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Sudden onset sensorineural hearing loss has been associated with infection by severe acute respiratory syndrome coronavirus-2. However, little is known regarding how this differs from sudden onset sensorineural hearing loss of other aetiologies. This systematic review summarises existing literature on severe acute respiratory syndrome coronavirus-2 associated sudden onset sensorineural hearing loss treatment and outcomes.
Methods
A literature search using Ovid was performed for studies which evaluated treatments and outcomes of patients with sudden onset sensorineural hearing loss associated with severe acute respiratory syndrome coronavirus-2 infection.
Results
A total of 99 studies were identified, from which 14 studies were selected for inclusion - collectively including 154 patients. Nine of these studies were single participant case reports and five were larger case series. Corticosteroid treatment varied between studies in terms of administration route, dose, and duration. Only 63/154 patients in this review achieved complete resolution of their symptoms following steroid treatment.
Conclusion
Oral, intravenous, and intratympanic steroids demonstrate a good safety profile. However, the majority of patients are left with unresolved hearing loss.
The BiZact device offers precise and versatile functionality for tonsillectomies. The objective of this study is to assess the efficacy and safety of the BiZact instrument for tonsillectomies.
Methods
The researchers used the PRISMA guidelines to retrieve relevant articles from PubMed, Embase and Web of Science. Eight articles were aggregated and examined for this systematic review.
Results
The BiZact device shortens operative time when compared to cold dissection and bipolar electrocautery, where no difference was found when compared to coblation. Intra-operative bleeding was decreased with BiZact tonsillectomy compared to cold dissection and electrocautery, although bleeding was slightly increased when compared to coblation.
Conclusion
The BiZact instrument is an alternative tonsillectomy device that may shorten surgical time as well as reduce intra-operative blood loss. More studies are needed to conduct a meta-analysis directly comparing surgical outcomes of the BiZact device to other techniques.
A range of chronic ear complaints may be attributed to Eustachian tube dysfunction. Eustachian tube dysfunction secondary to a deviated nasal septum has been described in several clinical studies, with symptomatic improvement demonstrated following septoplasty. However, uncertainty exists as to the size of the effect and consistency between studies.
Methods
Electronic searches were carried out of Pubmed, Embase and the Cochrane Library for adult patients with complaints of nasal obstruction and/or impairment and/or complaints of ear fullness undergoing nasal surgery.
Results
Seven studies met the inclusion criteria. Studies evaluated the effect of nasal surgery on Eustachian tube dysfunction using a variety of outcomes, including Eustachian tube function tests, the Eustachian Tube Dysfunction Questionnaire-7, tympanometry and Nasal Obstruction Symptom Evaluation scores. The results demonstrated the positive impact of nasal surgery on various outcomes related to Eustachian tube dysfunction.
Conclusion
Nasal surgery has been demonstrated to have promising results as a therapeutic option for patients with Eustachian tube dysfunction and a deviated nasal septum, offering significant symptom relief and improved quality of life. Through the integration of the treatment of nasal symptoms in the management of Eustachian tube dysfunction, clinicians can adopt a comprehensive approach to addressing the underlying pathologies contributing to Eustachian tube dysfunction.
This study aimed to evaluate if there is a role for hypoglossal nerve stimulation outside the original Stimulation Therapy for Apnea Reduction (STAR) trial criteria.
Methods
This review was conducted using PubMed, Embase and Cochrane Library databases.
Results
Hypoglossal nerve stimulation led to improved outcomes in individuals who fell outside the STAR trial criteria for apnoea-hypopnoea index and body mass index. However, this improvement did not extend to patients with complete concentric palatal collapse or those with a significant central apnoea component.
Conclusion
Hypoglossal nerve stimulation can be effective in patients outside the original STAR trial criteria for certain parameters. Further research is needed to refine patient selection criteria for optimal outcomes.
To compare long-term impedance and functional outcomes between the round window and cochleostomy approaches in cochlear implantation patients.
