Sublingual ranulas present diagnostic and therapeutic challenges due to their heterogenous clinical presentations. This systematic review and meta-analysis aims to synthesise treatment outcomes and proposes a new classification for this condition.

Following PRISMA guidelines, a thorough literature search identified studies on patients with sublingual ranulas receiving medical or surgical treatment. Proportion meta-analysis compared success rates among studies using a random-effects model.

Forty-two studies were included, covering 686 endoral ranulas, 429 plunging ranulas, and 16 ranulas extending into the parapharyngeal space. Sublingual sialoadenectomy with or without pseudocyst wall excision showed low heterogeneity and the highest success rates. Consequently, a new classification system is proposed categorising ranulas by intraoral (Type 1), cervical (Type 2) or parapharyngeal space (Type 3) extension.

This study confirms the role of sublingual gland resection as standard of care and highlights the need for a revised classification to improve patient outcomes.

Congenital hearing loss is a chronic condition which occurs worldwide. In the past, investigations focused on testing the most common genes associated with hearing loss (such as Connexin 26-related hearing loss). Targeted testing of specific genes was requested only when a particular syndrome was suspected. Recent advances have led to the development of a large gene panel which utilises next-generation sequencing to simultaneously test for pathogenic variants in many genes associated with hearing loss.

This review article aims to highlight the changes in the approach to congenital hearing loss in the context of the R67 gene panel, and how its use may increase the efficiency of the diagnosis and management of this condition.

The use of this large gene panel has revolutionised the approach to hearing loss. Uptake of this large gene panel has resulted in prompter diagnosis and therefore more appropriate clinical management.

To evaluate the predictive value of peripheral blood eosinophil levels for eosinophilic chronic rhinosinusitis.

Electronic searches were conducted in PubMed, Embase and the Cochrane Library. Data were analysed using Stata 16.0.

In total, 23 studies that fulfilled the inclusion criteria were analysed. For peripheral blood eosinophil percentage in identifying eosinophilic chronic rhinosinusitis, the pooled sensitivity was 0.77 (95 per cent confidence interval (CI) = 0.69–0.83) and specificity was 0.74 (95 per cent CI = 0.68–0.80), with a positive likelihood ratio of 2.97 (95 per cent CI = 2.38–3.72) and a negative likelihood ratio of 0.31 (95 per cent CI = 0.24–0.42). Similarly, for peripheral blood eosinophil count, the pooled sensitivity was 0.78 (95 per cent CI = 0.73–0.82) and specificity was 0.73 (95 per cent CI = 0.69–0.77), with a positive likelihood ratio of 2.93 (95 per cent CI = 2.45–3.50) and a negative likelihood ratio of 0.30 (95 per cent CI = 0.24–0.37).

There is not sufficient evidence to support peripheral eosinophilia as a good predictor of eosinophilic chronic rhinosinusitis.

This study evaluates the safety and utility of Eustachian tube balloon dilatation in treating Eustachian tube dysfunction symptoms in adults without middle-ear disease.

A prospective cohort study was performed. Adults with dilatory Eustachian tube dysfunction symptoms and no middle-ear disease underwent Eustachian tube balloon dilatation. A clinical assessment including tympanometry, pure tone audiometry, otoscopy, ability to Valsalva, and Eustachian Tube Dysfunction Questionnaire-7 was performed pre-operatively and repeated during a 12-month follow-up period.

Fifteen participants were enrolled. The mean pre-operative Eustachian Tube Dysfunction Questionnaire-7 score of 4.6 reduced to 2.5 at six weeks (P < 0.01), 3.0 at six months (P = 0.02) and 2.6 at 12 months (P < 0.01) post-operatively. All patients without evidence of negative middle-ear pressure had Eustachian Tube Dysfunction Questionnaire-7 score improvements. There were no post-operative complications.

Eustachian tube balloon dilatation is safe and effective at treating Eustachian tube dysfunction in patients with no middle-ear disease or evidence of negative middle-ear pressure.

This study aimed to assess the impact of the scutum on oval window accessibility during stapedotomy surgery. Radio-clinical correlation was applied to determine the impact.

This was a prospective observational case-series study that included 127 candidates for stapedotomy surgery. The oval fossa was classified into two types according to the accessibility of the stapes footplate.

Both study groups showed a statistically significant difference in pre-operative radiological length as the p value was less than 0.001. The Spearman correlation coefficient revealed that the intra-operative oval window fossa was only significantly related to the radiological scutum length because the p value was less than 0.001.

