Congenital hearing loss is a chronic condition which occurs worldwide. In the past, investigations focused on testing the most common genes associated with hearing loss (such as Connexin 26-related hearing loss). Targeted testing of specific genes was requested only when a particular syndrome was suspected. Recent advances have led to the development of a large gene panel which utilises next-generation sequencing to simultaneously test for pathogenic variants in many genes associated with hearing loss.

This review article aims to highlight the changes in the approach to congenital hearing loss in the context of the R67 gene panel, and how its use may increase the efficiency of the diagnosis and management of this condition.

The use of this large gene panel has revolutionised the approach to hearing loss. Uptake of this large gene panel has resulted in prompter diagnosis and therefore more appropriate clinical management.

This study evaluates the safety and utility of Eustachian tube balloon dilatation in treating Eustachian tube dysfunction symptoms in adults without middle-ear disease.

A prospective cohort study was performed. Adults with dilatory Eustachian tube dysfunction symptoms and no middle-ear disease underwent Eustachian tube balloon dilatation. A clinical assessment including tympanometry, pure tone audiometry, otoscopy, ability to Valsalva, and Eustachian Tube Dysfunction Questionnaire-7 was performed pre-operatively and repeated during a 12-month follow-up period.

Fifteen participants were enrolled. The mean pre-operative Eustachian Tube Dysfunction Questionnaire-7 score of 4.6 reduced to 2.5 at six weeks (P < 0.01), 3.0 at six months (P = 0.02) and 2.6 at 12 months (P < 0.01) post-operatively. All patients without evidence of negative middle-ear pressure had Eustachian Tube Dysfunction Questionnaire-7 score improvements. There were no post-operative complications.

Eustachian tube balloon dilatation is safe and effective at treating Eustachian tube dysfunction in patients with no middle-ear disease or evidence of negative middle-ear pressure.

For 50 years, the Thomas Wickham-Jones (TWJ) Foundation has promoted the advancement of otology and audiology in the UK and Republic of Ireland through a series of overseas Fellowships and other grants.

The paper examines the history of the Foundation since its establishment in 1974, drawing upon the Foundation's archives and personal recollections. The analysis is located within a framework concerning the factors that shape the success or failure of a foundation including vision, strategy, information, leadership and finance.

The activities of the TWJ Foundation are charted over five decades, and the governance of the Foundation is detailed. Particular attention is given to the Major Fellowships offered, at first in North America, and to their subsequent development into the Foundation's current rotation.

The paper offers an assessment of the TWJ Foundation's impact on the training of otologists in the British Isles and concludes with a brief self-reflective analysis.

To compare characteristics between stroke populations with and without sensorineural hearing loss (SNHL) and assess the impact of SNHL on stroke outcome.

A retrospective study of patients admitted with stroke was carried out. Patients were divided into two groups, where group A were diagnosed with SNHL and group B were without SNHL. Baseline age, gender, vascular risk factors and disability were compared. Logistic regression analyses were performed with three-month mortality and SNHL as dependent variables.

A total of 631 admissions were reviewed, with mean age 79.2 years, including 305 patients with SNHL and 326 without. More severe disability was more prevalent in patients with SNHL. Sensorineural hearing loss was not associated with increased mortality (odds ratio = 1.1, 95 per cent confidence interval = 0.7–2.0, p = 0.668). Hypertension was present in 210 (68.9 per cent) with SNHL versus 189 (58 per cent) without SNHL (p = 0.005). Small-vessel disease aetiology was more prevalent in SNHL 51 (16.7 per cent) versus 30 (9.2 per cent) without SNHL (p = 0.005).

Sensorineural hearing loss appears to have an association with stroke of small-vessel disease aetiology and hypertension. Sensorineural hearing loss does not affect three-month mortality but is associated with increased disability.

This study aimed is to analyse the quality of stapedotomy videos as an educational tool and to test the feasibility of the IVORY grading system (IVORY-GS) in an otological procedure.

YouTube was searched using the terms “stapedectomy”, “stapedotomy” and “otosclerosis surgery.” Video length, upload date, view count and likes were evaluated. The included videos were scored according to the IVORY-GS.

Sixty-seven videos were evaluated. The mean IVORY-GS total score was 21.8. Video scores were higher in the ethics part. Case presentation items got the lowest scores in total. The total score showed a significantly positive correlation with like counts. No significant correlation was found between the total score and view count and video age.

The educational quality of most of the stapedotomy videos on YouTube is insufficient. The IVORY-GS is a comprehensive guideline in the otorhinolaryngology field. However, it may require some modifications based on the type of surgery.

