To compare two high-resolution computerised tomography based pre-surgical planning software in measuring the cochlear dimensions, which can aid in designing/choosing customised cochlear implant electrodes.

A cross-sectional-observational study was conducted in a tertiary care centre using high-resolution computerised tomography–supported software Otoplan and curved multi-planar reconstruction to find cochlear duct length’s maximum and minimum width/diameter and height in 110 ears (55 subjects). Measurements and the time taken by both techniques were compared.

There were no significant differences in the measurements taken with the two software; however, the time taken for analysis was significantly higher for curved multi-planar reconstruction than with Otoplan.

The steep learning curve, the need for an expert radiologist and the difficulty of use are factors that significantly limit the use of curved multi-planar reconstruction. Otoplan requires less time and can be operated even by someone with less expertise in measuring cochlear dimensions for pre-surgical planning and research.

Rosai–Dorfman disease is a rare histiocytic disorder typically presenting with cervical lymphadenopathy. Sinonasal involvement is uncommon and presents diagnostic and therapeutic challenges. This scoping review synthesises literature on the clinical presentation, diagnosis, management and outcomes of sinonasal Rosai–Dorfman disease.

We systematically searched PubMed, Scopus and Embase. Articles were screened using Endnote. Studies reporting sinonasal Rosai–Dorfman disease were included. The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses-ScR (Scoping Review) guidelines.

Thirty studies comprising 36 patients were included. Common symptoms were nasal obstruction (80.6 per cent) and epistaxis (41.7 per cent). Computed tomography (75 per cent) and magnetic resonance imaging (36.1 per cent) were primary imaging modalities. Histopathology showed emperipolesis (66.7 per cent), S-100 (69.4 per cent) and CD68 (47.2 per cent) positivity. Management was mainly surgical (72.2 per cent), with corticosteroids (44.4 per cent), radiotherapy (5.6 per cent) and chemotherapy (5.6 per cent) used less frequently. Outcomes included complete resolution (38.9 per cent), stable disease (38.9 per cent) and recurrence (16.7 per cent).

Diagnosis relies on histopathology and imaging. Surgical procedures, often with corticosteroids, remain the primary treatment. Future research should guide diagnostic and treatment protocols.

To evaluate the experiences and perspectives of otolaryngology residents regarding current parental leave (PL) practices, incorporating insights from both male and female trainees to assess institutional policies and support mechanisms.

A 43-item anonymous survey was distributed to 125 ACGME-accredited otolaryngology residency programs, yielding responses from 105 residents (response rate: 29%). Data were analyzed using descriptive statistics and thematic analysis to evaluate perceptions of PL policies, barriers to leave, and postpartum support.

Most respondents were female (57%) and married (77%), with an average age of 30 years. Only 26% were aware of the American Board of Otolaryngology’s 8-week PL policy. Female residents typically took 4-6 weeks of leave, while male residents took none. Concerns about program strain (29%) and lack of lactation support (60%) were significant barriers. Despite this, most respondents felt supported by co-residents and faculty.

Otolaryngology residents reported dissatisfaction with PL policies, inadequate lactation support, and poor awareness of institutional guidelines. Addressing these issues is critical to fostering a supportive environment for residents pursuing parenthood during training.

This study evaluated laryngeal changes and voice quality in patients with obstructive lung disease treated with combination inhalational agents.

A prospective observational study at a tertiary care hospital in southern India included 112 newly diagnosed obstructive lung disease patients. Initial assessments involved history-taking, clinical examination, direct laryngoscopy and voice analysis using PRAAT® software. Parameters such as mean pitch, jitter, shimmer, harmonic-to-noise ratio and maximum phonation time were measured, with follow-ups at 3, 6 and 12 months.

Patients had a mean age of 43.05 years. Progressive laryngeal changes, including oedema (5.3 per cent) and hyperaemia (7.1 per cent), were noted by 12 months. Significant increases in shimmer and jitter, along with decreases in harmonic-to-noise ratio and maximum phonation time, indicated deteriorating voice quality (p < 0.001).

Long-term inhalational corticosteroid use in obstructive lung disease patients leads to progressive laryngeal changes and voice deterioration, emphasising the need for vocal function monitoring and preventive strategies.

Palatine tonsil squamous cell carcinoma can be diagnosed with either tonsillectomy or tonsil biopsies. Biopsies are quicker to perform, less invasive, and provide potentially quicker results. Tonsillectomy minimises risk of missed pathology, but with greater associated morbidity. We compared whether tonsillectomy or biopsy affected surgical margin status at subsequent resection.

Our Business Intelligence Team provided a list of all patients with a primary tonsil squamous cell carcinoma who underwent surgery as their primary treatment modality in the last five years at University Hospitals Bristol. Demographic and treatment details were collected along with margin status following surgical resection.

