Cochlear implantation is an effective intervention to rehabilitate patients with severe-to-profound sensorineural hearing loss (SNHL).Reference Shah, Xue, Rehman, Watson, Hitos and da Cruz1-Reference Kubina, Fornwalt, Patel, Sharma and Jeyakumar4 The use of bilateral stimulation is becoming common for cochlear implantation recipients, with either a cochlear implantation in one ear and a hearing aid in the contralateral ear (bimodal) or cochlear implantations in both ears (bilateral cochlear implants). Presently, there are only a few studies that address the comparison in the sound localisation abilities of bilateral cochlear implant and bimodal cochlear implantation users. This question has been investigated by Long et al. in this month’s issue.Reference Long, Wang, Liu, Liu and Gong5 A horizontal sound source discrimination task was conducted with 44 bimodal and 20 bilateral cochlear implant users. The study demonstrated that the sound localisation ability of bilateral cochlear implant users was significantly better than that of bimodal cochlear implantation users. The better low-frequency hearing threshold of the non-implanted ears did not help the bimodal cochlear implantation users obtain better sound localisation ability. These results suggest that bilateral cochlear implantation might be more helpful for sound source localisation in patients with bilateral severe-to-profound SNHL.
Anterior commissure involvement poses diagnostic and therapeutic challenges because of its anatomical complexities, namely, the propensity for deep tissue extension and potential for diagnostic underestimation, often contributing to poorer prognosis. A study in this month’s issue sought to identify factors influencing progression to malignancy by retrospectively reviewing long-term follow-up data of 221 patients with laryngeal dysplasia.Reference Karakaya Gojayev, Yaldız ZÇ, Dursun and Gökcan6 The study determined an 11.7 per cent progression rate of laryngeal dysplasia to invasive malignancy. The results also found that dysplastic lesions involving the anterior commissure had an approximately 8.2-fold increased risk of progression to invasive cancer compared with those without such involvement, thereby highlighting the importance of targeted management of such cases.
Palatine tonsil squamous cell carcinoma can be histologically confirmed with either tonsillectomy or tonsillar biopsies. Biopsies have the advantage of being quicker to perform, less invasive and potentially able to provide quicker results, whereas tonsillectomies have the advantage of minimising the risk of missed pathology, but with greater associated morbidity. The 2024 UK Head and Neck Cancer Guidelines do not recommend one approach over the other.Reference Homer, Winter, Abbey, Aga, Agrawal and Dafydd7 A study in this month’s issue by Heining et al. compared whether tonsillectomy or tonsillar biopsies influenced surgical margin status at subsequent curative-intent surgery.Reference Heining, Dale and Constable8 To the authors’ knowledge no previous study has compared surgical margin status in these two groups. Although this is a small study, the data demonstrated tonsillectomy patients had significantly fewer close or involved margins at definitive surgery (p < 0.001). Although the two study groups were not matched, no statistically significant difference was found in T stage or human papillomavirus status between the two groups. The authors of the study recommend that further research studies be undertaken, which should be prospective, multicentred and stratified for both diagnostic and curative-intent surgical techniques.
JONATHAN FISHMAN
ANN-LOUISE MCDERMOTT
STEPHEN JONES
Senior Editors
