To evaluate the predictive performance, methodological quality and clinical readiness of radiomics and machine learning approaches for predicting radiation-induced xerostomia.

A structured narrative review was conducted. PubMed and Embase were searched for studies evaluating radiomics, machine learning and deep learning approaches for predicting xerostomia following head and neck radiotherapy. Methodological quality was assessed using the Radiomics Quality Score.

Twenty-two eligible studies, with cohorts ranging from 19 to 1208 patients, were identified. Delta-radiomics and deep learning approaches generally demonstrated the strongest predictive performance, although gains over conventional models were typically modest. Mean Radiomics Quality Score was 14 out of 36, with common limitations including limited external validation, absence of prospective studies, lack of open science and no cost-effectiveness analyses.

Radiomics and machine learning show potential as adjuncts to existing xerostomia prediction models; however, methodological limitations and poor generalisability remain barriers to routine clinical implementation.

To evaluate systemic inflammatory indices as predictors of thyroid malignancy.

Of 316 thyroidectomy patients, 186 had benign and 130 had malignant histopathology. Pre-operative inflammatory indices, including haemoglobin–albumin–lymphocyte–platelet score, neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index and systemic inflammatory response index, were compared. Logistic regression identified independent predictors after age and sex adjustment. Receiver operating characteristic analysis assessed diagnostic performance.

All indices except systemic inflammatory response index differed significantly between groups (p < 0.05). Haemoglobin–albumin–lymphocyte–platelet score (p < 0.001) and systemic immune-inflammation index (p = 0.035) independently predicted malignancy. Platelet-to-lymphocyte ratio (area under the curve = 0.696) and haemoglobin–albumin–lymphocyte–platelet score (area under the curve = 0.689) showed the highest, albeit limited, diagnostic performance.

Systemic inflammatory indices, particularly haemoglobin–albumin–lymphocyte–platelet score and systemic immune-inflammation index, may aid pre-operative risk stratification as adjunctive biomarkers of thyroid malignancy.

Effective communication between specialists and primary care providers is important for optimal care. This cross-sectional study explored primary care providers’ preferences for concise versus detailed clinical letters in otolaryngology–head and neck surgery.

A survey was sent to primary care providers in Manitoba, Canada, to reflect on their past experiences and review sample concise and detailed letters. Quantitative data were analysed using Wilcoxon matched-pairs signed-rank tests and chi-squared tests. Qualitative responses were thematically analysed.

Seventy-five percent of respondents (57 incomplete responses, 39 complete) preferred concise letters, citing the readability, inclusion of key information and clear treatment plans. Some participants requested the inclusion of interim recommendations and more comprehensive details. Preferences did not differ by profession (p < 0.05).

Most primary care providers prefer concise clinical letters. Detailed rationale and interim plans can be integrated into concise formats to enhance usability without sacrificing essential information. Optimising clinical letters for conciseness may enhance interprofessional communication and care coordination.

To identify clinical risk factors for spontaneous and traumatic extrusion of bone-anchored hearing implants in adults.

A retrospective cohort study was carried out from 2003 to 2025 at a tertiary-care neurotology centre in adults with primary bone-anchored implantation.

Of 1090 total implanted ears, 73 cases (6.7 per cent) experienced device extrusion. The estimated 10-year incidence of extrusion was 10.2 per cent. Temporal bone radiation and obesity were independently associated with a 5- and 2-fold increased risk of extrusion, respectively, whereas early (<60 days) or frequent (>3 instances) wound complications were not.

Temporal bone radiation and obesity were independent predictors, whereas post-operative wound complications were not. Patients with these risk factors may benefit from close post-operative surveillance.

Oropharyngeal squamous cell carcinoma accounts for over a third of head and neck cancers, with the cost of treatment in the UK reaching £14.3 billion over 15 years. Human papillomavirus (HPV) has surpassed smoking and alcohol as the leading aetiological driver. This review examines HPV pathogenesis and the impact of vaccination on disease prevention.