Of the 31 patients that met inclusion criteria, 16 had biopsies and 15 had diagnostic tonsillectomies. The group who underwent tonsillectomy had a reduced risk of close or involved margins (< 5 mm) at subsequent curative-intent surgery (p < 0.001).

Our results suggest that tonsillectomy is associated with reduced likelihood of close or involved margins at subsequent curative-intent surgery. We hope this work can prompt larger multicentre comparisons between these two groups to investigate this relationship in more detail.

To compare the sound localisation abilities of bimodal cochlear implant and bilateral cochlear implant users.

A horizontal sound source discrimination task was conducted with 44 and 20 bimodal and bilateral cochlear implant users, respectively. Paired and two-sample t-tests were performed for paired and unpaired data, respectively.

The root mean square error scores of the bimodal cochlear implant and bilateral cochlear implant users were 75.77 ± 10.49° and 54.39 ± 19.82°, respectively. The bilateral cochlear implant users’ root mean square error score was significantly better than that of the bimodal cochlear implant users (t = 5.65, p < 0.001). The root mean square error scores of bimodal cochlear implant users with good and poor low-frequency hearing were 75.45 ± 11.07° and 76.10 ± 10.14°, respectively, with no significant intergroup difference (t = 0.20, p = 0.84).

Bilateral cochlear implantation may be more helpful for sound localisation in patients with bilateral sensorineural hearing loss. The better low-frequency hearing threshold of the non-implanted ears did not result in better sound localisation ability in bimodal cochlear implant users.

Laryngeal dysplasia is a pre-cancerous lesion within the larynx. This study aims to identify factors influencing progression to cancer by analysing long-term follow-up data.

Data from 221 patients diagnosed between 2005 and 2017 were reviewed retrospectively. Patient demographics, treatment strategies and follow-up results were compared.

Progression to cancer occurred in 26 patients (11.7 per cent). A significant association was found between cancer progression and initial biopsies obtained from the anterior commissure (34.6 per cent in progressing cases vs. 6.2 per cent in non-progressing; p < 0.001). Carcinoma in situ cases showed a higher progression rate (21.7%) compared to mild dysplasia (3.4 per cent) (p = 0.007). The group with cancer progression also had higher rates of other cancers (15.4 per cent vs. 2.1 per cent; p = 0.008), including lung cancer (11.5 per cent vs. 0 per cent; p = 0.001).

The study determined an 11.7 per cent progression rate of laryngeal dysplasia to cancer. Lesions involving the anterior commissure carried an approximately 8.1-fold increased risk of progression.

The aim of this study was to evaluate the vestibular system in substance addicts.

A total of 34 substance addicts were included in the study. A demographic data form, the Dizziness Handicap Inventory, the Addiction Profile Index Screening – Short Form, the Video Head Impulse Test, videonystagmography, and cervical and ocular vestibular evoked myogenic potentials tests were administered in all participants.

A statistically significant difference was found between the study group and the control group (p < 0.05) in terms of gaze, saccade, pursuit and optokinetic results in the videonystagmography test; lateral, anterior and posterior semicircular canal gain values in the Video Head Impulse Test; P1 latency, P1–N1 interlatency, P1–N1 amplitude and asymmetry values in the cervical vestibular evoked myogenic potentials test; and N1–P1 interlatency, N1–P1 amplitude and asymmetry values in the ocular vestibular evoked myogenic potentials test (p < 0.05).

As a result of our study, it was observed that the vestibular system was affected in substance addicts.

The immune-modified Glasgow Prognostic Score, encompassing C-reactive protein, serum albumin, and lymphocyte count, is a valuable prognostic tool for head and neck squamous cell carcinoma. We aimed to assess the utility of immune-modified Glasgow Prognostic Score in predicting the treatment response to nivolumab in patients with head and neck squamous cell carcinoma.

Seventy-six patients with head and neck squamous cell carcinoma treated with nivolumab were included in this study. The imGPS was assessed before the initial nivolumab dose and four weeks after immune-modified Glasgow Prognostic Score.

Multivariable analysis identified four weeks after immune-modified Glasgow Prognostic Score as an adverse prognostic factor for progression-free and overall survival. The best overall response was significantly associated with four weeks after immune-modified Glasgow Prognostic Score. Remarkably, all patients with four weeks after immune-modified Glasgow Prognostic Score = 3 and 8 (80.0%) of 10 patients with four weeks after immune-modified Glasgow Prognostic Score = 2 experienced progressive disease.

The immune-modified Glasgow Prognostic Score proves valuable for predicting prognosis in patients with head and neck squamous cell carcinoma undergoing nivolumab treatment, particularly excelling in identifying individuals unlikely to respond to nivolumab.

