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.

Total ossicular replacement prostheses are commonly used to restore hearing in the conductive hearing impaired. However, total ossicular replacement prostheses are expensive and scarcely available in low- and middle-income countries. Therefore, the aim was to develop and validate an open-source design of a total ossicular replacement prosthesis that can be produced locally for low- and middle-income countries hospitals.

Based on input from literature and clinicians a design was made and verified. Accuracy, re-bending safety, cadaver ear fitting, sound transmission and production learning curves were tested.

A titanium sheet metal total ossicular replacement prosthesis, costing 9 euro, showed accurate dimensions, surgeons showed short learning curves, and sound transmission was similar to commercial total ossicular replacement prostheses. Re-bending tests demonstrated bending corrections could be safely done. Good cadaver ear fitting could be demonstrated, without conflicts between the titanium sheet metal total ossicular replacement prosthesis and anatomical features.

The titanium sheet metal total ossicular replacement prosthesis design has proved to be feasible for implementation in low- and middle-income countries.

Deep neck space infections are uncommon but potentially life-threatening conditions with variable presentation in children without clear indications for medical versus surgical management. This study aimed to identify predictors of surgical intervention.

A retrospective review was conducted of paediatric patients with deep neck space infections at a tertiary centre between 2014 and 2024. Patients were grouped by treatment approach: medical therapy, primary surgery or surgery following medical therapy. Clinical, radiological and outcome variables were analysed to identify predictors of surgical intervention.

Ninety-two patients were included: 51.1 per cent were managed successfully with antibiotics alone, and 48.9 per cent required surgery initially or after medical trial. Independent predictors of surgical intervention included younger age, fever (< 38.0° Celsius) at presentation, computed tomography confirmed abscess and cross-sectional area greater than 3.00 cm2.

Most deep neck infections respond to medical management, though younger age, fever and larger abscess size should prompt consideration for surgical consideration.

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.

This retrospective study evaluated the concordance between fine-needle aspiration cytology and histopathology in parotid gland masses and assessed the diagnostic value of magnetic resonance imaging features.

Forty-two patients who underwent parotidectomy with available fine-needle aspiration cytology, magnetic resonance imaging, and histopathology results were included. fine-needle aspiration cytology–histopathology agreement was analysed for multicategorical and binary (benign vs. malignant) classifications. Magnetic resonance imaging findings, including signal intensity, contrast enhancement, cystic-like appearance and lesion size, were compared, and predictors of malignancy were evaluated using Firth logistic regression.

Thirty-eight lesions (90.5 per cent) were benign and four (9.5per cent) were malignant. Fine-needle aspiration cytology–histopathology concordance was low for histological subtype differentiation (κ = 0.082) but substantial for benign–malignant distinction (κ = 0.636; p < 0.01). All lesions were T2-hyperintense, and cystic-like appearance was strongly associated with Warthin tumour (p = 0.001; odds ratio 38.5).

No magnetic resonance imaging or clinical variable independently predicted malignancy. Overall, these findings support fine-needle aspiration cytology as the cornerstone of pre-operative evaluation of parotid masses, with magnetic resonance imaging serving primarily for surgical planning.

This study aimed to investigate the prevalence of misophonia among university students, examine its relationship with hyperacusis and tinnitus and explore the sensory processing patterns of individuals with misophonia in comparison to the control group.

Based on the Misophonia Questionnaire severity scores, 81 clinical misophonia and 163 subclinical misophonia patients and 60 matched healthy-controls participated the study and evaluated with the Tinnitus Handicap Inventory, Khalfa Hyperacusis Questionnaire and the Dunn Adult/Adolescent Sensory Profile questionnaire.

The incidence of clinical misophonia was 19 per cent. The clinical misophonia group had significantly higher sensory-sensitivity and sensation-avoiding scores and lower low-registration scores (Mann–Whitney U-test with Bonferroni correction; p < 0.017). Sensory processing scores across all sensory domains were significantly correlated with Misophonia Questionnaire scores. The strongest associations were moderate positive correlations in the touch (r = 0.444; p = 0.00) and visual (r = 0.420; p = 0.00) processing domains.

