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The purpose of this single-centre retrospective study was to determine the long-term outcomes of the BIA400 and Ponto Wide, in terms of implant stability, soft tissue reactions, skin thickening and implant loss.
Methods
Adults who had the BIA400 or Ponto Wide implanted between January 2013 and December 2023 and had at least two follow-up appointments were included, leading to a cohort of 93 BIA400 and 114 Ponto Wide implants.
Results
Significantly more soft tissue reactions with a Holgers Scale score of 1 or greater (p = 0.003), adverse soft tissue reactions of Holgers Scale score of 2 or greater (p = 0.018), skin thickening (p < 0.001) and skin thickening requiring treatment (p ≤ 0.001) occurred in the BIA400 group. No difference in implant stability was found. One BIA400 implant (1.1 per cent) and three Ponto Wide implants (2.7 per cent) were lost.
Conclusion
Both implants have excellent implant stability and similar implant survival rates. The Ponto Wide has favourable outcomes in terms of (adverse) soft tissue reaction and skin thickening (requiring treatment).
To evaluate the publication efficiency of registered cochlear implant (CI) trials and characterise evolving research trends following the 2022 update.
Methods
This study queried ClinicalTrials.gov to assess publication rates for trials completed before October 2022 and characterise research trends for subsequent registrations. Publication status was ascertained via PubMed and Google Scholar, and trial characteristics were analysed to identify predictors.
Results
Among 98 completed trials, only 26.5% were published. Publication was lowest for industry-sponsored (20.6%) and device trials (20.9%). Interventional design and larger enrolment showed positive but non-significant associations. Post-2022 registrations signalled diversification: device trials decreased (43.9% to 31.9%), while rehabilitation (13.3% to 20.3%) and procedural refinements (11.2% to 17.4%) expanded.
Conclusion
A marked gap persists in CI evidence dissemination, with only one-quarter of trials published. While device studies remain prominent, recent trends reflect a broadening research agenda with increasing emphasis on rehabilitation and surgical techniques, warranting continued monitoring.
To evaluate medications, surgical procedures, demographics and co-morbidities in Ménière’s disease using TriNetX.
Method
Retrospective cohort analysis.
Results
Among 117,059 Ménière’s disease patients, common medications were corticosteroids benzodiazepines, diuretics and antacids. Surgical procedures were rare: cochlear implantation (1 percent), endolymphatic sac surgery (1 percent), labyrinthectomy (0.3 percent) and vestibular nerve section (0.1 percent). Surgical patients were older (mean 68.4 vs 66 years, p < 0.001), more often male (44.3 percent vs 34.6 percent) and less likely to be Asian (1.6 percent vs 8.3 percent) or African American (2.0 percent vs 4.4 per cent). Co-morbidities included musculoskeletal diseases, metabolic disorders, hypertension, anxiety and/or depression, gastro-oesophageal reflux disease, thyroid disordersand migraine. Melanoma prevalence (6 percent) was 12–15 times higher than in the US population.
Conclusion
Ménière’s disease treatment is dominated by corticosteroids, benzodiazepines and diuretics, with rare surgical procedures. Surgical patients are older, more often male and less likely to be Asian or African American. Co-morbidities include musculoskeletal diseases, hypertension, gastroesophageal reflux disease, thyroid disorders, migraine and higher melanoma prevalence, warranting further research.
Rhinitis medicamentosa is a challenging condition resulting from prolonged nasal decongestant use. This study aimed to compare holmium laser turbinate reduction and partial turbinoplasty surgical options.
Methods
A retrospective cohort study was conducted, including 65 patients diagnosed with rhinitis medicamentosa, with a minimum post-operative follow up of 12 months. Symptom severity and quality of life were assessed pre- and post-operatively using the Sino-Nasal Outcome Test 22 (SNOT-22) and the visual analogue scale (VAS).
Results
Both surgical techniques resulted in significant post-operative improvement in SNOT-22 and VAS scores. Post-operative SNOT-22 total and obstruction scores were significantly lower in the partial turbinoplasty group compared with the holmium laser turbinate reduction group (p < 0.05). Post-operative VAS scores did not differ significantly between groups (p > 0.05). The partial turbinoplasty group demonstrated higher incidence of early post-operative complications.
Conclusion
Both holmium laser turbinate reduction and partial turbinoplasty are effective surgical options for rhinitis medicamentosa. Surgical technique selection should be individualised based on disease severity, patient expectations and risk tolerance.
This study aimed to evaluate whether the presence of an intact stapes superstructure is a significant factor in the success of an ossiculoplasty. Secondary factors assessed included presence of cholesteatoma and revision surgery.
Methods.
