Wiley: Clinical Otolaryngology: Table of Contents

Tonsillectomy Complications in Adults: A Retrospective Observational Cohort Study of National Health Service Patients in England Using Hospital Episode Statistics

Fri, 05 Jun 2026 17:34:19 -0700

ABSTRACT

Objectives

To characterise adult tonsillectomy procedures conducted in the NHS from routine administrative data in England and investigate trends in their associated complications over time.

Design

Retrospective observational cohort study using routine data from Hospital Episode Statistics (HES).

Setting

Acute NHS trusts in England are conducting adult tonsillectomy.

Participants

Adults (> 16 years old) undergoing tonsillectomy procedure with a primary diagnosis of any non-malignant indication, and with no current or historic cancer, or benign neoplasm.

Main Outcome Measures

Number of procedures, in-hospital complications, readmissions within 28 days and trends over time.

Results

A total of 198 130 adult patients had a tonsillectomy between 1 April 2008 and 31st March 2023 in NHS trusts in England. The total number of procedures is falling over time. It is more commonly undertaken in women (68.3%), with 79.3% performed for tonsillitis. The majority (59.6%) are discharged on the same day, with 37.5% staying 1 night in hospital. 1.5% of patients had an in-hospital complication, with a total of 1967 patients having a haemorrhage or surgical arrest of post-operative bleeding from the tonsillar bed or adenoid; occurring more frequently in men (1.7% versus 0.7%, p < 0.001). A total of 33 934 patients were readmitted as an emergency within 28 days of surgery, almost doubling between 2008/09 and 2022/23. Readmission with bleeding within 28 days has also increased from 8.8% in 2008/09 to 15.6% in 2022/23. The return to theatre rate during readmissions has been relatively stable over the study time period with a higher proportion of admissions being managed without a further operative procedure.

Conclusions

Tonsillectomy is a very common operation in the NHS in England. It currently has a readmission rate of 1 in 5 adults and this information is important for informed consent and local resource planning.

Serum Cotinine Is Associated With Tympanometric Abnormalities Suggestive of Middle‐Ear Pressure Dysregulation in US Adults

Nilipaer Alimu, Tong Wu, Ayiheng Qukuerhan, Jiankang Liu — Fri, 05 Jun 2026 01:45:23 -0700

ABSTRACT

Objective

To examine the association between serum cotinine and tympanometric abnormalities in US adults.

Design

Cross-sectional study.

Setting

National Health and Nutrition Examination Survey.

Participants

Adults aged 20 years or older with available data on serum cotinine and tympanometry.

Main Outcome Measures

The primary outcome was defined as a Type B or Type C tympanogram in either ear. Sensitivity analyses were performed for outcomes defined as a Type C tympanogram in either ear and a Type B tympanogram in either ear.

Results

A total of 13 169 adults were included. In the fully adjusted model, higher serum cotinine was associated with higher odds of the primary tympanometric abnormality outcome. For each log₂ increase in serum cotinine, the odds ratio (OR) was 1.024 (95% confidence interval [CI], 1.011–1.037; p < 0.001). Compared with the lowest quartile, the highest quartile had an OR of 1.295 (95% CI, 1.060–1.582; p = 0.011), with a significant trend across quartiles (p for trend = 0.009). In sensitivity analyses, the association was more evident for Type C tympanometric patterns (OR 1.570, 95% CI 1.259–1.957 for the highest vs. lowest quartile) than for Type B patterns, for which no significant association was observed (OR 0.652, 95% CI 0.406–1.048; p = 0.077).

Conclusions

Higher serum cotinine levels were associated with higher odds of tympanometric abnormalities in US adults. The association was more apparent for Type C than for Type B tympanometric patterns, suggesting that tobacco exposure may be more closely related to negative middle-ear pressure abnormalities than to nonspecific abnormal tympanograms.

Joint Special Issue Clinical Otolaryngology and Headache

James R. Tysome, Amy A. Gelfand — Wed, 03 Jun 2026 02:22:01 -0700

Clinical Otolaryngology, Volume 51, Issue 4, Page 486-487, July 2026.

Paediatric Obstructive Sleep Apnoea—We Have to Work Together!

May M. C. Yaneza — Wed, 03 Jun 2026 02:22:01 -0700

Clinical Otolaryngology, Volume 51, Issue 4, Page 481-485, July 2026.

Issue Information

Wed, 03 Jun 2026 02:22:01 -0700

Clinical Otolaryngology, Volume 51, Issue 4, July 2026.

Correction to ’Non‐Recurrent Laryngeal Nerve: Surgical Risk of Injury in Comparison With the Normal Recurrent Laryngeal Nerve—A Systematic Review and Meta‐Analysis’

Wed, 03 Jun 2026 02:22:01 -0700

Clinical Otolaryngology, Volume 51, Issue 4, Page 610-610, July 2026.

Association Between Nasal Septal Deviation and Estimated Pulmonary Artery Pressures—Scoping Review

Wed, 03 Jun 2026 02:22:01 -0700

ABSTRACT

Objective

Nasal septal deviation (NSD) is a common cause of chronic upper airway obstruction (UAO), and surgical correction via nasal septoplasty results in improvements in airflow. Multiple studies have been conducted to assess possible relationships between chronic UAO (including due to NSD) and cardiorespiratory function (such as pulmonary artery pressures). The objective of this scoping review is to identify and examine the current evidence on the potential relationship between nasal septal deviation, estimated mean pulmonary artery pressure (mPAP), and estimated pulmonary artery systolic pressure (ePASP) in patients who undergo nasal septoplasty.

Data Sources

PubMed, EMBASE, Ovid.

Methods

A scoping review was performed in accordance with the PRISMA Extension for Scoping Reviews guidelines.

Results

Two independent reviewers screened 411 articles; 9 before-after studies met eligibility criteria for review inclusion. There was a total of 458 study participants, of which 395 underwent septoplasty and 63 were matched controls. All studies reported a statistically significant decrease between the pre-operative and post-operative estimated mPAP (p < 0.05) and/or ePASP (p < 0.001) in subjects who underwent nasal septoplasty. Two studies included control participants and reported a statistically significant difference between the pre-operative estimated mPAP of patients with NSD and controls (p < 0.001).

