This study aimed to evaluate if there is a role for hypoglossal nerve stimulation outside the original Stimulation Therapy for Apnea Reduction (STAR) trial criteria.

This review was conducted using PubMed, Embase and Cochrane Library databases.

Hypoglossal nerve stimulation led to improved outcomes in individuals who fell outside the STAR trial criteria for apnoea-hypopnoea index and body mass index. However, this improvement did not extend to patients with complete concentric palatal collapse or those with a significant central apnoea component.

Hypoglossal nerve stimulation can be effective in patients outside the original STAR trial criteria for certain parameters. Further research is needed to refine patient selection criteria for optimal outcomes.

This research aims to assess the prevalence, severity and underlying causes of hearing impairments.

This cross-sectional study used multistage stratified sampling to select 2148 individuals from Salyan and Surkhet, following the World Health Organization’s Ear and Hearing Survey Handbook.

Among 1946 participants, 38.9 per cent had hearing impairments, including 15.9 per cent with disabling hearing loss, with severity increasing with age. Ear diseases affected 34.3 per cent, including dull or retracted tympanic membranes (18 per cent), impacted wax (8 per cent), perforated tympanic membrane (6.1 per cent), and abnormal tympanometry (23.1 per cent). The major causes were age-related hearing loss (50.5 per cent), Eustachian tube dysfunction (23 per cent), chronic suppurative otitis media (10.8 per cent), and otitis media with effusion (4.7 per cent). Higher education and immunisation were associated with reduced risk, while chronic conditions, earaches, drainage and tinnitus increased the risk.

The high prevalence of hearing impairment, primarily from preventable causes, underscores the importance of early screening and strengthened primary health care.

Radiomics refers to converting medical images into high-quality quantitative data. This review examines applications of radiomics in vestibular schwannomas and future considerations for translation into clinical practice.

The review was pre-registered on Prospero (ID: CRD42024579319). A comprehensive systematic review-informed search of the Ovid Medline, Embase and Global Health online databases was undertaken using the keywords ‘acoustic neuroma’ or ‘vestibular schwannoma’ or ‘cerebellopontine angle tumour’ or ‘cerebellopontine tumour’ or ‘head and neck cancer’ were combined with ‘radiomic’ or ‘signature’ or ‘machine learning’ or ‘artificial intelligence’.

The studies (n = 6) were categorised into two groups: radiomics for pre-operative decision-making (n = 1) and radiomics for treatment outcomes (n = 5). Radiomic features were significantly associated with clinical outcomes. Radiomics-based predictive models were superior to expert vision.

Radiomics has potential for improving multiple aspects of vestibular schwannoma care, but lack of studies inhibited firm conclusions. Prospective studies are required to progress this field.

To clarify incidence, progression and effect on quality of life of shoulder/neck disability, oral asymmetry, neuropathic pain and numbness following neck dissection.

This prospective telephone-interview study delivered the Neck Dissection Impairment Index, Neuropathic Pain Questionnaire, House–Brackmann Scale and questions assessing numbness to patients before and three times after neck dissection.

Mean Neck Dissection Impairment Index (6.43 vs 22.17; p = 0.004) and Neuropathic Pain Questionnaire scores (0.76 vs 2.30; p = 0.004), proportions of patients with oral asymmetry (3 per cent vs 33.3 per cent; p = 0.016), ear (5.9 per cent vs 46.7 per cent; p = 0.002), jaw (5.9 per cent vs 53.3 per cent; p < 0.001) and neck numbness (5.9 per cent vs 53.3 per cent; p < 0.001) each increased significantly from pre-operation versus 12 weeks after. Neuropathic pain diagnoses did not reach significance. No outcome returned to baseline and progression of each was illustrated over time.

The findings demonstrated that these complications are common and persist throughout short-term recovery. Screening to identify and manage complications could improve post-operative care.

