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.

Hypoglossal nerve stimulation has emerged as a promising therapeutic approach for obstructive sleep apnoea patients who are intolerant to continuous positive airway pressure therapy. This paper aimed to explore reasons for hypoglossal nerve stimulation device explantation and associated complications.

Following Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, a systematic search across Embase Ovid, PubMed, Scopus, and the Cochrane library yielded 14 articles that met the inclusion criteria. Exclusion criteria were (1) systematic reviews and meta-analyses, conference posters and editorials; (2) non-English studies; and (3) studies published before 2010.

Of the 121 patients identified as having undergone hypoglossal nerve stimulation device explantation, 126 reasons were identified for the procedure. The primary reasons included device malfunction (19.8 per cent), infection (19.0 per cent) and device migration (18.3 per cent). Other reasons included discomfort (9.5 per cent), improper placement (6.3 per cent) and ineffective devices (6.3 per cent). Complications were infrequent (2.48 per cent).

Device malfunction, infection and device migration were prominent reasons for hypoglossal nerve stimulation device explantation. Complications post-explantation were rare but included temporary hypoglossal paresis.

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.

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.

Eustachian tube balloon dilatation performed for obstructive Eustachian tube dysfunction can lead to improvements in symptoms and a reduction in Eustachian Tube Dysfunction Questionnaire-7 scores. While historically performed under general anaesthetic, studies have demonstrated that Eustachian tube balloon dilatation can be performed under local anaesthetic with equivalent efficacy. We describe our local anaesthetic protocol used to perform Eustachian tube balloon dilatation in the out-patient setting and report outcomes from our case series.

Prospective analysis of all patients undergoing Eustachian tube balloon dilatation between October 2019 and July 2024.

Thirty-one patients underwent 40 dilatations under local anaesthetic. All were well tolerated, with no adverse events. There was a statistically significant decrease in the average total Eustachian Tube Dilatation Questionnaire-7 score of -6.75 points (p = 0.0029) at short-term follow-up and of -7.58 points (p = 0.034) at long-term follow-up.

Our study provides further evidence that Eustachian tube balloon dilatation for obstructive Eustachian tube dysfunction can improve Eustachian Tube Dilatation Questionnaire-7 scores, and can be performed successfully under local anaesthetic in the out-patient setting.

To define extended high-frequency hearing threshold ranges in normal hearing elderly (aged 55 years and above) and identify associated risk factors for extended high-frequency hearing loss.

Pure-tone thresholds (0.25–16 kHz) and word recognition scores were measured using portable audiometric equipment. Lifestyle and medical histories were collected, and generalised linear models analysed risk factors for extended high-frequency hearing (10–12 kHz).

In normal hearing elderly (28 ears, 18 subjects), 95 per cent confidence intervals for 10 and 12 kHz were 34.770–49.301 and 56.976–65.809, respectively. Among 342 ears (200 subjects), hypertension emerged as a leading risk factor for extended high-frequency hearing loss, while lipid-lowering medications showed potential protective effects.

Preliminary extended high-frequency hearing thresholds were established, with hypertension identified as a key risk factor and lipid-lowering medications as a potential protective factor.

This study aimed to assess the surgical and patient reported outcomes for monocanalicular and bicanalicular silicone stent insertion in endoscopic dacryocystorhinostomy for distal nasolacrimal duct obstruction.

A retrospective cohort study was undertaken for all endoscopic dacryocystorhinostomy cases performed collaboratively by ENT and ophthalmology at Royal Blackburn Hospital.

A total of 60 patients were included in the study. Tubes were used in 95 per cent of cases; 92 per cent reported a positive outcome. Minor post-operative complications occurred in 30 per cent. When further broken down by tube type, success rates were 94 per cent for monocanalicular and 95.5 per cent for bicanalicular stents, however, the difference was not statistically significant. In contrast, the complication rates were 22 per cent for monocanalicular stents and 63.6 per cent for bicanalicular stents, with this difference being statistically significant.

Both monocanalicular and bicanalicular stents showed similar high surgical success rates. However, monocanalicular stents were better tolerated by patients and associated with fewer complications.

To assess the outcomes of a protocol-led, same-day discharge for elective tonsillectomy patients.

A retrospective case-series of all tonsillectomies performed from January 2018 to May 2023 at a tertiary hospital in Adelaide, Australia. The primary outcome was rate of readmission within 24 hours for same-day surgery compared to hospital-stay tonsillectomy patients. Secondary outcomes included post-tonsillectomy haemorrhage.