Conclusion

This scoping review highlights the current evidence on the potential relationship between NSD, estimated mPAP, and ePASP in patients who undergo nasal septoplasty for NSD. Further studies of higher statistical and methodological quality are required to assess for cause-and-effect relationships and examine the potential link between chronic UAO and cardiorespiratory function.

An Update on the Management of Otogenic Cerebral Sinus Thrombosis: A Systematic Review

Wed, 03 Jun 2026 02:22:01 -0700

ABSTRACT

Introduction

Otogenic cerebral sinus thrombosis (OCST) represents a rare but serious pathology. The medical and surgical treatment to achieve optimal patient outcomes remains unclear. This review assesses the published evidence of OCST to guide best practice.

Methods

A search of electronic databases Medline, Embase, Emacare, Cochrane and Clinicaltrials.gov was conducted from inception to November 2024. Eligible studies were identified and relevant findings extracted.

Results

Sixty-eight papers, 43 case reports and 25 case series met the inclusion criteria with a total of 149 patients. 88.5% of patients underwent surgery, most commonly cortical mastoidectomy. 54.8% of patients received anticoagulation. Sixty-five percent of patients with reimaging had complete recannalisation of the sinus and 9.4% of patients experienced long term complications.

Conclusions

The combination of antibiotics, anticoagulation and surgery was associated with the most favourable outcome. Mastoidectomy and decompression of the sigmoid were commonly performed and largely safe. However, no additional benefit of incision and drainage of the sigmoid sinus was found and this was associated with a higher complication rate.

NBI Interpretation After Radiotherapy: A Fundamental Limitation in This RCT

Regin William — Wed, 03 Jun 2026 02:22:01 -0700

Clinical Otolaryngology, Volume 51, Issue 4, Page 606-607, July 2026.

Letter to Editor: Analysis of Vestibular Function Assessment Methods for Patients With Peripheral Vertigo Disease: A 5‐Year Retrospective Study

Nasser Junedi, Akarsh Lal, Andrew J. Stefan, Swetha Reddy, Michael A. Carron — Wed, 03 Jun 2026 02:22:01 -0700

Clinical Otolaryngology, Volume 51, Issue 4, Page 608-609, July 2026.

Investigating the Effect of Tumour Necrosis Factor Antagonist on Olfaction

Wed, 03 Jun 2026 02:22:01 -0700

ABSTRACT

Objectives

Tumour Necrosis factor antagonists is a potent anti-inflammatory medication and has shown to improve olfactory function in murine models. The primary aim was to determine the effect of TNF antagonists on olfactory performance in humans. Secondary aim is to generate pilot data on the suitability of TNF for a randomised controlled trial in patients with smell disorders.

Design

This study is a single centre observatory prospective proof of concept cohort study. Adult patients are recruited from a tertiary rheumatology centre, who are to be initiated on TNF antagonists therapy (adalimumab biosimilar) for the first time. Participants were assessed with a simple questionnaire and a baseline olfactory assessment with the extended Sniffin’ Stick Test. Participants were then brought back after 3 months of treatment for a repeat questionnaire and Sniffin’ Sticks Test.

Main Outcome Measures

The primary outcome was to determine the difference between smell test scores in the Sniffin’ Sticks TDI score before and after 3-months of treatment. Secondary outcomes include changes in visual analogue score from baseline to follow-up (questionnaire).

Results

Sixty-three participants were recruited in the study; 21 were lost to follow up and two had stopped taking their medication, hence 40 were included in the analysis. There was no statistically significant improvement in TDI score of all participants at 3 months after treatment (p value = 0.08). However, analysis of participants who had olfactory dysfunction at baseline (n = 20, TDI < 31 or 30.5 if aged 20–30) showed a statistically significant improvement in TDI score after 3 months (p value = 0.012).

Conclusion

TNF antagonists have the potential to improve olfactory function in those with olfactory dysfunction and should be subjected to further study in a selected group of patients with olfactory dysfunction.

The Value of NBI in the Detection of Local Recurrences of Head and Neck Squamous Cell Carcinoma After (Chemo)radiotherapy: A Randomised Controlled Trial

Wed, 03 Jun 2026 02:22:01 -0700

ABSTRACT

Objectives

Detection of local recurrences after (chemo)radiotherapy (C)RT for head and neck squamous cell carcinoma (HNSCC) is challenging due to post-treatment mucosal changes. This study assessed the added diagnostic value of narrow band imaging (NBI) compared to white light imaging (WLI) during rigid endoscopy under general anaesthesia for recurrence detection. A secondary aim was to assess NBI's ability to detect tumour extension surrounding the suspected carcinoma, which remained undetected by WLI.

Design

Prospective randomised controlled trial with 1:1 block randomisation.

Setting

Single tertiary referral centre.

Participants

Ninety-four patients with a suspected local recurrence after (C)RT, randomised to WLI (n = 47) or WLI+NBI (n = 47).

Main Outcome Measures

Sensitivity, specificity, predictive values and survival outcomes, with histopathology as reference standard.

Results

A recurrence was histopathologically confirmed in 36 patients (38%). Surgeons judged lesions as highly suspected of malignancy in 48 patients (51%): 24 (50%) in each group. WLI yielded sensitivity 84.2%, specificity 71.4%, PPV 66.7%, and NPV 87.0%. WLI+NBI showed slightly lower sensitivity (75.0%) and specificity (66.7%), with PPV 62.5% and NPV 78.3%. Identification of Ni type V lesions alone significantly improved specificity, PPV and accuracy. No differences in disease-specific or overall survival were found between groups.

Conclusion

In previously irradiated patients, NBI provides marginal additional diagnostic value over WLI in detecting local recurrence of HNSCC. Isolated use of Ni type V as a malignancy marker improves specificity, PPV and accuracy.

