As rheumatoid arthritis of the cricoarytenoid joint can be life-threatening, this study aimed to provide a comparison of survival and decannulation after tracheostomy for those with this condition.

Following Preferred Reporting Items for Systematic Review and Meta-Analyses (‘PRISMA’) guidelines, PubMed, Web of Science, Scopus, Embase and MEDLINE library databases were queried to find all reported cases of rheumatoid arthritis of the cricoarytenoid joint.

A total of 55 articles with 82 patients were included in the analysis. The mean age at diagnosis was 60.1 ± 11.2 years. In cases of bilateral involvement, 71.2 per cent of patients required a tracheostomy. For those who had bilateral cricoarytenoid joint involvement and a tracheostomy, there was a significant relationship between having a primary laryngeal surgery, with or without medical management, and overall survival with ultimate decannulation compared with those with just medical management (p = 0.0022).

Tracheostomy is often necessary for acute symptom management of rheumatoid arthritis of the cricoarytenoid joint, and laryngeal surgery may be offered to facilitate ultimate decannulation.

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 evaluate the publication efficiency of registered cochlear implant (CI) trials and characterise evolving research trends following the 2022 update.

This study queried ClinicalTrials.gov to assess publication rates for trials completed before October 2022 and characterise research trends for subsequent registrations. Publication status was ascertained via PubMed and Google Scholar, and trial characteristics were analysed to identify predictors.

Among 98 completed trials, only 26.5% were published. Publication was lowest for industry-sponsored (20.6%) and device trials (20.9%). Interventional design and larger enrolment showed positive but non-significant associations. Post-2022 registrations signalled diversification: device trials decreased (43.9% to 31.9%), while rehabilitation (13.3% to 20.3%) and procedural refinements (11.2% to 17.4%) expanded.

A marked gap persists in CI evidence dissemination, with only one-quarter of trials published. While device studies remain prominent, recent trends reflect a broadening research agenda with increasing emphasis on rehabilitation and surgical techniques, warranting continued monitoring.

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.

This study aimed to evaluate whether the presence of an intact stapes superstructure is a significant factor in the success of an ossiculoplasty. Secondary factors assessed included presence of cholesteatoma and revision surgery.

A retrospective cohort study in a Scottish tertiary centre analysed audiological outcomes from 100 consecutive adult patients undergoing single-stage ossiculoplasty with titanium prostheses (partial ossicular replacement prosthesis; total ossicular replacement prosthesis). Patient demographics and pre- and post-surgery audiometric data were collected. Bivariate analysis and multivariate linear regression determined independent predictors of post-operative air–bone gap closure.

Presence of an intact stapes superstructure significantly improved air–bone gap closure (27.4 dB vs. 21.1 dB; p = 0.048), remaining independently significant in multivariate analysis (β = 9.93; p < 0.001). Larger pre-operative air–bone gap strongly predicted better closure (β = 0.87; p < 0.001). Cholesteatoma and revision status were not independent predictors.

Preservation of the stapes superstructure enhances ossiculoplasty outcomes using titanium prosthesis. Patients with larger initial air–bone gaps, especially those with an intact stapes, experience the greatest post-operative improvement.

To evaluate medications, surgical procedures, demographics and co-morbidities in Ménière’s disease using TriNetX.

Retrospective cohort analysis.

Among 117,059 Ménière’s disease patients, common medications were corticosteroids benzodiazepines, diuretics and antacids. Surgical procedures were rare: cochlear implantation (1 percent), endolymphatic sac surgery (1 percent), labyrinthectomy (0.3 percent) and vestibular nerve section (0.1 percent). Surgical patients were older (mean 68.4 vs 66 years, p < 0.001), more often male (44.3 percent vs 34.6 percent) and less likely to be Asian (1.6 percent vs 8.3 percent) or African American (2.0 percent vs 4.4 per cent). Co-morbidities included musculoskeletal diseases, metabolic disorders, hypertension, anxiety and/or depression, gastro-oesophageal reflux disease, thyroid disordersand migraine. Melanoma prevalence (6 percent) was 12–15 times higher than in the US population.

Ménière’s disease treatment is dominated by corticosteroids, benzodiazepines and diuretics, with rare surgical procedures. Surgical patients are older, more often male and less likely to be Asian or African American. Co-morbidities include musculoskeletal diseases, hypertension, gastroesophageal reflux disease, thyroid disorders, migraine and higher melanoma prevalence, warranting further research.

This study aimed to determine what motivates rhinoplasty surgery after septoplasty, and the clinical characterisation of patients undergoing these interventions.

