Sublingual ranulas present diagnostic and therapeutic challenges due to their heterogenous clinical presentations. This systematic review and meta-analysis aims to synthesise treatment outcomes and proposes a new classification for this condition.

Following PRISMA guidelines, a thorough literature search identified studies on patients with sublingual ranulas receiving medical or surgical treatment. Proportion meta-analysis compared success rates among studies using a random-effects model.

Forty-two studies were included, covering 686 endoral ranulas, 429 plunging ranulas, and 16 ranulas extending into the parapharyngeal space. Sublingual sialoadenectomy with or without pseudocyst wall excision showed low heterogeneity and the highest success rates. Consequently, a new classification system is proposed categorising ranulas by intraoral (Type 1), cervical (Type 2) or parapharyngeal space (Type 3) extension.

This study confirms the role of sublingual gland resection as standard of care and highlights the need for a revised classification to improve patient outcomes.

To evaluate the predictive value of peripheral blood eosinophil levels for eosinophilic chronic rhinosinusitis.

Electronic searches were conducted in PubMed, Embase and the Cochrane Library. Data were analysed using Stata 16.0.

In total, 23 studies that fulfilled the inclusion criteria were analysed. For peripheral blood eosinophil percentage in identifying eosinophilic chronic rhinosinusitis, the pooled sensitivity was 0.77 (95 per cent confidence interval (CI) = 0.69–0.83) and specificity was 0.74 (95 per cent CI = 0.68–0.80), with a positive likelihood ratio of 2.97 (95 per cent CI = 2.38–3.72) and a negative likelihood ratio of 0.31 (95 per cent CI = 0.24–0.42). Similarly, for peripheral blood eosinophil count, the pooled sensitivity was 0.78 (95 per cent CI = 0.73–0.82) and specificity was 0.73 (95 per cent CI = 0.69–0.77), with a positive likelihood ratio of 2.93 (95 per cent CI = 2.45–3.50) and a negative likelihood ratio of 0.30 (95 per cent CI = 0.24–0.37).

There is not sufficient evidence to support peripheral eosinophilia as a good predictor of eosinophilic chronic rhinosinusitis.

This study aimed to assess the impact of the scutum on oval window accessibility during stapedotomy surgery. Radio-clinical correlation was applied to determine the impact.

This was a prospective observational case-series study that included 127 candidates for stapedotomy surgery. The oval fossa was classified into two types according to the accessibility of the stapes footplate.

Both study groups showed a statistically significant difference in pre-operative radiological length as the p value was less than 0.001. The Spearman correlation coefficient revealed that the intra-operative oval window fossa was only significantly related to the radiological scutum length because the p value was less than 0.001.

Our results revealed that the pre-operative radiological length can predict the intra-operative oval fossa type with high sensitivity and specificity. Patients with a pre-operative scutum length of less than 2.35 mm were predicted to have an easily accessible oval window without requiring intra-operative scutum curettage.

This study aimed to compare the graft success rate, hearing outcomes, operation time and complications between myringoplasty with raising of a mucosal flap (RMF) and raising of a tympanomeatal flap (RTF) for the repair of subtotal perforations.

Subtotal perforations were recruited and randomly allocated to either the RMF group or the RTF group. The graft success rate, hearing outcomes and complications were evaluated at 6 months post-operatively.

The mean operation time was 31.4 ± 2.8 minutes (range: 26–47) in the RMF group and 57.6 ± 0.9 minutes in the RTF group (p < 0.01). The graft success rate was 96.0 per cent in the RMF group and 88.9 per cent in the RTF group (p = 0.659).

Endoscopic myringoplasty with the RMF achieved similar graft success and hearing gain compared to the tympanomeatal flap technique for repairing subtotal perforations, but with significantly shorter operation time and minimal temporary hypogeusia.

This study aimed to evaluate clinical characteristics, treatments and outcomes of paediatric temporal bone fractures at our institute.

A retrospective study of paediatric skull fractures confirmed by imaging from January 2010 to December 2022. Data on demographics, clinical presentations, injury mechanisms and complications were analysed, and fractures were categorised into otic capsule sparing (OCS) and violating (OCV).

Of 369 skull fracture cases, 88 (24 per cent) involved temporal bones, predominantly caused by falls and vehicle accidents. Common symptoms were loss of consciousness, hematoma, and hemotympanum, with complications like facial nerve injury and cerebrospinal fluid leaks in 3.4 per cent of cases. OCV fractures led to more severe complications, including hearing loss. Audiology showed 65 per cent without hearing impairment, while others had various degrees of loss.

Paediatric temporal bone fractures, particularly OCV types, pose significant challenges. Early detection and thorough management are vital, underscoring the need for consistent data collection and regular audiometric monitoring.

Hereditary haemorrhagic telangiectasia (HHT) is characterised by recurrent, severe epistaxis. While nasal closure is a relatively well-established treatment for HHT patients with intractable epistaxis, recent studies highlight the efficacy of bevacizumab in this subgroup. We aim to evaluate the effectiveness of nasal closure for patients with contraindications to bevacizumab.

A case series of five patients with HHT and severe refractory transfusion-dependent epistaxis who were treated with nasal closure.

All patients had subjective improvement in epistaxis. Haemoglobin concentrations increased in all patients, with none requiring transfusion for epistaxis post-operatively. Four patients experienced complete cessation in epistaxis. Four returned positive Glasgow Benefit Inventory scores.

