This study aimed to evaluate the clinical efficacy and potential immunomodulatory effects of autologous platelet concentrates in promoting tissue regeneration and enhancing post-operative recovery in otorhinolaryngology.

A systematic search of PubMed, Scopus and the Cochrane Library was conducted through November 2025, focusing on randomised controlled trials and prospective studies using autologous platelet concentrates in otological, rhinological and laryngological surgery.

Twelve studies met the inclusion criteria. Autologous platelet concentrates improved tissue healing, most notably by increasing graft uptake rates in myringoplasty. Recent trials (2024–2025) also reported reduced post-operative pain and mucosal oedema following tonsillectomy and tympanoplasty.

Autologous platelet concentrates appear to be effective adjuncts for enhancing regeneration and reducing post-operative morbidity in ear, nose, and throat procedures. These benefits likely involve downregulation of pro-inflammatory cytokines (e.g., interleukin-6) and modulation of matrix metalloproteinases (e.g., matrix metalloproteinase-9). Standardised biomarker-based studies are needed to confirm these mechanisms.

This study aimed to evaluate the anatomical variants of the stylohyoid chain complex.

Multi-detector computed tomography angiography scans of 406 individuals (812 heminecks) were retrospectively evaluated.

Hemineck analysis revealed an elongated styloid process in 10.1 per cent and an aberrant hyoid apparatus in 4.6 per cent. A combination of elongated styloid process and aberrant hyoid apparatus was seen in 1 per cent of individuals. The 60-year or older group had significantly longer elongated styloid process lengths (3.82 ± 0.45 cm) compared to the less than 24-year group (3.50 ± 0.27 cm) and the 25- to 59-year group adults (3.56 ± 0.35 cm) (p < 0.001). Elongated styloid process was significantly more common in greater than or equal to 60-year group compared to the less than 24-year group and the 25- to 59-year group adults, while aberrant hyoid apparatus showed no age-related differences. No gender differences were observed for either elongated styloid process or aberrant hyoid apparatus .

Elongated styloid process may be associated with degenerative post-natal ossification processes, whereas aberrant hyoid apparatus could be related to persistent embryological remnants of the second pharyngeal arch.

Strategic workforce planning is essential for equitable, high-quality healthcare. ENT services currently hold the second-longest NHS waiting list, with over 638,000 outstanding appointments, underscoring the urgency of accurate workforce planning.

Data were collected across all 135 NHS trusts providing ENT services. Information was collated on consultants, associates, locally employed doctors (LEDs), trainee residents, fellows, advanced nurse practitioners (ANPs) and physician assistants (PAs). For consultants, subspecialty interest, working patterns, age and contract type were recorded.

The UK ENT workforce comprised 1207 consultants (mean 1.77 per 100,000 population), with an over two-fold regional variation. On average, there were 1.29 second-on-call residents and 1.17 first-on-call residents per 100,000 population, with considerable regional variation.

The UK ENT workforce demonstrates marked geographic and subspecialty imbalances with looming retirement risks. Targeted recruitment and retention initiatives, subspecialty redistribution and training capacity adjustments are critical to address current shortfalls and meet future service demands.

This study aimed to report a 10-year single-centre experience of cochlear implantation in children with CHARGE syndrome (manifests as coloboma, heart defects, atresia of the choanae, growth retardation and genital and ear anomalies) and evaluate surgical strategies and outcomes.

Children with CHARGE syndrome who underwent cochlear implantation between 2014 and 2024 were retrospectively reviewed. Patient characteristics and post-operative auditory outcomes were analysed.

Six patients (nine ears) were included. Most had airway anomalies, one-third required post-operative intensive care. Temporal bone malformations were present in 78 per cent of ears. Standard posterior tympanotomy was feasible in one-third; the remainder required transcanal or combined approaches. Full-electrode insertion was achieved in all ears. Median follow-up was 3.4 years; aided thresholds ranged 25 to 50 dB hearing level. Three patients developed reliable open-set speech perception, two achieved closed-set recognition and one demonstrated environmental sound awareness.

Cochlear implantation provides meaningful auditory benefit in selected children with CHARGE syndrome. Pre-operative cochlear nerve imaging, flexible surgical planning and coordinated peri-operative airway management are essential.

To examine the effects of age and hearing loss on travelling wave delay by comparing frequency-specific action potential latencies obtained with electrocochleography.

A cross-sectional design was applied. Tympanic membrane electrocochleography recordings at 0.5 and 4 kHz were analysed in 85 ears from 49 adults. Participants were divided into four groups: older adults with hearing loss (n = 22), older adults with normal hearing (n = 18), younger adults with hearing loss (n = 19) and younger adults with normal hearing (n = 26).