Transoral robotic surgery is a minimally invasive technique used in the management of head and neck cancer, though post-operative odynophagia can be a significant issue. There is debate about the necessity of elective nasogastric tube placement during the peri-operative period. This study examines the proportion of patients requiring elective nasogastric tube placement and evaluates whether pre-operative factors predict the need for nasogastric tube feeding.

Data from patients who underwent transoral robotic surgery in Oxford were analysed to assess correlations between pre-operative factors and nasogastric tube feeding.

Fifty-three patients undergoing transoral robotic surgery underwent elective nasogastric tube placement; 43 per cent required the nasogastric tube for feeding or medication. Multivariate analysis showed significant associations between nasogastric tube feeding and sex (p = 0.028), peri-neural invasion (p = 0.024), tumour size (p = 0.012) and concurrent neck dissection (p = 0.019).

Although nearly half of the patients benefited from elective nasogastric tube placement, the remainder did not. Benefits and risks of elective nasogastric tube placement should be carefully considered.

The relationship between clinical examination findings and objective nasal patency measures in structural nasal obstruction remains uncertain. This review aims to explore the relationship between clinical nasal examination findings and objective nasal patency measures using acoustic rhinometry, peak nasal inspiratory flow, rhinomanometry and rhinospirometry.

Qualitative systematic review using the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 statement.

A total of 17 articles were included in the systematic review. Several studies showed a positive relationship between objective nasal patency measures and clinical nasal examination findings, however evidence in the literature is limited and confined to cohort studies. Objective nasal patency measures using acoustic rhinometry, rhinomanometry and rhinospirometry assessment correlate positively in severe anterior septal deviation but its role in assessing middle/posterior and mild/moderate septal deviation in isolation remains uncertain. There is limited evidence in the literature to assess the relationship between peak nasal inspiratory flow and clinical examination findings.

Objective nasal patency measures has a limited role in supporting clinical examination findings in severe structural nasal obstruction.

Mucoepidermoid carcinoma of unknown primary (MEC-UP) in the head and neck is a rare presentation of the most common salivary gland cancer. Cancers of unknown primary sites often have poorer prognoses than similar cancers with known primary. Few cases of MEC-UP have been reported; therefore, the objective of this report is an overview of the diagnosis and management of MEC-UP.

We present two patients with low-grade MEC-UP at a high-volume tertiary care institution in Ontario, and a database search returning 1560 citations of which five studies with seven MEC-UP cases were identified.

Review of the limited cases suggest many clinicians use positron emission tomography-computed tomography (PET-CT) in addition to panendoscopy and targeted biopsies with consideration for diagnostic tonsillectomy in diagnostic work-up.

Like other salivary gland cancers, primary therapeutic surgical resection is recommended with low threshold for adjuvant radiotherapy to regions at high risk for harbouring the primary malignancy, especially in cases of high-grade histopathology.

The posterior pharyngeal wall is an anatomical subsite of both the oropharynx and hypopharynx. The treatment outcomes of squamous cell carcinoma (SCC) of these sites are generally published together, which makes the interpretation of data challenging. The aim of this analysis was to determine if there is any difference in the treatment outcomes of these two rare disease entities.

Retrospetive analysis showed that the posterior pharyngeal wall was the primary subsite in 17 patients (1.65 per cent) out of 1031 patients with oropharyngeal SCC, and in 23 patients (11.73 per cent) out of 196 patients with hypopharyngeal SCC.

The five-year overall survival was 45 per cent for oropharyngeal origin and 53 per cent for hypopharyngeal origin patients. There was no significant difference in survival and locoregional control between these two groups of patients.

Squamous cell carcinoma of the posterior pharyngeal wall is a rare entity, which in our series represents 1.65 per cent of oropharyngeal cases and 11.73 per cent of hypopharyngeal tumours. There was no difference in treatment outcomes between the two groups.

The primary objective of our study was to survey ENT surgeons who perform functional endoscopic sinus surgery in the UK regarding their post-sinus surgery practices.