Platelet‐Rich Fibrin Can Improve Septoplasty Results: A Prospective Randomised Controlled Trial

Emre Solguntekin, Sedat Çağlı, Kerem Kökoğlu, Emrah Gülmez — Wed, 03 Jun 2026 02:22:01 -0700

ABSTRACT

Aim

This study aims to assess the impact of platelet-rich fibrin (PRF) on nasal mucociliary clearance (NMC) time and post-operative pain following septoplasty.

Patients and Methods

This trial was conducted involving patients who underwent septoplasty. Participants were randomly assigned to either a control group or a PRF group. The control group underwent standard septoplasty, while in the PRF group, PRF membranes were placed and sutured between the Doyle splint and septal mucosa at the end of the surgery. NMC times were measured in both groups and in both nasal passages preoperatively and post-operatively using the saccharin test. Additionally, pain levels were assessed at the fourth post-operative hour. Changes in NMC times and pain scores were statistically analysed, with both intragroup and intergroup comparisons conducted.

Results

A total of 41 participants were included in the study, with PRF applied to 20 randomly selected individuals. The groups were comparable in terms of age, gender, smoking status, and deviation side and type (p > 0.05). A statistically significant reduction in median NMC duration was observed in the PRF group in the deviated nasal passage. Although a statistically significant increase in median NMC time was noted in the control group in the non-deviated passage (p < 0.05), this increase was limited in the PRF group. Furthermore, post-operative pain scores were significantly lower in the PRF group compared to the control group (p < 0.05).

Conclusion

The application of PRF post-operatively may enhance nasal mucociliary clearance in the deviated nasal passage and alleviate post-operative pain in patients undergoing septoplasty.

Happiness and Smell: Overlooked Factors in Endoscopic Sinus Surgery?

Wed, 03 Jun 2026 02:22:01 -0700

ABSTRACT

Objective

This study investigates the impact of functional endoscopic sinus surgery (FESS) on happiness levels in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and examines the factors influencing postoperative happiness.

Methods

This study included 55 patients (34 males, 21 females; mean age, 41.2 ± 14.7 years) who underwent FESS for CRSwNP. Preoperative and postoperative evaluations included the Sinonasal Outcome Test-22 (SNOT-22), Oxford Happiness Scale (OHS), Visual Analog Scale (VAS) for olfactory function, and saccharin clearance test for mucociliary clearance. Radiological and endoscopic disease severity was assessed preoperatively using the Lund–Mackay (LM) and Mackay–Lund Endoscopic Polyp Scores (MLEPS). A linear regression model was used to identify predictors of postoperative happiness.

Results

Postoperatively, SNOT-22 scores significantly decreased (p = 0.005), while OHS and olfactory VAS scores significantly increased (p < 0.001). Mucociliary clearance times were significantly shorter after surgery (p = 0.025). Regression analysis revealed that both the improvement in olfactory VAS scores (p = 0.006) and lower preoperative MLEPS values (p = 0.01) were independent predictors of increased OHS scores.

Conclusion

FESS not only alleviates symptoms and enhances QoL in CRSwNP patients but also is associated with increased happiness at 1 month postoperatively. Improvement in olfactory function emerged as the strongest determinant of postoperative happiness, while patients with less extensive polyp disease experienced more favorable emotional recovery. Therefore, efforts aimed at optimizing olfactory outcomes, preserving existing olfactory function, and performing surgical intervention before widespread polyp formation may contribute to more favorable psychological outcomes after FESS.

A Modified Delphi UK Consensus to Develop a Surgical Safety Checklist for Transoral Robotic Surgery

Wed, 03 Jun 2026 02:22:01 -0700

ABSTRACT

Objectives

The utilisation of transoral robotic surgery (TORS) has grown in popularity over recent years with wide applications for both benign and malignant disease. It is important to recognise that the introduction of robotic surgery inserts a new variable into an already error-prone healthcare service that has a high preventable adverse event rate. Surgical safety checklists (SSC) have been well established in recent years and demonstrated to improve outcomes and reduce complications. This study aims to introduce a novel SSC designed for use specifically in operating theatres for cases using TORS.

Methods

A modified Delphi process was utilised to define consensus for a proposed TORS specific SSC. An initial iteration was devised using a literature search. Experts with significant TORS experience rated each proposed item for potential inclusion using a Likert scale. The process was repeated until consensus was reached for all items.

Results

Two rounds were completed with seven experts agreeing on various items to be included in the TORS specific SSC.

Conclusions

This novel surgical safety checklist is the first developed specifically for use with TORS. It has been designed using robust Delphi methodology with several TORS experts from high-volume centres across the UK. The aim of the TORS SSC is to be used alongside the WHO SSC and requires ideally long-term and multi-centre adoption in order to validate its implementation.

Paediatric Adenoidectomy: A Retrospective Cohort Study of Clinical Practice and Outcomes in NHS England (2008–2024)

Wed, 03 Jun 2026 02:22:01 -0700

ABSTRACT

Objectives

To examine trends and outcomes for paediatric adenoidectomies in NHS England between 2008 and 2024.

Design

Retrospective observational cohort study using Hospital Episode Statistics.

Setting

NHS trusts in England.

Participants

Children (≤ 16 years) undergoing adenoidectomy.

Main Outcome Measures

Adenoidectomies and concurrent procedures performed. In-hospital complications and readmissions within 28 days. All-cause mortality and revision procedures.

Results

Between 2008 and 2024, 351 540 adenoidectomies were performed; 305 922 alongside ventilation tube insertion and/or tonsillectomy and 45 618 without these concurrent procedures. In-hospital complications occurred in 4422 admissions (1.3%) and 21 398 patients (6.1%) were readmitted within 28 days. Across all cases, the rate of haemorrhage was 3.4%, while in adenoidectomies occurring in the absence of concurrent ventilation tube insertion and/or tonsillectomy, the overall rate of haemorrhage was 0.7%, and 0.16% cases required return to theatre for surgical arrest of haemorrhage from the adenoid. Over the study period, emergency readmission rates rose from 3.8% to 6.7% while the proportion of day-case procedures increased from 46.3% to 81.1%. For adenoidectomies without concurrent ventilation tube insertion and/or tonsillectomy the rate of emergency admission rose from 2.07% to 2.91%, while adenoidectomies occurring concurrently alongside these procedures rose from 4.61% to 7.52%. The estimated overall revision rate was 4.52% (95% CI 4.44%–4.61%).

