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 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.

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.

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.

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.

The aim of this study is to assess outcomes in managing post-operative chyle leaks, following neck dissection using a volume-based risk stratification algorithm.

A retrospective series (2010–2024) at a tertiary head and neck centre included all patients with chyle leaks after neck dissection for malignancy. Chyle leaks were stratified as low, medium or high volume and managed either medically or with planned intervention, video-assisted thoracoscopic surgery, thoracic duct ligation or thoracic duct embolisation.

Thirty-five patients were identified. Sixty-five point seven per cent (n = 23) with low-volume leaks resolved with conservative management, 31.4 per cent (n = 11) with moderate-/high-volume leaks underwent video-assisted thoracic duct ligation, with 10/11 resolving within one day post-operatively, 5.7 per cent (n = 2) underwent thoracic duct embolisation. All cases with ongoing chyle leaks resolved without neck re-exploration surgery.

Volume-based risk stratification, paired with early video-assisted thoracoscopic surgery ligation or embolisation, provides a highly effective, low-morbidity strategy for managing post-operative chyle leaks.

To evaluate the evidence for superior laryngeal nerve block in neurogenic cough and outline practical considerations for clinical use.

A systematic review was conducted in May 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible studies reported validated cough-specific quality-of-life outcomes and safety data.

Nine studies (1 randomised trial, 8 case series; n = 490) were included. All studies reported subjective improvement: eight conducted statistical testing and seven showed significant benefit, with the Leicester Cough Questionnaire exceeding the minimal clinically important difference and the Cough Severity Index showing reductions post treatment. Patients received an average of 2 to 3 injections, with follow-up of up to 22 months. Adverse effects were mild and transient. Neuromodulator use and behavioural therapy were inconsistently reported.

Superior laryngeal nerve block appears safe and effective as a short-term intervention, with long-term efficacy remaining uncertain. This review highlights procedural gaps and introduces a structured pathway to guide patient selection, injection and follow up. Robust multicentred trials and consensus guidelines are needed to define long-term benefit and standardise practice.

Malignant otitis externa is a life-threatening infection in which facial nerve palsy is a morbid complication. This TriNetX study identified predictors of facial nerve palsy in malignant otitis externa.

Retrospective analysis compared malignant otitis externa-only (n = 12 032) versus malignant otitis externa plus facial nerve palsy (n = 719) cohorts for demographics, biochemical markers and co-morbidities using t-tests and odds ratios (p < 0.05).

Male gender (p = 4.65 × 10−15) and Hispanic and/or Latino ethnicity (17.66 vs 13.02 per cent, p = 0.0014) predicted facial nerve palsy. The significant biochemical markers were albumin, blood urea nitrogen (p < 10−18), glucose, erythrocyte sedimentation rate (ESR), creatinine, iron and activated partial thromboplastin time. The key co-morbidities were hypertension (odds ratio = 3.72, p = 6.95 × 10−55), chronic kidney disease (odds ratio = 3.12, p = 1.44 × 10−49), malnutrition (odds ratio = 3.44) and electrolyte imbalances (odds ratio = 2.59). Migraines and/or headaches were non-significant.

Male sex, Hispanic and/or Latino ethnicity, hypoalbuminemia, elevated blood urea nitrogen and/or glucose and/or ESR, and co-morbidities (hypertension, chronic kidney disease, malnutrition) strongly predict facial nerve palsy in malignant otitis externa. Early risk factor management may prevent facial nerve palsy.

Button batteries are a common household item that are, unfortunately, attractive to young children. If ingested, they are corrosive and potentially fatal. Button battery ingestion is frequently unwitnessed, delaying the diagnosis. In the USA, approximately 6,000 accidental ingestions occur annually (2.2 deaths per year over a decade on average). Community awareness of this danger appears to be low.

We conducted a 22-question online questionnaire-based study to assess and raise awareness of this exceptional childhood risk.

A total of 561 survey responses were analysed; 77 per cent were female, and 60 per cent were aged 30–50. Despite 87 per cent using button batteries, 65 per cent did not consider their safety, and 68 per cent found existing packaging warnings inadequate. Notably, 80 per cent recognised the potential for fatality, but 88 per cent were unaware that a spoonful of honey could delay this corrosive process.

