This study aims to provide an updated systematic review on the clinicopathological features, treatment modalities and survival outcomes on SMARCB1-deficient sinonasal carcinoma.

Five databases were searched: PubMed, Cochrane, Embase, Web of Science and Scopus. Extracted information include demographic data, clinicopathological characteristics and survival outcomes.

A total of 70 studies were included making up a total of 372 patients. Univariable and multivariable analysis performed for prognostic factors of SDSC showed that N+ disease was a statistically significant poor prognostic factor for overall survival, while surgical treatment was a favourable prognostic factor. Treatment with surgery combined with chemotherapy and/or radiotherapy conferred significantly better prognosis compared to chemotherapy or radiotherapy alone.

Our study suggests that N+ disease and isolated treatment with radiotherapy or chemotherapy alone are significant poor prognostic factors for SMARCB1-deficient sinonasal carcinoma, while patients who undergo surgical treatment have significantly better prognosis.

To evaluate the efficacy and safety of stellate ganglion block for persistent and refractory sensorineural olfactory dysfunction.

A systematic search of PubMed, Scopus, Embase, Web of Science, Google Scholar and the Cochrane Library was conducted for studies published before December 2025. Eligible studies assessed subjective and/or objective olfactory outcomes before and after stellate ganglion block and, when available, compared stellate ganglion block with placebo or no treatment.

Nine studies involving 441 participants were included. Stellate ganglion block was associated with greater improvements in olfactory composite, identification and subjective scores than controls, but between-group differences were not statistically significant. Subjective and objective improvement rates following stellate ganglion block were 68.9 and 63.4 per cent, respectively. No major adverse events were reported.

Stellate ganglion block appears safe and may provide modest olfactory improvement, but its superiority over control treatments remains unproven, warranting further randomised controlled trials.

Bilateral vocal fold immobility is a rare, often delayed complication of head and neck radiotherapy that is not well described in the literature. This study aimed to characterise its timing and clinical course.

Patients from 2016 to 2024 with prior head and neck radiotherapy, a diagnosis of bilateral vocal fold immobility and no residual disease were reviewed. Data included demographics, tumour site, radiotherapy type/dose, chemotherapy, interval to bilateral vocal fold immobility, airway intervention, nutrition route and mobility recovery.

Twelve patients (10 male, 2 female; median age 65.8 years) were identified. Glottic (4, 33.3 per cent) and nasopharyngeal (3, 25 per cent) tumours were the most common. Most (11, 91.7 per cent) received intensity-modulated radiotherapy (median dose 68 Gy); eight had chemoradiation. Median time to bilateral vocal fold immobility was 7.5 years. Seven required tracheostomy (two decannulated); eight needed percutaneous gastric tubes. No patients recovered mobility.

Bilateral vocal fold immobility following radiotherapy is rare, delayed, often irreversible, and frequently requires tracheostomy and enteral nutrition.

Drop attacks are a rare, debilitating symptom of Ménière’s disease that affect an individual’s physical and mental health. The aim of this series was to assess the response to treatment regimens in patients presenting with drop attacks.

A retrospective case series of 8 patients with Ménière’s disease and drop attacks was followed up for an average of 67 months (range, 17–120 months).

All patients were initially managed with intratympanic steroids, with four patients having a complete response. The four non-responding patients were treated with intratympanic gentamicin, with one patient responding. Three patients were treated with triple canal occlusion. Two patients demonstrated drop attack resolution and one had a partial response. Seven out of 8 patients (87.5 per cent) suffered from depression.

Steroid injections had a 50 per cent success rate in complete resolution of drop attacks. Gentamicin injections and triple semi-circular canal occlusion can bring benefits in patients failing steroid treatment.

Inner ear malformations, particularly incomplete partition type I, are well-recognised risk factors for cerebrospinal fluid leakage, which may result in recurrent meningitis.

We present a case series of three paediatric patients with incomplete partition type I malformation who experienced an intra-operative cerebrospinal fluid ‘gusher’ during cochlear implantation and subsequently developed meningitis due to contralateral cerebrospinal fluid leakage from a stapes footplate fistula. Detailed clinical assessments, radiological findings and surgical management are described.

In all three cases, the initial suspicion of a cerebrospinal fluid fistula was directed towards the implanted ear. However, radiological evaluation and intra-operative findings confirmed a stapes footplate fistula in the non-implanted ear. Surgical closure was achieved using temporal fascia and fibrin glue. In one case, subtotal petrosectomy was required because of persistent cerebrospinal fluid leakage.