Findings indicate that misophonia involves heightened sensitivity and avoidance not only in auditory but also in movement, visual, touch and activity-related sensory areas, suggesting it is a complex atypical multisensory condition rather than purely audiological or psychiatric.

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.

This study aimed to analyse respiratory infection rates (RI) in a representative cohort and evaluate if tumour size, pre-existing respiratory co-morbidities, smoking history, and tracheostomy predicted postoperative infection.

A retrospective observational study at a London tertiary head and neck oncology centre reviewed six years of patient data. BMJ Best Practice guidelines for hospital-acquired pneumonia (2022) were applied to medical records alongside postoperative RI prescriptions.

RI occurred in 32% of patients, more often in those with tracheostomy (36%) than intubation (12%). Infected patients were older (p=0.025), had tracheostomy (p=0.045), and underwent bilateral neck dissection (p<0.001). ICU (p=0.008) and hospital LOS (p<0.001) were significantly higher. Age, smoking, respiratory disease, tumour stage, and airway type were not predictors.

RI were more frequent in tracheostomised patients, though assessed risk factors were not predictive. Further research should explore additional contributors and evaluate targeted interventions to reduce incidence.

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.

To explore the effect of parental presence on the recovery period of paediatric patients undergoing general anaesthesia for snoring surgery.

Forty-two paediatric patients who underwent snoring surgery were randomly divided into control and observation groups. The control group received routine nursing intervention, while the observation group allowed either the father or mother to enter the recovery room immediately after the child was awake and extubated, in addition to the routine nursing intervention.

Paediatric anaesthesia emergence delirium score during the recovery period was significantly lower in the observation group than the control group. The Face, Legs, Activity, Cry, Consolability score during the recovery period was also significantly lower in the observation group. Parental satisfaction with nursing was significantly higher in the observation group.

Immediate parental presence can effectively alleviate insecurity, reduce pain, decrease crying and restlessness of paediatric patients, and improve parental satisfaction with nursing.

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 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.

To assess the efficacy of intranasal cryotherapy to treat chronic rhinitis refractory to medical therapy.

An evaluation was performed for all patients (n = 36) with chronic rhinitis refractory to medical treatment who underwent intranasal cryotherapy between 2022 and 2024 at this centre. The primary outcome measures were changes in validated pre- and post-operative scoring systems (Total Nasal Symptom Score, Sino-Nasal Outcome Test 22 (SNOT-22), Nasal Obstruction Symptom Evaluation and peak inspiratory nasal flow).

Objective scoring pre- and post-procedure showed statistically significant improvement across all measures (p < 0.001): mean Total Nasal Symptom Score (12 hours) 8.4 to 5.3, Total Nasal Symptom Score (2 weeks) 9.2 to 5.9, SNOT-22 56 to 31, Nasal Obstruction Symptom Evaluation 57.5 to 28.5 and peak inspiratory nasal flow 98 to 138 l/min.

This is the only dataset for patients receiving intranasal cryotherapy in the UK to date and follows patients over a two-year period. The results support the ongoing use of intranasal cryotherapy for sustained treatment of refractory chronic rhinitis.

This study aimed to evaluate the effectiveness of the SmartNav in detecting tip fold-over during cochlear implantation and to compare angular insertion depth measurements obtained via SmartNav and transorbital X-ray imaging.

This retrospective multicentre study included patients with normal cochlear anatomy, comprising 163 individuals and 213 ears who underwent cochlear implantation using Nucleus CI522 and CI622 systems at Gazi University Faculty of Medicine and Gaziantep City Hospital.

Of the 213 cochlear implantations, tip fold-over was detected in 4 implantations (1.88 per cent) intra-operatively with SmartNav. One case (0.47 per cent) of tip fold-over was not detected by SmartNav and identified post-operatively through X-ray imaging. SmartNav showed a sensitivity of 80 per cent, specificity of 100 per cent. A strong correlation was found between SmartNav and X-ray angular insertion depth measurements (p < 0.001).

