Medial flap turbinoplasty pulls ahead at twelve months

The edition in brief

Four findings for ENT practice. A prospective randomised trial with blinded outcome assessors compared medial flap turbinoplasty with coblation-assisted turbinoplasty in 44 patients with inferior turbinate hypertrophy. Both improved symptoms markedly at every timepoint, but at 12 months the medial flap group had better NOSE scores (18.5 vs 34.5, P=0.027) and visual analogue scores (2.2 vs 4.0, P=0.043), greater turbinate size reduction and less postoperative crusting, with comparable pain and recovery. A retrospective cohort of 70 children evaluated for recurrent croup found household tobacco exposure and gastro-oesophageal reflux associated with earlier onset, and Childhood Opportunity Index wealth, health and educational resource scores correlated with shorter disease duration and fewer emergency visits. A shorter interval from first emergency department visit to otolaryngology evaluation correlated with fewer emergency visits (r=0.28), fewer corticosteroid courses (r=0.28) and shorter disease duration (r=0.51). Among 630 infants having auditory brainstem response testing, 55.6% reached a definitive diagnosis with one test, 29.7% needed two and 14.7% needed three or more; those diagnosed after 3 months were fitted with a hearing aid at 11.2 months against 5.9 months. A randomised trial of intraoperative patient-specific 3D-printed temporal bones in 40 cochlear implant operations found attending surgeons had lower cognitive load with the model while residents had higher. And in situ simulation across 11 paediatric hospitals found 77% of teams replaced a tracheostomy tube within five minutes, with a median of 3.2 latent safety threats identified per simulation.