The present study aimed to measure an association between the caloric test and vestibulo-ocular reflex gain and refixation saccades in individuals with auditory neuropathy spectrum disorders.

Twenty individuals (9 males and 11 females), in the age range of 17 to 38 years, diagnosed with auditory neuropathy spectrum disorders, and 20 normal-hearing individuals (age and gender matched) participated in the study. All the individuals underwent case history, pure tone audiometry, immittance evaluation, otoacoustic emissions, auditory brainstem response, caloric tests and video head impulse tests.

All the patients with auditory neuropathy spectrum disorders in the present study had hypoactive caloric responses, which suggested peripheral vestibular lesions. The mean vestibulo-ocular reflex gain was reduced in few patients with auditory neuropathy, whereas few patients had normal vestibulo-ocular reflex gain.

The present study revealed a discrepancy between the caloric and video head impulse test results in auditory neuropathy spectrum disorders. The vestibular evaluation should be done for all patients with auditory neuropathy spectrum disorders to understand the various types of vestibular nerve lesions.

This study aimed to examine the efficacy of the automated mechanical repositioning chairs compared to canalith repositioning manoeuvres for elderly patients with benign paroxysmal positional vertigo (BPPV).

A retrospective study included 969 patients with BPPV who were first diagnosed at Beijing Chaoyang Hospital, Capital Medical University between 1 January 2020 and 31 December 2020. Patients were followed up for one year. Demographics, disease status, treatment and various outcomes were collected through medical record reviews and follow-up interviews.

Based on the criteria for evaluating treatment efficacy using objective and subjective indicators, BPPV patients treated with automated mechanical repositioning chair therapy showed a significantly better prognosis and lower recurrence rates.

Automated mechanical repositioning chair therapy is an effective approach for BPPV treatment, with advantages over conventional manual canalith repositioning procedures.

This study aimed to investigate the impact of vitamin D deficiency on vestibular function and recurrence in patients with benign paroxysmal positional vertigo.

This study enrolled 138 patients diagnosed with benign paroxysmal positional vertigo. Vestibular function was evaluated, including ocular vestibular evoked myogenic potentials, cervical vestibular evoked myogenic potentials and caloric tests. Vitamin D levels were recorded.

There was a significant difference in mean vitamin D levels between the normal and abnormal groups of the caloric test, cervical vestibular evoked myogenic potentials, and ocular vestibular evoked myogenic potentials. The likelihood of abnormal vestibular function was lower in patients with normal vitamin D levels than those with deficient levels (< 10 ng/ml). Vitamin D levels were the only predictive factor for recurrence among patients with benign paroxysmal positional vertigo.

A deficiency in vitamin D is more likely to result in abnormalities in the caloric test, cervical vestibular evoked myogenic potentials, and ocular vestibular evoked myogenic potentials in benign paroxysmal positional vertigo patients. The interaction among these factors may contribute to the recurrence.

To evaluate the clinical efficacy of tobramycin dexamethasone eye ointment combined with a catheter in endoscopic dacryocystorhinostomy.

Eighty chronic dacryocystitis patients were randomly divided into two groups: observation (n = 39) and control (n = 41). Both groups underwent endoscopic dacryocystorhinostomy. The observation group used tobramycin dexamethasone eye ointment and catheter support, while the control group used only the eye ointment.

No statistical differences were found in gender, age, disease course or eye type. However, the anastomotic formation time and bleeding amount were significantly different between the two groups (p < 0.001). After six months of follow up, there were no significant complications differences (p > 0.05). The fluorescein disappearance test time in the observation group was significantly shorter (p < 0.001), and the clinical effective rate was significantly higher (97.4 per cent vs 78 per cent, p < 0.05) in the observation group.

Using tobramycin dexamethasone eye ointment combined with a catheter slightly prolongs the operation time and increases bleeding, but promotes anastomotic healing, accelerates tear drainage, improves the operation success rate and is economically efficient.

This study aimed to explore the influence of laryngopharyngeal reflux on the features of vocal fold polyps and prognosis after office-based transnasal vocal fold polypectomy.

Eighty-four vocal fold polyp patients were retrospectively analysed. Patients were assigned to laryngopharyngeal reflux or non-laryngopharyngeal reflux groups using pre-operative Reflux Symptom Score-12.

