Cholesteatoma is a pathological growth of squamous epithelium in the middle ear and mastoid. Pre-operative high-resolution computed tomography is commonly performed to guide the surgical approach and evaluate disease extent. The purpose of this review is to demonstrate the level of correlation between high-resolution computed tomography and intra-operative findings during cholesteatoma surgery.

Medline, Embase and Cochrane databases were searched in December 2024 for studies comparing high-resolution computed tomography and intra-operative findings of adult patients diagnosed with cholesteatoma.

Out of 2514 abstracts identified, 15 were included. The correlation between pre-operative high-resolution computed tomography and intra-operative findings was strongest for the identification of erosion of the malleus (k = 0.77), followed by the lateral semicircular canal and tegmen tympani (k = 0.69). The weakest correlation was found for facial nerve dehiscence (k = 0.55).

High-resolution computed tomography is useful for providing a roadmap for surgery. It offers a strong correlation for intra-operative detection of malleus, incus, lateral semicircular canal and tegmen tympani involvement.

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.

We aim to investigate nutritional management of chyle leaks by a systematic review of the published literature.

We searched the following databases (Medline, Embase, Cochrane) for literature incorporating nutritional aspects in chyle leak management. We excluded non-English papers, paediatric studies, conference papers, and studies without nutritional intervention.

Among 260 patients (out of 26,270), 81.5.% (n=212/260) achieved chyle leak resolution with nutritional management, while 18.5% (n=48/260) required surgery. Median resolution duration with nutritional management was 8.7 days (range: 4.3 to 22.2), compared to surgical treatment’s median of 32 days (range: 18 to 40).

We recommend use of nutritional management in all patients with chyle leaks. There is no evidence supporting one diet over the other however clinically we suggest starting with medium–chain triglyceride/non–/low–fat diets and moving onto total parenteral nutrition, unless medically indicated otherwise.

This study aimed to examine anatomical factors predicting anterior ethmoidal artery type.

Paranasal sinus computed tomography images from adult patients were reviewed. Anterior ethmoidal artery types were categorised based on skull base relationship: type A (embedded within skull base), type B (in a protruding canal) and type C (separated from skull base). Statistical analyses encompassed inter-type comparisons, multinomial logistic regression and correlation analysis.

Anterior ethmoidal artery types differed significantly in lateral lamella height and Keros classification, with type C showing the greatest lateral lamella height and predominant Keros III. Type C was additionally characterised by enlarged frontal sinus volume, increased volume and height of frontal recess anterior cells and higher supraorbital ethmoid cell prevalence. The anterior ethmoidal artery–skull base distance demonstrated significantly positive correlations with lateral lamella height, frontal sinus volume and the volume and height of frontal recess anterior cells.

More extensive pneumatisation of frontal sinus and ethmoid cells and increased lateral lamella height might predict a free-running anterior ethmoidal artery.

This study aimed to evaluate physical simulation models for endoscopic ear surgery including model types, validation methodology and educational outcomes.

A Preferred Reporting Items for Systematic reviews and Meta-Analyses compliant search of PubMed, Embase and the Cochrane Library was conducted to June 2025. Studies describing physical endoscopic ear surgery simulators with reported validation or educational outcomes were included.

Fourteen studies met inclusion criteria. Simulators comprised cadaveric animal heads, synthetic task trainers and single- and multi-material three-dimensional-printed models. Face validity was consistently high. Construct validity, assessed using Objective Structured Assessment of Technical Skills scores or timed tasks, was demonstrated in five studies. Content validity was reported in three studies. No study evaluated transfer validity. Educational outcomes included improvements in confidence, anatomical knowledge and task completion time.

Physical endoscopic ear surgery simulators show strong face validity and emerging construct validity, but evidence is limited by small, single-centre studies and methodological variability. Standardised validation and assessment of clinical transfer are needed to support integration into training pathways.