In patients with incomplete partition type I malformations undergoing cochlear implantation, contralateral cerebrospinal fluid fistula should be considered in the differential diagnosis of post-operative meningitis.

To compare long-term vestibular function in cochlear implant recipients with enlarged vestibular aqueduct and those without inner-ear malformations.

A comparative analysis was conducted on 53 cochlear implant recipients (27 with enlarged vestibular aqueduct, 26 with no inner-ear malformations). Vestibular function was assessed using caloric testing, vestibular-evoked myogenic potential, the video head impulse test and age-appropriate symptom questionnaires.

Enlarged vestibular aqueduct patients demonstrated significantly better preservation of otolithic function post-implantation, with higher cervical vestibular-evoked myogenic potential response rates (56 vs 12 per cent, p = 0.001). Caloric testing showed similar vestibular dysfunction across both groups. Both cohorts exhibited significant asymmetry between implanted and non-implanted ears.

Cochlear implantation impairs vestibular function regardless of cochlear morphology, affecting both otolithic and low-frequency semicircular canal function. However, better saccular function preservation in enlarged vestibular aqueduct patients suggests unique vestibular adaptation, with implications for counselling and rehabilitation.

This study aimed to compare the graft outcomes between endoscopic cartilage inlay myringoplasty with free perichondrial flap fold technique vs. raising the tympanomeatal flap technique for repairing large marginal perforation.

A total of 61 ears with marginal perforation were recruited and allocated to free perichondrial flap fold (n = 31) group and raising the tympanomeatal flap (n = 30) group using semi-random control trial. The graft success rate, hearing gain, operation time, visual analog scale score and post-operative complications were compared between the groups at six months.

The mean operation time was 26.4 plus-or-minus 3.1 minutes in the free perichondrial flap fold group and 50.7 plus-or-minus 2.6 minutes in the raising the tympanomeatal flap group (p < 0.001). The graft success rate was 93.5 per cent in the free perichondrial flap fold group and 96.7 per cent in the raising the tympanomeatal flap group (p = 0.977) at post-operative six months.

The free perichondrial flap fold technique may achieve similar graft success rate and hearing improvement as raising the tympanomeatal flap technique for repairing large marginal perforations; however, it is simple, time-saving and minimal invasive technique.

Assess the impact of anticoagulation or antiplatelet medications on endoscopic ear surgery visibility and procedural progress.

A case–control retrospective chart review of patients on anticoagulation/antiplatelet undergoing endoscopic ear surgery from April 2018 to April 2023 was conducted. Surgical videos were blindly rated by two surgeons utilising the Modena Bleeding Scale during clips of key operative steps; scores and outcomes were compared. Equivalence analysis was performed using two one-sided tests with an equivalence range of plus-or-minus 0.4 Modena Bleeding Scale points.

Fourteen cases were matched with 28 controls. Cases were more male (85.7 per cent; p < 0.01) and older (median: 54.9 years) than controls (median: 37.8; p < 0.01). Eleven cases (78.6 per cent) were on aspirin 81 mg, two (14.2 per cent) coumadin (4–6 mg) and one (7.1 per cent) aspirin 325 mg. No significant differences in Modena Bleeding Scale, blood loss, complications or outcomes were found.

This study revealed no significant difference in intra-operative visibility, progress, complications or outcomes with patients on anticoagulation/antiplatelet. Endoscopic ear surgery may be considered while on anticoagulation/antiplatelet.

This study aimed to investigate the risk of laryngopharyngeal reflux in Hubble Bubble smokers in comparison to non-smokers

The medical records of patients who presented with hoarseness were reviewed. Patients with a history of Hubble Bubble smoking and a control group of non-smokers were included in the study. The risk of laryngopharyngeal reflux was assessed using the Reflux Symptom Index and the Reflux Finding Score.

Eighty-six Hubble Bubble smokers and 86 controls were included in the study. There was a statistically significant difference in the mean RSI between the two subgroups (10.05 ± 8.27 vs. 5.05 ± 6.58; p < 0.001). Hubble Bubble smokers were 4.24 times more likely to have a Reflux Symptom Index score greater than 13 in comparison to non-smokers (odds ratio = 4.24; 95 per cent confidence interval: 1.97–9.14).

