Nobody has compared the treatments for radiation fibrosis

The edition in brief

A quiet day on the ENT desk, anchored by radiation-induced fibrosis. The edition opens with a technique report: a vascularised nasoseptal flap harvested from the septum and nasal floor, rotated through the nasopharynx and sutured transorally to close an 8 by 6 mm soft palatal fistula after transoral options had failed. Closure resolved nasal regurgitation, partly improved velopharyngeal function and did not cause Eustachian tube dysfunction - one patient, but a route that avoids regional or free tissue transfer. A historical review using University of Tokyo archives and an interview with the lead inventor places the invention of the flexible fiberoptic nasopharyngolaryngoscope in 1967, at the Research Institute of Logopedics and Phoniatrics, inspired by the fiberoptic bronchoscope developed in Japan five years earlier; the instrument produced the first real-time images of the glottis during unperturbed speech and breathing, and was never patented. A review of 196 otolaryngology residency applicants found that those who took a dedicated research year listed more research products in total (median 32 against 24), but the difference lay almost entirely in unpublished work and oral presentations - published articles and first-author manuscripts did not differ. The edition closes on treatments for radiation-induced fibrosis. Of 4,078 records screened, eight studies met inclusion. One uncontrolled trial reported that 83% of patients on pentoxifylline-tocopherol achieved at least a 50% reduction in fibrotic surface area; pravastatin reduced fibrosis thickness by at least 30% in 35.7%; lipotransfer was associated with physical improvement in 97% of 38 patients and microcurrent therapy improved cervical mobility in 92% of 26. No head-to-head comparison exists.