Conclusions

This study describes key outcomes, providing the basis for accurate preoperative counselling in paediatric adenoidectomy. However, clinical coding does not capture surgical indication or technique, limiting procedure-specific assessment. Improved coding and prospective research are critically needed to examine technique-specific outcomes.

The Septoplasty Healthcare Monitor: An Outcome Assessment Infrastructure to Enhance the Quality and Transparency of Care

Wed, 03 Jun 2026 02:22:01 -0700

ABSTRACT

Objective and Design

The growing demand for transparency about the efficacy of healthcare has accelerated the use of Patient-Reported Outcome Measures (PROMs), but their integration into daily practice is challenging. This observational study describes how the Septoplasty Healthcare Monitor (SHM) addresses these challenges and highlights the benefits of standardised outcome assessments and visualisation for various stakeholders, including physicians and patients.

Main Outcome Measures

Since 2014, all eligible septoplasty patients have been included in the SHM. Patients are automatically offered the Nasal Obstruction Symptom Evaluation (NOSE) scale and bilateral Visual Analogue Scales (VAS) to assess nasal obstruction before initial consultation and during postoperative visits. Data are entered into a preformatted database and automatically analysed. Real-time results are visually presented on a user-friendly dashboard.

Results

A total of 173 patients participated. First, the dashboard provides insights into outcomes on a cohort level. The mean NOSE scores significantly decreased from 68.8 ± 19.0 at baseline to 19.8 ± 22.3 at 12 months (Cohen's d = −1.96). VAS scores improved from 4.6 ± 3.0 (left) and 4.7 ± 2.9 (right) preoperatively to 7.5 ± 2.1 (left) and 7.6 ± 1.7 (right) at 12 months (p < 0.001; d = 0.85; d = 1.05). Second, quality of care is monitored through annual performance metrics and can be improved by critically appraising auto-identified underperforming patients. Third, visualisation of individual PROM symptom-severity scores in relation to peers assists in patient-counselling and shared decision-making.

Conclusion

The integration of standardised outcome assessments into daily practice is highly valuable but challenging. The SHM addresses these challenges and offers opportunities to enhance septoplasty care standards.

Symptom Clusters and Symptom Networks Analysis During Illness in Peripheral Facial Paralysis Patients: A Cross‐Sectional Study

Luyi Huang, Xinrui Huang, Yan Xu, Min Xu — Wed, 03 Jun 2026 02:22:01 -0700

ABSTRACT

Objective

Identify the types of symptom clusters in patients with peripheral facial paralysis during the disease, construct symptom networks, explore core symptoms, and analyze the factors affecting the symptom scores of patients.

Study Design

A cross-sectional study.

Methods

From December 2024 to May 2025, 283 patients with PFP in Zhejiang Province were assessed using the Memorial Symptom Assessment Scale (MSAS). Symptom clusters were extracted via exploratory factor analysis, and multiple linear regression was employed to examine factors associated with symptom burden. A symptom network was constructed using R software to identify core symptoms based on centrality indices. Network stability and accuracy were evaluated using nonparametric bootstrapping.

Results

Five symptom clusters were identified: psychological, neurological, fatigue-related, gastrointestinal, and PFP-specific. Factors associated with higher symptom scores included age ≥ 70 years, House–Brackmann grade VI, autumn onset, no corticosteroid therapy, and initiation of acupuncture 7–14 days after onset. Centrality analysis revealed that difficulty concentrating (s = 1.041), feeling sad (s = 1.006), and worrying (s = 0.980) were core symptoms within the network.

Conclusion

Patients with PFP experience a significant symptom burden. Network analysis elucidates the complex interrelationships amongst symptoms and identifies difficulty concentrating, feeling sad, and worrying as central to the symptom experience. These findings provide a scientific basis for targeted symptom assessment and the development of personalised interventions aimed at core symptoms to improve patient quality of life.

Oncological Outcomes for Primary Head and Neck Squamous Cell Carcinoma in the United Kingdom: Results From a National Cross‐Sectional Cohort Study

Wed, 03 Jun 2026 02:22:01 -0700

ABSTRACT

Objectives

To investigate overall survival outcomes from primary head and neck squamous cell carcinoma (HNSCC) in the UK.

Design

A retrospective national observational cohort study with consecutive participants.

Setting

UK-wide head and neck cancer centres.

Participants

All patients with HNSCC who received a definitive treatment decision between 01/09/2021 and 30/11/2021. Subgroup analysis of patients was stratified by head and neck subsites.

Main Outcome Measures

Two-year overall (OS), disease-free (DFS), disease-specific (DSS), and local-recurrence-free-survival (LRFS) from primary HNSCC.

Results

Data from 1488 patients was submitted by 50 centres, of which 1286 were primary HNSCC. Median age was 65.5 years (IQR 57–74), and 911 (71.0%) were male. The most common subsites were oropharynx (37.6%), oral cavity (28.3%), larynx (22.0%), and hypopharynx (6.8%). Treatment intent was curative in 79.9% of cases. Of treatment modalities, 529 (41.3%) underwent surgery, 874 (68.4%) underwent radiotherapy, and 391 (30.7%) underwent chemotherapy. Two-year OS, DFS, DSS and LRFS were 79.7%, 72.2%, 84.8%, and 75.1%, respectively. Two-year OS was 83.5%, 55.4%, 73.9% and 84.6% for laryngeal, hypopharyngeal, oral cavity and oropharyngeal subsites, respectively. On multivariate analysis, clinical T staging, age, ECOG performance status, and p16 status were independent prognostic factors for survival.