Methods
Ninety prelingually deafened children who underwent unilateral cochlear implantation participated in this prospective observational study. Participants were divided into round window and cochleostomy groups. Impedance and speech perception were assessed at switch-on, and at 6, 12, and 24 months.
Results
Impedance was similar between groups except at switch-on, where the cochleostomy group had higher basal turn impedance (2.41 vs 1.32 kΩ). At 24 months, speech outcomes were as follows: word recognition in quiet (round window 96.2 per cent, cochleostomy 95.3 per cent), word recognition in noise (round window 88.8 per cent, cochleostomy 87.4 per cent), sentence recognition (round window 78.2 per cent, cochleostomy 77.3 per cent), and vowel recognition (round window 91.2 per cent, cochleostomy 90.1 per cent).
Conclusion
No significant differences in impedance or speech outcomes were found between the round window and cochleostomy groups, except for higher basal-turn impedance at switch-on in the cochleostomy group, indicating more fibrosis.
Ménière’s disease is an inner-ear disorder caused by endolymphatic hydrops, characterised by recurrent episodes of vertigo, fluctuating hearing loss, and tinnitus. Ménière’s disease can be classified as ‘probable’ and ‘definite’ according to the criteria determined by the Bárány Society.
Methods
This analytical cross-sectional retrospective study included 28 Ménière’s disease patients (15 with definite Ménière’s disease and 13 with probable Ménière’s disease). Vestibular function was assessed using ocular-vestibular evoked myogenic potentials, cervical-vestibular evoked myogenic potentials and caloric test.
Results
The results of these tests were evaluated separately for probable Ménière’s disease and definite Ménière’s disease groups and comparisons were made. Significant differences in vestibular evoked myogenic potential asymmetry rates were observed between the probable Ménière’s disease and definite Ménière’s disease groups, with the definite Ménière’s disease group exhibiting a higher rate of abnormal responses.
Conclusion
This suggests that vestibular evoked myogenic potentials testing may be a valuable tool in distinguishing between these two subtypes of Ménière’s disease. Further research is necessary to validate these findings and explore their implications for clinical practice.
Cubism graft technique offers controlled thinning of the cartilage and prevents over-curling. This article compares tragal perichondrium with the new cubism graft in tympanoplasty in small- to medium-size tympanic membrane perforations.
Methodology
In our study, we included 40 patients, where tragal perichondrium was used as a graft in 20 patients, while cubism graft with tragal cartilage was used in the other 20 patients.
Results
Only two patients had a failure in graft uptake in the tragal perichondrium group, while three patients had a failure in graft uptake in the group where cubism graft with tragal cartilage was used. Significant closure of the air-bone gap (≥ 9 dB) was observed in post-operative audiogram at three-month follow-up in both groups.
Conclusion
This study concludes that the new cubism graft is comparable to tragal perichondrium graft in terms of graft uptake and closure of the air-bone gap.
The posterior pharyngeal wall is an anatomical subsite of both the oropharynx and hypopharynx. The treatment outcomes of squamous cell carcinoma (SCC) of these sites are generally published together, which makes the interpretation of data challenging. The aim of this analysis was to determine if there is any difference in the treatment outcomes of these two rare disease entities.
Materials and Methods
Retrospetive analysis showed that the posterior pharyngeal wall was the primary subsite in 17 patients (1.65 per cent) out of 1031 patients with oropharyngeal SCC, and in 23 patients (11.73 per cent) out of 196 patients with hypopharyngeal SCC.
Results
The five-year overall survival was 45 per cent for oropharyngeal origin and 53 per cent for hypopharyngeal origin patients. There was no significant difference in survival and locoregional control between these two groups of patients.
Conclusion
Squamous cell carcinoma of the posterior pharyngeal wall is a rare entity, which in our series represents 1.65 per cent of oropharyngeal cases and 11.73 per cent of hypopharyngeal tumours. There was no difference in treatment outcomes between the two groups.
This study aimed to compare permeatal and post-aural tympanoplasty techniques, focusing on scar perception, post-operative symptoms, return to work and quality of life.