A 28-item questionnaire on post-functional endoscopic sinus surgery practices was distributed electronically to ENT UK members specialising in rhinology.

Ninety (90 per cent) surgeons prescribe saline nasal irrigation post-functional endoscopic sinus surgery but administration timing and methods vary. Following functional endoscopic sinus surgery, 17.7 per cent (n = 17) of respondents routinely prescribe antibiotics, whilst about a quarter (26.0 per cent, n = 25) do not prescribe antibiotics at all. The rest of the respondents only prescribe antibiotics in specific cases. Thirty-three (34.7 per cent) respondents do not prescribe oral steroids whilst most clinicians (83.9 per cent, n = 78) prescribe intranasal corticosteroids post-operatively.

Our study highlights homogeneous, evidence-based practices post-functional endoscopic sinus surgery from UK-based specialists, specifically in the use of saline irrigation and intranasal corticosteroids. However, our cohort displayed significant heterogeneity regarding oral antibiotics, oral steroids, and other specific aspects of post-operative care.

To evaluate four dimensions of fatigue, including subjective fatigue severity, concentration problems, reduced motivation, and activity in patients with single-sided deafness.

Following audiological assessment, the Checklist Individual Strength scale and Montreal Cognitive Assessment were performed on 41 adults with single-sided deafness and 41 sex-matched adults with normal bilateral hearing in the study group and control group, respectively. Subjective fatigue severity, concentration, motivation, activity level and cognitive performance were analysed between and within groups.

Individuals with single-sided deafness exhibited reduced concentration and motivation; however, their activity level was average. Subjective fatigue symptoms were more prevalent in individuals with single-sided deafness than in control participants. The concentration problem was related to decreased cognitive performance.

This study revealed negative somatic consequences of single-sided deafness. Self-perceived fatigue is likely underestimated in this population due to the limited studies reported in the literature. Further studies should focus on counselling, follow up and hearing rehabilitation concerning ameliorating fatigue.

The aim of this study was to compare the internet and social media use of teenagers with hearing loss with that of their normal hearing peers.

The study included 27 hearing-impaired and 27 normal-hearing peers (12–18 years). The Social Media Attitude Scale, the Internet Use Purposes Scale, University of California, Los Angeles Loneliness Scale and the Problematic Internet Use Scale were used to compare hearing-loss and normal-hearing groups.

The social isolation subscale and Social Media Attitude Scale total score differed between groups (p = 0.001 and p = 0.048, respectively). Internet Use Purposes Scale education subscale differences were statistically significant (p = 0.042). Negative consequences (p = 0.007), excessive use (p = 0.021) and Problematic Internet Use Scale total score (p = 0.005) differed significantly. The University of California, Los Angeles Loneliness Scale had a moderate negative connection with the Problematic Internet Use Scale's social benefit/comfort subscale and total score (r = 0.369, p = 0.006 and r = −0.309, p = 0.023, respectively).

While adolescents with hearing loss have limited online educational resources, problematic internet use is a concern. When overused, the internet can reduce loneliness, but it can also have harmful consequences.

To compare perioperative and oncological outcomes between stapler and manual closure in patients undergoing total laryngectomy for advanced endolaryngeal squamous cell carcinoma.

Patients with advanced endolaryngeal tumours operated between July 2017 and July 2023 were retrospectively dichotomised into stapler closure and manual closure cohorts and compared.

Seventy-one patients with a median age of 57 years were included in our study. The median surgical duration was 270 minutes for the manual closure cohort and 245 minutes for the stapler closure cohort. The pharyngo-cutaneous salivary fistula rate was 6 per cent less in the stapler closure cohort. The estimated mean survival was not significantly different 54.5 months (95 per cent, confidence interval 46.3–62.71) in the manual closure cohort versus 28.12 months (95 per cent, confidence interval 23.6–32.63) in the stapler closure cohort (p = 0.79).