This is a retrospective observational study including all patients submitted to rhinoplasty after septoplasty between January 2018 and July 2023. Demographic, clinical and surgical data were collected using patients’ digital hospital records.

Of 219 patients who underwent rhinoplasty, 15 per cent (n = 33) had a previous history of septoplasty. All patients (n = 33) who had undergone septoplasty before rhinoplasty reported maintenance of nasal obstruction, with most patients presenting with nasal deformities upon physical examination (54%; n = 18), of which 15 per cent (n = 5) presented with nasal tip ptosis and with 9 per cent (n = 3) presenting with nasal septum perforation. The mean interval between septoplasty and rhinoplasty was 77 months. An open approach was used in 58 per cent of patients, and grafts in 73 per cent, most commonly columella struts, with cartilage harvested from the nasal septum in 55 per cent but requiring auricular cartilage in 18 per cent.

Persistent nasal obstruction is the main indication for rhinoplasty after septoplasty, commonly associated with residual septal deviation, nasal valve dysfunction or external nasal deformities. These findings emphasise the importance of a thorough pre-operative assessment of all nasal structures in patients with nasal obstruction. Rhinoplasty in this context often represents a more complex surgical challenge, frequently requiring an open approach and a greater use of cartilage grafts, sometimes harvested from sites beyond the nasal septum. A comprehensive approach that addresses both functional and aesthetic components during the primary surgery may reduce revision rates, facilitate easier corrective procedures if needed and improve long-term patient satisfaction.

To compare subjective and psychophysical olfactory outcomes in patients with eosinophilic chronic rhinosinusitis controlled after primary functional endoscopic sinus surgery (FESS) alone versus those treated with dupilumab for post-operative recurrence.

This retrospective cohort study included 357 adults undergoing primary FESS. Patients were classified into a FESS group (disease controlled after surgery alone, n = 334) and a dupilumab group (post-operative recurrence treated with dupilumab without revision surgery, n = 23). Subjective olfaction was assessed using the self-administered odour questionnaire and psychophysical function was assessed using standardised olfactory threshold testing. Pre- and post-treatment outcomes were compared within and between groups.

Baseline age, sex, asthma prevalence and psychophysical thresholds did not differ significantly. The Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis scores, blood eosinophils and self-administered odour questionnaire scores were worse in the dupilumab group at baseline. Both groups showed significant improvement after treatment, with no significant differences in post-treatment outcomes.

Dupilumab for post-operative recurrence achieved olfactory improvement comparable to primary FESS alone.

Rhinitis medicamentosa is a challenging condition resulting from prolonged nasal decongestant use. This study aimed to compare holmium laser turbinate reduction and partial turbinoplasty surgical options.

A retrospective cohort study was conducted, including 65 patients diagnosed with rhinitis medicamentosa, with a minimum post-operative follow up of 12 months. Symptom severity and quality of life were assessed pre- and post-operatively using the Sino-Nasal Outcome Test 22 (SNOT-22) and the visual analogue scale (VAS).

Both surgical techniques resulted in significant post-operative improvement in SNOT-22 and VAS scores. Post-operative SNOT-22 total and obstruction scores were significantly lower in the partial turbinoplasty group compared with the holmium laser turbinate reduction group (p < 0.05). Post-operative VAS scores did not differ significantly between groups (p > 0.05). The partial turbinoplasty group demonstrated higher incidence of early post-operative complications.

Both holmium laser turbinate reduction and partial turbinoplasty are effective surgical options for rhinitis medicamentosa. Surgical technique selection should be individualised based on disease severity, patient expectations and risk tolerance.

This study aimed to determine the incidence of post-operative dysphonia following anterior cervical discectomy and fusion, identify associated risk factors and assess utilisation of diagnostic and therapeutic interventions.

This retrospective cohort study analysed data from the PearlDiver Mariner Patient Records Database (2010–2022). Adults (≥18 years) undergoing primary anterior cervical discectomy and fusion without pre-existing dysphonia were included (n = 613,978). Outcomes included incidence, risk factors (odds ratios, 95 per cent confidence intervals) and intervention rates.

Dysphonia occurred in 2.6 per cent of patients. Risk factors included female sex (odds ratio 1.43), age 50–64 (odds ratio 1.10), 65–79 (odds ratio 1.21), smoking (odds ratio 2.41), obesity (odds ratio 2.80), diabetes (odds ratio 1.89) and multilevel anterior cervical discectomy and fusion (odds ratio 1.20) (p < 0.01). Diagnosis was delayed (>12 months) in 73.2 per cent. Only 52.7 per cent underwent laryngoscopy; 15.0 per cent received voice therapy.