The laryngopharyngeal reflux group had significantly higher pre-operative Reflux Sign Assessment scores, worse lifestyle and worse eating habits than the non-laryngopharyngeal reflux group. After office-based transnasal vocal fold polypectomy, the Reflux Symptom Score-12 and Reflux Sign Assessment score decreased in both groups, although the laryngopharyngeal reflux group still had higher values. The non-laryngopharyngeal reflux group had better vocal fold morphology recovery than the laryngopharyngeal reflux group. Multivariate logistic regression analysis demonstrated that smoking and a higher pre-operative Reflux Symptom Score-12 score were independent risk factors for poor prognosis.

Laryngopharyngeal reflux is detrimental to vocal fold recovery of vocal fold polyp patients following office-based transnasal vocal fold polypectomy. For vocal fold polyp patients with laryngopharyngeal reflux, lifestyle and diet guidance should be focused.

To appraise clinical practice guidelines for anaplastic thyroid carcinoma treatment and management using the Appraisal of Guidelines for Research and Evaluation II tool.

A literature search was performed using MEDLINE/PubMed, Embase, Scopus, Cochrane, and Google Scholar. Four reviewers evaluated clinical practice guidelines utilising Appraisal of Guidelines for Research and Evaluation II, with domain scores requiring a threshold of greater than 60 per cent. Inter-reviewer agreement was evaluated using intraclass correlation coefficients.

Twelve clinical practice guidelines were evaluated after application of inclusion and exclusion criteria. There were two “high-”, four “average-”, and six “low-” quality clinical practice guidelines. The domains with the highest scores were “clarity of presentation” (69.44 ± 16.75) and “scope and purpose” (68.87 ± 20.88), while “applicability” (7.12 ± 6.17) and “rigor of development” (50.26 ± 20.77) had the lowest scores. Intraclass correlation coefficients showed a high level of inter-reviewer agreement (0.689–0.924; good–excellent).

These results showcased wide variability in quality amongst guidelines for the treatment and management of anaplastic thyroid carcinoma. These findings necessitate greater standardisation among clinical practice guidelines and greater focus on the applicability of recommended practices.

The healthcare industry is estimated to contribute 4.4 per cent of global greenhouse gas emissions. This pilot study aimed to investigate the impact of rationalising surgical instruments in tonsillectomy trays on greenhouse gas emissions and costs.

We conducted a prospective observational study over a six-month period. All patients who underwent tonsillectomy were included. The instruments used during the procedure and their frequency of use were counted, with the operating surgeon being unaware of the study.

During the 6-month timeframe, 46 tonsillectomies were performed. From the standard tonsillectomy tray containing 38 pieces, 9 pieces were never used. The removal of unused reusable instruments resulted in an estimated total reduction of 594 g of carbon dioxide equivalents and a saving of €9.63 per operation.

Rationalising the contents of the surgical instrument tray can have a positive environmental impact by reducing greenhouse gas emissions. There are also pecuniary benefits for the National Health Service because of the potential for cost savings.

The purpose of this study is to investigate whether sex plays a role in donor-site dysfunction after head and neck reconstruction.

In this retrospective case series, 76 patients were assessed for donor-site morbidity using the Short Form 36, Short Musculoskeletal Function Assessment, disabilities of the arm, shoulder, and hand, and lower-limb core scale. Differences by sex were compared using t-tests. Multivariable linear regression analysis was conducted to adjust for potential confounders.

Females observed significantly greater disability for the SF-36 mental component summary score with a mean of 45.9 (standard deviation 10.5) compared to males, with a mean of 51.8 (standard deviation 10.2), p = 0.02. Sex is significantly related to SF-36 mental component summary score after controlling for neuropsychiatric disease and tracheostomy status.

Females reported significantly worse mental component scores compared to males undergoing free flap reconstruction of the head and neck.

To compare perioperative and oncological outcomes between stapler and manual closure in patients undergoing total laryngectomy for advanced endolaryngeal squamous cell carcinoma.

Patients with advanced endolaryngeal tumours operated between July 2017 and July 2023 were retrospectively dichotomised into stapler closure and manual closure cohorts and compared.

Seventy-one patients with a median age of 57 years were included in our study. The median surgical duration was 270 minutes for the manual closure cohort and 245 minutes for the stapler closure cohort. The pharyngo-cutaneous salivary fistula rate was 6 per cent less in the stapler closure cohort. The estimated mean survival was not significantly different 54.5 months (95 per cent, confidence interval 46.3–62.71) in the manual closure cohort versus 28.12 months (95 per cent, confidence interval 23.6–32.63) in the stapler closure cohort (p = 0.79).

Stapler closure can be used in endolaryngeal tumours, and it reduces operating time, thus facilitating efficient utilisation of operation time with non-inferior oncological outcomes as compared to traditional manual closure.