Ménière’s disease is an inner-ear disorder caused by endolymphatic hydrops, characterised by recurrent episodes of vertigo, fluctuating hearing loss, and tinnitus. Ménière’s disease can be classified as ‘probable’ and ‘definite’ according to the criteria determined by the Bárány Society.

This analytical cross-sectional retrospective study included 28 Ménière’s disease patients (15 with definite Ménière’s disease and 13 with probable Ménière’s disease). Vestibular function was assessed using ocular-vestibular evoked myogenic potentials, cervical-vestibular evoked myogenic potentials and caloric test.

The results of these tests were evaluated separately for probable Ménière’s disease and definite Ménière’s disease groups and comparisons were made. Significant differences in vestibular evoked myogenic potential asymmetry rates were observed between the probable Ménière’s disease and definite Ménière’s disease groups, with the definite Ménière’s disease group exhibiting a higher rate of abnormal responses.

This suggests that vestibular evoked myogenic potentials testing may be a valuable tool in distinguishing between these two subtypes of Ménière’s disease. Further research is necessary to validate these findings and explore their implications for clinical practice.

To report a case of cutaneous tumour seeding following core biopsy of a thyroid malignancy.

This paper presents a case report of cutaneous tumour seeding following core biopsy and a review of the literature concerning the role, and risks, of fine needle aspiration and core biopsy in the diagnostic evaluation of neck lumps.

A 75-year-old woman presented with a left-sided level IV neck lump adjacent to the left lobe of the thyroid. Fine needle aspiration revealed that the neck lump contained follicular epithelial cell groups; however, nuclear grooves and pseudo-inclusions could not exclude a diagnosis of papillary thyroid carcinoma. Subsequent core biopsy confirmed features of a thyroid neoplasm, although abundant necrosis and limited lesional cells within the specimen made histological diagnosis difficult. The patient underwent total thyroidectomy and left-sided selective neck dissection for symptom control. A superficial nodule overlying the core biopsy site was noted at operation and excised; it was found to contain cells of poorly differentiated papillary carcinoma identical to the subsequently confirmed thyroid primary.

This case highlights a rare but important risk associated with sampling neck lumps. Nevertheless, ultrasound-guided sampling is an essential investigative step with great diagnostic accuracy and patient acceptability.

This study investigates the seasonal and regional distribution of paediatric laryngomalacia admissions in the United States, hypothesizing higher admission rates in winter and colder regions due to reduced sunlight exposure affecting vitamin D levels.

We analyzed data from the 2016 Kids’ Inpatient Database (KID), focusing on children under three years old. Laryngomalacia cases were identified using International Classification of Diseases and Related Health Problems 10th Revision (ICD-10) code Q31.5. Seasonal and regional differences in admission rates were assessed using Pearson’s chi-squared test, with a significance level of p less than 0.05.

Of 4,512,196 estimated national admissions, 11,638 were due to laryngomalacia. Admissions increased by 10.0 per cent in winter and decreased by 10.9 per cent in summer (p < 0.005). Regionally, admissions were higher in the Midwest/Central (18.6 per cent) and Northeast (9.3 per cent) and lower in the South (7.4 per cent) and West (11.1 per cent) (p < 0.005).

Laryngomalacia admissions are significantly influenced by seasonal and regional factors, likely related to environmental conditions affecting vitamin D synthesis.

Managing benign tumours of the external nose involves balancing optimal excision with the preservation of nasal function and aesthetics. This study aims to identify histologic diagnoses, surgical strategies and post-operative outcomes.

A retrospective cohort study was conducted from November 2006 to March 2023. All surgeries were performed by a single surgeon

The included 24 patients with a mean age of 32.7 ± 19.2 years (range, 3 months to 65 years) at diagnosis. Tumours were predominantly located on the nasal dorsum (n = 11). Among the 11 histologic tumour types, haemangioma was the most common (n = 8). Most patients (70.8 per cent) underwent an open rhinoplasty approach. Recurrence occurred in four patients (16.7 per cent).

Benign tumours of the external nose exhibit diverse pathology. Partial tumour removal may be considered in extensive cases with skin involvement for preserving nasal aesthetics. A tailored surgical strategy is crucial for managing these rare tumours.

The relationship between clinical examination findings and objective nasal patency measures in structural nasal obstruction remains uncertain. This review aims to explore the relationship between clinical nasal examination findings and objective nasal patency measures using acoustic rhinometry, peak nasal inspiratory flow, rhinomanometry and rhinospirometry.