To identify ‘on-table optimal meatal opening size’ that predicts post-operative mastoid cavity healing in the canal wall down tympanomastoidectomy. To develop a specific, measurable, achievable, acceptable, replicable and time-bound (SMAART) meatoplasty.

A double-blind randomised control trial where patients were randomly assigned to standard Portmann 3 flap and new SMAART 2 flap technique.

There were 18 and 17 participants in the former and latter, respectively. Dry ear was achieved when the on-table ratio of tympanomastoid cavity volume to meatal opening size was 2:1. In a mastoid cavity of 6 ml or less, among the 2 flap patients, the majority had epithelialisation completed by the first month, meatoplasty having significantly shorter duration (12.2 versus 32.3 minutes) and cosmetically better than 3 flap.

Optimal meatoplasty is when tympanomastoid cavity volume ratio to meatal opening size is 2:1. When the on-table mastoid cavity is either 6 ml and less or is obliterated to 6 ml and less, the new SMAART 2 flap meatoplasty should be considered.

This study aims to report our experience with endoscopic tenotomy in treatment of Ménière’s disease as its reported role in literature is still controversial.

Patients diagnosed with unilateral definite Ménière’s disease and underwent endoscopic tenotomy of middle-ear muscles in our tertiary care centre were retrospectively evaluated. Pure tone average, frequency of vertiginous attacks, functional level, tinnitus scale and Dizziness Handicap Inventory were compared pre-operatively and post-operatively.

Twenty-eight cases were included in the study with an average age of 50.78 ± 12.16 years. At the 2-year follow-up period, 16 cases (57.14 per cent) achieved complete control of vertigo, 5 cases (17.85 per cent) had substantial vertigo control, and 3 cases (10.71 per cent) had limited control. Significant improvement in Dizziness Handicap Inventory and functional level also was found post-operatively.

Endoscopic tenotomy for Ménière’s disease is easy and simple with no serious complications, but its relatively low results of absolute vertigo control limit its consideration as a definitive treatment.

Retropharyngeal and parapharyngeal infections can be managed surgically or conservatively. A trial of medical treatment before considering computed tomography (CT) imaging may be appropriate.

This is a retrospective review of patients with retropharyngeal and parapharyngeal infections between October 2022 and April 2023. Descriptive and statistical analysis compared surgically and conservatively managed patients.

There were 33 patients (median age 58 months). CT imaging was acquired for 30 of 33 patients (90.9 per cent) and 25 had a CT scan within 24 hours of presentation. Fourteen patients (42.4 per cent) were managed surgically. The mean duration of antibiotics for surgically and conservatively managed patients was not significantly different (19.9 vs 21.4 days, p = 0.73). Larger lesions were observed on the CT scans of surgically treated patients (22.8 vs 15.6 mm, p = 0.01).

Management of paediatric retropharyngeal and parapharyngeal infections can be surgical or conservative. We propose a management algorithm that allows an initial trial of intravenous antibiotics before CT imaging for selected patients.

The study aim is to validate the utility and implications of the Manjila jugular bulb classification.

A retrospective study of 182 patients who underwent lateral skull base or otologic surgery was conducted. Pre-operative temporal bone computed tomography and magnetic resonance imagery scans were reviewed, and the classification was independently applied by a neuroradiologist and neuro-otologist. Concordance among imaging, intra-operative findings, complications, and functional outcomes was assessed.

Substantial agreement was found between imaging and intra-operative findings (Cohen’s kappa = 0.78). High-riding jugular bulbs were present in 13.7 per cent of cases, with complications such as venous bleeding (5.5 per cent) and cranial nerve palsy (2.7 per cent). Surgical approaches were altered in 25 per cent of cases. Functional outcomes, including hearing and facial nerve preservation, were not correlated with jugular bulb grades.

The classification demonstrated strong concordance with intra-operative findings, emphasising the importance of pre-operative identification for tailored surgical planning.

This study evaluates the relationship between Systemic Immune-Inflammation Index and secondary tonsillar haemorrhage after tonsillectomy.

Sixty pediatric patients with secondary haemorrhage and 60 without bleeding were grouped for comparative analysis. Laboratory parameters and Systemic Immune-Inflammation Index values were collected preoperatively, on the bleeding day and on the control day, then compared.

Secondary haemorrhage occurred in 60 patients (3.11 per cent), with a mean age of 8.85 ± 3.07 years. Bleeding occurred at 8.63 ± 2.32 days post-operatively (range: 72 hours–21 days). Tonsillectomy day: Neutrophil count and Systemic Immune-Inflammation Index were significantly higher in the haemorrhage group (p < 0.001). Haemorrhage vs. tonsillectomy day (haemorrhage group): Platelet, neutrophil and Systemic Immune-Inflammation Index increased, while lymphocytes decreased (p < 0.001). Haemorrhage vs. control day: Neutrophil count and Systemic Immune-Inflammation Index remained significantly higher (p < 0.001).