A retrospective cohort study in a Scottish tertiary centre analysed audiological outcomes from 100 consecutive adult patients undergoing single-stage ossiculoplasty with titanium prostheses (partial ossicular replacement prosthesis; total ossicular replacement prosthesis). Patient demographics and pre- and post-surgery audiometric data were collected. Bivariate analysis and multivariate linear regression determined independent predictors of post-operative air–bone gap closure.
Results.
Presence of an intact stapes superstructure significantly improved air–bone gap closure (27.4 dB vs. 21.1 dB; p = 0.048), remaining independently significant in multivariate analysis (β = 9.93; p < 0.001). Larger pre-operative air–bone gap strongly predicted better closure (β = 0.87; p < 0.001). Cholesteatoma and revision status were not independent predictors.
Conclusion.
Preservation of the stapes superstructure enhances ossiculoplasty outcomes using titanium prosthesis. Patients with larger initial air–bone gaps, especially those with an intact stapes, experience the greatest post-operative improvement.
This study aimed to evaluate the clinical applications, observed haemostatic outcomes of a self-assembling peptide haemostat (PuraBond®) across a range of ENT surgical procedures using a large UK observational registry.
Methods.
A two-cycle observational study of 600 patients at University Hospitals Birmingham NHS Foundation Trust (September 2019–July 2024). Data collected included patient demographics, comorbidities, anticoagulation status, surgical details, intra-operative haemostatic outcomes and post-operative complications.
Results.
Intra-operative haemostasis was documented without the need for additional haemostatic intervention in 99.8% of cases (599/600). Immediate haemostasis-related complication rate was 0.2% (1/600). The overall complication rate was 3% per cent, with most complications unrelated to haemostasis or the use of PuraBond. The study limitations include participant heterogeneity, absence of a control group and small subspeciality sample sizes underscoring the need for comparative studies.
Conclusion.
This registry demonstrates PuraBond’s broad applicability in ENT surgery as an adjunct to routine haemostats and provides essential groundwork for designing future comparative trials.
Post-radiotherapy tissue changes in laryngeal cancer can hinder accurate imaging assessment of recurrence and tumour extent. We compared pre-operative magnetic resonance imaging staging performance in recurrent laryngeal cancer versus primary laryngeal cancer.
Methods.
Retrospective single-centre study of 51 total laryngectomy patients (2012–2021). Magnetic resonance imaging assessments of invasion/extension were compared with histopathology (reference standard) to compute accuracy, sensitivity and specificity.
Results.
Magnetic resonance imaging accuracy differed between groups. In the recurrent laryngeal cancer group, accuracy was highest for lymph node metastasis (88.5 per cent) and extra-laryngeal spread (76.9 per cent), whereas it was lowest for cartilage invasion (53.9 per cent) and paraglottic involvement (57.8 per cent). In the primary laryngeal cancer group, magnetic resonance imaging performed best for subglottic and supraglottic extension (76.0 per cent each) and cartilage invasion (72.0 per cent), but showed limited accuracy for extra-laryngeal spread (36.0 per cent) and lymph node metastasis (60.0 per cent).
Conclusion.
Magnetic resonance imaging tended to overestimate tumour extent in both groups. It was sensitive overall, but less specific in certain subsites, particularly the paraglottic region. Negative nodal findings may be reassuring, although conclusions regarding nodal status remain limited.
To determine whether sex independently predicts survival in oropharyngeal squamous cell carcinoma and whether human papillomavirus status mediates apparent sex-related survival differences at the population level.
Methods.
Population-based cohort study using the Surveillance, Epidemiology, and End Results (SEER) database (17 Registries, 2018–2021). Multivariable Cox regression and a formal sex–human papillomavirus interaction test (likelihood ratio test) were performed in 19,716 patients with known p16/HPV status.
Results.
p16-positive disease was more prevalent in males (73.6 per cent vs. 56.2 per cent; p < 0.001). Within human papillomavirus subgroups, survival did not differ significantly between sexes (all p > 0.30). After full adjustment, female sex was not independently associated with overall survival (hazard ratio 0.98; 95 per cent confidence interval 0.91–1.05; p = 0.52) or disease-specific survival (hazard ratio 1.01; p = 0.80). The sex–human papillomavirus interaction was non-significant (hazard ratio 1.057; p = 0.459), confirming human papillomavirus status fully mediates the apparent female survival disadvantage.
Conclusion.
Sex is not an independent prognostic variable in oropharyngeal squamous cell carcinoma. HPV/p16-based stratification remains the primary prognostic framework.
To compare subjective and psychophysical olfactory outcomes in patients with eosinophilic chronic rhinosinusitis controlled after primary functional endoscopic sinus surgery (FESS) alone versus those treated with dupilumab for post-operative recurrence.