Perineural invasion (PNI) is an unfavorable pathological characteristic associated with poor prognosis. The relationship between PNI and clinicopathological features of hypopharyngeal squamous cell carcinoma (HPSCC) remains unclear. The aim of this study was to investigate the relationship between PNI and clinicopathological features and risk factors for PNI in HPSCC.

Clinicopathological data from 182 patients with HPSCC treated at our hospital between September 2019 and March 2024 were collected and analysed retrospectively.

PNI was observed in 68 (37.4%) patients, and was associated with tumor thickness (TT), lymph node metastasis (LNM), lymphovascular invasion (LVI), number of positive nodes (pN), and lymph node density (LND). PNI was only significantly correlated with TT in the multivariate analysis.

We observed a definite correlation between PNI and TT, LVI, LNM, LND, and pN value. TT emerged as an independent risk factor for PNI, with its incidence increasing with TT.

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.

Paediatric septoplasty remains a contentious topic due to concerns about its potential impact on midfacial growth and the landscape in the UK has been largely unexplored to date. We aimed to describe the current attitudes and practice patterns surrounding paediatric septoplasty practice in the UK.

A survey was distributed to independently practising ENT surgeons across the UK. Statistical analysis and qualitative thematic analysis were performed.

A total of 103 responses from all UK regions were analysed. Opinions on septoplasty in children were polarised. Rhinologists, as well as consultants with more than 10 years’ experience, were more likely to offer surgery. Qualitative thematic analysis identified six themes within free-text responses, reflecting the diversity of current practice.

Paediatric septoplasty is being offered in the UK, but attitudes remain divided and practice is highly variable. Prospective longitudinal studies are needed to clarify long-term outcomes.

Langerhans cell histiocytosis is a rare disorder in children that can involve the head and neck, may mimic common ENT conditions and delay diagnosis. While various case reports exist, ENT-focused reviews remain limited.

We conducted a literature review of 73 studies encompassing 244 paediatric patients with head and neck Langerhans cell histiocytosis, extracting data on presentation, treatment and outcomes. We also present a retrospective case series of 25 patients treated at a single tertiary institution.

Otologic and craniofacial bone involvement were the most common presentations. Treatments ranged from surgical curettage and intra-lesional steroids to systemic chemotherapy. Recurrence was more common in multifocal and multisystem disease. Our institutional series supported many of these findings, with detailed follow-up data and treatment responses.

This is the most extensive ENT-focused review of paediatric Langerhans cell histiocytosis to date. It highlights key clinical patterns and management approaches to aid early recognition and tailored treatment.

This study aimed to evaluate the diagnostic and surveillance performance of circulating tumour human papillomavirus DNA for post-treatment monitoring of human papilloma virus–positive oropharyngeal squamous cell carcinoma.

Systematic review and meta-analysis of prospective studies (2019–2024) identified from PubMed, Web of Science and Scopus. Random-effects models were used to pool circulating tumour human papillomavirus DNA detectability and summarise lead-times to recurrence.

Fifteen studies (n=1,447) were included; 10 cohorts (n=731) entered the quantitative meta-analysis. Pooled baseline detectability was 85.5 per cent (95 per cent confidence interval 78.2–90.6). Circulating tumour human papillomavirus DNA positivity preceded clinical recurrence by a mean of 76.8 days (median 87.5). Specificity and negative predictive value were consistently high, whereas sensitivity varied by assay platform and sampling frequency.

Serial circulating tumour human papilloma virus DNA testing is a reliable adjunct to post-treatment surveillance in HPV-positive oropharyngeal squamous cell carcinoma, offering a clinically meaningful lead-time to recurrence. Standardised assays and multicentre validation are warranted.

This study compared endoscopic butterfly inlay and microscopic over-underlay cartilage tympanoplasty regarding graft success and hearing outcomes.