PubMed, Embase and Medline were searched for articles published to December 2025, combining terms including oropharyngeal, squamous cell carcinoma, HPV, vaccines, pathogenesis and phosphoinositide 3 kinase. Gynaecological HPV malignancies were excluded, and reference lists were hand-searched.

Human papillomavirus 16 E6 and E7 oncoproteins degrade p53 and retinoblastoma protein, dysregulate phosphoinositide 3 kinase, protein kinase B and mechanistic target of rapamycin signalling and drive genomic instability. p16 is a useful but imperfect surrogate biomarker. Vaccination reduces oral HPV prevalence and is projected to lower incidence, although uptake remains suboptimal among males and in deprived areas.

Gender-neutral vaccination, improved uptake and the development of therapeutic vaccines and phosphoinositide 3 kinase-targeted therapies offer realistic strategies to reduce disease burden.

Unilateral radiotherapy for well-lateralised oropharyngeal squamous cell carcinoma reduces treatment toxicity. This study evaluated whether routine contralateral tonsillectomy, performed to look for synchronous tonsillar malignancies, is justified.

A retrospective analysis was conducted of 81 patients treated with curative intent for oropharyngeal squamous cell carcinoma at a tertiary centre (2022–2024). All patients underwent positron emission tomography computed tomography. Contralateral tonsillectomy was performed in candidates for unilateral radiotherapy.

Forty-two patients underwent contralateral tonsillectomy. Synchronous contralateral squamous cell carcinoma was identified in one patient (2.4 per cent) who required bilateral cervical chemoradiation because of extranodal extension found on neck dissection. Eleven patients (26 per cent) underwent staged procedures after a median interval of 21 days. Post-tonsillectomy haemorrhage requiring hospital re-admission occurred in one patient (2.4 per cent).

Routine contralateral tonsillectomy did not yield any findings that altered the laterality of treatment in any patient. This suggests that omitting contralateral tonsillectomy may complement de-escalation strategies.

To compare the effectiveness of implanted and non-implanted hearing solutions on subjective hearing disability and health-related quality of life in adults with acquired single-sided deafness.

This systematic review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and was registered in the Prospective Register of Systematic Reviews. Multiple databases were searched from January 1965 to October 2025 for studies reporting patient-reported hearing disability and health-related quality of life utility measures with cochlear implants, bone-conduction devices and contralateral routing of signal hearing aids as single-sided deafness treatments.

Pooled analysis of 13 studies (403 participants) demonstrated improved hearing disability scores with implanted solutions compared with no intervention [mean difference = −14.71 (95% CI: −23.48, −5.93), p < 0.00001]. Non-implanted bone-conduction devices demonstrated lower hearing disability than contralateral routing of signal aids [mean difference = 4.70 (95% CI: 0.27, 9.14); p = 0.04]. Cochlear implants significantly improved health-related quality of life compared with no hearing solution [mean difference = 0.21 (95% CI: 0.10, 0.31); p = 0.0001].

Single-sided deafness patients reported greater mean hearing-related improvement with implanted than non-implanted hearing solutions.

To evaluate whether menstrual cycle phase and serum oestrogen influence tympanoplasty outcomes in premenopausal women.

Eighty women with small central tympanic membrane perforations (follicular phase, days 1–5, n = 40; ovulatory phase, days 12–16, n = 40) underwent endoscopic transcanal type I tympanoplasty. Outcomes were anatomical success (at 12 weeks) and hearing improvement. Pre-operative serum oestrogen and its predictive value were assessed.

Graft success was higher in the ovulatory than follicular phase (90 vs 70 per cent, p = 0.025). Hearing gain was greater in the ovulatory phase (12.35 ± 4.84 dB vs 4.70 ± 3.92 dB, p < 0.001). Serum oestrogen was significantly higher in the ovulatory phase. Receiver operating characteristic analysis showed modest predictive performance (area under the curve = 0.643).

Tympanoplasty during the ovulatory phase is associated with improved anatomical and functional outcomes, suggesting that endogenous oestrogen benefits tympanic membrane healing.