Our results revealed that the pre-operative radiological length can predict the intra-operative oval fossa type with high sensitivity and specificity. Patients with a pre-operative scutum length of less than 2.35 mm were predicted to have an easily accessible oval window without requiring intra-operative scutum curettage.

For 50 years, the Thomas Wickham-Jones (TWJ) Foundation has promoted the advancement of otology and audiology in the UK and Republic of Ireland through a series of overseas Fellowships and other grants.

The paper examines the history of the Foundation since its establishment in 1974, drawing upon the Foundation's archives and personal recollections. The analysis is located within a framework concerning the factors that shape the success or failure of a foundation including vision, strategy, information, leadership and finance.

The activities of the TWJ Foundation are charted over five decades, and the governance of the Foundation is detailed. Particular attention is given to the Major Fellowships offered, at first in North America, and to their subsequent development into the Foundation's current rotation.

The paper offers an assessment of the TWJ Foundation's impact on the training of otologists in the British Isles and concludes with a brief self-reflective analysis.

To compare characteristics between stroke populations with and without sensorineural hearing loss (SNHL) and assess the impact of SNHL on stroke outcome.

A retrospective study of patients admitted with stroke was carried out. Patients were divided into two groups, where group A were diagnosed with SNHL and group B were without SNHL. Baseline age, gender, vascular risk factors and disability were compared. Logistic regression analyses were performed with three-month mortality and SNHL as dependent variables.

A total of 631 admissions were reviewed, with mean age 79.2 years, including 305 patients with SNHL and 326 without. More severe disability was more prevalent in patients with SNHL. Sensorineural hearing loss was not associated with increased mortality (odds ratio = 1.1, 95 per cent confidence interval = 0.7–2.0, p = 0.668). Hypertension was present in 210 (68.9 per cent) with SNHL versus 189 (58 per cent) without SNHL (p = 0.005). Small-vessel disease aetiology was more prevalent in SNHL 51 (16.7 per cent) versus 30 (9.2 per cent) without SNHL (p = 0.005).

Sensorineural hearing loss appears to have an association with stroke of small-vessel disease aetiology and hypertension. Sensorineural hearing loss does not affect three-month mortality but is associated with increased disability.

This study aimed to compare the graft success rate, hearing outcomes, operation time and complications between myringoplasty with raising of a mucosal flap (RMF) and raising of a tympanomeatal flap (RTF) for the repair of subtotal perforations.

Subtotal perforations were recruited and randomly allocated to either the RMF group or the RTF group. The graft success rate, hearing outcomes and complications were evaluated at 6 months post-operatively.

The mean operation time was 31.4 ± 2.8 minutes (range: 26–47) in the RMF group and 57.6 ± 0.9 minutes in the RTF group (p < 0.01). The graft success rate was 96.0 per cent in the RMF group and 88.9 per cent in the RTF group (p = 0.659).

Endoscopic myringoplasty with the RMF achieved similar graft success and hearing gain compared to the tympanomeatal flap technique for repairing subtotal perforations, but with significantly shorter operation time and minimal temporary hypogeusia.

This study aimed to evaluate clinical characteristics, treatments and outcomes of paediatric temporal bone fractures at our institute.

A retrospective study of paediatric skull fractures confirmed by imaging from January 2010 to December 2022. Data on demographics, clinical presentations, injury mechanisms and complications were analysed, and fractures were categorised into otic capsule sparing (OCS) and violating (OCV).

Of 369 skull fracture cases, 88 (24 per cent) involved temporal bones, predominantly caused by falls and vehicle accidents. Common symptoms were loss of consciousness, hematoma, and hemotympanum, with complications like facial nerve injury and cerebrospinal fluid leaks in 3.4 per cent of cases. OCV fractures led to more severe complications, including hearing loss. Audiology showed 65 per cent without hearing impairment, while others had various degrees of loss.

Paediatric temporal bone fractures, particularly OCV types, pose significant challenges. Early detection and thorough management are vital, underscoring the need for consistent data collection and regular audiometric monitoring.

This study aimed is to analyse the quality of stapedotomy videos as an educational tool and to test the feasibility of the IVORY grading system (IVORY-GS) in an otological procedure.