Hubble Bubble smoking increases the risk of laryngopharyngeal reflux by two-fold. A larger prospective study is needed to substantiate the association between Hubble Bubble smoking and laryngopharyngeal reflux.

This study aims to compare the effectiveness of the spreader grafts and cantilever grafts in correcting the narrow internal nasal valve in patients undergoing functional septorhinoplasty.

This ambispective interventional cohort study, involving 50 patients who underwent septorhinoplasty between December 2020 and November 2023 at our tertiary-care referral hospital, with 25 receiving spreader grafts (control group) and 25 undergoing surgery with cantilever grafts.

The results showed a significant improvement in nasal airflow in both groups post-operatively, with the cantilever graft group showing a slightly higher improvement than the spreader graft group, although not statistically significant (p = 0.062).

Septorhinoplasty is a surgical procedure that aims to improve both the aesthetic appearance of the nose and nasal function. While spreader grafts are considered a standard technique for aesthetic improvement, the balanced cantilever graft offers a promising alternative for functional enhancement, particularly in patients with a narrow internal nasal valve.

This study aimed to compare Merocel and Surgicel nasal packing following inferior turbinoplasty, focusing on post-operative bleeding, pain, discomfort and nasal obstruction.

A randomised controlled trial (2017–2021) was conducted in the Department of Otolaryngology, Changi General Hospital, Singapore. Sixty adults undergoing inferior turbinoplasty and/or septoplasty were randomised to receive Merocel or Surgicel packing. Standardised surgical and post-operative protocols were used. Outcomes—bleeding, pain, discomfort and nasal obstruction—were assessed on post-operative day 1 and post-operative days 5–7 using validated scales.

Fifty-eight patients completed the study (Merocel = 30; Surgicel = 28). On post-operative day 1, Surgicel had significantly lower nasal obstruction scores (1.57 ± 0.74 vs 2.10 ± 0.71; p = 0.008). By post-operative days 5–7, Merocel showed significantly less bleeding (0.77 ± 0.63 vs 1.18 ± 0.86; p = 0.044). Pain and discomfort were comparable.

Merocel provided superior sustained haemostasis, while Surgicel offered better early comfort. Both materials have comparable outcomes.

Electronic consent (eConsent) and procedure-specific consent forms have been highlighted as methods of improving the consent process. In this two-cycle audit, we assessed the quality of consent documentation pre- and post-implementation of eConsent.

We reviewed paper (first cycle) and eConsent (second cycle) forms for discussion of benefits, risks and alternatives for septorhinoplasty and functional endoscopic sinus surgery. A survey which included the System Usability Scale was distributed to clinicians.

Post-implementation of eConsent, there was a statistically significant increase in the number of risks documented in septorhinoplasty (p-value < 0.001) though this was not the same for functional endoscopic sinus surgery. Feedback was generally positive with a System Usability Scale score of 85.3 indicating high usability.

The implementation of eConsent with procedure-specific consent forms in our centre was well received with significant improvements in septorhinoplasty documentation and more modest improvements in FESS.

To compare 12-month functional, aesthetic and scar outcomes after septorhinoplasty in patients with and without allergic rhinitis and to assess allergy symptoms in the allergic rhinitis group.

Ninety-six patients were included (allergic rhinitis, n = 47; non-allergic rhinitis, n = 49). No turbinate surgery was performed. Allergy symptoms (allergic rhinitis group) were rated pre-operatively and at 12 months using a visual analogue scale (VAS). At 12 months, all patients completed the Standardised Cosmesis and Health Nasal Outcomes Survey; scars were evaluated with the Stony Brook Scar Evaluation Scale and patient- and physician-reported VAS scores for scar and nasal shape.

The Standardised Cosmesis and Health Nasal Outcomes Survey, the Stony Brook Scar Evaluation Scale and scar VAS scores were similar between groups. Nasal shape VAS scores were higher in the non-allergic rhinitis group, significant only for physician ratings (p = 0.03). In the allergic rhinitis group, allergy VAS decreased from 39.32 ± 42.25 to 24.22 ± 31.96 (p < 0.001).

Allergic rhinitis does not adversely affect functional, aesthetic or scar outcomes after septorhinoplasty, and septorhinoplasty may clinically reduce allergy symptoms in patients with allergic rhinitis.

