The vestibulo-ocular reflex is essential for maintaining visual stability during head movements. Individual neurophysiological characteristics, such as hand dominance, may influence vestibular responses through hemispheric lateralisation. This study aimed to investigate the effect of hand dominance on functional vestibulo-ocular reflex performance using the Functional Head Impulse Test.

Fifty-eight healthy volunteers were classified as right- or left-handed using the Edinburgh Handedness Inventory. Functional Head Impulse Test reading scores were obtained during passive rightward and leftward head impulses at acceleration levels of 4000, 5000 and 6000°/s2.

No significant differences were observed between right- and left-handed individuals during rightward head movements. In contrast, during leftward head movements, right-handed individuals demonstrated significantly higher Functional Head Impulse Test scores at 4000 and 6000°/s2, as well as higher total reading scores.

Hand dominance influences functional vestibulo-ocular performance, particularly during leftward head impulses. Considering hand dominance in the interpretation of Functional Head Impulse Test results may enhance the accuracy and individualisation of vestibular assessments.

Gross tumour volume has been proposed as a complementary prognostic marker in laryngeal squamous cell carcinoma. This systematic review and meta-analysis evaluates the prognostic value of pre-treatment gross tumour volume.

MEDLINE, Embase and Scopus were systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting pre-treatment gross tumour volume and survival outcomes in laryngeal cancer were included. The primary outcome was overall survival, and the secondary outcome was disease-free survival. Hazard ratios were pooled using random-effects meta-analysis. Risk of bias was assessed using the Quality in Prognosis Studies tool, and certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation approach.

Eight retrospective studies including 1351 patients were included. Increasing gross tumour volume was significantly associated with worse overall survival (pooled hazard ratio per 1 cm3 increase: 1.03; 95 per cent confidence interval: 1.02–1.05), with a similar association observed for disease-free survival. Overall risk of bias was moderate.

Higher gross tumour volume is independently associated with poorer survival in laryngeal cancer and may provide prognostic information beyond tumour-node-metastasis staging.

This study aimed to synthesise existing systematic reviews to determine the true long-term recurrence rate of cholesteatoma following primary surgery and to evaluate the comparative effectiveness of surgical approaches (canal wall up vs canal wall down ) and adjunctive procedures on disease recidivism.

A systematic search of PubMed, Scopus and OpenAlex identified 23 studies (predominantly systematic reviews and meta-analyses) encompassing 12,819 patients with an equal to or greater than 12 months’ follow-up and clearly defined recurrence, evaluating canal wall up, canal wall down, mastoid obliteration and endoscopic assistance.

Recurrence increased from 7 per cent at 12 months to 39 per cent at 15 years. Canal wall down showed lower recurrence than canal wall up. Mastoid obliteration (odds ratio, 0.33–0.45) and endoscopic techniques (risk ratio, 0.48–0.68) reduced recidivism and residual disease. Age and staged surgery increased risk, whereas planned second-look surgery was protective.

Cholesteatoma recurrence is strongly time-dependent. Combining appropriate surgical techniques with mastoid obliteration, endoscopic assistance and long-term surveillance improves long-term disease control.

Tinnitus is a common and potentially distressing symptom associated with chronic ear disease. Its burden in patients with chronic suppurative otitis media in low-resource settings is not well characterised.

A cross-sectional study was conducted during an ear surgery camp in Nepal. One hundred patients with chronic suppurative otitis media completed the validated Nepali Tinnitus Handicap Inventory. Severity was categorised using established grading systems. Associations between sex and severity were assessed using chi-squared analysis.

Nepali Tinnitus Handicap Inventory scores ranged from 0 to 94. Overall, 62 per cent of patients reported moderate or worse tinnitus, and 36 per cent reported severe or catastrophic symptoms. Female patients demonstrated a greater burden, with a higher proportion in severe and catastrophic categories. This difference was statistically significant (χ2 = 11.05; df = 4; p = 0.026).

Patients undergoing surgery for chronic suppurative otitis media experience a substantial and under-recognised tinnitus burden. Routine assessment may support more comprehensive, patient-centred care.

Necrotising otitis externa is a severe, potentially life-threatening infection of the external auditory canal and skull base, first formally described by Chandler in 1968. However, historical literature suggests that its clinical features were recognised long before this, without conceptual unification.

A narrative historical review was undertaken using primary and secondary sources, including early otological texts, case reports and modern literature.