Post-operative dysphonia is under-recognised and undertreated. Structured screening and otolaryngology referral pathways may improve diagnosis and management.

To determine whether sex independently predicts survival in oropharyngeal squamous cell carcinoma and whether human papillomavirus status mediates apparent sex-related survival differences at the population level.

Population-based cohort study using the Surveillance, Epidemiology, and End Results (SEER) database (17 Registries, 2018–2021). Multivariable Cox regression and a formal sex–human papillomavirus interaction test (likelihood ratio test) were performed in 19,716 patients with known p16/HPV status.

p16-positive disease was more prevalent in males (73.6 per cent vs. 56.2 per cent; p < 0.001). Within human papillomavirus subgroups, survival did not differ significantly between sexes (all p > 0.30). After full adjustment, female sex was not independently associated with overall survival (hazard ratio 0.98; 95 per cent confidence interval 0.91–1.05; p = 0.52) or disease-specific survival (hazard ratio 1.01; p = 0.80). The sex–human papillomavirus interaction was non-significant (hazard ratio 1.057; p = 0.459), confirming human papillomavirus status fully mediates the apparent female survival disadvantage.

Sex is not an independent prognostic variable in oropharyngeal squamous cell carcinoma. HPV/p16-based stratification remains the primary prognostic framework.

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.

This study aimed to evaluate outcomes of a high-throughput tonsillectomy pathway using the BiZact™ device and consider its applicability in National Health Service practice.

A prospective service evaluation was undertaken in a UK teaching hospital (April–July 2023). Fifty consecutive patients underwent BiZact™ tonsillectomy across five morning lists. Data included demographics, operative time, blood loss, post-tonsillectomy haemorrhage, pain and satisfaction.

Fifty patients (15 male, 35 female; mean age 24.6 years) underwent surgery. Indications were recurrent tonsillitis (86 per cent), asymmetry (10 per cent) and tonsilloliths (4 per cent). Mean operative time was 5 minutes; blood loss less than 10 ml. No primary haemorrhage occurred. Secondary post-tonsillectomy haemorrhage occurred in 5/50 (10 per cent): 3/48 adults (6.3 per cent) and 2/2 adolescents; three required return to theatre. Of 33 patients completing follow-up, 70 per cent reported severe pain. Four (8 per cent) reattended for analgesia. Waiting time fell from ∼40 weeks to ∼two weeks.

BiZact™ enabled efficient list turnover but with higher post-tonsillectomy haemorrhage rates, likely reflecting a learning curve.

This study aimed to evaluate the clinical applications, observed haemostatic outcomes of a self-assembling peptide haemostat (PuraBond®) across a range of ENT surgical procedures using a large UK observational registry.

A two-cycle observational study of 600 patients at University Hospitals Birmingham NHS Foundation Trust (September 2019–July 2024). Data collected included patient demographics, comorbidities, anticoagulation status, surgical details, intra-operative haemostatic outcomes and post-operative complications.

Intra-operative haemostasis was documented without the need for additional haemostatic intervention in 99.8% of cases (599/600). Immediate haemostasis-related complication rate was 0.2% (1/600). The overall complication rate was 3% per cent, with most complications unrelated to haemostasis or the use of PuraBond. The study limitations include participant heterogeneity, absence of a control group and small subspeciality sample sizes underscoring the need for comparative studies.

This registry demonstrates PuraBond’s broad applicability in ENT surgery as an adjunct to routine haemostats and provides essential groundwork for designing future comparative trials.

The modified endoscopic Lothrop (Draf III) procedure requires reliable mucosal coverage of the exposed bone within the frontal neo-ostium to prevent post-operative restenosis. Free mucosal grafts are effective but difficult to secure due to limited access and absent anchoring sites. We describe a novel use of bioabsorbable steroid-eluting implants as a pragmatic approach to achieve mucosal graft fixation.

Following completion of a Draf III frontal sinusotomy, a PROPEL™ implant is deployed over a free mucosal graft within the frontal neo-ostium. Endoscopic assessment is performed at standard post-operative intervals.

In our experience, the technique provides mechanical stabilisation and local steroid delivery and is associated with visually satisfactory graft apposition and mucosalisation in the post-operative period.

The use of bioabsorbable steroid-eluting implants offers a practical and complementary endoscopic adjunct in patients undergoing Draf III frontal sinus surgery, supporting graft fixation and contributing to improved long-term neo-ostium patency.

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.