To compare the efficacy and safety of trans-septal suturing versus intranasal splinting after septoplasty through a systematic review and meta-analysis, focusing on post-operative complications and patient-centred outcomes.

Comparative studies directly evaluating both techniques were included. Pooled odds ratios and standardised mean differences with 95 per cent confidence intervals were calculated.

Seventeen studies involving 1502 patients were included. No significant differences were found in adhesion, crust formation, septal haematoma, septal perforation or post-operative bleeding. Trans-septal suturing significantly reduced post-operative pain (standardised mean differences, −1.09; 95 per cent confidence intervals, −1.68 to −0.49) and sleep disturbance (standardised mean differences, −0.32; 95 per cent confidence intervals, −0.60 to −0.05) but increased operative time (standardised mean differences, 0.65; 95 per cent confidence intervals, 0.19–1.10). Infection and epiphora tended to be less frequent with trans-septal suturing.

Both techniques provide comparable protection against major post-operative complications, but trans-septal suturing improves post-operative comfort at the cost of a modest increase in operative time.

This review evaluates contemporary therapeutic strategies for rhinophyma, emphasising evidence-based treatment selection according to disease severity and clinical grading.

A structured literature search of PubMed/Medline, Scopus, Embase and Web of Science was performed for studies published between 1990 and 2025 evaluating medical, surgical and laser-based rhinophyma treatments.

Medical therapy, including doxycycline and isotretinoin, is primarily beneficial in early inflammatory disease (Clark Grade I). Established fibrotic rhinophyma (Grades II–IV) generally requires surgical intervention. Current Level III–IV evidence supports partial-thickness sharp excision combined with adjunctive laser contouring using CO₂, Er:YAG and emerging blue laser technologies to improve haemostasis, tissue preservation and cosmetic outcomes. Histopathological assessment remains essential because occult malignancies may coexist within rhinophymatous tissue.

Treatment should be individualised according to clinical severity. Combined excisional and laser-based approaches currently provide the most favourable functional and aesthetic outcomes, although prospective comparative studies remain limited.

This study aimed to assess long-term audiological outcomes in 465 primary myringoplasties and evaluate factors influencing surgical success.

A retrospective analysis was conducted on 442 patients (465 procedures) between 2001 and 2024. Outcomes were evaluated based on perforation location and surgical period.

Mean air–bone gap improved from 19.1 dB to 9.8 dB post-operatively. Air–bone gap closure less than 10 dB was achieved in 53 per cent of patients. Posterior perforations yielded significantly better outcomes (8.7 dB vs. 10.2 dB; p = 0.0226).

A residual air–bone gap of 8–12 dB is common despite anatomical success. Accurate reporting must include long-term data and high-frequency (4 kHz) analysis.

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 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.

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.

The United Kingdom’s Talking Therapies for Anxiety and Depression (TTAD) programme provides standardised definitions for recovery-related outcomes, allowing transparent and comparable reporting. This study aimed to descriptively examine recovery-related outcomes following cognitive behavioural therapy (CBT) in a Japanese clinical sample using established TTAD definitions.

Data were drawn from patients who received CBT in routine clinical practice. Depressive and anxiety symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) questionnaire, respectively. Recovery, reliable improvement, and reliable recovery were classified according to the TTAD criteria.

The sample consisted of 241 participants, of whom 178 (73.9%) met the criteria for caseness at baseline. Among those with baseline caseness, 75 participants (42.1%) met the criteria for recovery at the end of treatment. Across the full sample, 103 participants (47.2%) demonstrated reliable improvement. Reliable recovery, defined as meeting the criteria for both recovery and reliable improvement, was observed in 65 participants (36.5% of those with baseline caseness).

Using standardised TTAD definitions, this study provides a descriptive account of recovery-related outcomes following CBT in routine clinical practice in Japan. The findings show the distribution of recovery and improvement outcomes in this sample and highlight the importance of clearly distinguishing between recovery-related indicators when interpreting outcomes in real-world clinical settings.