Descriptions consistent with necrotising otitis externa appear as early as the nineteenth century, with recurrent observations of severe otitis externa, temporal bone involvement and systemic vulnerability. These remained fragmented across diagnostic categories until the mid-twentieth century. Chandler’s work represents a transition from clinical observation to conceptual recognition, providing a unifying framework that enabled consistent diagnosis, comparison and subsequent study of the condition.

The evolution of necrotising otitis externa reflects a process of progressive recognition, offering insight into ongoing challenges in defining and studying the disease in contemporary clinical practice.

This study aimed to determine the safety of selective cyclooxygenase 2 inhibitors in tonsillectomy patients.

A systematic review of the literature was undertaken in August 2024 (updated March 2025) using Joanna Briggs Institute systematic review and critical appraisal methodology. Study outcomes were bleeding incidence, analgesic efficacy and adverse effects. Eligible comparators were non–cyclooxygenase-2-selective non-steroidal anti-inflammatory drugs or placebo.

Fifteen studies were included for meta-analysis, 14 of which were randomised control trials. The studies were overall of good quality. There was no increased risk of bleeding with selective cyclooxygenase 2 inhibitors (odds ratio = 1.27; 95 per cent confidence interval: 0.51 to 3.16; p = 0.61). They were more effective than placebo in providing analgesia (odds ratio = -1.22; 95 per cent confidence interval, -2.12 to -0.33; Z = 2.67; p = 0.007; I2 = 84 per cent).

Selective cyclooxygenase 2 inhibitors do not cause an increase in bleeding risk for tonsillectomy patients. There is insufficient evidence to compare their safety and efficacy to non-selective non-steroidal anti-inflammatory drugs such as ibuprofen.

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.

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.

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.

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).

Up to 60 per cent of patients with enlarged vestibular aqueduct syndrome experience sudden hearing loss. This review analyses treatment options and outcomes when sudden hearing loss occurs.

Embase, Ovid MEDLINE and Web of Science databases were the data sources. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered on PROSPERO. The number of patients, episodes, treatments, baseline hearing and change in hearing thresholds after intervention and return to baseline were extracted.

The final analysis included 60 episodes of hearing loss from 11 studies, from a search of 1,064 studies. The treatment groups were: 1, no treatment; 2, systemic steroids; 3, salvage hyperbaric oxygen therapy in steroid partial or non-responders. The hearing improvement across the groups was 9.1 per cent, 50 per cent and 89.5 per cent, respectively.

Enlarged vestibular aqueduct patients with sudden hearing loss may first be treated with systemic steroids. Salvage hyperbaric oxygen therapy can be considered in steroid non-responders to improve further chances of recovery.

Evaluating the effectiveness of intra-operative nerve monitoring and stimulation in preventing spinal accessory nerve and marginal mandibular nerve injuries during neck dissection.

Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review methodology was used to map and summarise current literature. Online PubMed/MEDLINE searches and manual screening identified relevant studies for inclusion.

Seven studies met the inclusion criteria. Six addressed the spinal accessory nerve and one the marginal mandibular nerve. No randomised controlled trials were identified. The evidence tentatively supports the use of intra-operative neurophysiological monitoring in reducing spinal accessory nerve and marginal mandibular nerve palsy rates during neck dissection. Intra-operative neurophysiological monitoring modalities varied across studies, from continuous neuromonitoring to handheld nerve stimulation and nerve mapping. Monitoring criteria and outcome definitions differed across studies.

The evidence base for intra-operative neurophysiological monitoring of standard accessory nerve and marginal mandibular nerve during neck dissection remains methodologically heterogeneous. Standardised protocols, prospective controlled studies and dedicated marginal mandibular nerve monitoring studies are required before routine implementation can be recommended.

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.

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.

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).

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.

Supernumerary nostril with an accessory nasal fistula is an exceptionally rare congenital anomaly with no standardised reconstructive protocol, especially with nasolacrimal involvement.

A nine-year-old boy presented with a complete supernumerary nostril and synchronous accessory nasal fistula at the right alar base, persistent epiphora and prior endoscopic dacryocystorhinostomy. Imaging demonstrated a cystic tract communicating with the nasolacrimal system. Definitive management utilised a modified alar wedge excision type 2, incorporating both orifices into a single reconstructive unit. Three-month follow up demonstrated excellent aesthetic and functional outcomes with minimal scarring.

A review of 12 previously published cases (2001–2025) revealed heterogeneous, largely non-standardised techniques, often relying on simple excision that may not correct alar asymmetry.