Otoscopy is an essential but technically challenging diagnostic skill, particularly in resource-limited settings where access to specialist training is limited. Simulation may provide a scalable approach to improve otoscopy education.

A retrospective evaluation was conducted following an Otosim®-based quality improvement training initiative at three clinical sites in Malawi. Participants included ENT clinicians, audiologists, audiology students, clinical officers, and physicians. Pre- and post-training surveys assessed preparedness, confidence, perceived diagnostic ability, realism, and educational value. A literature review of otoscopy training modalities was also performed.

Forty-six participants completed the training. Participants had varied clinical backgrounds and otoscopy experience. Most reported improved preparedness following simulation training and rated Otosim as useful, realistic, and effective for improving diagnostic ability and confidence. Participants also perceived simulation as more effective than traditional classroom teaching.

Simulation-based otoscopy training was feasible and well received in Malawi and improved participants’ perceived preparedness and confidence. Simulation may offer a valuable strategy for expanding otoscopy education in resource-constrained settings, although future studies should include objective competency measures and assessment of long-term skill retention.

This study aimed to determine the effects of being overweight and obese on central and peripheral olfactory pathways using magnetic resonance imaging.

The cranial magnetic resonance images of 40 overweight (Group 2) and 40 obese patients (Group 3), and 40 healthy adults with a normal body mass index (Group 1, control) were included in the study. In both groups, olfactory bulb volume and olfactory sulcus depth, and insular gyrus and corpus amygdala areas were measured.

In overweight and obese patients, olfactory bulb volumes decreased (padjusted < 0.0175). Insular gyrus and corpus amygdala areas also decreased in obese patients (padjusted < 0.0175). As body mass indices increased, olfactory bulb volumes, olfactory sulcus depths, insular gyrus areas and corpus amygdala areas decreased bilaterally.

Higher body mass index values were related to a decrease in the measurements of peripheral and central olfactory regions. We also recommend taking into account the effects of obesity on the olfactory system in weight control and the fight against obesity.

Endolymphatic hydrops and normal pressure hydrocephalus may be linked via cerebrospinal fluid–perilymph pressure transmission, and shunting for normal pressure hydrocephalus can improve otologic symptoms. This study evaluated whether normal pressure hydrocephalus magnetic resonance imaging biomarkers are associated with endolymphatic hydrops severity.

In 108 patients undergoing high-resolution 3T magnetic resonance imaging with delayed post-gadolinium inner ear imaging, two radiologists graded cochlear and vestibular endolymphatic hydrops and assessed established normal pressure hydrocephalus magnetic resonance imaging markers. Associations with endolymphatic hydrops grades, age and audiovestibular symptoms were analysed.

Grade 2 endolymphatic hydrops predominated. No significant associations were found between normal pressure hydrocephalus magnetic resonance imaging markers, age and endolymphatic hydrops severity. Mild endolymphatic hydrops grades showed several side-specific and site-specific associations with hearing symptoms.

Endolymphatic hydrops severity was not associated with normal pressure hydrocephalus magnetic resonance imaging markers, arguing against routine normal pressure hydrocephalus screening in isolated endolymphatic hydrops. Findings challenge simple cerebrospinal fluid-driven secondary endolymphatic hydrops models and support distinct glymphatic–endolymphatic mechanisms.

This study aimed to design and evaluate a low-cost, high-fidelity nasal cautery model (CauterClay) for increasing user confidence in carrying out nasal cautery.

We created CauterClay with an air-dry clay scaffold, simulated nasal mucosal lining and bleeding point. We carried out single-centre assessment with a variety of nasal cautery-naive and experienced doctors. Doctors were asked to complete pre- and post-induction surveys regarding confidence, prior experience and model fidelity.

CauterClay use was associated with a statistically significant increase in user confidence in carrying out nasal cautery. All nasal cautery-naive users reported an increase in self-reported confidence following model use. Users rated the fidelity of our model highly, here we demonstrate how others can create their own CauterClay model.

Here we outline the first published low-cost, high-fidelity nasal cautery model. Our findings demonstrate it is associated with increased user confidence, suggesting it may be valuable for training nasal cautery-naive clinicians.