Age and hearing loss significantly influenced action potential latencies. At 0.5 kHz, the older adults with hearing loss showed the longest latencies (p < 0.001). At 4 kHz, older adults with hearing loss differed from older adults with normal hearing (p = 0.027). Travelling wave delay varied across groups (p < 0.001), with the shortest travelling wave delay in younger adults with normal hearing and the longest travelling wave delay in older adults with hearing loss.

Ageing and hearing loss slow travelling wave velocity, providing an indirect but sensitive marker of early cochlear transmission deficits.

To compare the diagnostic accuracy of nasal endoscopy, computed tomography and magnetic resonance imaging for chronic rhinosinusitis and chronic rhinosinusitis with nasal polyps.

PubMed, Embase, Web of Science, Scopus and the Cochrane Library were searched from 1990 to August 2025. Studies reporting 2 × 2 diagnostic data for diagnostic nasal endoscopy, computed tomography or magnetic resonance imaging were pooled using random-effects models to estimate sensitivity, specificity and summary receiver-operating characteristic measures.

Nine diagnostic datasets were included. Diagnostic nasal endoscopy showed high sensitivity (0.87) but moderate specificity (0.63) versus computed tomography. Computed tomography demonstrated good sensitivity (0.90) but limited specificity (0.50) versus histopathology. Magnetic resonance imaging provided moderate sensitivity (0.71) and high specificity (0.88) versus computed tomography. Substantial heterogeneity existed across modalities and reference standards.

Diagnostic nasal endoscopy is highly sensitive but moderately specific. Computed tomography is sensitive but limited by false positives. Magnetic resonance imaging appears more specific, although evidence remains scarce. Further paired imaging–histopathology studies are required.

To assess the efficacy of intranasal cryotherapy to treat chronic rhinitis refractory to medical therapy.

An evaluation was performed for all patients (n = 36) with chronic rhinitis refractory to medical treatment who underwent intranasal cryotherapy between 2022 and 2024 at this centre. The primary outcome measures were changes in validated pre- and post-operative scoring systems (Total Nasal Symptom Score, Sino-Nasal Outcome Test 22 (SNOT-22), Nasal Obstruction Symptom Evaluation and peak inspiratory nasal flow).

Objective scoring pre- and post-procedure showed statistically significant improvement across all measures (p < 0.001): mean Total Nasal Symptom Score (12 hours) 8.4 to 5.3, Total Nasal Symptom Score (2 weeks) 9.2 to 5.9, SNOT-22 56 to 31, Nasal Obstruction Symptom Evaluation 57.5 to 28.5 and peak inspiratory nasal flow 98 to 138 l/min.

This is the only dataset for patients receiving intranasal cryotherapy in the UK to date and follows patients over a two-year period. The results support the ongoing use of intranasal cryotherapy for sustained treatment of refractory chronic rhinitis.

While Eustachian tube dysfunction is a known comorbidity of chronic rhinosinusitis with nasal polyps, the prevalence of Eustachian tube dysfunction symptoms in this population is poorly understood.

Retrospective analysis of patient-reported sino-nasal (Sino-Nasal Outcome Test 22) and ear (Eustachian Tube Dysfunction Questionnaire 7) symptoms with type-2 markers (peripheral blood eosinophils and total immunoglobulin E, Nasal Polyp Score and Lund-Mackay Score on computed tomography in chronic rhinosinusitis with nasal polyps (study group) and non–chronic rhinosinusitis patients (control group). The control group were patients presenting with symptoms of chronic rhinosinusitis and Eustachian tube dysfunction with normal endoscopy and computed tomography sinus scan.

Chronic rhinosinusitis with nasal polyps patients were significantly older, had a higher proportion of males and higher levels of type-2 markers. There was no significant difference in Sino-Nasal Outcome Test 22, Eustachian Tube Dysfunction Questionnaire 7 and the proportion of patients with Eustachian tube dysfunction between the groups. Sino-Nasal Outcome Test 22, Sino-Nasal Outcome Test 5 and Sino-Nasal Outcome Test 22 ear domain correlated significantly with Eustachian Tube Dysfunction Questionnaire 7 in chronic rhinosinusitis with nasal polyps patients.

The clinical relevance of the Eustachian Tube Dysfunction Questionnaire 7 in chronic rhinosinusitis with nasal polyps is rather debatable as our findings reveal the presence of elevated scores not only in chronic rhinosinusitis with nasal polyps but also in the control group.

Chronic rhinosinusitis with nasal polyps patients awaiting functional endoscopic sinus surgery have unmet psychological needs. This study evaluated cognitive behavioural therapy’s efficacy in relieving their anxiety, depression and sinus symptoms.

