To examine the correlation of video head impulse test, functional head impulse test and Dizziness Handicap Inventory results in patients with chronic unilateral vestibular loss, and to compare the results with healthy controls.

Forty-eight patients diagnosed with chronic unilateral vestibular loss and 35 healthy individuals, aged 18–65 years, were included. The video head impulse test, functional head impulse test and Dizziness Handicap Inventory were administered.

A significant positive correlation was found between functional head impulse test and video head impulse test results for the study group in all semicircular canals (p < 0.05). There was no significant correlation between Dizziness Handicap Inventory, functional head impulse test and video head impulse test results (p > 0.05). The functional head impulse test and video head impulse test results of the control group were significantly higher than those of the study group in all semicircular canals planes (p < 0.05).

In chronic unilateral vestibular loss patients, with high head accelerations, the functional head impulse test indicates deterioration in vestibulo-ocular reflex functionality. It would be beneficial to include the video head impulse test and functional head impulse test in clinical practice as complementary tests in vestibulo-ocular reflex evaluation.

A previous study in 2016 found that the quality of YouTube videos on epistaxis first-aid management was highly variable. This study aimed to reassess the accuracy and patient understandability of such YouTube videos.

YouTube was searched using the phrase ‘How to stop a nosebleed’. The highest 50 ranking videos, based on relevance, were screened. Each video was assessed objectively using a standardised ‘advice score’, and subjectively using a video understandability and actionability checklist, the Patient Education Materials Assessment Tool for Audiovisual Materials (‘PEMAT-A/V’).

The mean advice score was 4.1 out of 8. The mean (standard deviation) understandability and actionability scores were 76 per cent (17 per cent) and 89 per cent (18 per cent), respectively. There was a strong positive correlation between the actionability scores and the advice scores (ρ = 0.634; p < 0.001), and between the actionability scores and the understandability scores (ρ = 0.519; p = 0.002).

YouTube videos are providing increasingly relevant advice for patients seeking healthcare information. YouTube is proposed as a useful medium for teaching epistaxis management to patients and community practitioners.

Rhinitis medicamentosa poses a therapeutic challenge for both patients and physicians. Treatment strategies vary, starting with avoidance of decongestants, followed by medications or surgical intervention. This study aimed to compare two treatment strategies for this condition.

A review was conducted of patients diagnosed with rhinitis medicamentosa from 2013 to 2021, who were managed conservatively with medications or surgically by inferior turbinate reduction.

Forty-seven patients were included: 21 patients were treated conservatively and 26 underwent turbinate reduction. Following surgical therapy, the frequency of using decongestants was significantly reduced (p < 0.001), with a significant improvement in Sino-Nasal Outcome Test-22 scores (p < 0.001). The conservative treatment group was significantly older with more co-morbidities. Following medical therapy, the conservative treatment group had a significant decrease in the frequency of decongestant use, but there was no significant improvement in their Sino-Nasal Outcome Test-22 scores.

Compared to conservative treatment, inferior turbinate reduction for rhinitis medicamentosa resulted in reduced decongestant use and improved quality of life.

To investigate epidermal growth factor, transforming growth factor-α and interleukin-8 production in nasal mucosa irrigated with hypertonic 2.3 per cent solution with algae extracts, in comparison to 0.9 per cent NaCl during the first two weeks after surgery for nasal polyposis, in relation to symptoms and local findings.

This prospective study included 20 nasal polyposis patients postoperatively irrigated with hypertonic solution and 20 nasal polyposis patients postoperatively irrigated with isotonic solution. We evaluated nasal symptom score, endoscopic score and mediator levels in nasal secretions before and after irrigation.

Following treatment, nasal symptom score and endoscopic score were significantly lower in the hypertonic solution group (p = 0.023; p < 0.001, respectively). The increase in the epidermal growth factor and the decrease in the transforming growth factor-α and interleukin-8 concentration were higher in the hypertonic group (p < 0.001 for all mediators).

Irrigation with a hypertonic solution was found to be more effective than an isotonic solution in nasal mucosa reparation.

Rhinosinusitis is one of the most common reasons for a visit to otolaryngology clinics. Some patients are candidates for sinus surgery. Infiltration of 1:100 000 adrenaline in the pterygopalatine fossa was studied, with the aim of evaluating the effect on bleeding in the surgical field.

This double-blind clinical trial was conducted in 2021–2022 on 40 candidates for endoscopic sinus surgery. For each patient, one side of the pterygopalatine fossa was randomly selected to be infiltrated with a vasoconstrictor. Surgical field bleeding on each side was evaluated.