Systemic Immune-Inflammation Index, a novel inflammatory marker, may help predict post-tonsillectomy haemorrhage risk.

Necrotising otitis externa is a serious infective condition with significant risk of complications and a profound impact on patients’ quality of life.

A quantitative descriptive study was undertaken using epidemiological data from the National Health Service Hospital Episode Statistics database and other national databases. Data correlating with reported cases 2002-2024 were compiled and analysed.

The national incidence of necrotising otitis externa has demonstrated a sustained increase 2002-2024. The 30 per cent incidence drop during the coronavirus disease 2019 pandemic may be attributable to reduced exposure to risk factors, reduced contact between susceptible patients and health professionals and pandemic-related deaths of at-risk populations. There remains a strong correlation between growths in necrotising otitis externa incidence, the ageing population and national incidence of diabetes mellitus. These are all projected to continue to rise. Antibiotic resistance is not a significant contributing factor.

This study demonstrates several significant trends, offering a strong foundation for deeper exploration in future studies.

This study is to evaluate the results obtained in a group of implanted otosclerotic patients and compare them with a matching group of non- otosclerosis cochlear implant patients.

Pre-operative computed tomographic scans, intra-operative findings, type of electrode used and difficulties of 17 patients with otosclerosis were documented. Post-operative complications, facial nerve stimulation, electrode dislocation and audiological and speech outcomes were documented and the data analysed.

Surgical difficulties were directly related to the advanced stage of the disease. No major complications were reported in this cohort. No significant difference was found between both groups one year after surgery; the mean pure tone average was 35 dB ± 4.43, speech reception threshold was 40 ± 4.96 and speech discrimination score was 80 per cent ± 12.55 in the otosclerotic group.

Cochlear implantation is a safe and effective management for advanced otosclerosis patients even after stapes surgery.

This pilot randomised controlled trial evaluated virtual reality as a supplementary teaching tool for peritonsillar abscess drainage among third year medical students.

Twenty students were randomised to virtual reality-based or traditional teaching, each receiving a 90-minute session followed by an objective structured clinical examination and pre-/post-session knowledge tests. The virtual reality group used HTC Vive Focus 3 headsets with Virti, 3D Organon and EXR platforms.

The virtual reality group scored higher in objective structured clinical examinations (26.9 vs. 21.5; p = 0.005) and reported greater procedural confidence (p = 0.008) and engagement (p = 0.003). Both groups improved knowledge (p < 0.001) without significant difference post-session (p = 0.701). Virtual reality was rated highly for effectiveness (9.6/10) and immersion (8.5/10) and had minimal cybersickness (1.8/10).

Virtual reality significantly enhances procedural confidence and performance. Its immersive format supports integration into surgical education, warranting further validation in larger studies.

We present the case of a patient with bilateral vocal fold paralysis following extensive surgical repair of congenital cardiac abnormalities and the management of the subsequent airway compromise with primary endoscopic anterior–posterior cricoid split.

Review of our management of a patient with bilateral vocal fold paralysis using anterior–posterior cricoid split and literature search of alternative management options for patients with bilateral vocal fold paralysis.

Our newborn patient developed stridor and respiratory failure following surgery for multiple cardiac malformations. Flexible fiberoptic laryngoscopy revealed bilateral vocal fold paralysis, and the patient was intubated for airway protection. We addressed the bilateral vocal fold paralysis with primary endoscopic anterior–posterior cricoid split to avoid tracheostomy, successfully extubating to room air 13 days later. The patient regained nearly total function of both folds and, at two-year follow-up, was asymptomatic from an airway, voice, sleep and swallowing perspective.

APCS was effective in managing bilateral vocal fold paralysis-associated respiratory failure and avoiding tracheostomy, with long-term follow-up demonstrating symptom resolution and bilateral recovery of laryngeal mobility.

Squamous cell carcinoma of the external auditory canal is rare, with bilateral cases even rarer. We report the management of a patient with bilateral external auditory canal squamous cell carcinoma related to radiotherapy and immunosuppression.

A 47-year-old woman with a history of radiotherapy 14 years prior and renal transplantation 6 years prior presented with bilateral external auditory canal squamous cell carcinoma. Squamous cell carcinoma was excised with a purely surgical approach. The two operations included a tympanic membrane graft to preserve hearing on the left side. The patient remains disease-free six months post-op. She uses a bone-conduction hearing aid to good effect on the right side and has mild hearing loss on the left. The operative areas have healed well.

The patient’s previous radiotherapy and immunosuppression may have contributed to her bilateral external auditory canal squamous cell carcinoma. Preventative positron emission tomography scans have the potential to identify second malignancies early, allowing more conservative treatment plans.