A single-centred randomised controlled trial enrolled 144 patients (51 females, 93 males), randomising 72 to six weeks of cognitive behavioural therapy (cognitive restructuring, behavioural activation) and 72 to routine pre-operative education. Outcomes were assessed via Self-rating Anxiety Scale, Self-rating Depression Scale and Sino-Nasal Outcome Test at pre-intervention and 1, 3, 6 and 12 months post–functional endoscopic sinus surgery.

Compared with the control group, the cognitive behavioural therapy group had significantly lower scores at all post–functional endoscopic sinus surgery time points (all p < 0.001), with benefits sustained for one year. Efficacy was consistent across most subgroups (ages and disease duration), except the 61- to 70-year-old cognitive behavioural therapy subgroup with late-phase score increases (still lower than controls).

Six weeks of structured cognitive behavioural therapy improves chronic rhinosinusitis with nasal polyps patients’ pre-operative mental health and sinus symptoms and should be core to their multimodal pre-rehabilitation.

Transoral robotic surgery (TORS) has emerged as a promising alternative to conventional open approaches for parapharyngeal space malignancies. This review aimed to evaluate the surgical indications, oncologic efficacy and functional outcomes of robotic-assisted procedures.

A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 guidelines. PubMed, Scopus and Cochrane databases were searched for studies published between 2007 and 2025. Eligible studies included patients with parapharyngeal space malignancies managed by transoral robotic surgery or combined transoral robotic surgery–open approaches.

Eleven studies, comprising 20 patients, met the inclusion criteria. Ten patients underwent transoral robotic surgery-only resection, with no intra-operative or post-operative complications and no evidence of recurrence during follow-up. Eight patients were treated with combined transoral robotic surgery–open approaches, achieving comparable oncologic control, albeit with a higher rate of tracheostomy and feeding tube placement.

Transoral robotic surgery-only represents a valid strategy for selected small and well-localised parapharyngeal space malignancies, ensuring favourable oncologic and functional outcomes. Combined transoral robotic surgery–open approaches expand surgical indications to larger and anatomically complex tumours, while maintaining acceptable morbidity and oncologic results.

Frailty is associated with adverse outcomes among patients with head and neck cancers. We evaluated the awareness of frailty among Irish head and neck healthcare professionals.

A cross-sectional survey was distributed to Irish multidisciplinary head and neck healthcare professionals.

Eighty responses were received with varying clinical experience. Seventy-nine (99 per cent) participants believed frailty could influence: post-treatment functional outcomes (77 [96 per cent]), overall survival (72 [90 per cent]) and treatment related toxicity among head and neck cancer patients. Eighteen (23 per cent) participants had used frailty in practice. A lack of awareness / training (68 [85 per cent]) and time / practical constraints (62 [78 per cent]) were the main barriers identified to the utilisation of frailty in practice.

Irish head and neck healthcare professionals are aware of frailty and believe it may be of benefit in clinical practice. Barriers to incorporation of frailty in head and neck care included a lack of training, time or resources.

We evaluated the olfactory fossa and Keros classification in patients with unilateral mucosal contact points in septal deviation.

Paranasal sinus computed tomography images of 60 patients with mucosal contact points on the septum were compared with those of the control group (N = 60). The Keros types, septal deviation angles, mucosal contact point angles, olfactory fossa widths and depths, crista galli lengths, widths and pneumatisations, as well as the presence of anatomical variations, were analysed.

The depth of the olfactory fossa contralateral to the mucosal contact point was greater in patients with septal deviation compared to those without (p < 0.05). A significant correlation was found between increased crista galli height and a higher Keros degree on the right side (p < 0.05).

The presence and differences of mucosal contact points should alert surgeons both before and during the surgical procedure, and further studies on this topic are of great importance.

This study aimed to analyse respiratory infection rates (RI) in a representative cohort and evaluate if tumour size, pre-existing respiratory co-morbidities, smoking history, and tracheostomy predicted postoperative infection.

A retrospective observational study at a London tertiary head and neck oncology centre reviewed six years of patient data. BMJ Best Practice guidelines for hospital-acquired pneumonia (2022) were applied to medical records alongside postoperative RI prescriptions.

RI occurred in 32% of patients, more often in those with tracheostomy (36%) than intubation (12%). Infected patients were older (p=0.025), had tracheostomy (p=0.045), and underwent bilateral neck dissection (p<0.001). ICU (p=0.008) and hospital LOS (p<0.001) were significantly higher. Age, smoking, respiratory disease, tumour stage, and airway type were not predictors.