Conclusion

UK survival variations according to disease subsite reflect larger studies. Broader data over larger periods will reveal whether long-term improvements in the diagnosis, biological understanding, and treatments of HNSCC have translated into improvements in UK survival outcomes.

Smell and Taste Disorder Impact on Eating Habits: A Cross‐Sectional Observational Study

L. Camp, D. Boak, N. J. Garner, C. Philpott — Wed, 03 Jun 2026 02:22:01 -0700

ABSTRACT

Background

Smell and Taste disorders (SATDs) are underreported. There is a wide range of aetiology but recently we have seen growing prevalence related to Covid-19 infection. SATDs have broad implications for people's lives, including a significant impact on nutritional intake and eating behaviours, which we further explore here.

Methods

This was a cross-sectional observational study using an online questionnaire to gather data. Questions covered aetiology of SATDs, impact on BMI, social eating habits and enjoyment of food.

Results

A total of 794 participants responded of which 75% were female and the most common age selected was 56–70 years (46%). Since the onset of their SATDs, 46% reported no change in weight, 24% weight gain, 15% weight loss, 52% felt it impacted how healthily they ate, 59% dined out less or not at all anymore, 59% no longer enjoy preparing food at home, 58% do not enjoy eating out and 54% do not enjoy eating at the homes of friends/family/partners.

Conclusion

We have built on existing literature highlighting the impact SATDs have on participant eating behaviour. Although there is clearly an impact on diet and social behaviours around food/eating it is hard to know the full health and economic impact. Especially when we consider that poor nutritional intake has been linked to cognitive decline in an older age group, it is an important area for further research and it may be beneficial for healthcare providers to offer tailored nutritional advice and discuss possible coping mechanisms upon diagnosis of SATDs.

Longitudinal Analysis of Sleep‐Disordered Breathing and Cognitive Outcomes in Children Living With Sickle Cell Anaemia

Wed, 03 Jun 2026 02:22:01 -0700

ABSTRACT

Objectives

Sleep-disordered breathing (SDB) and cognitive challenges are commonly observed in children living with sickle cell anaemia (SCA). This study investigated the longitudinal change in polysomnographic outcomes and the association with cognitive functions in children living with SCA.

Method

Data from the Sleep Asthma Cohort (SAC 1, 2 and 3) included participants living with SCA (aged 4–18 years) who were initially recruited between 2006 and 2009, with follow-up studies conducted through until 2019. Polysomnographic indices (PSG indices), that is, obstructive apnoea hypopnoea index (OAHI), central apnoea index (CAI), mean overnight oxygen saturation and total sleep time, were assessed over two visits. Additional analyses assessed the impact of PSG indices on cognitive outcomes collected at Visit 3.

Results

Ninety-two participants (91 HbSS, 1HbSβ) completed a PSG at Visit 1 and 56 participants returned for Visit 2, 40 of whom returned for the Visit 3 cognitive assessment; mean ages were 9.9 (3.8), 14.7 (3.69) and 17.7 (4.64) years, respectively. Total sleep time significantly decreased between the two visits, while overall PSG indices remained stable. Mean overnight oxygen saturation at Visit 1 significantly predicted working memory at Visit 3. In addition, CAI at Visit 2 was associated with lower scores on the verbal comprehension index and self or caregiver-reported measures of executive function.

Conclusions

PSG indices did not change significantly over time; however, at least one PSG screening is recommended, given the complexity of sickle pathology. Overnight oxygen saturation levels and central apnoea influence cognitive outcomes for children living with SCA.

In‐Office Circumferential Sweeping KTP Photocoagulation for Oedematous Sessile Vocal Polyps: A Retrospective Cohort Study

Ji‐Hoon Kim — Wed, 03 Jun 2026 02:22:01 -0700

Clinical Otolaryngology, Volume 51, Issue 4, Page 600-605, July 2026.

Airway Intervention in Paediatric Angioedema: A National Analysis of Clinical Predictors and Outcomes

Saharsh Talwar, Aryan Mahajan, Gaurav N. Pathak, Babar K. Rao, Rachel Kaye — Sun, 31 May 2026 19:04:31 -0700

ABSTRACT

Objective

To characterize paediatric hospitalizations for angioedema and identify the prevalence and outcomes of airway interventions using a large national database.

Methods

We performed a cross-sectional analysis of the Kids' Inpatient Database (2003–2019), including paediatric patients (0–20 years) hospitalized with angioedema identified by ICD-9/10 codes. Outcomes included hospital length of stay (LOS), total charges, and in-hospital mortality. Multivariable logistic regression evaluated predictors of airway intervention, and comparative analyses assessed outcome differences between patients with and without airway procedures.

Results

Among 4238 paediatric angioedema hospitalizations, 174 (4.1%) underwent airway procedures. Compared to non-intervention cases, these patients had significantly longer LOS (median 6 vs. 2 days, p < 0.001), higher charges ($59 571 vs. $7628, p < 0.001), and higher mortality (5.8% vs. 0.15%, p < 0.001). Black (adjusted odds ratio [AOR] 5.23, 95% CI 1.56–19.30) and Hispanic race (AOR 7.83, 95% CI 1.51–44.89) were associated with higher odds of intervention, while hospitalizations in the Northeast (AOR 0.10, 95% CI 0.015–0.55) and South (AOR 0.13, 95% CI 0.03–0.49) had lower odds compared to the Midwest.

Conclusion

Airway interventions in paediatric angioedema are rare but linked to significantly higher morbidity, mortality, and healthcare costs. Geographic and racial disparities highlight the need to explore systemic factors shaping airway management decisions.

Efficacy of Platelet‐Rich Plasma in Post‐Tonsillectomy Wound Healing and Pain Management: A Randomized Controlled Study

Nilnetre Mahathanaruk, Chattarin Jongkittipong, Vipa Rath Marpukdee — Fri, 29 May 2026 20:19:57 -0700

ABSTRACT

Background

Tonsillectomy is one of the most common surgical procedures in otolaryngology, but the healing process remains unknown in individual patients. Several interventions, including platelet-rich plasma, have been investigated to improve healing and pain control due to their regenerative properties.