Methods
A retrospective study was conducted in a secondary care hospital, with 54 patients undergoing tympanoplasty via permeatal or post-aural approaches. Outcome measures reported were scar perception, post-operative symptoms, quality of life using the Chronic Otitis Media Benefit Inventory score and time off work reported by patients.
Results
Scar perception was favourable in both groups. In the post-aural group, 96 per cent of patients were content with their scar, while 83 per cent in the permeatal group were unconcerned about having a scar behind the ear. Long-term post-operative symptoms, return to work and quality of life measures were comparable. Chronic Otitis Media Benefit Inventory scores showed no significant difference between techniques.
Conclusion
Patient experiences and perspectives were similar between permeatal and post-aural techniques. Surgeons should consider individual patient factors and outcomes when selecting a surgical approach.
Smoking is a risk factor for head and neck cancer. Referral for suspected head and neck cancer can be an opportunity for reassessing smoking behaviour. This study examined attitudes towards smoking in patients referred urgently with suspected head and neck cancer.
Method
A total of 98 smokers were referred urgently for suspected head and neck cancer. Patients completed the Fagerstrom Test for Nicotine Dependence and the Perceived Risk and Benefits Questionnaire.
Results
In the Fagerstrom Test for Nicotine Dependence, higher education background (education beyond secondary or high school level) had a lower dependence score (p = 0.02) and men were more likely to have higher dependence scores (p = 0.02). In the Perceived Risk and Benefits Questionnaire, women scored higher for concerns regarding the negative effects of smoking cessation (p = 0.01) and the perceived health benefits of smoking cessation were greater in those with higher education (p = 0.03).
Conclusion
Men are more nicotine dependent. Women are concerned about perceived side effects of smoking cessation. Patients with a higher education background are more receptive to cessation interventions and should be identified early.
This article aimed to evaluate the diagnostic accuracy of the contrast swallow study and its role in informing management decisions in patients following laryngectomy.
Methods
A five-year retrospective case note review on all patients who underwent laryngectomy between April 2018 and July 2023 at a tertiary head and neck cancer centre.
Results
A total of 82 patients met inclusion criteria; 22 had reported radiological evidence of a pharyngocutaneous fistula on contrast swallow study; of these only 1 developed a clinical pharyngocutaneous fistula. Of the 60 with no radiological evidence of a pharyngocutaneous fistula, 3 developed clinical pharyngocutaneous fistulas. This represents a positive predictive value of 5 per cent and a negative predictive value of 95 per cent.
Conclusion
In this cohort, the contrast swallow study was a sub-optimal investigation. The high NPV may support decision-making when there is little clinical suspicion, however the low PPV represents significant over-reporting and may cloud the clinical decision-making process.
The aim of this research is to determine the rate of recurrence, metastasis and survival outcomes of patients diagnosed with and treated for parathyroid carcinoma.
Methods
This research is a retrospective chart review for patients diagnosed with parathyroid carcinomas between 1 January 2007 and 31 December 2022 in a UK tertiary centre.
Results
Fourteen patients were identified, all of whom received surgery following their diagnosis. On presentation, all patients (100 per cent) were hypercalcaemic, with two patients (14 per cent) having metastatic lesions. There was a single case (7 per cent) of loco-regional recurrence following surgery. Six patients passed away after a median follow up of 2.5 years, four due to causes related to parathyroid carcinoma.
Conclusion
Surgical excision remains the mainstay of treatment, but this can only be undertaken after the patient has been medically stabilised. Mortality in this group of patients generally arose from the effects of hypercalcaemia. Metastasis and recurrence from our cohort were rare, but long-term follow up with monitoring of calcium and parathyroid hormone levels remain keys.
This study investigates the association between a history of previous cancers and the subsequent risk of developing head and neck cancer.
Method
A retrospective case–control design was employed, analysing 561 patient records from two National Health Service hospitals, with 273 patients diagnosed with head and neck cancer and 288 patients serving as controls.
