The edition · ENT & Head and Neck Surgery
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.
The edition in brief
Today's ENT edition closes on a five-centre US cohort (Laryngoscope, 10 September) of 68 adults implanted after more than ten years of unilateral severe-to-profound deafness, median 17 years. Word recognition rose by a mean 28 percentage points; over half gained at least 20 points and a third at least 50, and devices were worn about 7–8 hours a day. Duration of deafness did not predict outcome on multivariable analysis, so it should not by itself exclude a candidate. The lead is a national US survey analysis (OHNS, 11 September): over a third of head and neck cancer survivors lacked the smoking history needed to judge lung screening eligibility, and only 40% of those eligible under 2021 criteria had been screened. A systematic review of 11 studies (OHNS, 10 September) found frailty consistently associated with medical complications, longer stay, non-home discharge and slower swallowing recovery after free flap reconstruction, with nutrition and sarcopenia measures predicting best. A Laryngoscope cohort of 223 people aged about 65 (13 September) found poorer word recognition associated with higher amyloid on PET across several regions — a small association that does not show cause. The pearl is on recording pack-years in every head and neck cancer follow-up letter.
Head and neck cancer survivors: a third have no smoking history recorded, and most eligible are not screened for lung cancer
Record pack-years in every head and neck cancer survivor and refer those eligible for lung cancer screening.
Frailty before free flap reconstruction predicts a longer stay, slower swallowing and non-home discharge
Assess frailty and nutrition before free flap surgery, and use them to set expectations for recovery and discharge.
Poorer word recognition was associated with more brain amyloid in late middle age
Measure word recognition as well as pure tones; poorer speech understanding tracks with brain amyloid, though cause is unproven.
Put pack-years in every head and neck follow-up letter
Carry pack-years, quit date and screening eligibility in the header of every head and neck cancer follow-up letter.
Long-standing unilateral deafness is not a reason to refuse a cochlear implant
Refer adults with long-standing one-sided deafness for cochlear implant assessment; duration alone should not rule them out.
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