ENT & Head and Neck Surgery
Weekly cisplatin with postoperative radiotherapy held up against 3-weekly dosing at five years
Long-term JCOG1008 data confirm weekly 40 mg/m² as a non-inferior alternative for high-risk resected head and neck cancer. Oral dexamethasone after tonsillectomy cut opioid prescriptions in children, and adults from deprived areas came to cochlear implant assessment with worse hearing but did as well after implantation.
A nebulised tranexamic acid protocol was followed by far fewer returns to theatre for tonsil bleeds
Surgical control of paediatric post-tonsillectomy haemorrhage fell from 44% to 15% as a standard protocol took hold; earlier ENT review in recurrent croup went with shorter illness; and obesity reshaped sleep in children with OSA.
Before blaming a small thyroid nodule for globus, look for reflux and muscle tension
A 10-year series finds breathlessness, orthopnoea and larger nodules predict relief from thyroidectomy while alternative causes explain many 'compressive' symptoms; depression and anxiety track with septoplasty complications; and single-sided deafness implant users need a different rehabilitation plan.
Hoarseness referrals still miss the guideline half the time — look at the larynx before PPIs, steroids or scans
A 528-patient audit finds referral quality did not improve after the 2018 dysphonia guideline, long-deaf adults still gain from cochlear implants, and simulation exposes the hazards in paediatric tracheostomy emergencies.
Swallowing exercises started with radiotherapy preserved function in a small head and neck trial; CT osteitis flags eosinophilic nasal polyps
A randomised trial supports home exercise alongside head and neck radiotherapy, CT osteitis scoring predicts eosinophilic polyp disease before surgery, European laryngologists agree what belongs in the office, adults bleed four times as often after tonsillectomy, and vestibular diagnoses are associated with prior atrial fibrillation.
Two hearing aids gave more self-reported benefit than one in age-related hearing loss
A 275-patient trial favours bilateral fitting by a margin of uncertain clinical size; a 30,000-flap meta-analysis names the modifiable drivers of free flap compromise; routine tonsil pathology found one unexpected cancer in 769 specimens; and medial flap turbinoplasty outlasted coblation.
After a median 17 years of one-sided deafness, most adults still gained from a cochlear implant
A five-centre cohort challenges duration of deafness as a bar to implantation, head and neck cancer survivors are missing lung cancer screening, frailty predicts a hard recovery after free flap surgery, and poorer hearing tracks with brain amyloid.
Free flaps carry a 6% thromboembolism rate — the rest of ENT does not
A 277,187-patient database analysis shows where the clot risk in head and neck surgery actually sits, and where blanket prophylaxis buys nothing. Plus what the evidence supports for radiation fibrosis, and how long a probiotic lozenge stays in the throat.
Five years on, weekly cisplatin holds against the three-weekly schedule
JCOG1008's final analysis confirms non-inferiority in postoperative high-risk head and neck cancer; plus where circulating tumour DNA actually stands, antiviral treatment for congenital cytomegalovirus started after the neonatal period, and three doses of dexamethasone that cut opioid prescriptions after tonsillectomy.
A nebulised tranexamic acid protocol cut return to theatre for post-tonsillectomy bleeds from 44% to 15%
Two quality improvement cycles at one children's hospital, 501 patients, and no increase in transfusion, readmission or complications. Alongside it: what the initial audiogram shape tells you about sudden hearing loss before you start steroids, and an epiglottopexy literature that has quietly grown a new indication.
Half the patients sent for thyroid compression had something else
In 214 referrals for compressive symptoms, reflux and laryngeal muscle tension were the commonest alternative diagnoses — and orthopnoea, not globus, was the symptom that predicted a good surgical outcome. Plus who actually wears a cochlear implant, what a 3D-printed temporal bone does to a trainee, and a hearing-and-gait signal that vanished on adjustment.
An MDADI score below about 74 identifies the head and neck cancer patients who need a swallow study
Thresholds from 470 paired questionnaires and videofluoroscopies, a four-item short form that performs almost as well, dysphonia referrals that got worse after the guideline, and minor head trauma turning silent canal dehiscence into symptoms.
