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Cholesteatoma is a pathological growth of squamous epithelium in the middle ear and mastoid. Pre-operative high-resolution computed tomography is commonly performed to guide the surgical approach and evaluate disease extent. The purpose of this review is to demonstrate the level of correlation between high-resolution computed tomography and intra-operative findings during cholesteatoma surgery.
Method
Medline, Embase and Cochrane databases were searched in December 2024 for studies comparing high-resolution computed tomography and intra-operative findings of adult patients diagnosed with cholesteatoma.
Results
Out of 2514 abstracts identified, 15 were included. The correlation between pre-operative high-resolution computed tomography and intra-operative findings was strongest for the identification of erosion of the malleus (k = 0.77), followed by the lateral semicircular canal and tegmen tympani (k = 0.69). The weakest correlation was found for facial nerve dehiscence (k = 0.55).
Conclusion
High-resolution computed tomography is useful for providing a roadmap for surgery. It offers a strong correlation for intra-operative detection of malleus, incus, lateral semicircular canal and tegmen tympani involvement.
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.
Methods
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.
Results
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.
Conclusion
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.
We aim to investigate nutritional management of chyle leaks by a systematic review of the published literature.
Methods
We searched the following databases (Medline, Embase, Cochrane) for literature incorporating nutritional aspects in chyle leak management. We excluded non-English papers, paediatric studies, conference papers, and studies without nutritional intervention.
Results
Among 260 patients (out of 26,270), 81.5.% (n=212/260) achieved chyle leak resolution with nutritional management, while 18.5% (n=48/260) required surgery. Median resolution duration with nutritional management was 8.7 days (range: 4.3 to 22.2), compared to surgical treatment’s median of 32 days (range: 18 to 40).
Conclusion
We recommend use of nutritional management in all patients with chyle leaks. There is no evidence supporting one diet over the other however clinically we suggest starting with medium–chain triglyceride/non–/low–fat diets and moving onto total parenteral nutrition, unless medically indicated otherwise.
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.
Methods
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.
Results
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.
Conclusion
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.
This study aimed to examine anatomical factors predicting anterior ethmoidal artery type.
Methods
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.
Results
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.
Conclusion
More extensive pneumatisation of frontal sinus and ethmoid cells and increased lateral lamella height might predict a free-running anterior ethmoidal artery.
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.
Methods
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.
Results
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.
Conclusions
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 evaluate physical simulation models for endoscopic ear surgery including model types, validation methodology and educational outcomes.
Methods
A Preferred Reporting Items for Systematic reviews and Meta-Analyses compliant search of PubMed, Embase and the Cochrane Library was conducted to June 2025. Studies describing physical endoscopic ear surgery simulators with reported validation or educational outcomes were included.
Results
Fourteen studies met inclusion criteria. Simulators comprised cadaveric animal heads, synthetic task trainers and single- and multi-material three-dimensional-printed models. Face validity was consistently high. Construct validity, assessed using Objective Structured Assessment of Technical Skills scores or timed tasks, was demonstrated in five studies. Content validity was reported in three studies. No study evaluated transfer validity. Educational outcomes included improvements in confidence, anatomical knowledge and task completion time.
Conclusion
Physical endoscopic ear surgery simulators show strong face validity and emerging construct validity, but evidence is limited by small, single-centre studies and methodological variability. Standardised validation and assessment of clinical transfer are needed to support integration into training pathways.
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.
Methods
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.
Results
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).
Conclusion
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.
This study aims to provide an updated systematic review on the clinicopathological features, treatment modalities and survival outcomes on SMARCB1-deficient sinonasal carcinoma.
Methods
Five databases were searched: PubMed, Cochrane, Embase, Web of Science and Scopus. Extracted information include demographic data, clinicopathological characteristics and survival outcomes.
Results
A total of 70 studies were included making up a total of 372 patients. Univariable and multivariable analysis performed for prognostic factors of SDSC showed that N+ disease was a statistically significant poor prognostic factor for overall survival, while surgical treatment was a favourable prognostic factor. Treatment with surgery combined with chemotherapy and/or radiotherapy conferred significantly better prognosis compared to chemotherapy or radiotherapy alone.
Conclusion
Our study suggests that N+ disease and isolated treatment with radiotherapy or chemotherapy alone are significant poor prognostic factors for SMARCB1-deficient sinonasal carcinoma, while patients who undergo surgical treatment have significantly better prognosis.
Perineural invasion (PNI) is an unfavorable pathological characteristic associated with poor prognosis. The relationship between PNI and clinicopathological features of hypopharyngeal squamous cell carcinoma (HPSCC) remains unclear. The aim of this study was to investigate the relationship between PNI and clinicopathological features and risk factors for PNI in HPSCC.
Methods
Clinicopathological data from 182 patients with HPSCC treated at our hospital between September 2019 and March 2024 were collected and analysed retrospectively.
Results
PNI was observed in 68 (37.4%) patients, and was associated with tumor thickness (TT), lymph node metastasis (LNM), lymphovascular invasion (LVI), number of positive nodes (pN), and lymph node density (LND). PNI was only significantly correlated with TT in the multivariate analysis.
Conclusion
We observed a definite correlation between PNI and TT, LVI, LNM, LND, and pN value. TT emerged as an independent risk factor for PNI, with its incidence increasing with TT.
This study aimed to evaluate the anatomical variants of the stylohyoid chain complex.
Methods
Multi-detector computed tomography angiography scans of 406 individuals (812 heminecks) were retrospectively evaluated.
Results
Hemineck analysis revealed an elongated styloid process in 10.1 per cent and an aberrant hyoid apparatus in 4.6 per cent. A combination of elongated styloid process and aberrant hyoid apparatus was seen in 1 per cent of individuals. The 60-year or older group had significantly longer elongated styloid process lengths (3.82 ± 0.45 cm) compared to the less than 24-year group (3.50 ± 0.27 cm) and the 25- to 59-year group adults (3.56 ± 0.35 cm) (p < 0.001). Elongated styloid process was significantly more common in greater than or equal to 60-year group compared to the less than 24-year group and the 25- to 59-year group adults, while aberrant hyoid apparatus showed no age-related differences. No gender differences were observed for either elongated styloid process or aberrant hyoid apparatus .
Conclusion
Elongated styloid process may be associated with degenerative post-natal ossification processes, whereas aberrant hyoid apparatus could be related to persistent embryological remnants of the second pharyngeal arch.