The effectiveness of electroconvulsive therapy (ECT) for depression strongly depends on patient characteristics. Clinical factors may increase (e.g. age, psychotic symptoms) or decrease (e.g. episode duration) response rates.

This prospective study aimed to develop an instrument for the prediction of ECT response in patients with unipolar depression.

N = 45 patients were assessed using the Göttingen Response to ECT Assessment Tool (GREAT; seven items, 0 to 14 points). Clinical outcome was measured using the Montgomery Åsberg Depression Rating Scale (MADRS). Response was defined as ≥ 50% MADRS-improvement or a clinical global impression improvement (CGI-I) score ≤ 2. Analyses were conducted between responders and non-responders.

Results showed a high correlation between GREAT-score and dichotomous response (r = 0.585) as well as MADRS-improvement (r = 0.554, both p < 0.001). Receiver operating characteristic (ROC)-analysis yielded an area under the curve (AUC) of 0.841 (asymptotic significance: p < 0.001). A cut-off point at ≥7 points predicted ECT response in individual cases with 80% accuracy. GLM-analyses showed a significantly better MADRS-improvement for patients with a GREAT-score ≥ 7 v. < 7 (interaction-effect: p < 0.001).

Our prospective study shows that an instrument consisting of seven clinical items is able to predict ECT response in depression with good accuracy. Limitations include a relatively small sample size and the lack of further potential predictors suggested by recent studies. GREAT will thus be modified to further improve its accuracy. Currently, it may give clinicians a relevant estimate of the likelihood and the extent of the individual response to ECT.

Tonsillectomy is a common paediatric procedure with potential morbidity, notably post-operative pain and bleeding. One proposed factor influencing these outcomes is the surgeon’s level of training.

To evaluate whether surgical training level affects short-term outcomes in paediatric tonsillectomy.

In a prospective randomised study (2019–2022), outcomes were compared in children undergoing cold dissection tonsillectomy performed by either an attending or a supervised resident. Measured outcomes included duration of analgesia use, time to resume oral intake, length of hospital stay and post-operative bleeding.

A total of 115 children were included in the study, of which 60 (52.2 per cent) were operated on by residents and 55 (47.8 per cent) were operated on by attending surgeons. Baseline characteristics were similar. Operations by attending surgeons were shorter (20.4 vs 29.1 minutes), but no significant differences were found in post-operative pain, diet resumption, length of stay (1.1 days) or bleeding.

Supervised residents achieve comparable outcomes to attending surgeons. Surgical training level does not impact tonsillectomy outcomes under supervision.

The aim of this study is to assess outcomes in managing post-operative chyle leaks, following neck dissection using a volume-based risk stratification algorithm.

A retrospective series (2010–2024) at a tertiary head and neck centre included all patients with chyle leaks after neck dissection for malignancy. Chyle leaks were stratified as low, medium or high volume and managed either medically or with planned intervention, video-assisted thoracoscopic surgery, thoracic duct ligation or thoracic duct embolisation.

Thirty-five patients were identified. Sixty-five point seven per cent (n = 23) with low-volume leaks resolved with conservative management, 31.4 per cent (n = 11) with moderate-/high-volume leaks underwent video-assisted thoracic duct ligation, with 10/11 resolving within one day post-operatively, 5.7 per cent (n = 2) underwent thoracic duct embolisation. All cases with ongoing chyle leaks resolved without neck re-exploration surgery.

Volume-based risk stratification, paired with early video-assisted thoracoscopic surgery ligation or embolisation, provides a highly effective, low-morbidity strategy for managing post-operative chyle leaks.

To evaluate the indications, outcomes, and recurrence rates of elective paediatric functional endoscopic sinus surgery at a tertiary centre, and to highlight the continued importance of multidisciplinary management.

A retrospective review included 65 patients (age range 5–17 years) undergoing elective paediatric functional endoscopic sinus surgery from January 2017 to December 2024. Data on demographics, surgical details, additional procedures, and revision rates were collected. Logistic regression identified predictors of revision.