Adults bled after tonsillectomy nearly four times as often as children, mostly around day 7
A ten-year tonsillectomy cohort closes the edition. Before it: a European consensus on office-based laryngology, pembrolizumab with metformin in metastatic head and neck cancer, awake tympanostomy in children, and a link between vertigo and atrial fibrillation.
Vitamin D halved BPPV recurrence in deficient adults, and a UK guideline makes the case for MT-RNR1 testing before aminoglycosides
A two-year placebo-controlled trial puts the number needed to treat at 3.6; one in 330 people carries a variant that makes a single aminoglycoside dose deafening; and bilateral hearing aids beat one aid, though perhaps not by enough to matter.
Seventeen years deaf, and the implant still worked
A five-centre cohort undermines duration of deafness as an exclusion for cochlear implantation; word recognition tracks brain amyloid better than the pure-tone average does; and one in three head and neck cancer survivors has no smoking history recorded at all.
Nobody has compared the treatments for radiation fibrosis
Eight studies survived a screen of 4,078. Pentoxifylline-tocopherol, pravastatin, lipotransfer and microcurrent all report improvement; none has been tested against another, and the outcome measures barely overlap. Plus a nasoseptal flap rotated through the nasopharynx to close a palatal fistula, where the flexible laryngoscope actually came from, and what a research year buys an applicant.
Hearing that can still be recovered, a larynx that does not settle, and steroids after tonsillectomy
Pooled data suggest antivirals started after the neonatal period still improve hearing in congenital CMV; a 180-million-record cohort finds laryngeal symptoms peaking one to two years after COVID-19; and a quadruple-blind trial cuts opioid prescriptions after paediatric adenotonsillectomy.
The shape of the first audiogram tells you who will recover from sudden deafness
In 487 patients with idiopathic sudden sensorineural hearing loss, complete recovery ran from half of ascending curves to none of the totally deaf ears; a nebulised tranexamic acid protocol cut the need to take children back to theatre for post-tonsillectomy bleeding by two-thirds; and HPV vaccination in the target age group has fallen by nearly half since 2016.
Two in five head and neck cancer survivors develop chronic rhinosinusitis
Pooled data from 17 studies put the incidence at 37 per cent overall and 45 per cent after nasopharyngeal cancer, with radiotherapy the main driver; single-sided deafness turns out to predict who stops wearing a cochlear implant; and a device that logs under four hours a day is the strongest warning sign in paediatric bone conduction.
Fewer cervical fusions, more dysphagia after them
Across nearly half a million admissions, ACDF volume fell by 57% while the odds of postoperative dysphagia rose 11% a year — the operations left are the harder ones. Also: what temporal bone histopathology says about implanting after otogenic meningitis, voice fatigue in vapers, and a hoarseness guideline that changed nothing.
Medial flap turbinoplasty pulls ahead at twelve months
A blinded randomised trial finds the two turbinate techniques equivalent early and separated by 16 NOSE points at a year; the interval from first emergency visit to ENT review predicted the whole course of recurrent croup; and 45% of infants needed more than one brainstem response test to reach a diagnosis.
Vitamin D halved recurrent positional vertigo in deficient patients over two years
A double-blind trial in 160 adults with BPPV and vitamin D deficiency found recurrence at 24 months fell from 55.0% to 27.5% with weekly cholecalciferol, a number needed to treat of 3.6, and a meta-analysis warns that elective tracheostomy after head and neck reconstruction carries its own substantial morbidity.
Immune checkpoint inhibitors after surgery cut recurrence in high-risk head and neck cancer
A meta-analysis of phase III trials shows adjuvant checkpoint inhibitors improve survival in resected high-risk head and neck cancer, lateral-wall cochlear electrodes preserve hearing better than perimodiolar ones, and a pharmacogenomic guideline flags the patients who lose their hearing after a single aminoglycoside dose.
Adjuvant checkpoint inhibitors improve survival in resected head and neck cancer, at a real toxicity cost
A meta-analysis of phase III trials finds a 26% reduction in the risk of death when checkpoint inhibitors are added after chemoradiotherapy, elective tracheostomy after head and neck reconstruction protects the airway but costs flaps and feeding, and vitamin D halves recurrent positional vertigo in deficient patients.