Human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (SCC) has favourable oncological outcomes, supporting the use of transoral robotic surgery with risk-adapted adjuvant therapy. While anticipated adjuvant treatment intensity is informed by pre-operative assessment, definitive post-operative histopathology determines final risk stratification.

A single-centre study was conducted at University College London Hospitals of 44 HPV-positive oropharyngeal SCC patients treated with primary transoral robotic surgery and selective neck dissection. Discrepancies between clinical and pathological staging, and their impact on adjuvant treatment recommendations, were assessed.

Staging discrepancies were identified in 38 per cent of patients. Pathological nodal upstaging occurred in 20.5 per cent of patients, commonly caused by higher-than-anticipated nodal burden. Involved surgical margins were present in 70.5 per cent of patients. Overall, definitive histopathology resulted in escalation of anticipated adjuvant treatment intensity in 61 per cent of patients, with 52 per cent reclassified as high-risk disease.

Post-operative histopathology frequently altered anticipated risk stratification, highlighting the limitations of pre-operative staging and the clinical impact of a surgical-first approach.

We evaluated airway volume in patients after total laryngectomy.

A total of 53 patients who underwent total laryngectomy were included in this study. Twelve of the patients had supraglottic Ca and 41 had transglottic Ca. Total lung volume, and intrapulmonary and tracheal airway volumes were measured.

After total laryngectomy, tracheal airway volume decreased more in transglottic Ca patients compared with supraglottic Ca patients (p < 0.05). Even though intrapulmonary airway volumes and total lung volumes were not different between transglottic Ca and supraglottic Ca patients (p > 0.05), these volumes decreased post-operatively in both groups (p < 0.05). In older patients, the post-operative decrease in the tracheal airway volume was higher than in younger patients (p < 0.05). Pre-operative radiotherapy was applied in 50.0 per cent of supraglottic Ca patients and 58.5 per cent of transglottic Ca patients (p > 0.05).

Because lower airway volume and total lung volume decrease after total laryngectomy, pulmonary rehabilitation should be administered post-operatively and appropriate follow up is essential to prevent tracheostomal narrowing.

Tonsillectomy carries a significant risk of post-tonsillectomy haemorrhage. The relationship between body mass index (BMI) and adult post-tonsillectomy haemorrhage remains unclear. This study aimed to evaluate BMI’s impact on adult post-tonsillectomy haemorrhage incidence and severity.

A retrospective observational study analysed 995 adult tonsillectomies. The chi-square test and logistic regression models were used for statistical analysis.

The mean BMI was 26.47 ± 5.54. Post-tonsillectomy haemorrhage occurred in 193 patients (19.8 per cent), with 48 patients (4.8 per cent) requiring operative intervention. The BMI category had no association with post-tonsillectomy haemorrhage occurrence (p = 0.467), timing (p = 0.617) or severity (p = 0.568). Body mass index and likelihood (p = 0.682) or length of in-patient stay (p = 0.191) were not correlated. Increasing BMI was not associated with post-tonsillectomy haemorrhage incidence (odds ratio = 0.98, 95 per cent confidence interval (CI) = 0.95–1.02). Male sex (odds ratio = 1.71, 95 per cent CI = 1.13–2.57) was an independent predictor.

This study did not show an increased risk of post-tonsillectomy haemorrhage in overweight adults. For tonsillectomy, a patient’s BMI should be considered in the context of overall anaesthetic risk.

To analyse the clinical characteristics, treatment and outcomes of minor salivary gland tumours of the upper aerodigestive tract.

A retrospective study was conducted of patients treated for minor salivary gland tumours between 1988 and 2020. Clinical, pathological and treatment variables were analysed. Survival outcomes were assessed using the Kaplan–Meier method.

Seventy-three patients were included, of which 64 (87.7 per cent) had malignant tumours. The most common histological type was adenoid cystic carcinoma (46.9 per cent), followed by mucoepidermoid carcinoma (32.8 per cent). The oropharynx was the most frequent tumour site. Treatment consisted mainly of surgery with or without adjuvant radiotherapy. During follow up, 28.1 per cent of patients developed local recurrence and 32.8 per cent developed distant metastases. Five- and 10-year disease-specific survival rates were 77.0 and 50.8 per cent, respectively. Advanced stage, tumour location and histological grade were associated with survival.

Minor salivary gland tumours are predominantly malignant and show heterogeneous behaviour. Prognosis is mainly determined by tumour stage, location and histological grade, supporting the need for long-term follow up.