Objective

To assess the effect of platelet-rich plasma injection during tonsillectomy on postoperative results especially on epithelization stage and postoperative pain.

Method

A prospective randomized controlled trial was conducted between January 2023 and December 2024, including 19 patients with platelet-rich plasma randomly injected in one of the fossae [treatment group] and normal saline in the other fossa [control group]. The endpoints were the epithelialization stage and pain score on days 1–7 after tonsillectomy.

Results

There were no statistically significant differences between groups in the postoperative epithelization stage. At the treatment sites, grade III wound epithelization was 21.1%, compared with the control site, where none had grade III wound epithelization. The p-values for wound epithelization (0.903) and pain score (0.222) indicate no difference between groups. Both groups' pain scores improved over time (p < 0.001).

Conclusions

Intraoperative injection of platelet-rich plasma into the tonsillar beds was effective in stimulating tonsillar wound healing. Because of its properties, the treatment group appeared to have faster wound recovery than the control group. However, the differences were not statistically significant. Further studies with larger sample sizes are warranted to elucidate the potential benefits of platelet-rich plasma in post-tonsillectomy healing.

Prognostic Analysis of Patients With N1 Nasopharyngeal Carcinoma With Different Lymph Node Characteristics

Thu, 28 May 2026 23:10:00 -0700

ABSTRACT

Background

Prognosis in patients with N1 nasopharyngeal carcinoma (NPC) remains heterogeneous, partly due to variations in lymph node involvement. This study evaluated the prognostic significance of different lymph node characteristics in N1 NPC.

Methods

We retrospectively analysed 160 newly diagnosed non-metastatic N1 NPC patients treated at Liuzhou Worker's Hospital from January 2017 to May 2023. Kaplan–Meier curves were used to estimate survival outcomes, and Cox regression analysis was performed to identify independent prognostic factors.

Results

Among the 160 patients, 57 had retropharyngeal lymph nodes (RLNs) only, 24 had cervical lymph nodes (CLNs) only, and 79 had concurrent CLNs and RLNs involvement. The 5-year overall survival (OS), progression-free survival (PFS), locoregional relapse-free survival (LRRFS), and distant metastasis-free survival (DMFS) rates were 94.7%, 80.1%, 89.6%, and 88.8%, respectively. Patients with concurrent CLNs and RLNs involvement had worse OS than those with single-region involvement (5-year OS: 90.2% vs. 98.4%, p = 0.0238). Subgroup analysis showed that in T1-2 patients, combined nodal involvement was associated with inferior OS, PFS, and LRRFS, whereas no significant survival differences were observed in T3-4 patients. Multivariate analysis identified lymph node necrosis (LNN) as an independent adverse prognostic factor for LRRFS (HR = 4.056; 95% CI: 1.262–13.035; p = 0.019).

Conclusion

Lymph node characteristics further refine prognostic stratification in N1 NPC. Concurrent CLNs and RLNs involvement was associated with poorer survival, particularly in early T-stage disease, while LNN was associated with an increased risk of locoregional recurrence.

Evaluation of the NHS R67 Monogenic Hearing Loss Panel in a Single UK Centre

Wed, 27 May 2026 02:37:19 -0700

ABSTRACT

Introduction

The NHS R67 genetic hearing loss panel was introduced in England in 2021 and has expanded the diagnostic approach to hearing loss. This study aimed to evaluate the diagnostic yield and clinical utility of the panel in paediatric and adult patients assessed through a tertiary multidisciplinary genetic hearing loss clinic.

Methods

A retrospective case review was conducted of patients referred to a tertiary genetic hearing loss multidisciplinary clinic who underwent R67 monogenic hearing loss analysis. Demographic data, referral patterns, family history, hearing loss severity, age at diagnosis, congenital cytomegalovirus testing, radiological findings, genetic results and hearing habilitation or rehabilitation strategies were analysed descriptively. Diagnostic yield was compared across hearing loss severity categories.

Results

Eighty-four patients were included, comprising 46 children and 38 adults. A monogenic diagnosis was identified in 48.8% of patients overall, with a higher yield in children than adults: 63.0% versus 31.6%, respectively. Variants of uncertain significance were identified in 7.1% of patients. Hearing loss severity was significantly associated with identification of a genetic cause, although 35% of patients with an identified genetic cause had mild or moderate hearing loss.

Conclusion

The R67 monogenic hearing loss panel is a valuable diagnostic tool for investigating sensorineural hearing loss in children and adults, particularly when delivered through multidisciplinary clinics that support counselling and clinical decision-making. Further reporting is needed to refine referral criteria and support patient selection for targeted therapies.

Efficacy of Multiple Interventions for Moderate to Large Traumatic Tympanic Membrane Perforations: A Systematic Review and Network Meta‐Analysis

Yueyue Cai, Rui Lai, Tingting Zhu, Qiang Li — Mon, 25 May 2026 01:48:26 -0700

ABSTRACT

Objective

This study aimed to evaluate the comparative efficacy of various therapeutic interventions for moderate to large traumatic tympanic membrane perforations (TTMP) through a network meta-analysis. Different treatment strategies were compared with respect to tympanic membrane healing rate, healing time, hearing improvement and incidence of otorrhea, providing evidence-based support for clinical decision-making.

Methods

A systematic search of multiple databases, including PubMed, Web of Science and Embase, was conducted to identify randomised controlled trials (RCTs) involving patients with moderate to large TTMP. A Bayesian hierarchical model was utilised to perform the network meta-analysis, assessing the relative effects of different interventions. Effect sizes, including relative risk (RR) and mean difference (MD), were computed for each intervention, with all analyses reported alongside 95% confidence intervals (CIs).

Results

A total of 13 studies involving 1285 patients were included in the analysis. The findings suggested that fibroblast growth factor-2 (FGF-2) demonstrated the highest efficacy in enhancing tympanic membrane healing rates and reducing healing times, particularly when combined with gelfoam patching. Additionally, ofloxacin otic solution appeared to have positive effects on healing rates. Conversely, edge approximation ranked lowest among all interventions, suggesting limited effectiveness in treating moderate to large perforations.