Stapler closure can be used in endolaryngeal tumours, and it reduces operating time, thus facilitating efficient utilisation of operation time with non-inferior oncological outcomes as compared to traditional manual closure.

Sublingual ranulas present diagnostic and therapeutic challenges due to their heterogenous clinical presentations. This systematic review and meta-analysis aims to synthesise treatment outcomes and proposes a new classification for this condition.

Following PRISMA guidelines, a thorough literature search identified studies on patients with sublingual ranulas receiving medical or surgical treatment. Proportion meta-analysis compared success rates among studies using a random-effects model.

Forty-two studies were included, covering 686 endoral ranulas, 429 plunging ranulas, and 16 ranulas extending into the parapharyngeal space. Sublingual sialoadenectomy with or without pseudocyst wall excision showed low heterogeneity and the highest success rates. Consequently, a new classification system is proposed categorising ranulas by intraoral (Type 1), cervical (Type 2) or parapharyngeal space (Type 3) extension.

This study confirms the role of sublingual gland resection as standard of care and highlights the need for a revised classification to improve patient outcomes.

Surgical resection for pterygopalatine fossa schwannomas can be challenging due to the complex anatomy and potential morbidity. Gamma knife radiosurgery (GKRS) offers a minimally invasive alternative with precise targeting and minimal damage to surrounding structures.

A 21-year-old female patient who had a history of progressive left-sided facial numbness over the past year and was diagnosed with progressive pterygopalatine fossa schwannoma underwent gamma knife radiosurgery. The radiological and clinical outcomes of the patient were evaluated over a period of 15 years, with the patient remaining symptom-free and experiencing no adverse effects from the treatment.

The patient’s positive outcome, with significant tumour reduction and symptom relief, underscores the potential of this non-invasive technique as a primary treatment modality for schwannomas in challenging anatomical locations.

This study aimed to determine if a history of tinnitus is associated with the risk of developing dementia.

A nationwide population-based case–control study including all eligible adults in Taiwan.

A total of 15 686 patients were included in the study, with 7843 individuals making up each of the case and control groups. Patients with a history of tinnitus were associated with a statistically significant higher risk of being diagnosed with dementia before reaching 65 years old (50 years ≤ age <65 years) (adjusted odds ratio 2.68, 95 per cent confidence interval (CI) 1.19–6.05, p = 0.017). No statistical significance was found among those 65 years and older (adjusted odds ratio 1.17, 95 per cent CI 0.90–1.51, p = 0.235).

A history of tinnitus was associated with a 168 per cent increased risk of being diagnosed with dementia in those aged 50–65 years old. This association was not significant in those older than 65 years.

Deafness is a leading cause of disability worldwide. This prospective cohort study investigates the impact of cochlear implants on self-reported quality of life in post-lingually deaf adults.

The self-administered 36-item World Health Organization Disability Assessment Schedule 2.0 and the Speech, Spatial, and Qualities of Hearing Scale questionnaires were prospectively used to investigate the impact of cochlear implants in 98 post-lingually deaf adults aged more than or equal to 50 years.

Quality of life improved post-cochlear implant in the cumulative scores and scores for all domains of the Speech, Spatial, and Qualities of Hearing Scale (p < 0.05). QoL improved post-cochlear implant in the sub-domains related to cognition and participation in society of the World Health Organization Disability Assessment Schedule 2.0 (p < 0.05), but there was no significant difference in the cumulative score. Subgroup analysis showed improvement in the participation in society domain only and only in males and participants aged younger than 75 years (p < 0.05).

Cochlear implant improves quality of life in post-lingually deaf adults.

The aim of this study is to investigate hearing outcomes in patients who have undergone cerebrospinal fluid (CSF) leak repair via a middle cranial fossa (MCF) approach and to identify any variables that influence post-operative hearing outcomes.