YouTube was searched using the terms “stapedectomy”, “stapedotomy” and “otosclerosis surgery.” Video length, upload date, view count and likes were evaluated. The included videos were scored according to the IVORY-GS.

Sixty-seven videos were evaluated. The mean IVORY-GS total score was 21.8. Video scores were higher in the ethics part. Case presentation items got the lowest scores in total. The total score showed a significantly positive correlation with like counts. No significant correlation was found between the total score and view count and video age.

The educational quality of most of the stapedotomy videos on YouTube is insufficient. The IVORY-GS is a comprehensive guideline in the otorhinolaryngology field. However, it may require some modifications based on the type of surgery.

The present study aimed to measure an association between the caloric test and vestibulo-ocular reflex gain and refixation saccades in individuals with auditory neuropathy spectrum disorders.

Twenty individuals (9 males and 11 females), in the age range of 17 to 38 years, diagnosed with auditory neuropathy spectrum disorders, and 20 normal-hearing individuals (age and gender matched) participated in the study. All the individuals underwent case history, pure tone audiometry, immittance evaluation, otoacoustic emissions, auditory brainstem response, caloric tests and video head impulse tests.

All the patients with auditory neuropathy spectrum disorders in the present study had hypoactive caloric responses, which suggested peripheral vestibular lesions. The mean vestibulo-ocular reflex gain was reduced in few patients with auditory neuropathy, whereas few patients had normal vestibulo-ocular reflex gain.

The present study revealed a discrepancy between the caloric and video head impulse test results in auditory neuropathy spectrum disorders. The vestibular evaluation should be done for all patients with auditory neuropathy spectrum disorders to understand the various types of vestibular nerve lesions.

Hereditary haemorrhagic telangiectasia (HHT) is characterised by recurrent, severe epistaxis. While nasal closure is a relatively well-established treatment for HHT patients with intractable epistaxis, recent studies highlight the efficacy of bevacizumab in this subgroup. We aim to evaluate the effectiveness of nasal closure for patients with contraindications to bevacizumab.

A case series of five patients with HHT and severe refractory transfusion-dependent epistaxis who were treated with nasal closure.

All patients had subjective improvement in epistaxis. Haemoglobin concentrations increased in all patients, with none requiring transfusion for epistaxis post-operatively. Four patients experienced complete cessation in epistaxis. Four returned positive Glasgow Benefit Inventory scores.

Nasal closure appears to be a safe and effective option for the management of epistaxis in patients with severe, refractory HHT-related epistaxis. Treatment improved quality of life, reduced severity of epistaxis and increased haemoglobin concentrations. Nasal closure should be considered for HHT patients with severe, refractory epistaxis, particularly in cases where bevacizumab is contraindicated.

This study aimed to examine the efficacy of the automated mechanical repositioning chairs compared to canalith repositioning manoeuvres for elderly patients with benign paroxysmal positional vertigo (BPPV).

A retrospective study included 969 patients with BPPV who were first diagnosed at Beijing Chaoyang Hospital, Capital Medical University between 1 January 2020 and 31 December 2020. Patients were followed up for one year. Demographics, disease status, treatment and various outcomes were collected through medical record reviews and follow-up interviews.

Based on the criteria for evaluating treatment efficacy using objective and subjective indicators, BPPV patients treated with automated mechanical repositioning chair therapy showed a significantly better prognosis and lower recurrence rates.

Automated mechanical repositioning chair therapy is an effective approach for BPPV treatment, with advantages over conventional manual canalith repositioning procedures.

To assess the value of corrected calcium decline at 6 hours as a predictor of hypocalcaemia post total thyroidectomy by comparing it to the currently widely used intact parathyroid hormone.

A retrospective cohort study of patients who underwent total thyroidectomy from January 2016 to February 2020. Serum intact parathyroid hormone and corrected calcium data pre-operatively and 6 hours post-operatively were obtained. Receiver operating characteristic curves were used to compare corrected calcium decline at 6 hours versus 6 hours for relative intact parathyroid hormone decline as predictors of hypocalcaemia, and the area under the curve for each metric was reported.

Patients included in this analysis totalled 209. The receiver operating characteristic analysis suggested that corrected calcium decline at 6 hours has a similar predictive value to 6 hours relative intact parathyroid hormone. The areas under the curves for predicting hypocalcaemia were 0.797 for corrected calcium decline at 6 hours and 0.737 for 6 hours relative intact parathyroid hormone, but the difference (0.06) was not statistically significant.