During the study period, 1658 elective tonsillectomies were performed, with 664 patients (40.0 per cent) discharged the same day following tonsillectomy. The readmission rate within 24 hours was comparable between the two groups: 0.60 per cent for day surgery and 0.64 per cent for those who stayed overnight in hospital (Χ2(1, N = 1600) = 0.009, p = 0.9244). The primary post-tonsillectomy haemorrhage rate for day-surgery patients was 0.3 per cent, with a relative risk of 0.5 (Χ2(1, N = 1658) = 0.751, p = 0.3862).

The low readmission and primary post-tonsillectomy haemorrhage rates indicate that a protocol-led, same-day tonsillectomy is safe and feasible to implement in carefully selected patients.

Sjogren’s syndrome is a chronic inflammatory condition with an autoimmune history that primarily affects women in middle age (male to female ratio is 1:9). This study aims to evaluate the functional balance status of the patients in primary Sjogren’s syndrome and to examine their peripheral and central vestibular functions.

A total of 24 patients with primary Sjogren’s syndrome and 26 sex-matched controls were included in this study. Gaze, saccade, tracking, optokinetic, video head impulse and sensory organisation tests were performed on the participants.

Significant decreases were observed in video head impulse and sensory organisation tests in participants with Sjogren’s syndrome compared to controls.

This study documented the findings of patients with Sjogren’s syndrome from a vestibular and balance perspective. The study’s findings have guided relevant professionals in the follow-up of patients with Sjogren’s syndrome to improve patients’ daily life, balancing performance and quality of life.

To describe vestibular dysfunction accompanied by sudden sensorineural hearing loss and explore its potential prognostic role.

A total of 44 Idiopathic Sudden Sensorineural Hearing loss cases were enrolled. Pure tone audiometry (PTA) was performed at the first visit and three months after standard therapy. Patients’ improvement and severity of hearing loss were categorised based on Siegel and American Speech and Hearing Association criteria. Their recovery rate and factors affecting recovery were explored.

The mean age of the participants was 52.1 years. The caloric and cervical vestibular-evoked myogenic potential test abnormalities were detected in 36.4 and 31.8 per cent of participants. Vertigo was present in 36.4 per cent at the first visit. Based on American Speech and Hearing Association criteria, 16 patients experienced at least 1 grade improvement to a less severe hearing loss status at the follow up. A total of 31.7 per cent of patients demonstrated complete or partial recovery. Vestibular dysfunction was associated with poorer PTA results.

Abnormal caloric and cervical vestibular-evoked myogenic potential tests, as well as the presence of vertigo, can indicate more profound inner-ear damage.

The important role of the saccule is the sensing of gravity. In other words, gravity always stimulates the macula of the saccule.

The aim of this study was to clarify whether nystagmus and dizziness occur by intentional changes upon stimulation to the saccules.

The subjects were eight healthy humans. Experiment 1: Subjects were asked to maintain a supine position to check for nystagmus and dizziness. Experiment 2: Subjects were asked to tilt their heads 45º to the left in the supine position to check for nystagmus and dizziness. Experiment 3: Subjects were asked to maintain a left-ear-down 90º position to check for nystagmus and dizziness.

In all the experiments, no one revealed nystagmus and no one complained of dizziness.

Neither nystagmus nor dizziness occurs by intentional changes in the stimulation to the saccules.

To analyse the evolution of the vertigo index and its relationship with perceived disability in unilateral and bilateral Ménière’s disease, assessing differences based on disease progression and clinical subtypes.

A longitudinal descriptive study was conducted on unilateral and bilateral Ménière’s disease patients, with data collected between 1977 and 2023 from two referral centres. Clinical and functional data were retrospectively reviewed to ensure compliance with updated diagnostic criteria. The vertigo index, integrating episode duration and frequency, quantified vertigo burden. Functional impact was assessed using the six-item American Academy of Otolaryngology Head and Neck Surgery disability scale, categorising patients into mild or moderate/severe disability groups.

Bilateral Ménière’s disease patients had a higher proportion of moderate/severe episodes (31.4 per cent) than unilateral Ménière’s disease patients (11 per cent). In unilateral Ménière’s disease patients, disability perception increased after 20 years of disease evolution. The vertigo index declined over time, except in later stages, where episodes were more disabling.

These findings underscore the need for long-term follow up, particularly in bilateral Ménière’s disease, where greater disability was observed. Disease management should adapt over time, addressing both vertigo burden and psycho-affective consequences.