Qualitative systematic review using the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 statement.

A total of 17 articles were included in the systematic review. Several studies showed a positive relationship between objective nasal patency measures and clinical nasal examination findings, however evidence in the literature is limited and confined to cohort studies. Objective nasal patency measures using acoustic rhinometry, rhinomanometry and rhinospirometry assessment correlate positively in severe anterior septal deviation but its role in assessing middle/posterior and mild/moderate septal deviation in isolation remains uncertain. There is limited evidence in the literature to assess the relationship between peak nasal inspiratory flow and clinical examination findings.

Objective nasal patency measures has a limited role in supporting clinical examination findings in severe structural nasal obstruction.

Mucoepidermoid carcinoma of unknown primary (MEC-UP) in the head and neck is a rare presentation of the most common salivary gland cancer. Cancers of unknown primary sites often have poorer prognoses than similar cancers with known primary. Few cases of MEC-UP have been reported; therefore, the objective of this report is an overview of the diagnosis and management of MEC-UP.

We present two patients with low-grade MEC-UP at a high-volume tertiary care institution in Ontario, and a database search returning 1560 citations of which five studies with seven MEC-UP cases were identified.

Review of the limited cases suggest many clinicians use positron emission tomography-computed tomography (PET-CT) in addition to panendoscopy and targeted biopsies with consideration for diagnostic tonsillectomy in diagnostic work-up.

Like other salivary gland cancers, primary therapeutic surgical resection is recommended with low threshold for adjuvant radiotherapy to regions at high risk for harbouring the primary malignancy, especially in cases of high-grade histopathology.

This study analyses the current literature to evaluate the effectiveness of dabrafenib and trametinib in the multi-modal treatment of anaplastic thyroid cancer (ATC).

A systematic review and meta-analysis of the literature were undertaken. The primary endpoint measured was overall response rate (ORR) defined by the RECIST v1.1 guidelines. Secondary endpoints were 12-month overall survival (OS), median OS and progression-free survival (PFS).

Of 656 identified reports, 8 studies were included which featured 95 patients (median age 68.5 years, 46 per cent male). Median follow-up period was 11.8 months with a 12-month OS of 51 per cent. Median OS was 10.4 months. Progression-free survival (PFS) was 6.5 months. The ORR was 71 per cent. A total of 65 patients exhibited a partial or complete response in radiological tumour size. Side effects compared favourably to other kinase inhibitors.

Dabrafenib and trametinib exhibit a promising tumour response with a tolerable side profile. BRAF/MEK inhibitors continue to provide robust responses in BRAF-mutated ATC. The heterogeneity and lack of controls in included studies limits the confidence in the conclusions drawn.

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.

We intended to investigate the deviation of septal swell body, perpendicular plate, septal spur and vomer in patients with and without nasal obstruction.

We compared the deviation of these septal areas in computed tomography scans of patients scheduled for nasal surgical procedures (cases) and of patients without clinically relevant nasal obstruction (controls).

Septal swell body was similarly deviated between 56 cases (median value: 6.5 mm) and 56 controls (6.4 mm; p > 0.2). Septal spur was more deviated in cases (5.6 mm) than in controls (4.7 mm; p < 0.001). The deviation of perpendicular plate (found in 28/112 subjects) did not differ significantly between cases (3.0 mm) and controls (2.2 mm; p > 0.2). The deviation of vomer (found in 71/112 subjects) was larger in cases (7.1 mm) than in controls (4.3 mm; p = 0.001).

Septal spur, vomer and perpendicular plate were more frequent causes of nasal obstruction compared to septal swell body.

First branchial arch abnormalities are rare. Surgical excision is the mainstay of treatment and described in the literature. Excision can be associated with significant complications. We describe factors influencing operative and non-operative management of patients.

Case review was conducted between January 2012 and September 2022 of patients with first branchial arch abnormalities at Alder Hey Children’s Hospital, UK. Analysis of electronic patient records, operation notes and extraction of clinical outcomes were obtained.

Four patients were identified with an average age of 2 years and 4 months. Three were female. Three underwent operative intervention, one of which had a recurrence post-operatively and was manged conservatively. The non-operatively managed patient remains conservatively managed with no complications.

First branchial arch abnormalities can be managed operatively and non-operatively, depending on patient factors. Steps to improve surgical planning such as constructive interference in steady state magnetic resonance imaging may help decision making and risk stratification of operative management.