Blood loss was 35.8 ± 20.9 ml in the study group and 38.4 ± 23.7 ml for the control group, with no statistically significant difference between groups (p = 0.49). In addition, there was no difference between the two groups in terms of the surgical field based on Boezaart scores.

Although there are some recommendations on the usage of vasoconstrictors via the pterygopalatine foramen, debate remains.

Using Otoplan software, it is possible to measure the cochlea before cochlear implant surgery. Until now, computed tomography (CT) of the cochlea has been necessary for this purpose. The aim of this study was to find out whether measuring the cochlea with magnetic resonance imaging (MRI) using Otoplan is possible with the same accuracy.

The cochlea of 44 patients of the local cochlear implant centre was measured by Otoplan using high-resolution CT-bone and MRI images, and the determined lengths were compared.

No significant difference was found between the cochlear lengths measured, regardless of whether the length measurement was based on a CT or an MRI data set.

For the determination of cochlear length prior to cochlear implant surgery, MRI images are just as suitable as CT images, therefore CT is not mandatory for length measurement by Otoplan, which could reduce the patient's radiation exposure.

Chondrodermatitis nodularis helicis is a benign, but painful inflammatory condition of the ear, characterised by a tender nodule located on the helix or antihelix. This study aimed to investigate the occurrence of chondrodermatitis nodularis helicis associated with the use of coronavirus disease 2019 masks during the pandemic.

A retrospective single-centre study was performed from February 2020 to February 2022 in the Maxillo-Facial Unit at the University Hospital of Siena, Italy.

During the indexed period, 11 patients were affected by chondrodermatitis nodularis helicis. All patients wore a mask for more than 8 hours a day, every day for several months.

Although there is no certain proof of the correlation between masks and chondrodermatitis nodularis helicis, an increase in the incidence of this condition was highlighted in our single-centre experience in the pandemic period. The prolonged use of coronavirus disease 2019 masks may explain this correlation.

Clinician acceptance influences technology adoption, but UK health professionals' attitudes towards artificial intelligence (AI) in hearing healthcare are unclear. This study aimed to address this knowledge gap.

An online survey, based on the Checklist for Reporting Results of Internet E-Surveys, was distributed to audiologists, ENT specialists and general practitioners. The survey collected quantitative and qualitative data on demographics and attitudes to AI in hearing healthcare.

Ninety-three participants (mean age 39 years, 56 per cent female) from three professional groups (21 audiologists, 24 ENT specialists and 48 general practitioners) responded. They acknowledged AI's benefits, emphasised the importance of the clinician–patient relationship, and stressed the need for proper training and ethical considerations to ensure successful AI integration in hearing healthcare.

This study provides valuable insights into UK healthcare professionals' attitudes towards AI in hearing health and highlights the need for further research to address specific concerns and uncertainties surrounding AI integration in hearing healthcare.

To determine the prevalence of laryngeal muscle tension in patients with sinonasal diseases.

The medical records and video-recordings of patients with a history of sinonasal disease were reviewed to identify one of four muscle tension patterns during phonation. A control group with no history of sinonasal diseases was matched according to age and gender.

Seventy-seven patients were divided into a study group (n = 47) and a control group (n = 30). In the study group, 29 patients had at least one muscle tension pattern compared with only 9 in the control group (p = 0.007). The most common muscle tension patterns observed in the study and control groups were muscle tension patterns II and III. In the study group, 79.3 per cent of patients with at least one muscle tension pattern reported dysphonia compared with only 33.3 per cent in the control group.

Patients with sinonasal diseases are more likely to exhibit laryngeal muscle tension and dysphonia in comparison with healthy subjects.

Exploratory tympanotomy in cases of traumatic ossicular disruption with intact tympanic membrane is crucial for both diagnostic and therapeutic purposes. Performing this procedure using the endoscope is gaining popularity. Hence, this study aimed to demonstrate varieties of ossicular pathology and their management in our institution.

A retrospective evaluation was conducted of 136 ears in patients with traumatic ossicular disruption with an intact tympanic membrane, who underwent endoscopic exploratory tympanotomy. A proposed algorithm was followed, to incorporate different traumatic ossicular possibilities. Assessment of hearing outcomes and surgical complications was performed six months post-operatively.

Incudostapedial dislocation was the most commonly encountered type of traumatic ossicular disruption (35.3 per cent). Air conduction threshold improved significantly following endoscopic ossiculoplasty, from 50.9 ± 6.35 dB pre-operatively to 22.35 ± 3.27 dB post-operatively, with successful air–bone gap closure.