Complete tract eradication and restoration of alar symmetry were achieved. Alar wedge excision type 2 offers a reproducible technique for complex supernumerary nostril–accessory nasal fistula anomalies, particularly in Asian patients where tension-free closure minimises hypertrophic scarring.

Axillary lymph node metastases represent a rare and under-recognised pattern of disease progression in laryngeal squamous cell carcinoma, with limited data regarding their timing and clinical significance.

We retrospectively reviewed all patients treated for advanced-stage laryngeal squamous cell carcinoma at two tertiary medical centres between 2017–2022, identifying cases that subsequently developed axillary lymph node metastases.

Five patients (3.6 per cent) developed axillary lymph node metastases, all following total laryngectomy, four after salvage surgery for recurrent disease. Mean interval from surgery to axillary lymph node metastases diagnosis was 9.9 ± 4.2 months. All tumours were moderately to poorly differentiated, and axillary involvement was frequently associated with mediastinal nodal disease. All patients received systemic therapy, including chemotherapy and/or immunotherapy, and three died of disease during follow-up.

Axillary lymph node metastases occurred within a relatively narrow time window after total laryngectomy, suggesting a non-random metastatic pattern. Awareness of this pathway is important for post-laryngectomy surveillance and interpretation of follow-up imaging.

Angiosarcoma is a rare malignant vascular tumour. Its occurrence in the nasal cavity is uncommon, and septal cases are particularly rare. Because symptoms are often non-specific, nasal septal angiosarcoma may initially mimic benign vascular lesion and delay diagnosis.

We report a 46-year-old woman with recurrent epistaxis and nasal obstruction. Nasal endoscopy and excisional biopsy were performed, with histopathology and immunohistochemistry.

Endoscopy revealed a 1.0 × 0.5 cm mass on the anterior septum. The lesion appeared completely excised on gross inspection; however, histopathology demonstrated infiltrative margins with residual tumour at the resection edges. Microscopy showed irregular vascular channels, pleomorphic endothelial cells, high mitotic activity and focal necrosis. Immunohistochemistry confirmed endothelial differentiation. No cartilage invasion was identified on histology.

This case highlights the diagnostic challenge of nasal septal angiosarcoma and the emphasises the importance of early biopsy, histopathological confirmation and multidisciplinary management.

To investigate whether socioeconomic deprivation is associated with residual or recurrent cholesteatoma following primary mastoidectomy.

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.

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.

Socioeconomic deprivation is linked to higher recurrence/residual in children, highlighting disparities in postoperative outcomes and the importance of targeted follow-up.

Juvenile nasopharyngeal angiofibroma is a highly vascular benign tumour affecting adolescent males. Our aim was to compare operative outcomes in embolised and non-embolised patients, with emphasis on tumour stage.

A systematic review was conducted using three databases (PubMed, Scopus and Google Scholar) in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.

Overall, 17 studies with a total of 524 patients met the inclusion criteria. The meta-analysis showed a significant difference in estimated blood loss between embolised and non-embolised groups (overall effect size -685 ml; p < 0.001). Additionally, embolised patients with advanced stage tumours tended to lose less blood during surgery than non-embolised patients (mean of 1551.9 ml vs. 4051.5 ml; p = 0.065).

This systematic review and meta-analysis demonstrate that pre-operative endovascular embolisation provides an operative advantage in patients undergoing juvenile nasopharyngeal angiofibroma surgical resection. A near-significant trend towards greater benefit in higher-stage tumours was observed (p = 0.065), warranting further prospective investigation.

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.

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.

There is increasing demand for high-quality anatomy teaching for medical undergraduates. This study investigates medical students’ perspectives on using virtual reality to learn laryngeal anatomy.

Thirty-six Year 4 university teaching hospital medical students participated in a virtual reality laryngeal anatomy learning experience (Oculus Quest 2® headsets). Students interacted with a VR model and completed a confidential feedback survey assessing their virtual reality exposure, learning environment, perceived usefulness and willingness to use virtual reality in future training.

A total of 75 per cent of students had minimal prior virtual reality exposure. Despite this, 69.5 per cent agreed that virtual reality helped them learn the anatomy better than traditional lectures; 76.1 per cent believed virtual reality enhanced their learning; and 80 per cent expressed willingness to use virtual reality in their training. High satisfaction was reported regarding the learning environment, with 97.2 per cent feeling comfortable and engaged.

Virtual reality is a useful adjunct to laryngeal anatomy education, providing an interactive, engaging and resource-efficient adjunct to traditional methods.