To evaluate the impact of a consultant-governed Advanced Nurse Practitioner-led tonsillectomy assessment pathway on patient access to care and service delivery.

A retrospective service evaluation was conducted using routinely collected data for patients referred for tonsillectomy assessment to one consultant service in 2018, prior to implementation, and during the subsequent four years, from 2019 to 2022.

Prior to implementation, 34 per cent of patients waited more than 36 months for assessment. By 2022, all patients were assessed within 18 months, with 89 per cent assessed within 12 months. Assessment activity increased substantially, overall referral-to-surgical procedure waiting times reduced and many patients were managed within the Advanced Nurse Practitioner-led pathway without onward consultant review.

This consultant-governed Advanced Nurse Practitioner-led pathway was associated with improved access to specialist assessment, increased out-patient capacity and more efficient patient flow within a regional tertiary ear, nose and throat service.

This study aimed to explore patients’ experience of active transcutaneous hearing implants and identify factors influencing outcomes and access to care.

A qualitative study was conducted at a tertiary referral centre. Adult recipients of active transcutaneous hearing implants were invited to complete open-ended questionnaires. Responses were analysed thematically using NVivo® software until saturation was achieved.

Thirty-one responses were analysed (69 percent response rate). Six themes were identified: impact of hearing loss; pre-operative experience; positive impact of the hearing implant; associated drawbacks; variation in audiology support; and limited awareness of hearing implants. Most patients reported significant improvements in hearing, confidence and quality of life. However, experiences were influenced by prior device use, expectations and individual circumstances. Limited clinician awareness was repeatedly identified as a barrier to timely access.

Active transcutaneous hearing implants provide substantial patient-reported benefit. Improving clinician awareness and managing expectations may enhance patient experience and access to care.

This review evaluates evidence-based criteria for selecting ideal candidates for biologic therapies in chronic rhinosinusitis with nasal polyps.

A narrative literature search of PubMed, Scopus, Embase and Web of Science (2016-2026) was performed, synthesising data from clinical trials, observational studies and European Position paper on Rhinosinusitis and Nasal Polyps/European Forum for Research and Education in Allergy and Airway Diseasesguidelines.

Three United States Food and Drug Administration-approved biologics (dupilumab, mepolizumab and omalizumab) effectively target severe type 2 inflammation. Ideal candidates have prior sinus surgery and greater than or equal to three criteria: elevated T2 biomarkers, systemic corticosteroid dependence, severe anosmia, impaired quality of life or comorbid asthma. Drug selection must be endotype-driven: dupilumab for broad efficacy/non-steroidal anti-inflammatory drug exacerbated respiratory disease, mepolizumab for high eosinophilia/eosinophilic granulomatosis with polyangiitis and omalizumab for severe allergic asthma. Therapeutic efficacy requires mandatory reassessment at six- and 12-month intervals using objective clinical thresholds.

Biologics act as a targeted, complementary strategy for refractory disease. Selecting patients demands a precision medicine approach based on accurate phenotyping within a collaborative multidisciplinary framework.

This study investigated whether the inflammatory potential of diet, assessed by the Dietary Inflammatory Index, is associated with sudden sensorineural hearing loss by comparing patients with sudden sensorineural hearing loss and healthy controls.

This retrospective case–control study included 30 patients with sudden sensorineural hearing loss and 32 matched controls. Dietary intake in the preceding 12 months was assessed by food frequency questionnaire, and Dietary Inflammatory Index scores were calculated. Between-group comparisons and receiver operating characteristics analysis were performed.

Mean Dietary Inflammatory Index score was significantly higher in the sudden sensorineural hearing loss group than in controls (2.27 ± 1.21 vs. 1.46 ± 1.14; p = 0.01). Patients with sudden sensorineural hearing loss had higher energy, saturated fat and cholesterol intake, while omega-3 fatty acid and fibre intake were lower (p < 0.05). Dietary Inflammatory Index scores demonstrated moderate discriminative ability for sudden sensorineural hearing loss (area under the curve = 0.690; p = 0.005).