Challenges persist regarding the design and marketing of button batteries and public awareness of their ingestion. Action is required to prevent further tragedies.

To evaluate the efficacy differences of house dust mite sublingual immunotherapy in allergic rhinitis patients of different ages.

Ninety-two patients who underwent 1 year of house dust mite sublingual immunotherapy were retrospectively analysed and divided into groups of children (<14 years, n = 46) and adolescents and adults (≥14 years, n = 46). The total nasal symptoms, total medication, combined symptom and medication, and mini Rhinoconjunctivitis Quality of Life Questionnaire scores were assessed.

Significant improvements were displayed after sublingual immunotherapy treatment compared with baseline (p < 0.001). In particular, children exhibited more pronounced improvements on each indicator than adolescents and adults at the end of 1 year of sublingual immunotherapy treatment (p < 0.05). Meanwhile, correlation analysis revealed that the mini Rhinoconjunctivitis Quality of Life Questionnaire score has positive correlations with the total nasal symptoms, total medication, and combined symptom and medication scores (all p < 0.001).

More notable improvements were seen in children than in adolescents and adults with allergic rhinitis after one year of house dust mite sublingual immunotherapy treatment.

Clinical trials provide valuable treatment insights but often fail to represent real-world outcomes. This is particularly true for advanced laryngeal cancer patients, who face significant co-morbidities and socioeconomic challenges. This study evaluates whether outcomes from research datasets in The Cancer Imaging Archive reflect real-world survival in a regional cohort from North-East England.

This retrospective analysis compares outcomes between The Cancer Imaging Archive (n = 198) and North-East England (n = 222) cohorts. Demographics, treatment modalities and five-year disease-specific survival were assessed via Kaplan–Meier curves and Cox regression.

North-East England had a lower five-year disease-specific survival (59.2 per cent vs. 76.9 per cent; p = 0.0018) and was characterised by greater co-morbidity burden and upfront surgery with adjuvant therapy (51 per cent), whereas The Cancer Imaging Archive patients received upfront chemoradiotherapy (53 per cent) or radiotherapy alone (41 per cent).

The poorer real-world outcomes reflect the challenges of generalising research data to heterogeneous populations. Bridging the gap between research efficacy and real-world effectiveness is critical to delivering equitable care for advanced laryngeal cancer.

This study aimed to estimate the prevalence of Eustachian tube dysfunction and identify associated risk factors in a consecutive cohort of children undergoing adenotonsillectomy for sleep-disordered breathing.

This was a retrospective study of children with sleep-disordered breathing admitted for adenotonsillectomy in two tertiary public hospitals in South China from January 2019 to November 2023. The prevalence of Eustachian tube dysfunction was assessed based on tympanograms. Demographic information and clinical characteristics were collected for risk factors analysis.

A total of 1,044 children aged 3 to 14 years were enrolled in the present study, 375 (35.92%) of whom had Eustachian tube dysfunction. Risk factors for Eustachian tube dysfunction included age less than or equal to six years, allergic rhinitis, sinusitis, adenoid hypertrophy and hypoxemia. No significant association was found between Eustachian tube dysfunction and gender, disease duration, tonsillar hypertrophy, obesity or obstructive sleep apnoea.

Eustachian tube dysfunction is highly prevalent in children undergoing adenotonsillectomy for sleep-disordered breathing and, therefore, warrants further attention and intervention.

This study examined the temporal and seasonal distribution of sudden sensorineural hearing loss admissions and audiogram types from 2015 to 2024 using seasonal-trend decomposition with locally estimated scatterplot smoothing.

A retrospective analysis included sudden sensorineural hearing loss patients admitted to a tertiary otorhinolaryngology clinic between January 2015 and December 2024. Demographics, admission dates and audiogram types were evaluated.

Among 738 patients (mean age 45.7 ± 15.6 years; 58.4% male), admissions varied significantly across years, months and seasons, peaking from November to March. Winter admissions were highest, while autumn had the lowest. Seasonal-trend decomposition with locally estimated scatterplot smoothing confirmed recurring seasonal patterns. Although audiogram types showed no seasonal or pandemic association, their distribution differed significantly by month.

Sudden sensorineural hearing loss admissions demonstrate clear temporal and seasonal clustering, aligning with influenza-like illness peaks and suggesting a viral contribution. Monthly audiogram variations imply possible environmental influences.