RI were more frequent in tracheostomised patients, though assessed risk factors were not predictive. Further research should explore additional contributors and evaluate targeted interventions to reduce incidence.

This study focuses on early recognition of carotid blowout syndrome type 1 (threatened artery) and the results of integrity restoration of the surrounding tissue by a pectoralis major myofascial flap.

This retrospective study included all patients in the period 2010–2020 with carotid blowout syndrome type 1 of the common or internal carotid artery, treated by pectoralis major myofascial flap.

Fifteen patients with carotid blowout syndrome type 1 were included, all but one after previous radiotherapy with a total dose up to 136 Gray (range 46–136). Median time from diagnosis till treatment was 1 day. None of the patients progressed to actual bleeding (type 2 or 3).

Carotid blowout syndrome type 1 should be early recognised and treated by insertion of a pectoralis major myofascial flap that protects the common or internal carotid artery and might prevent progression to a potentially fatal bleed. In our opinion, this policy should be part of the algorithmic approach of this complication.

Pharyngo-oesophageal spasm is a common reason behind the failure of tracheo-oesophageal voice production. This study aims to describe the feasibility of high-resolution ultrasound for localisation of the spasmodic segment for botulinum toxin injection.

The pharyngo-oesophageal segment was localised using a 6–13 Hz linear probe. It was visualised as a concentric muscular area between the great vessels of the neck. The spasmodic segment was identified as the narrowest region when the patient was asked to attempt phonation and swallow.

This technique was utilised in one patient who had pharyngo-oesophageal spasm following total laryngectomy. Following botulinum toxin injection, the patient was able to attempt phonation after one week.

High-resolution ultrasound is an effective modality to guide botulinum toxin injection into the spasmodic pharyngo-oesophageal segment. It allows intervention to be performed at the bedside or outpatient setting without associated radiation exposure.

Dengue fever, a mosquito-borne viral illness, has varied systemic manifestations, but its auditory effects remain underexplored. The objective of this study was to assess the association between dengue infection and hearing loss.

A prospective case-control study was conducted on 79 patients—40 dengue-positive (NS1 antigen confirmed) and 39 with other febrile illnesses. All participants underwent otological examination and pure tone audiometry.

Hearing loss was observed in 15.2 per cent of dengue patients, with none in controls (p < 0.001). The odds ratio for hearing loss in dengue was 34.6 (95 per cent confidence interval: 1.97–610). Dengue patients exhibited significantly elevated air and bone conduction thresholds (p < 0.001). Lower platelet counts and higher C-reactive protein levels correlated with hearing loss, suggesting vascular and inflammatory mechanisms.

Dengue fever may be associated with reversible sensorineural hearing loss, likely due to microvascular and inflammatory injury to the cochlea. Early audiological screening is recommended in dengue cases.

To highlight our experience in the management of patients with severe subglottic and/or upper tracheal stenosis associated with neurological co-morbidities. Effective tips and tricks in the surgical technique were emphasised.

This study included 33 patients with neurological co-morbidities who underwent tracheal and/or cricotracheal resection anastomosis. To decrease the anastomotic tension, suprahyoid release was performed and trachea-hyoid detensioning stitches were placed. Surgiflo® was applied over the anastomosis to enhance healing. Surgical and functional outcomes were evaluated.

The decannulation rate was 90.9 per cent. Regarding the functional outcomes, significant improvement of voice and swallowing was noticed after surgery. None of the patients experienced deterioration in their pre-existing neurological conditions following surgery.

Patients with severe subglottic and/or upper tracheal stenosis associated with neurological co-morbidities are challenging. Certain refinements in the surgical technique such as tailored suprahyoid release, tracheo-hyoid detensioning stitches and the application of Surgiflo are crucial to enhance healing, decrease anastomotic tension and improve outcomes.

This study investigated the impact of residual dizziness after successful canalith repositioning manoeuvre on cognitive functions and dual-task performance in patients with benign paroxysmal positional vertigo (BPPV).

Forty-four patients with posterior canal BPPV were assessed 1 week after successful treatment and divided into 2 groups: with residual dizziness (n = 22) and without residual dizziness (n = 22). Cognitive function was evaluated using the Stroop test and digit span test. Dual-task performance was assessed with a combination of the timed up and go test and the digit span test.

Residual dizziness was associated with longer BPPV duration, and higher anxiety and disability levels (p < 0.05). Patients with residual dizziness performed worse on the Stroop test (p < 0.05), while no significant differences were found in digit span or dual-task performance (p > 0.05).

The results highlight a dynamic interplay between cognitive and vestibular systems. Residual dizziness may impair cognitive performance, while baseline cognitive deficits may also increase vulnerability to residual dizziness.