This brief review summarises the efficacy of the treatments for post-irradiation otitis media with effusion.

Literature review.

Studies suggest that tympanocentesis is recommended for patients with post-irradiation otitis media with effusion The efficacy of balloon dilatation Eustachian tube for post-irradiation otitis media with effusion remains unclear.

The efficacy of different treatments for post-irradiation otitis media with effusion is unclear. Therefore, there are no recognised clinical guidelines, and long-term clinical research with a large sample size is needed.

This study investigated the influence of socioeconomic factors on the incidence of laryngomalacia in paediatric in-patients.

Data from the 2016 Healthcare Cost and Utilization Project Kid Inpatient Database were analysed. Variables included zip code median income, race and/or ethnicity, primary expected payer and associated International Statistical Classification of Diseases and Related Health Problems 10th Revision codes in admission.

Lower median income zip codes showed a 6.4 per cent increase in laryngomalacia admissions, while higher-income zip codes had an 8.0 per cent decrease. Black patients exhibited a 24.5 per cent increase and Asian or Pacific Islander patients showed a 42.5 per cent decrease in laryngomalacia admissions. Medicaid and other government programme payers had a 22.1 per cent increase, while Medicare, private insurance and self-pay patients had decreases of 35.5, 20.9 and 55.7 per cent, respectively. Laryngomalacia was associated with a number of disease processes from a multitude of organ systems in a statistically significant manor.

Socioeconomic status, race, primary expected payer and co-morbid disease process significantly impact laryngomalacia admissions.

The father of Czech music, Bedřich Smetana was a brilliant, patriotic Romantic composer who spent his last decade completely deaf. He became progressively ill in his final years and passed away prematurely at 60 years old. Since then, there have been two main propositions for the etiology of his neurological symptoms, in particular his hearing loss: neurosyphilis or osteomyelitis of the temporal bone.

This article compares the clinical presentation and pathology of neurosyphilis and osteomyelitis.

This article infers which one is arguably the most likely cause based on Smetana’s own medical history, signs and symptoms and autopsy findings.

Smetana’s clinical presentation and pathological results grant us a clearer picture of his neurological condition and allows us to diagnose his final neurological deterioration as complications of neurosyphilis and not osteomyelitis of the temporal bone.

Carcinoma ex pleomorphic adenoma is a rare malignant salivary gland tumour for which distinct radiological features are unclear. We aim to identify radiological features that may pre-operatively predict for carcinoma ex pleomorphic adenoma and its degree of invasion.

Systematic review of Ovid Medline, Embase, Scopus, Web of Science (BIOSIS), Cochrane, PROSPERO, OpenDOAR, and OpenGrey from inception to 29 April 2023. Primary outcomes of interest were radiological features in magnetic resonance imaging, computed tomography and ultrasound.

Of 1729 studies, 12 studies (n = 426) underwent qualitative synthesis. Imaging findings for magnetic resonance imaging, computed tomography, and ultrasound were reported in 11 studies (n = 337), five studies (n = 253) and one study (n = 89), respectively. Magnetic resonance imaging features of lower mean apparent diffusion coefficient values and heterogenous T2 intensity were reported.

Magnetic resonance imaging has the greatest utility in predicting for carcinoma ex pleomorphic adenoma. Within the limits, a heterogenous body of evidence, in addition to general radiologic features of malignancy, lower mean apparent diffusion coefficient values and heterogenous T2 intensity, may indicate carcinoma ex pleomorphic adenoma.

To determine if there have been changes over time for indications and outcomes of tracheostomies in infants.

Retrospective review of infant tracheostomies at a tertiary children’s hospital across two time periods (epoch 1: 1997–2008; epoch 2: 2009–2020). Patient demographics, tracheostomy indications, comorbidities, length of stay, complications, decannulation and mortality were examined.

Seventy-two infants had a tracheostomy (40 epoch 1 vs 32 epoch 2). Airway obstruction decreased (80 per cent vs 50 per cent*) and long-term ventilation increased (17.5 per cent vs 40.6 per cent*) as the primary indication. Early complications decreased between the time periods (30 per cent vs 6.3 per cent*). The median hospital length of stay was 97 days (interquartile range 53–205.5), total complication rate was 53 per cent, decannulation rate was 61 per cent and mortality rate was 17 per cent (all non-tracheostomy related) across both time periods. There were no significant changes for these outcomes. *(p< 0.05)

Long-term ventilation has increased and airway obstruction has decreased as the primary indication for infant tracheostomy over time.

To study the clinicopathological features of collision tumours of the thyroid and to develop a logical management regimen in view of the rarity of these tumours.

A retrospective study on collision tumours of the thyroid, diagnosed over the previous 15 years in a tertiary cancer care centre. The inclusion criteria were proven cases of collision tumours of medullary thyroid carcinoma with papillary thyroid carcinoma and/or follicular thyroid carcinoma.

Among the 470 patients with medullary thyroid carcinoma, 24 were found to harbour collision tumours (5.1 per cent). Amongst 18 patients (75 per cent) with lymph node metastases, 88.8 per cent originated from medullary thyroid carcinoma and 22.2 per cent from the papillary thyroid carcinoma component. Two patients (8.3 per cent) presented with distant metastases. Eight patients underwent radioactive iodine scan, of whom seven demonstrated neck uptake and received radioactive iodine therapy. Fifteen patients (62.5 per cent) were disease free, eight patients (33.33 per cent) harboured biochemical and/or structural residual disease, and one patient died due to an unrelated aetiology.