Chronic rhinosinusitis was the most common indication (45/65), with 62 per cent requiring polypectomy and 84 per cent undergoing middle meatal antrostomy. Fifteen percent had cystic fibrosis; cystic fibrosis status significantly predicted revision (odds ratio 8.5, p = 0.007). A multidisciplinary approach was crucial for the 20 per cent needing additional procedures. No major complications were reported.

Paediatric functional endoscopic sinus surgery is safe and effective for paediatric sinonasal disease, particularly where balloon sinuplasty is insufficient for polyposis. Multicentre collaborations will help refine selection criteria and enhance long-term outcomes.

This study is to evaluate the results obtained in a group of implanted otosclerotic patients and compare them with a matching group of non- otosclerosis cochlear implant patients.

Pre-operative computed tomographic scans, intra-operative findings, type of electrode used and difficulties of 17 patients with otosclerosis were documented. Post-operative complications, facial nerve stimulation, electrode dislocation and audiological and speech outcomes were documented and the data analysed.

Surgical difficulties were directly related to the advanced stage of the disease. No major complications were reported in this cohort. No significant difference was found between both groups one year after surgery; the mean pure tone average was 35 dB ± 4.43, speech reception threshold was 40 ± 4.96 and speech discrimination score was 80 per cent ± 12.55 in the otosclerotic group.

Cochlear implantation is a safe and effective management for advanced otosclerosis patients even after stapes surgery.

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.

This study analyses the current literature to evaluate the effectiveness of dabrafenib and trametinib in the multi-modal treatment of anaplastic thyroid cancer (ATC).

A systematic review and meta-analysis of the literature were undertaken. The primary endpoint measured was overall response rate (ORR) defined by the RECIST v1.1 guidelines. Secondary endpoints were 12-month overall survival (OS), median OS and progression-free survival (PFS).

Of 656 identified reports, 8 studies were included which featured 95 patients (median age 68.5 years, 46 per cent male). Median follow-up period was 11.8 months with a 12-month OS of 51 per cent. Median OS was 10.4 months. Progression-free survival (PFS) was 6.5 months. The ORR was 71 per cent. A total of 65 patients exhibited a partial or complete response in radiological tumour size. Side effects compared favourably to other kinase inhibitors.

Dabrafenib and trametinib exhibit a promising tumour response with a tolerable side profile. BRAF/MEK inhibitors continue to provide robust responses in BRAF-mutated ATC. The heterogeneity and lack of controls in included studies limits the confidence in the conclusions drawn.

Associations between leptin (LEP) and leptin receptor (LEPR) gene polymorphisms and mood disorders have been found but not yet confirmed in multiple studies. The aim of our study was to study the associations between LEP and LEPR single nucleotide polymorphisms (SNPs) and treatment response of depression. Associations between leptin levels and depression severity were also investigated.

The data included 242 depressed patients in secondary psychiatric care. Symptoms of depression were assessed with the Montgomery–Åsberg Depression Rating Scale (MADRS). Previously found LEP and LEPR SNPs associated with depression and other mood disorders were studied. Furthermore, all available LEP and LEPR SNPs were clumped using proxy SNPs to represent gene areas in r2 > 0.2 linkage disequilibrium and their association with treatment response was analysed with logistic regression.

Two proxy SNPs of LEPR gene, rs12564738 and rs12029311, were associated with MADRS response at 6 weeks (p adjusted = 0.024, p adjusted = 0.024). SNPs from previous studies were not associated with MADRS response, but LEPR rs12145690 from a previous study was strongly associated with rs12564738 (r2 = 0.94). The positive association between leptin levels and MADRS score at baseline after adjusting with age, sex, body mass index (BMI), Alcohol Use Disorders Identification Test score, and smoking was found (p = 0.011).

Our findings suggest that LEPR polymorphisms are associated with depression treatment response. We also found associations between leptin levels and depression independently of BMI. Further studies and meta-analyses are needed to confirm the significance of found SNPs and the role of leptin in depression.

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.