Endoscopic ear surgery is effective in the diagnosis and management of challenging cases of post-traumatic ossicular disruption with an intact tympanic membrane.

Intranasal cocaine is commonly used in endoscopic sinus surgery due to its vasoconstrictive and anaesthetic properties. This study aimed to understand patients’ perspectives and whether patients should have to give their consent for its use.

Prospective data were collected over a three-month period in ENT departments in the out-patient setting of two district general hospitals. An anonymous questionnaire was distributed to all adult patients asking for their thoughts on cocaine use in sinonasal surgery and the need for peri-operative discussion.

In total, 123 patient questionnaires were analysed. It was found that 9.8 per cent of patients knew of cocaine use in sinonasal surgery, 73.2 per cent of patients stated they would like a pre-operative discussion on cocaine use before surgery and 83.1 per cent of patients raised concerns over cocaine's illicit status, mainly its effect on work and driving. Only 34 per cent of patients said that they would prefer an alternative to cocaine.

This study found that patients want to know if and when cocaine is being used intra-operatively without necessarily objecting to it.

To evaluate the functional magnetic resonance imaging changes in the olfactory structures of coronavirus disease 2019 patients experiencing olfactory dysfunction.

This study included patients aged 25–65 years who presented with a sudden loss of smell, confirmed coronavirus disease 2019 infection, and persistent olfactory dysfunction for a minimum of 2 months without any treatment.

Irrespective of the side of brain activation, the analysis of the cumulative maximum diameter of the activation zones revealed significantly lower activation in the upper frontal lobe (p = 0.037) and basal ganglia (p = 0.023) in olfactory dysfunction patients. Irrespective of the side of activation, the analysis of the number of activation points demonstrated significantly lower activation in the upper frontal lobe (p = 0.036) and basal ganglia (p = 0.009) in olfactory dysfunction patients.

Patients with coronavirus-triggered olfactory dysfunction exhibited lower activity in their basal ganglia and upper frontal lobe.

Otolaryngologists perform bilateral myringotomy and tube placement for surgical management for otitis media with effusion. This retrospective study aimed to address the extent to which the coronavirus disease 2019 pandemic and season impact the number of bilateral myringotomy and tube placement procedures performed at a tertiary care centre.

A total of 1248 charts of children who underwent bilateral myringotomy and tube placement from January 2018 through February 2021 were reviewed.

The cohort included 41.6 per cent females and 58.4 per cent males, with 63.7 per cent having private insurance. The median age at surgery was 2.6 years. The spring season had the most bilateral myringotomy and tube placement procedures per week. The number of bilateral myringotomy and tube placement procedures performed per week after the onset of the coronavirus disease 2019 pandemic was significantly lower compared to the years prior. There was no difference in number of intra-operative effusions pre-pandemic versus after the pandemic onset.

This study sheds light on the impact of the coronavirus disease 2019 pandemic and seasonality on the rates of tympanostomy tube procedures, vital for understanding the temporality of ear infections.

PTEN hamartoma tumour syndrome (PHTS) comprises a group of genetic disorders with varied clinical presentations, including macrocephaly, developmental delay, and increased cancer susceptibility. Recent reports have highlighted the occurrence of tonsil-related issues in PHTS.

Clinical data focusing on tonsil-related pathology and tonsillectomy details (indications, histology and post-operative complications) were collected from 53 patients with PHTS.

Tonsil issues affected 58 per cent of the cohort, with 43 per cent requiring tonsillectomy. Primary indications for tonsillectomy included obstructive sleep apnoea (43 per cent), recurrent tonsillitis (17 per cent) and other causes (17 per cent). Tonsil-related problems were observed both before (45 per cent) and after (55 per cent) PHTS. Tonsillectomy with adenoidectomy was the predominant surgical intervention performed (87 per cent), spanning a broad age range (1–27 years old).

Our findings highlight the complex nature of PHTS and its association with tonsil-related pathology, demonstrating its relevance for ENT surgeons. Early recognition and intervention are pivotal for managing sleep apnoea and the associated health problems.

To examine the newly established role of a primary contact physiotherapist in an ENT clinic, in an Australian cohort and context, over two phases of development.

A retrospective cohort study was conducted with data collected from a medical record audit. Over the study duration, the primary contact physiotherapist completed initial appointments with patients; follow-up appointments were subsequently conducted by medical staff.

