-operative vitamin D levels and post-operative hypocalcaemia (p = 0.254 and 0.52, respectively). Receiver operating characteristic analysis showed an area under the curve of 0.6 (p = 0.012), indicating limited predictive ability.

In our population, pre-operative vitamin D level was not a reliable predictor of post-thyroidectomy hypocalcaemia. Because of population-based differences in vitamin D metabolism and assay variability, universal cut-off values remain impractical. These findings highlight the need for further research to establish population-specific thresholds for vitamin D in predicting hypocalcaemia risk.

This study aimed to determine the prevalence of undiagnosed diabetes and prediabetes in patients presenting with recurrent otomycosis and to evaluate associated risk factors, fungal profiles and cerumen pH variations.

This cross-sectional study included 213 adults with greater than or equal to two episodes of otomycosis. Glycaemic status was assessed using fasting blood sugar, post-prandial blood sugar and glycated haemoglobin. Fungal identification and cerumen pH measurement were performed. Multivariate analysis identified predictors of recurrence.

Undiagnosed diabetes and prediabetes were found in 30 per cent and 13 per cent of patients, respectively. Candida albicans predominated in diabetics, while Aspergillus niger was common in normoglycaemics. Cerumen pH was significantly higher in diabetics (6.6) compared to normoglycaemics (5.3). Glycated haemoglobin greater than or equal to 6.5 per cent, Candida infection and steroid ear drop use were independent predictors of recurrence.

A substantial proportion of patients with recurrent otomycosis harbour unrecognised glycaemic abnormalities. Routine diabetes screening in ENT clinics may aid in early metabolic disease detection and reduce recurrence rates.

This study aimed to determine the incidence, location and outcome of incidental avid lesions on positron emission tomography-computed tomography scans for head and neck cancer.

A retrospective study reviewing digital case notes, performed from a single centre. Clinicopathological information was collected and incidental avid lesions on positron emission tomography-computed tomography reports were recorded. Further investigations were followed up to determine the outcome of the lesions.

A total of 281 patients undergoing staging positron emission tomography-computed tomography (stages T4, N3 or unknown primary) and/or treatment response positron emission tomography-computed tomography scans for head and neck cancer were identified, with 363 incidental avid lesions reported in 369 scans. The most common location was the abdomen (30.0 per cent), followed by thorax (28.9 per cent). A total of 33.1 per cent of lesions had further investigation. The rate of incidental synchronous primary was 3.6 per cent.

The benefit of investigating carefully selected incidental avid lesions outweighs the harm of investigation, as it may alter management. There is a need for a standardised pathway for investigating these lesions in head and neck cancer services.

This study aimed to investigate whether seasonal epistaxis patterns differ between cases manageable in emergency departments versus those requiring hospital admission and to examine weather parameter correlations by severity category.

A retrospective severity-stratified analysis of 2,201 epistaxis presentations across two UK hospitals (January 2023–December 2024) with comprehensive weather correlation analysis was used.

Emergency department cases (1,762 presentations, 80.1 per cent) peaked in winter (475 cases, 27.0 per cent), while hospital admissions (439 cases, 19.9 per cent) peaked in spring (130 cases, 29.6 per cent). A critical 10°C temperature threshold effectively separated severity categories with high predictive accuracy.

Epistaxis demonstrates opposing seasonal patterns by clinical severity with distinct weather correlation profiles. Emergency departments should prepare for winter volume surges during cold, humid periods, whilst specialist ENT services require enhanced spring capacity during moderate temperature conditions.

The aim of this study was to compare KTP (potassium titanyl phosphate) laser therapy and dextracin ear drops for treatment of chronic myringitis.

A case series involving 31 patients (18 laser group; 13 dextracin group). Primary outcomes included otorrhoea resolution, improvement in Chronic Ear Survey scores and endoscopic resolution. Secondary outcomes included hearing outcome and complications. Statistical analyses were performed using Mann-Whitney U, Wilcoxon signed-rank and Fisher’s exact tests.