A retrospective analysis was performed on patients who underwent tympanoplasty between January 2022 and December 2024. Patients with additional otologic procedures, cholesteatoma or revision surgery were excluded. Patients were assigned to Group 1 (endoscopic butterfly inlay) or Group 2 (microscopic over-underlay). Demographic characteristics, perforation size, operative time, graft success and audiometric outcomes were evaluated using air–bone gap (ABG).

Sixty-four patients were included (33 in Group 1, 31 in Group 2). Operative time was significantly longer in the microscopic group, while perforation size and graft success rates were similar. Both techniques resulted in significant post-operative hearing improvement without inter-group differences.

Both techniques provided comparable graft success and hearing outcomes. The endoscopic butterfly inlay technique achieved similar results with shorter operative time, supporting its use as a minimally invasive alternative.

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 evaluate the epidemiological characteristics, incidence trends and survival outcomes of nasopharyngeal carcinoma from 2000 to 2021.

A retrospective analysis of 10,419 NPC cases from the SEER database (2000–2021) was conducted. Incidence rates were calculated per 100,000 population. Joinpoint regression assessed trends, and Kaplan–Meier and Cox regression evaluated survival.

Most patients were male (68.9 per cent) and White individuals (51.2 per cent), with 49.5 per cent presenting at a regional stage. Males were more likely to present with distant disease than females (72.2 per cent vs. 27.8 per cent; p < 0.001). Nasopharyngeal carcinoma incidence was higher in males (0.8/100,000) and Asian populations (1.87/100,000). Overall incidence declined (average annual per cent change: –0.8 per cent; p = 0.002). Median survival was 79 months, longer in females (90) and Asian populations (118). Distant disease predicted higher mortality (hazard ratio 1.71; p < 0.001). Nasopharyngeal carcinoma was the leading cause of death (43.6 per cent).

Males and Asian populations had higher nasopharyngeal carcinoma incidence. Female sex and Asian race predicted better survival, while distant-stage disease increased mortality.

This study aimed to systematically review the evidence on functional outcomes following dorsal preservation rhinoplasty, with a focus on nasal obstruction.

A systematic review was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. PubMed, Embase, Scopus and Cochrane databases were searched up to March 2025. Studies reporting nasal airway outcomes following dorsal preservation rhinoplasty using subjective or objective measures were included.

Six studies comprising 662 patients were included. Patient-reported outcomes (Nasal Obstruction Symptom Evaluation, Standardized Cosmesis and Health Nasal Outcomes Survey and Visual Analogue Scale) consistently demonstrated significant post-operative improvement. Objective measures (acoustic rhinometry, rhinomanometry and cone-beam computed tomography) showed maintained or improved airway dimensions. dorsal preservation rhinoplasty was functionally equivalent to traditional structural techniques, with low complication (<5 per cent) and revision rates (<2 per cent).

Dorsal preservation rhinoplasty maintains or improves nasal airway function while preserving structural integrity and reducing the need for grafting. It is a safe and effective alternative to traditional dorsal reduction techniques.

Human papillomavirus (HPV) associated oropharyngeal squamous cell carcinoma (OPSCC) exhibits a favourable prognosis compared to non-HPV OPCSCC. Tumour infiltrating lymphocytes (TILs) may predict better survival outcomes for patients with HPV+OPSCC.

A retrospective review of patients treated for HPV+OPSCC between 2003-2018. TIL density scores for each patient’s tumour specimen were determined. Patients were categorised as TIL-Hi or TIL-Lo. Survival outcomes for the two TIL groups were compared.

Fifty-seven patients, 33 in the TIL-Hi group, were included. 5-year overall survival was 81.8% in the TIL-Hi and 75% in the TIL-Lo groups. 5-year disease specific survival was 87.9% and 87.5%, respectively. There was no statistically significant difference in survival outcomes between TIL-Hi and TIL-Lo.

TIL density in HPV+OPSCC has been reported to predict survival outcomes. This is not supported by the findings of this study. Further prospective evaluation with a standardised scoring technique may fully elicit the prognostic value of TILs in HPV+OPSCC.