There was a 46 per cent reduction in patients with suggested vestibulopathy requiring an ENT medical review. This reduction could hypothetically increase to 71 per cent with follow-up primary contact physiotherapist appointments. Improvements in the service delivery model and a primary contact physiotherapist arranging diagnostic assessments could improve waitlist times and facilitate better utilisation of medical staff time.

The primary contact physiotherapist can help in the management of patients with suspected vestibulopathy on an ENT waitlist. This is achieved through: a reduction of patients requiring ENT review, improvements to waitlist time and improved utilisation of medical specialists’ time.

This study investigated the frequency of ear canal protection use and looked at its influence on external auditory exostosis severity and knowledge about external auditory exostosis among windsurfers and kitesurfers on the German coast.

This retrospective cross-sectional study interviewed 130 windsurfers and kitesurfers along the German coast on knowledge of external auditory exostosis, exposure time, use of neoprene hoods and earplugs, and otological complaints. Participants underwent bilateral video-otoscopic examination.

Knowledge of external auditory exostosis was ‘good’ or ‘excellent’ in 78 of 130 (60 per cent) individuals and ‘poor’ or non-existent in 52 of 130 (40 per cent) individuals. Knowledge was positively correlated with hours of exposure, otological complaints and frequency of ear canal protection use. A significant negative influence of neoprene hood use on external auditory exostosis severity was shown.

The positive effect of external auditory exostosis knowledge on the frequency of ear canal protection and the reduction of external auditory exostosis risk implies a need for health education on this topic.

To report a single-centre experience in the endoscopic carbon dioxide laser-assisted approach to glomus tympanicum tumours.

A retrospective case review was conducted of patients diagnosed with class A1 to B1 glomus tympanicum tumours who underwent exclusive transcanal endoscopic carbon dioxide laser surgery.

Seven patients fulfilled the inclusion criteria. All patients (100 per cent) were women, with a mean age of 65.4 years (standard deviation, 13.6). There were five A2 tumours, one A1 tumour and one B1 tumour. One patient presented with a delayed tympanic membrane perforation needing myringoplasty on follow up. There were no substantial post-operative complications. The mean hospitalisation time was 9.5 hours (standard deviation, 9.8). The mean follow-up period was 32.7 months (standard deviation, 13.1), with all cases having resolution of pulsatile tinnitus and no tumour recurrence.

The study provides further evidence on the safety and efficacy of endoscopic carbon dioxide laser surgery as a minimally invasive technique for treating early-stage glomus tympanicum tumours.

This study aimed to quantitatively investigate airborne particle load in the operating room during endoscopic or microscopic epitympanectomy or mastoidectomy.

In the transcanal endoscopic ear surgery group, drilling was performed underwater. A particle counter was used to measure the particle load before, during and after drilling during transcanal endoscopic ear surgery or microscopic ear surgery. The device counted the numbers of airborne particles of 0.3, 0.5 or 1.0 μm in diameter.

The particle load during drilling was significantly higher in the microscopic ear surgery group (n = 5) than in the transcanal endoscopic ear surgery group (n = 11) for all particle sizes (p < 0.01). In the transcanal endoscopic ear surgery group, no significant differences among the particle load observed before, during and after drilling were seen for any of the particle sizes.

Bone dissection carries a lower risk of airborne infection if it is performed using the endoscopic underwater drilling technique.

Maximum phonation time is a simple test used to assess glottic competency. Our objective was to evaluate any correlation between maximum phonation time and spasmodic dysphonia as adductor spasmodic dysphonia and abductor spasmodic dysphonia have an adductor and abductor overdrive, respectively.

A 3-year data-review was performed for patients diagnosed with adductor spasmodic dysphonia, abductor spasmodic dysphonia and mixed spasmodic dysphonia. Maximum phonation time was noted on the first visit and compared with a control group.

Average maximum phonation time in adductor spasmodic dysphonia, abductor spasmodic dysphonia and control group was 25 seconds, 9 seconds and 16 seconds. A significant difference was found for adductor spasmodic dysphonia and abductor spasmodic dysphonia. A receiver operating characteristic curve analysis between adductor spasmodic dysphonia and control groups showed a positive predictive value of 81.3 per cent, negative predictive value of 83.9 per cent, sensitivity of 79.6 per cent and specificity of 85.2 per cent. Level of evidence = 4.

We recommend that maximum phonation time be added to the diagnostic armamentarium of spasmodic dysphonia. This correlation between maximum phonation time and spasmodic dysphonia has not been previously published.