Conclusion

This network meta-analysis provides hypothesis-generating evidence that active intervention may be superior to watchful waiting for moderate to large TTMPs. FGF-2-based strategies, particularly when combined with physical scaffolds, show promise in improving healing outcomes. Additionally, ofloxacin otic solution may offer benefits in controlling local infections and optimising the middle ear microenvironment. In contrast, edge approximation appears less effective in this population. However, given the geographic homogeneity, limited number of studies and methodological constraints, these findings should be considered exploratory and require confirmation in large-scale, multicentre RCTs with standardised protocols and robust blinding procedures.

Determinants of Postoperative Outcomes and Cost in Short‐Stay Total Thyroidectomy Hospitalisations: A Retrospective Database Study

Elisa Bass, Justin Hintze, Brent Chang — Sun, 24 May 2026 19:19:36 -0700

ABSTRACT

Background

Predictors of complications and length of stay (LOS) in patients requiring brief inpatient stays after total thyroidectomy remain poorly understood. We identify preoperative risk factors for complications, differentiate predictors of overnight versus two-day stays and estimate associated hospital costs.

Methods

The National Inpatient Sample for 2016–2021 was used to analyse adult patients undergoing total thyroidectomy with LOS = 1 or 2 days. Multivariate regressions identified predictors of complications and LOS. Costs were transformed logarithmically.

Results

Of 26 560 patients, 70% had an overnight stay. Two-day stays were associated with higher complication rates, comorbidity index, neck dissection and increased cost. Hispanic and Asian or Pacific Islander race, comorbidity and surgery in a rural hospital increased the risk of any thyroidectomy-specific complication. Two-day stays had a 29% higher cost than overnight stays.

Conclusions

Preoperative characteristics can help predict complications and LOS following total thyroidectomy. Risk stratification supports cost-effective, patient-centred care planning.

Compliance and Effectiveness of the Scottish Referral Guidelines for Suspected Head and Neck Cancer: A Comparative Audit of 7088 Referrals

Oliver G. Denton, Ryan Morrison, Baryab Zahra, Ivy Drake, Jenny Montgomery — Fri, 22 May 2026 05:54:07 -0700

ABSTRACT

Introduction

In Scotland, patients with suspected head and neck cancer are referred based on the Scottish Referral Guidelines for Suspected Cancer (SRGSC). These were most recently updated in 2014 and 2019. A study using 2015–2016 data reported a compliance rate with the 2014 guidance of 55.1% and an all-cancer detection rate of 11.6% (8.6% primary head and neck cancer). This audit assessed referral compliance with the 2019 SRGSC and investigated what effect this update had on rates of head and neck cancer detection.

Methods

All ‘urgent suspicion of cancer’ referrals to the ENT department in the National Health Service Greater Glasgow and Clyde (NHS GGC) for 2021–2022 were audited and compared to corresponding data from 2015 to 2016.

Results

The number of referrals increased by 110% between 2015–2016 and 2021–2022. SRGSC compliance in referral letters was 72.5%, but only 48.9% when those patients were assessed in the ENT clinic. The all-cancer detection rate was 8.6% (6.2% primary head and neck cancer). The most common reasons for referral were neck lump (28%), persistent hoarseness (15%), and persistent throat pain (11%). The most common primary head and neck cancer sites were oropharynx (18%), larynx (17%), and thyroid (11%). There were significant differences between the 2015–2016 and 2021–2022 cohorts in age at referral, sex, and risk factors.

Conclusion

Compared to corresponding data from 2015 to 2016, there is increased workload in ‘urgent suspicion of cancer’ clinic for fewer cancer diagnoses. When compliant, the SRGSHNC criteria are a valuable predictive tool for cancer diagnosis.

Inflammatory Myofibroblastic Tumour of Head and Neck: A Systematic Review Plus Meta‐Analysis

Thu, 21 May 2026 22:15:49 -0700

ABSTRACT

Objectives

This systematic review with meta-analysis is aimed to examine clinical presentations, pathologic and imaging findings, treatment approaches, and prognosis of inflammatory myofibroblastic tumour.

Methods

PubMed, Medline, Scopus, Cochrane Central Register of Control Trials, Web of Science, Google Scholar, and Embase were systematically searched up to February 2026. The search strategy was structured by a combination of relevant keywords and medical subheadings. This review adhered to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and Population, Intervention, Comparison, and Outcome (PICO) statement.

Results

A total of 22 studies, including 337 patients, met the inclusion criteria. Most of the tumours originated from the sinonasal space (40.1%, proportion = 163), and the maxilla bone and hypopharynx had the least frequency (0.3%, proportion = 1). The most prevalent manifestations were proptosis and facial pain/swelling. Regarding immunohistochemical findings, tumours were mostly positive for vimentin and SMA, while they were commonly negative for desmin, S-100, anaplastic lymphoma kinase, and CD34. Many patients were treated with surgical resection alone without any recurrence occurring. Recurrence occurred in 21.6% (proportion = 67). Metastases occurred in 8.8% (proportion = 8).

Conclusions

The diagnosis of head and neck inflammatory myofibroblastic tumour appears related to the presence of vimentin, SMA, desmin, anaplastic lymphoma kinase, CD34, and S-100 on immunohistochemistry. The enhancement pattern on computed tomography cannot help diagnosis, but absence of calcification may distinguish tumour from other differential diagnoses. Surgical resection with a free margin is the most common treatment approach. Metastasis and malignant transformation rarely occur in this tumour of the head and neck region.

Quality of Life Outcomes in Salvage Laryngectomy Reconstruction

Thu, 14 May 2026 21:51:11 -0700

ABSTRACT

Objectives

To evaluate functional oral intake and patient-reported dysphagia, neck disability, and symptom-specific health-related quality of life (HRQOL) amongst patients who underwent pectoralis major myocutaneous flap (PMMF) versus microvascular free flap reconstruction after salvage laryngectomy.

Design

Retrospective analysis of prospectively collected data.