Thyroid collision tumours are relatively rare entities and are usually undiagnosed pre-operatively. The prognosis of the disease primarily depends on tumour aggressiveness the of medullary thyroid carcinoma component. A combined follow up with tumour markers and imaging, including positron emission tomography/computed tomography molecular imaging approaches should be adopted.

Ménière’s disease is a chronic inner-ear disease attributed to endolymphatic hydrops. Magnetic resonance imaging with gadolinium allows visualisation of endolymphatic hydrops in vivo and may be an adjunct to diagnosis.

Thirty-eight patients suspected of having Ménière’s disease underwent T2 weighted three-dimensional fluid-attenuated inversion recovery and true inversion recovery sequence magnetic resonance imaging 4 hours post double-dose intra-venous gadolinium. Presence of endolymphatic hydrops was graded by two radiologists at 0 and 4 months. Correlation to clinical diagnosis was assessed using Fisher’s exact test.

Hydrops was identified in 88 per cent, 17 per cent and 27 per cent of patients with Definite Ménière’s, Probable Ménière’s and Undifferentiated disease, respectively. A significant correlation existed between diagnosis and presence of hydrops. Sensitivity and specificity were 88 per cent and 67 per cent, respectively. Intra- and inter-observer agreement for presence and grading of hydrops was near-perfect and substantial to near-perfect, respectively.

Magnetic resonance imaging demonstrates radiographic hydrops with significant correlation to clinical diagnosis and good intra- and inter-observer agreement.

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 assess the face and content validity of artificial temporal bone dissection in surgical training in the UK.

Expert and non-expert groups participated in artificial temporal bone dissection at the Queen Elizabeth Hospital, Birmingham, UK. Face and content validity were assessed by a validated post-dissection questionnaire.

The median content validity score was 34 out of 35 (interquartile range 32.00–35.00). Mean face validity score compared to human was 45.76 out of 65 (95 per cent CI 42.57–48.94). Face validity compared to cadaveric models demonstrated equivalence (95 per cent CI 25.30–30.70, crossing equivalence value 27.00). Experts rated face validity less favourably than non-experts (p = 0.012 and 0.042, respectively). Content validity was equivalent between experts and non-experts (p = 0.052). There were no significant differences in total content (p = 0.606) and face validity (p = 0.133, p = 0.105) scores between different artificial bones.

The high content and face validity suggests ENT training programs should consider formally incorporating artificial models into mastoid surgery training pathways.

This study measured the effectiveness of an in-house designed, cast silicone airway model in addressing the lack of easily accessible, validated transoral laser microsurgery simulation models.

Participants performed resection of two marked vocal fold lesions on the model. The model underwent face, content and construct validation assessment using a five-point Likert scale questionnaire measuring the mean resection time for each lesion and the completeness of lesion excision. Comparative analyses were performed for these measures.

Thirteen otolaryngologists participated in this study. The model achieved validation threshold on all face and content measures (median, ≥4). Construct validation was demonstrated by the improvement in mean resection time between lesions one and two (86 vs 54 seconds, W = 11, p = 0.017). The mean resection time was lower amongst more senior otolaryngologists (61.5 vs 107.1 seconds, W = 11, p = 0.017).

This synthetic silicone model is a low-cost, easily reproducible, high-fidelity synthetic airway model, demonstrating face, content and construct validity.

The objective of this study was to evaluate graft success, hearing improvement, and complications following perichondrium–cartilage underlay myringoplasty without external auditory canal packing.

In this prospective study, we examined 37 ears of 37 patients with large perforations who underwent endoscopic perichondrium–cartilage underlay myringoplasty without external auditory canal packing. Patients were followed up for six months.

At one week after the surgery, the graft was in situ in 35 (94.6 per cent) ears. At 2–3 weeks post-surgery, among the 35 ears without infection, the graft was in situ in 29 (82.9 per cent) ears, and the graft was bulging in 6 (17.1 per cent) ears. At six months post-surgery, the graft success rate was 94.6 per cent (35 of 37 ears). No graft lateralisation or graft medialisation was encountered during the follow-up period.

The absence of external auditory canal packing did not affect the graft success or hearing improvement following underlay myringoplasty. Thus, external auditory canal packing does not appear to be necessary for underlay myringoplasty.

Assess the post-operative complications of microscopic parotidectomy and its impact on quality of life.

Thirty patients were included in this prospective study. Three to six months post-surgery, patients underwent assessments for Frey’s syndrome by Minor test, aesthesiometer test, facial nerve function and Quality of Life questionnaire.

Frey’s syndrome symptom positive in none, Minor test positive in 50 per cent. The preservation rate of the great auricular nerve posterior branch was 90 per cent, but it had no significant impact on the aesthesiometer test. Transient and permanent facial paresis were observed in 13.3 per cent and 3.3 per cent, and salivary fistula in 3.3 per cent. In quality of life, the rating of general health as good/better was seen in 73.3 per cent, nil/minimal pain in 93.3 per cent, bothersome change of facial contour in none, and dry mouth in 23.3 per cent.

Microscopic parotidectomy achieves good surgical outcomes regarding Frey’s syndrome symptoms, greater auricular nerve preservation, facial paresis, salivary fistula and quality of life.