Methods.
This retrospective cohort study included 357 adults undergoing primary FESS. Patients were classified into a FESS group (disease controlled after surgery alone, n = 334) and a dupilumab group (post-operative recurrence treated with dupilumab without revision surgery, n = 23). Subjective olfaction was assessed using the self-administered odour questionnaire and psychophysical function was assessed using standardised olfactory threshold testing. Pre- and post-treatment outcomes were compared within and between groups.
Results.
Baseline age, sex, asthma prevalence and psychophysical thresholds did not differ significantly. The Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis scores, blood eosinophils and self-administered odour questionnaire scores were worse in the dupilumab group at baseline. Both groups showed significant improvement after treatment, with no significant differences in post-treatment outcomes.
Conclusion.
Dupilumab for post-operative recurrence achieved olfactory improvement comparable to primary FESS alone.
As rheumatoid arthritis of the cricoarytenoid joint can be life-threatening, this study aimed to provide a comparison of survival and decannulation after tracheostomy for those with this condition.
Methods
Following Preferred Reporting Items for Systematic Review and Meta-Analyses (‘PRISMA’) guidelines, PubMed, Web of Science, Scopus, Embase and MEDLINE library databases were queried to find all reported cases of rheumatoid arthritis of the cricoarytenoid joint.
Results
A total of 55 articles with 82 patients were included in the analysis. The mean age at diagnosis was 60.1 ± 11.2 years. In cases of bilateral involvement, 71.2 per cent of patients required a tracheostomy. For those who had bilateral cricoarytenoid joint involvement and a tracheostomy, there was a significant relationship between having a primary laryngeal surgery, with or without medical management, and overall survival with ultimate decannulation compared with those with just medical management (p = 0.0022).
Conclusion
Tracheostomy is often necessary for acute symptom management of rheumatoid arthritis of the cricoarytenoid joint, and laryngeal surgery may be offered to facilitate ultimate decannulation.
This study aimed to determine what motivates rhinoplasty surgery after septoplasty, and the clinical characterisation of patients undergoing these interventions.
Methods
This is a retrospective observational study including all patients submitted to rhinoplasty after septoplasty between January 2018 and July 2023. Demographic, clinical and surgical data were collected using patients’ digital hospital records.
Results
Of 219 patients who underwent rhinoplasty, 15 per cent (n = 33) had a previous history of septoplasty. All patients (n = 33) who had undergone septoplasty before rhinoplasty reported maintenance of nasal obstruction, with most patients presenting with nasal deformities upon physical examination (54%; n = 18), of which 15 per cent (n = 5) presented with nasal tip ptosis and with 9 per cent (n = 3) presenting with nasal septum perforation. The mean interval between septoplasty and rhinoplasty was 77 months. An open approach was used in 58 per cent of patients, and grafts in 73 per cent, most commonly columella struts, with cartilage harvested from the nasal septum in 55 per cent but requiring auricular cartilage in 18 per cent.
Conclusion
Persistent nasal obstruction is the main indication for rhinoplasty after septoplasty, commonly associated with residual septal deviation, nasal valve dysfunction or external nasal deformities. These findings emphasise the importance of a thorough pre-operative assessment of all nasal structures in patients with nasal obstruction. Rhinoplasty in this context often represents a more complex surgical challenge, frequently requiring an open approach and a greater use of cartilage grafts, sometimes harvested from sites beyond the nasal septum. A comprehensive approach that addresses both functional and aesthetic components during the primary surgery may reduce revision rates, facilitate easier corrective procedures if needed and improve long-term patient satisfaction.
To investigate whether socioeconomic deprivation is associated with residual or recurrent cholesteatoma following primary mastoidectomy.
Methods
A retrospective cohort study included all patients undergoing primary mastoidectomy for cholesteatoma in National Health Service Tayside between 2012 and 2020. Socioeconomic status was assessed using the Scottish Index of Multiple Deprivation 2020 and divided into quintiles. Patients were stratified into paediatric (≤16 years) and adult (>16 years) groups. Recurrence/residual rates across Scottish Index of Multiple Deprivation quintiles were compared using Fisher’s exact tests, and time to recurrence was analysed using Kaplan–Meier survival curves.
Results
One hundred eighty-four patients were included (59 children, 125 adults). Recurrence/residual occurred in 39 per cent of children and 24 per cent of adults. In children, higher deprivation was significantly associated with risk of recurrence/residual disease (p = 0.0013). No significant association was observed in adults.
Conclusion
Socioeconomic deprivation is linked to higher recurrence/residual in children, highlighting disparities in postoperative outcomes and the importance of targeted follow-up.