Nasal closure appears to be a safe and effective option for the management of epistaxis in patients with severe, refractory HHT-related epistaxis. Treatment improved quality of life, reduced severity of epistaxis and increased haemoglobin concentrations. Nasal closure should be considered for HHT patients with severe, refractory epistaxis, particularly in cases where bevacizumab is contraindicated.

To assess the value of corrected calcium decline at 6 hours as a predictor of hypocalcaemia post total thyroidectomy by comparing it to the currently widely used intact parathyroid hormone.

A retrospective cohort study of patients who underwent total thyroidectomy from January 2016 to February 2020. Serum intact parathyroid hormone and corrected calcium data pre-operatively and 6 hours post-operatively were obtained. Receiver operating characteristic curves were used to compare corrected calcium decline at 6 hours versus 6 hours for relative intact parathyroid hormone decline as predictors of hypocalcaemia, and the area under the curve for each metric was reported.

Patients included in this analysis totalled 209. The receiver operating characteristic analysis suggested that corrected calcium decline at 6 hours has a similar predictive value to 6 hours relative intact parathyroid hormone. The areas under the curves for predicting hypocalcaemia were 0.797 for corrected calcium decline at 6 hours and 0.737 for 6 hours relative intact parathyroid hormone, but the difference (0.06) was not statistically significant.

Our results suggest that corrected calcium decline at 6 hours has a similar predictive value to 6 hours relative intact parathyroid hormone and hence has the potential to predict post-operative hypocalcaemia.

To investigate the effect of heated-cigarette smoking on voice.

Participants completed a survey including three sections: section-1 comprised demographic data, section-2 comprised visual analogue scale grading of voice changes and fatigue and section-3 consisted of the voice handicap index-10.

Two hundred and eighty-two participants filled the survey. Heated-cigarette smokers had a significantly higher mean voice handicap index-10 score compared to non-smokers (p < 0.05). The difference in voice handicap index-10 scores between heated- and combustion-cigarette smokers was not statistically significant. The number of abnormal voice handicap index-10 scores was higher in heated-cigarette smokers compared to non-smokers (p < 0.05) and significantly higher in combustion-cigarette and dual heated- and combustion-cigarette smokers compared to the other 2 groups (p < 0.05). Non-smokers had significantly lower grades of voice changes and fatigue when compared to combustion and dual heated- and combustion-cigarette smokers (p < 0.05).

Smokers of heated cigarettes have a significantly higher mean voice handicap index-10 score compared to non-smokers and higher grade of voice changes and fatigue.

This study investigated the risk factors for developing pharyngocutaneous fistula, the most common complication following total laryngectomy.

We included all patients who underwent total laryngectomy and bilateral neck dissection from 2009 to 2021. Patients excluded were those with hypopharyngeal involvement, total or partial pharyngectomy, base of the tongue resection, large pharyngeal defects requiring free/pedicle flap reconstruction, or salvage laryngectomy.

A total of 164 patients participated in the study. Multivariate regression analysis identified two independent predictors of pharyngocutaneous fistula formation: pharyngeal reconstruction with simple interrupted sutures (odds ratio: 3.12, 95 per cent confidence interval: 1.31–17.00, p = 0.010) and radical neck dissection (odds ratio: 3.16, 95 per cent confidence interval: 1.13–8.82, p = 0.028).

Our findings suggest that pharyngeal reconstruction using simple interrupted sutures and radical neck dissection are independent risk factors for pharyngocutaneous fistula development. Based on this, we recommend using the modified Cushing suture technique over simple interrupted sutures due to its association with a significantly lower pharyngocutaneous fistula rate.

Salvage neck dissection for squamous cell carcinoma is performed for residual or recurrent nodal disease after chemoradiotherapy or radical radiotherapy for locally advanced head and neck cancer. Our study aims to investigate the extent to which salvage neck dissection can be safely performed in treating recurrent or residual nodal metastasis.

A retrospective analysis of 53 patients with suspected residual or recurrent nodal disease after primary treatment (January 2016 to December 2018) was performed.

Pathological confirmation of viable squamous cell carcinoma following surgery was found in 43.4 per cent of patients. Post-operative infection, accessory and vagal nerve injuries were more common in patients with dissection of levels I–V than that of levels II–IV. There was no significant difference in three-year survival rate between patients with levels II–IV dissection and that of levels I–V dissection (p = 0.84).

The extent of salvage neck dissection can be limited to reduce post-operative complications while maintaining acceptable oncological outcomes.

Surgical treatment of auricular concha, the helix root and the external auditory canal tumours, and their reconstruction, is a challenge because of the complexity of this anatomic region and the significant functional and aesthetic requirements of these treatments. The purpose of this study is to describe our experience with the retroauricular revolving door island flap technique.

This was a retrospective descriptive study (series of nine clinical cases) conducted between 2020 and 2023 of revolving door island flap reconstruction of auricular conchal and external auditory canal defects caused by tumour removal.

In all the cases, tumour-free margins and total reconstruction of the defect were achieved through the revolving door island flap intervention, with optimal aesthetic and functional results.

Revolving door island flap reconstruction is a viable surgical option for the reconstruction of auricular conchal and external auditory canal defects because of its versatility, reproducibility, low post-operative morbidity and optimal results.