A pro-inflammatory dietary profile may be associated with increased sudden sensorineural hearing loss risk and may contribute to understanding modifiable risk factors.

This review evaluates contemporary therapeutic strategies for rhinophyma, emphasising evidence-based treatment selection according to disease severity and clinical grading.

A structured literature search of PubMed/Medline, Scopus, Embase and Web of Science was performed for studies published between 1990 and 2025 evaluating medical, surgical and laser-based rhinophyma treatments.

Medical therapy, including doxycycline and isotretinoin, is primarily beneficial in early inflammatory disease (Clark Grade I). Established fibrotic rhinophyma (Grades II–IV) generally requires surgical intervention. Current Level III–IV evidence supports partial-thickness sharp excision combined with adjunctive laser contouring using CO₂, Er:YAG and emerging blue laser technologies to improve haemostasis, tissue preservation and cosmetic outcomes. Histopathological assessment remains essential because occult malignancies may coexist within rhinophymatous tissue.

Treatment should be individualised according to clinical severity. Combined excisional and laser-based approaches currently provide the most favourable functional and aesthetic outcomes, although prospective comparative studies remain limited.

Developmental mentoring is widely advocated within Otolaryngology training, yet programmes are often poorly defined and may not reflect its intended distinction from traditional hierarchical models. This study explored participant understanding of mentoring within a national Otolaryngology mentoring programme.

Prospective participants completed open-ended questionnaires prior to mentor training. Responses were analysed using grounded theory with iterative coding and constant comparison.

Twenty-seven participants responded. Many identified features consistent with developmental mentoring, including empowerment, goal exploration, reflection and psychological safety. However, there was notable variability in interpretation; some uncertain of the concept, others describing supervision or patronage. Broader personal, professional and value-based elements relevant to Otolaryngology training were also emphasised.

Understanding of developmental mentoring is heterogeneous and often diverges from its intended model. This lack of shared understanding may undermine programme effectiveness and efforts to support the Otolaryngology workforce. Clear definition and participant training are essential for successful implementation.

This study aimed to compare the environmental and financial impact of cochlear implantation performed with and without general anaesthesia.

Two cochlear implant procedures performed on the same day by the same surgical and anaesthetic teams were prospectively evaluated: one under total intravenous anaesthesia with bispectral index monitoring, and one under local anaesthesia with propofol sedation. Anaesthetic drugs, consumables, equipment, electricity use and procedural duration were recorded. Financial costs were estimated using procurement data and national formularies. Carbon dioxide equivalent emissions were calculated using published conversion factors.

Local anaesthesia was associated with lower cost (£59 vs. £179) and lower carbon footprint (2.85 vs. 5.28 kg carbon dioxide equivalent). Procedural duration was similar between pathways (71 vs. 74 minutes).

Cochlear implantation without general anaesthesia may reduce environmental and financial cost without prolonging procedural duration. Anaesthetic pathway selection represents a modifiable determinant of resource use in otological practice.

To investigate pain, discomfort, tolerance and complications during 24-hour multichannel intraluminal impedance-pH monitoring.

A prospective observational study at an academic out-patient clinic including 55 patients undergoing 24-hour multichannel intraluminal impedance-pH monitoring. Patient experience was measured using self-reported questionnaires at four time points: pre-insertion, post-insertion, before sleep and post-procedure. Anxiety, pain, discomfort, tolerance and other symptoms were assessed using visual analogue scale (VAS) scores. After treatment, the decision regret scale survey was administered.

Anxiety decreased after catheter insertion. Discomfort peaked immediately after insertion and declined over time, while intolerance remained relatively stable. Foreign body sensation showed the highest VAS score. The proportion of participants unwilling to undergo the examination again was high, but patients tended to have a positive perception of 24-hour multichannel intraluminal impedance-pH monitoring after treatment.

Although 24-hour multichannel intraluminal impedance-pH monitoring has been reported to be uncomfortable and difficult to tolerate, most patients were satisfied with their decision to undergo the test.