Results
Statistical analysis revealed a significant association between prior cancer history, particularly squamous cell carcinoma (SCC), and increased risk of developing head and neck cancer (p < 0.05). Subtype analysis highlighted specific head and neck cancers, such as oropharyngeal and laryngeal cancers, as particularly associated with a history of SCC.
Conclusion
The findings suggest that previous cancer diagnoses, especially SCC, may predispose individuals to head and neck cancer, challenging the traditional focus on tobacco, alcohol and human papillomavirus as primary risk factors. These results underscore the need for incorporating prior cancer history into risk assessment protocols and surveillance strategies to improve early detection and patient outcomes.
In the era of the competition for the first transatlantic flight at the beginning of the nineteenth century, numerous accidents occurred. Whereas engine failure, bad weather and navigational problems are usually held responsible, the human factor has hardly been addressed.
Methods
In view of current insights, an inventory was made of possible physiologic and otoneurologic factors that could have contributed to failures and accidents.
Results
Extreme fatigue, hyperventilation with vestibular hyperreactivity and airsickness may have played roles. When flying in the dark and in clouds, pilots were subject to spatial disorientation because of vestibulo-visual conflicts and gravitational misinformation. The loudness of the engines was deafening, which may have caused noise-induced vertigo. In some cases, asymptomatic third-window lesions may have become manifest and may have contributed to dizziness.
Conclusion
Accidents and failures in the early days of aviation were not only the result of technical defects. Undoubtedly, human physiology played a role as well.
This article aimed to summarize the clinical characteristics and our experience with the diagnosis and management of laryngocele. We offer our perspectives for cases associated with laryngeal cancer.
Methods
A retrospective study of 14 patients with laryngocele was accomplished from June 2014 to June 2024. Clinical data were analyzed through descriptive statistical methods.
Results
A total of 14 laryngocele patients were divided into internal type (n = 11; 78.6 per cent) and combined type (n = 3; 21.4 per cent). Nine laryngocele patients (n = 9; 64.3 per cent) were accompanied by laryngeal cancer. The transoral approach was applied in 11 internal laryngocele patients with no post-operative complications or recurrences.
Conclusion
Laryngoscopy and imaging examination are helpful for diagnosis especially to exclude laryngeal cancer. The transoral approach is effective for the internal type, and the key is to resect the anterior part of the false vocal fold. For patients with concomitant laryngeal cancer, the laryngocele should be promptly managed.
This study compared endoscopic and microscopic tympanoplasty regarding surgical duration and clinical outcomes for chronic suppurative otitis media.
Methods
Retrospective study included patients who underwent either endoscopic or microscopic tympanoplasty at King Abdullah Medical City between January 2020 and May 2022. It compared the groups’ surgical duration, residual perforation incidence, post-operative pain and audiological outcomes.
Results
The study included 58 patients, 29 of whom underwent endoscopic and 29 underwent microscopic tympanoplasty. Endoscopic tympanoplasty had a significantly shorter average surgical duration (75.46 ± 21.04 minutes) than microscopic (126.66 ± 34.27 minutes). Non-significant differences were detected between groups regarding residual perforation, post-operative pain or hearing improvements.
Conclusion
Both procedures resulted in non-significant differences regarding hearing and surgical complications. However, endoscopic tympanoplasty had a significantly shorter surgical duration, making it a preferable option due to reducing time required. Further randomized studies should be conducted to answer which approach is superior.
Patients undergoing total laryngectomy who have chronic obstructive pulmonary disease are unable to use dry-powder inhalers due to the anatomical changes after surgery and are therefore at greater risk of post-operative pulmonary complications. In our practice, we identified a scarcity of resources available to help clinicians decide on a suitable alternative. Hence, we sought to provide a solution that would address this issue.
Methods
Within our head and neck centre, we worked with the respiratory team and specialist pharmacists to create a simple conversion table to help clinicians identify alternatives to dry-powder inhalers.
Results
A table was designed that shows which metered-dose inhalers when connected to a spacer and an infant face mask overlying the laryngeal stoma can be used.
Conclusion
Our table can be used as a resource by clinicians to improve the perioperative and long-term care of patients who cannot use dry-powder inhalers.