The laser group had a higher rate of otorrhoea resolution 66.67 per cent (n = 12) vs 15.38 per cent (n = 2) (p = 0.006), showed significant improvement in symptom scores (median 31.43; p = 0.005) and medical resource use (16.67; p < 0.001) and had a significant myringitis area reduction of 31.84 per cent (p < 0.001). No significant differences were observed in Chronic Ear Survey scores and area reduction in the dextracin group. One laser-group patient developed a permanent perforation.

KTP laser therapy is effective for refractory chronic myringitis, offering superior symptom relief and reduced healthcare utilisation compared to topical treatment.

To evaluate clinical characteristics, complications and survival outcomes in patients undergoing lateral temporal bone resection for malignancy at a tertiary skull base centre.

This retrospective cohort study analysed patients treated between 2004 and 2023 at a UK tertiary referral centre. Data collected included demographics, histological diagnosis, stage, surgical approach, reconstruction and adjuvant therapy. Complications and survival were examined using descriptive statistics, Kaplan–Meier survival curves and Cox proportional hazards modelling.

Eighty-nine patients were included (mean age, 67.2 years; 69.7 per cent male). Squamous cell carcinoma (SCC) was the most frequent diagnosis (58.4 per cent) and lateral temporal bone resection was the predominant procedure (73.0 per cent). Post-operative complications occurred in 25.8 per cent of patients, with haematoma the most common complication. Median follow up was 19 months. The 5-year overall survival rate was 50 per cent, with significant differences by cancer stage and patient age.

Surgical management of lateral temporal bone malignancies, predominantly SCC, carries significant morbidity, while survival and complication rates mirror published literature, with outcomes chiefly influenced by age and cancer stage rather than nodal status.

This study aimed to compare long-term audiological outcomes of diode laser stapedotomy, microdrill stapedotomy and combined potassium titanyl phosphate laser–microdrill stapedotomy, and to identify predictors of surgical success.

Surgical, audiological and complications data were collected. Surgical success was analysed via the measurement of post-operative air–bone gap, air conduction gain.

A total of 615 patients were included; median follow-up was 16 months (range 1–1319). Overall, the 94.3 per cent achieved surgical success (air–bone gap < 15 dB). Median air–bone gap closure was 5 dB (interquartile range: 2.50–8.12), and median air conduction gain was 27.5dB (interquartile range: 19.37–36.25).

Compared across techniques, success rates were similar; however, post-operative air–bone gap was significantly better with laser techniques than with microdrill alone (p = 0.016). Longer prostheses were associated with improved outcomes.

All the examined techniques showed excellent audiological results. Laser use was associated with better post-operative air–bone gap than stapedotomy with microdrill only.

External auditory exostosis (surfer’s ear) is a progressive condition of benign hyperostotic overgrowths of the external auditory canal, secondary to repetitive cold-water exposure, in which symptoms correlate to degree of exostosis. Surgical intervention is the only available treatment, most commonly using the osteotome or microdrill, but these carry a risk of sensorineural hearing loss, post-operative stenosis, temporomandibular dysfunction and tympanic membrane perforation.

We describe in detail the Swansea technique, an innovative method of canaloplasty with endoscopic underwater excision of exostoses using a piezoelectric saw and continuous irrigation with 1:1,000,000 adrenaline, with the results from our first 34 procedures.

The inherent properties of the piezoelectric saw reduce the risk of overall complications when compared with traditional methods, whilst the surgical set-up is cost-equivocal and easily implemented in departments with endoscopic capabilities.

The piezoelectric saw is a promising novel technique for the treatment of external auditory exostosis.

This study aimed to describe a one-stage technique for nasal skin defect reconstruction using an oxidised regenerated cellulose/collagen matrix (Promogran™) to enhance contour and graft survival.

Following excision of a skin lesion, Promogran™ is cut to size, placed in the wound bed to restore contour and provide bulk, saturated with blood and covered with a full-thickness skin graft.

The technique improves cosmesis and enables graft survival over avascular structures, including exposed bone and cartilage. Promogran™ exerts wound-healing effects such as matrix metalloprotease inhibition, regulation of growth factors and cytokines, free-radical scavenging and fibroblast proliferation.

This simple, one-stage approach offers an alternative to complex or multistage reconstruction for patients unsuitable for, or preferring to avoid, more invasive procedures.