Our results suggest that corrected calcium decline at 6 hours has a similar predictive value to 6 hours relative intact parathyroid hormone and hence has the potential to predict post-operative hypocalcaemia.

This study aimed to investigate the impact of vitamin D deficiency on vestibular function and recurrence in patients with benign paroxysmal positional vertigo.

This study enrolled 138 patients diagnosed with benign paroxysmal positional vertigo. Vestibular function was evaluated, including ocular vestibular evoked myogenic potentials, cervical vestibular evoked myogenic potentials and caloric tests. Vitamin D levels were recorded.

There was a significant difference in mean vitamin D levels between the normal and abnormal groups of the caloric test, cervical vestibular evoked myogenic potentials, and ocular vestibular evoked myogenic potentials. The likelihood of abnormal vestibular function was lower in patients with normal vitamin D levels than those with deficient levels (< 10 ng/ml). Vitamin D levels were the only predictive factor for recurrence among patients with benign paroxysmal positional vertigo.

A deficiency in vitamin D is more likely to result in abnormalities in the caloric test, cervical vestibular evoked myogenic potentials, and ocular vestibular evoked myogenic potentials in benign paroxysmal positional vertigo patients. The interaction among these factors may contribute to the recurrence.

To investigate the effect of heated-cigarette smoking on voice.

Participants completed a survey including three sections: section-1 comprised demographic data, section-2 comprised visual analogue scale grading of voice changes and fatigue and section-3 consisted of the voice handicap index-10.

Two hundred and eighty-two participants filled the survey. Heated-cigarette smokers had a significantly higher mean voice handicap index-10 score compared to non-smokers (p < 0.05). The difference in voice handicap index-10 scores between heated- and combustion-cigarette smokers was not statistically significant. The number of abnormal voice handicap index-10 scores was higher in heated-cigarette smokers compared to non-smokers (p < 0.05) and significantly higher in combustion-cigarette and dual heated- and combustion-cigarette smokers compared to the other 2 groups (p < 0.05). Non-smokers had significantly lower grades of voice changes and fatigue when compared to combustion and dual heated- and combustion-cigarette smokers (p < 0.05).

Smokers of heated cigarettes have a significantly higher mean voice handicap index-10 score compared to non-smokers and higher grade of voice changes and fatigue.

This study investigated the risk factors for developing pharyngocutaneous fistula, the most common complication following total laryngectomy.

We included all patients who underwent total laryngectomy and bilateral neck dissection from 2009 to 2021. Patients excluded were those with hypopharyngeal involvement, total or partial pharyngectomy, base of the tongue resection, large pharyngeal defects requiring free/pedicle flap reconstruction, or salvage laryngectomy.

A total of 164 patients participated in the study. Multivariate regression analysis identified two independent predictors of pharyngocutaneous fistula formation: pharyngeal reconstruction with simple interrupted sutures (odds ratio: 3.12, 95 per cent confidence interval: 1.31–17.00, p = 0.010) and radical neck dissection (odds ratio: 3.16, 95 per cent confidence interval: 1.13–8.82, p = 0.028).

Our findings suggest that pharyngeal reconstruction using simple interrupted sutures and radical neck dissection are independent risk factors for pharyngocutaneous fistula development. Based on this, we recommend using the modified Cushing suture technique over simple interrupted sutures due to its association with a significantly lower pharyngocutaneous fistula rate.

To evaluate the clinical efficacy of tobramycin dexamethasone eye ointment combined with a catheter in endoscopic dacryocystorhinostomy.

Eighty chronic dacryocystitis patients were randomly divided into two groups: observation (n = 39) and control (n = 41). Both groups underwent endoscopic dacryocystorhinostomy. The observation group used tobramycin dexamethasone eye ointment and catheter support, while the control group used only the eye ointment.

No statistical differences were found in gender, age, disease course or eye type. However, the anastomotic formation time and bleeding amount were significantly different between the two groups (p < 0.001). After six months of follow up, there were no significant complications differences (p > 0.05). The fluorescein disappearance test time in the observation group was significantly shorter (p < 0.001), and the clinical effective rate was significantly higher (97.4 per cent vs 78 per cent, p < 0.05) in the observation group.

Using tobramycin dexamethasone eye ointment combined with a catheter slightly prolongs the operation time and increases bleeding, but promotes anastomotic healing, accelerates tear drainage, improves the operation success rate and is economically efficient.