This study aims to assess the pure tone auditory thresholds in infantry and artillery personnel to evaluate potential hearing loss and ascertain the effect of military service duration on these thresholds.

A total of 108 participants, comprising 35 infantry, 30 artillery personnel, and 43 healthy volunteers as controls, underwent conventional and high-frequency pure tone audiometry. Thresholds were measured across frequencies of 125–16000 Hz.

Artillery personnel exhibited significantly higher hearing thresholds compared to controls across various frequencies, particularly in the right ear. Infantry personnel showed elevated thresholds at specific frequencies in the left ear. Correlations were observed among age, years of service and number of shots fired.

Repetitive exposure to firearm noise can lead to significant hearing loss across a broad frequency range. Implementing comprehensive ear protection programs for military personnel is crucial to mitigate these risks.

Otology training solely using cadavers is challenging because of scarcity and high costs. The use of additive manufacturing technology is a promising alternative. This study aimed to qualitatively validate new additive manufacturing temporal bone specimens for their realism and ability to train surgical skills.

Three additive manufacturing models generated using cadaveric temporal bones were evaluated. Three otologists with experience as trainers dissected and evaluated each specimen.

The additive manufacturing specimens scored an average of 4.26 ± 0.72 (out of 5) points and received positive feedback. The agreement between the three expert raters was high (intra-class correlation coefficient of 0.745).

The results suggested that the additive manufacturing temporal bones were able to faithfully reproduce a training experience similar to that on cadaveric temporal bones. Further studies that investigate the effectiveness of these specimens in training surgical skills are needed before integrating them into surgical training curricula.

Hereditary haemorrhagic telangiectasia is an autosomal dominant vascular disorder characterised by mucocutaneous telangiectasia, leading to recurrent epistaxis in nearly all affected individuals. Treatment strategies are broadly categorised into conservative, medical and surgical approaches. This study aimed to provide a concise summary of the existing literature on epistaxis associated with hereditary haemorrhagic telangiectasia.

The Medline/PubMed database was searched for relevant articles using the keywords ‘hereditary haemorrhagic telangiectasia’, ‘Osler-Weber-Rendu’ and ‘epistaxis’.

Out of 93 reviewed articles, 59 contained pertinent information. Interventions were categorised into self-delivered therapy, intravenous treatment, in-office procedures and surgical intervention.

A stepwise approach to managing epistaxis in patients with HHT involves a gradual escalation of treatments, starting with conservative measures and progressing to more invasive interventions as necessary. Topical oils can be efficient and intranasal bevacizumab injection shows promise, but more data are needed. Surgical options range from bipolar cautery and laser therapy to complete closure of the nasal cavity. Proper patient selection remains crucial.

This study aimed to predict the risk of falling using patient characteristics, computerized dynamic posturography and functional balance tests in machine learning.

One hundred twenty elderly individuals were included in this study. The fall status, physical characteristics and medical history of individuals were investigated. Pure tone audiometry test, simple functional balance tests and sensory organization test were applied to the individuals.

The machine learning model that incorporated co-morbidities, physical characteristics and functional balance tests achieved a 100 per cent accuracy in predicting fall risk. Models using only co-morbidities and physical characteristics, functional balance tests or the sensory organization test had accuracies of 87.5 per cent, 83.34 per cent and 91.66 per cent, respectively.

Advanced balance systems are not always necessary to assess fall risk. Instead, fall risk can be effectively determined using simple balance tests, co-morbidities, and patient characteristics in machine learning.

This paper aims to introduce our combined approach, which provides definitive treatment for intractable aspiration while preserving phonation and highlights the importance of performing both procedures together.

We describe a case of intractable aspiration requiring a nasogastric tube and a tracheostomy tube. We propose a combined technique consisting of an open medialisation thyroplasty with intra-operative, intra-glandular botulinum toxin injection. The thyroplasty procedure medialises the left vocal fold to overcome glottic insufficiency. Botulinum toxin injection reduces salivary flow and prevents excessive pooling.

The patient was followed up for twelve months. Video fluoroscopy demonstrated no evidence of aspiration. The patient was allowed a regular oral diet and decannulated two months post-operatively.

This paper demonstrates the feasibility of our combined approach as a viable treatment option for intractable aspiration, particularly in patients with a strong desire for vocalisation. The cases must be selected carefully to ensure a favourable outcome.