The SmartNav is a reliable tool for the intra-operative detection of tip fold-overand the assessment of angular insertion depth in patients with normal cochlear anatomy.

The specialties of ENT and anaesthesia have always had a unique relationship because of their longstanding history of co-operation over the shared airway.

This historical review narrates how the modern practice of ENT surgery has developed following advances in anaesthetic techniques, as well as inspiring them.

From the earliest use of anaesthetic gases by Long, Wells and Morton, to their rapid adoption for use in tonsil and cleft palate surgical procedures, ENT surgeons were early beneficiaries of this new technology. The demands of surgery for facial injuries in World War II was a driver for anaesthetic advances, and Ivan Magill reinvented the specialty in response.

Further developments in managing the shared airway, including jet ventilation, total intravenous anaesthesia and awake fibre-optic intubation, have shaped the modern ENT operating theatre, and highlight the vital collaboration between ENT and anaesthesia over the past 150 years.

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.

This study aimed to explore the efficacy of tramadol for neurogenic cough and describe the longitudinal treatment experience.

A retrospective case series of adults with chronic cough who were treated with tramadol for neurogenic cough. A complete response was defined as no pathologic coughing, and a partial response was defined as 50 per cent or greater reduction in severity or frequency.

Sixty-nine patients were included: 38 per cent of patients reported a complete response with an additional 33 per cent reporting a partial response. The most common successful dosing regimen was 50 mg twice a day. Age, gender and body mass index did not impact treatment response. Patients with a history of laryngeal surgery were less likely to respond (p = 0.04). Sedation (10 per cent) was the most common side effect. Fifty per cent of complete responders (n = 13) were weaned off tramadol after a mean of 39 weeks of treatment.

Tramadol may be effective and is well tolerated in patients with neurogenic cough.

This study aimed to determine the incidence, location and outcome of incidental avid lesions on positron emission tomography-computed tomography scans for head and neck cancer.

A retrospective study reviewing digital case notes, performed from a single centre. Clinicopathological information was collected and incidental avid lesions on positron emission tomography-computed tomography reports were recorded. Further investigations were followed up to determine the outcome of the lesions.

A total of 281 patients undergoing staging positron emission tomography-computed tomography (stages T4, N3 or unknown primary) and/or treatment response positron emission tomography-computed tomography scans for head and neck cancer were identified, with 363 incidental avid lesions reported in 369 scans. The most common location was the abdomen (30.0 per cent), followed by thorax (28.9 per cent). A total of 33.1 per cent of lesions had further investigation. The rate of incidental synchronous primary was 3.6 per cent.

The benefit of investigating carefully selected incidental avid lesions outweighs the harm of investigation, as it may alter management. There is a need for a standardised pathway for investigating these lesions in head and neck cancer services.

To map the scope, methods and focus areas of qualitative research in paediatric otolaryngology.

A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant systematic mapping review searched MEDLINE, Embase, CENTRAL and PsycInfo (August 2025) for qualitative or mixed-methods studies with a qualitative component related to paediatric otolaryngology. Two reviewers independently applied the inclusion criteria. Key study characteristics were extracted; no formal risk-of-bias assessment was performed, in line with the aims of a mapping review.

Eighty-nine studies were included. Publications rose sharply after 2015, with nearly three-quarters from the USA, Canada and the UK. Otology (49 per cent) and laryngology (40 per cent) predominated; common topics were hearing loss, tonsillectomy and tracheostomy. Interviews, mainly semi-structured (73 per cent), were the dominant method, and caregivers were the most frequent participants (62 per cent).

Qualitative research in paediatric otolaryngology is growing but remains geographically and methodologically narrow. Broader stakeholder inclusion and methodological diversity are needed to deepen understanding and support patient-centred care.

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.