Oncological and functional outcomes for T1-2 N0-1 (TNMv8) p16-positive oropharyngeal squamous cell carcinoma patients were analysed according to treatment: either transoral robotic surgery (TORS) (Surgery group – TORS and neck dissection ± adjuvant radiotherapy/chemoradiotherapy) or primary radiotherapy/chemoradiotherapy (Oncology group).

Single-centre retrospective observational study.

The two-year disease-free survival rate was 88 per cent for the Oncology group (n = 42) and 95 per cent for the Surgery group (n = 44). The two-year overall survival rate was 98 per cent for the Oncology group and 100 per cent for the Surgery group. The functional swallowing outcome at two years post-treatment was similar in both groups. Subgroup analysis showed patients treated with surgery-only with no adjuvant treatment had the best functional outcome whilst patients treated with surgery and post-operative chemoradiotherapy had the worst functional outcome.

The overall oncological and functional outcomes at two years were similar in both groups. Patients treated with surgery-only had the best functional outcome without compromised oncological outcome.

This study aimed to assess whether frailty (measured using the 5-Item Modified Frailty Index) was associated with increased morbidity following surgical tracheostomy.

A single-centre retrospective cohort study analysed a prospectively maintained database between 2022 and 2023. Univariable and multivariable regressions were used to determine factors (including frailty) associated with increased morbidity.

A total of 174 patients underwent surgical tracheostomy in the study period with 28 patients determined as frail (16.1 per cent). Overall, 21 patients (12.1 per cent) suffered a tracheostomy-specific complication. Multivariable regression found an association between frail patient status and increased tracheostomy-specific complications (odds ratio 4.09, 95 per cent confidence interval 1.51–11.11; p = 0.006) and longer hospital length of stay (β 15.76 days, 95 per cent confidence interval 1.06–30.44; p = 0.036).

Frailty was associated with increased morbidity and longer hospital stay following tracheostomy. Assessment of frailty may guide decision making and patient discussions when planning tracheostomy.

Cochlear implantation is a groundbreaking surgical procedure offering significant benefits to individuals with severe hearing impairments. Correct placement of the electrode array within the cochlea is crucial for optimal device functionality and auditory outcomes. Our study describes four cases of electrode misplacement along with the factors causing it and discusses solutions for the same.

Eight hundred cochlear implant cases were reviewed in three tertiary care centres in India, spanning 2011 to 2023.

Four cases of electrode misplacement requiring reimplantation were identified.

This paper discusses the implications of electrode misplacement, the factors contributing to it and the critical role of multidisciplinary approaches in managing such complications. By addressing these issues, we aim to improve surgical techniques and outcomes in cochlear implant procedures.

Bone-conduction hearing devices provide good hearing outcomes for conductive/mixed hearing losses. Complications post-insertion can lead to additional procedures. Identifying factors that may increase likelihood of developing complications can mitigate risk and inform patients.

A retrospective cohort analysis of 166 adults receiving bone-anchored hearing aid connect operations from 2016–2021 was performed assessing complication rate and contributing factors causing revision procedures.

Twenty-nine per cent of patients had post-operative complications. In total, 17.5 per cent needed additional procedures. Skin overgrowth/infection, granulation and traumatic extrusion were most common reasons. No difference was found in complication rate between different surgical techniques, surgeon grade or general versus local anaesthetic. More complications were observed in decreasing age, male gender and severity of skin reaction.

Revision procedure and complication rates are similar to those reported in published literature. Patient characteristics are important in identifying those likely to develop complications. Non-patient factors did not seem to affect complication rate.

To evaluate the efficacy and safety of the dumbbell-shaped tragal cartilage–perichondrium air-filled chamber technique versus the gelatine sponge packing method for small–medium tympanic membrane perforations.

A retrospective analysis of 68 patients (39 air-filled chamber, 29 gelatine sponge) treated between January 2020 and September 2024. Pre- and post-operative assessments included pure tone audiometry, air–bone gap, tympanic membrane healing, and visual analogue scale scores.

Healing rates were similar (89.7 per cent vs 93.1 per cent, p = 0.959). At six months, pure tone audiometry and air–bone gap improvements were comparable (p > 0.05). At one month, the air-filled chamber group showed better hearing recovery (pure tone audiometry: 19.71 vs 24.27 dB HL; air–bone gap: 7.28 vs 12.28 dB HL; both p < 0.05) and lower pain scores (1.13 vs 1.59, p = 0.022). Complications and operative times were similar.

The air-filled chamber technique is a safe and effective alternative, offering superior early hearing recovery, reduced discomfort, and comparable long-term outcomes to the gelatine sponge method.