This is a multi-centre study. A total of 65 patients who underwent an MCF approach CSF leak repair were included. Retrospective case review was conducted to collect patient demographic and clinical data including pre- and post-operative audiometry.

A total of 65 patients were included: 9 patients (9.2per cent) had an encephalocele confirmed on magnetic resonance (MR) imaging, whilst the remaining patients had biochemically confirmed, beta-trace protein positive CSF leaks. Post-operatively, there was a statistically significant improvement in both bone conduction (Z = -3.71, p < 0.001) and air conduction thresholds (Z = -5.82, p < 0.001). None of the studied variables were found to be associated with the degree of hearing improvement.

The MCF approach for CSF leak repair yields favorable audiological outcomes.

Our centre (Freeman Hospital, Newcatle Upon Tyne NHS Trust) has favoured primary surgery over chemoradiotherapy for specific advanced laryngeal cancer patients (e.g. large-volume tumours, airway compromise, significant dysphagia, T4 disease). This study reports the survival outcomes for a modern, high-volume head and neck centre favouring surgical management to determine whether this approach improves survival.

Retrospective analysis of patient data over a seven-year period from a tertiary cancer centre.

In total, 121 patients were identified with T3 (n = 76) or T4 (n = 45) laryngeal cancer (mean follow up 2.9 years). In the cohort treated with curative intent (n = 104, 86.0 per cent), the 2- and 5-year estimated disease-specific survival rates were 77.9 and 64.1 per cent. chemoradiotherapy had the highest 2-year disease-specific survival (92.5 per cent), followed by surgery with adjuvant therapy (81.8 per cent), radiotherapy alone (75 per cent) and surgery alone (72.4 per cent).

For a centre favouring primary surgery for certain advanced laryngeal cancers, the disease-specific survival appears no higher than that found in the published literature. To enhance survival, future research should focus on precision medicine to define treatment pathways in this disease.

To appraise clinical practice guidelines for anaplastic thyroid carcinoma treatment and management using the Appraisal of Guidelines for Research and Evaluation II tool.

A literature search was performed using MEDLINE/PubMed, Embase, Scopus, Cochrane, and Google Scholar. Four reviewers evaluated clinical practice guidelines utilising Appraisal of Guidelines for Research and Evaluation II, with domain scores requiring a threshold of greater than 60 per cent. Inter-reviewer agreement was evaluated using intraclass correlation coefficients.

Twelve clinical practice guidelines were evaluated after application of inclusion and exclusion criteria. There were two “high-”, four “average-”, and six “low-” quality clinical practice guidelines. The domains with the highest scores were “clarity of presentation” (69.44 ± 16.75) and “scope and purpose” (68.87 ± 20.88), while “applicability” (7.12 ± 6.17) and “rigor of development” (50.26 ± 20.77) had the lowest scores. Intraclass correlation coefficients showed a high level of inter-reviewer agreement (0.689–0.924; good–excellent).

These results showcased wide variability in quality amongst guidelines for the treatment and management of anaplastic thyroid carcinoma. These findings necessitate greater standardisation among clinical practice guidelines and greater focus on the applicability of recommended practices.

The purpose of this study is to investigate whether sex plays a role in donor-site dysfunction after head and neck reconstruction.

In this retrospective case series, 76 patients were assessed for donor-site morbidity using the Short Form 36, Short Musculoskeletal Function Assessment, disabilities of the arm, shoulder, and hand, and lower-limb core scale. Differences by sex were compared using t-tests. Multivariable linear regression analysis was conducted to adjust for potential confounders.

Females observed significantly greater disability for the SF-36 mental component summary score with a mean of 45.9 (standard deviation 10.5) compared to males, with a mean of 51.8 (standard deviation 10.2), p = 0.02. Sex is significantly related to SF-36 mental component summary score after controlling for neuropsychiatric disease and tracheostomy status.

Females reported significantly worse mental component scores compared to males undergoing free flap reconstruction of the head and neck.