Setting

Multidisciplinary head and neck cancer (HNC) Survivorship clinic.

Participants

Patients with at least 6 months of postoperative follow-up from salvage total laryngectomy/total laryngectomy with partial pharyngectomy and subsequent PMMF or free flap reconstruction were included. Patients who underwent total laryngo-pharyngectomy, with recurrence, with metastatic disease, and/or with missing data were excluded.

Main Outcome Measures

Functional Oral Intake Scale (FOIS) and validated patient-reported outcome measures, including Eating Assessment Tool-10 (EAT-10), Neck Disability Index (NDI), and measures of pain-, swallowing-, and shoulder-specific University of Washington Quality of Life (UW-QOL) subscale scores.

Results

Twenty-four patients underwent PMMF, and 30 patients underwent microvascular free flaps. Mean EAT-10, NDI, and pain-, swallowing-, and shoulder-specific UW-QOL subscale scores were not significantly different between these two groups. Mean FOIS was slightly higher in patients reconstructed with PMMF (5.67 ± 1.52 vs. 4.57 ± 2.12), p = 0.047, but the clinical relevance of this finding is unclear.

Conclusion

Patient-reported outcomes pertaining to dysphagia, neck disability, and pain-, swallowing- and shoulder-specific HRQOL did not vary significantly between patients reconstructed with PMMF versus microvascular free flap. Future studies with larger cohorts are required to further establish differences in functional outcomes between reconstructive approaches following salvage laryngectomy.

Treatment Outcomes of Total Versus Superficial Parotidectomy With Postoperative Radiotherapy for High‐Grade Parotid Carcinoma Confined to the Superficial Lobe: A Propensity Score–Adjusted Analysis

Mon, 11 May 2026 23:02:02 -0700

ABSTRACT

Background

The optimal surgical management of high-grade parotid carcinoma confined to the superficial lobe remains controversial, with limited evidence comparing total and superficial parotidectomy in this setting.

Objective

To compare oncologic outcomes and complications between total parotidectomy with postoperative radiotherapy (TP + PORT) and superficial parotidectomy with postoperative radiotherapy (SP + PORT).

Study Design

Multicentre retrospective cohort study.

Methods

Adult patients (> 18 years) with high-grade parotid carcinoma confined to the superficial lobe treated between 2011 and 2023 were identified at tertiary centres. Exclusion criteria included preoperative facial nerve palsy, metastatic disease to the parotid gland, prior head and neck radiotherapy, receipt of concurrent chemoradiation and follow-up < 12 months.

Results

A total of 108 patients were included (TP + PORT, n = 63; SP + PORT, n = 45) with a median follow-up of 53 months. Baseline characteristics were comparable except for older age and a higher proportion of Milan category VI cytology in the TP + PORT group (p < 0.05). Local, regional and distant recurrence rates and mortality did not differ significantly between groups (p = 0.55, 0.26, 1.00 and 0.36, respectively). All local recurrences occurred within 24 months (mean: 7.2 months). Age and positive resection margins were independent predictors of mortality (p < 0.01). Five-year overall survival was 73.0% in the TP + PORT group and 81.5% in the SP + PORT group. IPTW-adjusted analyses confirmed no significant differences in recurrence or mortality between groups (hazard ratio for mortality, 0.78; 95% CI: 0.32–1.90; p = 0.59). Permanent facial nerve palsy was significantly more common after TP + PORT (14.3% vs. 2.2%, p < 0.001), while other complications were similar.

Conclusion

Superficial parotidectomy with adequate margins followed by PORT achieves comparable oncologic outcomes with significantly fewer complications and may be preferred for high-grade parotid carcinoma confined to the superficial lobe.

Level of Evidence

2d (JBI).

How Does the Morbidity of Sore Throat in Recurrent Tonsillitis Correlate With the Tonsillitis Outcome Inventory‐14 (TOI‐14)?

Mon, 11 May 2026 04:23:53 -0700

ABSTRACT

Introduction

The National Trial of Tonsillectomy in Adults (NATTINA) demonstrated that tonsillectomy is clinically and cost-effective; however, the generalizability of the results to a real-world population remains uncertain. The number of episodes of tonsillitis is used to assess candidacy for tonsillectomy. An alternative approach could be to utilise a patient-reported outcome measure such as the Tonsillectomy Outcome Inventory-14 (TOI-14).

Aim

To compare the TOI-14 scores in a real-world clinical cohort with the NATTINA cohort. To assess the relationship between the TOI-14 and the number of sore throat days. To assess the role of socioeconomic status in recurrent tonsillitis.

Methods

Baseline TOI-14 scores, the relationship between the number of sore throat days and TOI-14 scores, and socioeconomic deprivation were compared between a real-world clinical cohort and the NATTINA population.

Results

Individuals declining entry into NATTINA (n = 609) had the highest TOI-14 score (48.3 (SD 9.9)), followed by the clinical cohort (n = 422) (43.9 (SD 13.3)) and then the randomised NATTINA population (n = 452) (43.1 (SD 12.0), p < 0.001). The correlation between the number of sore throat days and baseline TOI-14 score in all participants was very weak, 0.114, p = 0.001. Approximately 50% of participants with recurrent tonsilitis reside in areas ranked from deciles 1 to 3 on the Scottish/English Index of Multiple Deprivation.

Conclusion

The findings from NATTINA can be applied to general clinical practice. The use of a patient-reported outcome measurement instead of sore throat episodes as a criterion for tonsillectomy candidacy requires further research and should consider the impact of socioeconomic status on tonsillitis.

The Norfolk Smell and Taste Clinic Experience—A Decade of Olfactory and Gustatory Dysfunction

Jeremy J. Wong, Adam Lloyd, Ishan Singh, Louis Luke, Carl Philpott — Wed, 29 Apr 2026 00:44:47 -0700

Clinical Otolaryngology, EarlyView.

Dynamic Inspiratory Oropharyngeal Obstruction in Children With Obstructive Sleep‐Disordered Breathing: A Cross‐Sectional Study

Fri, 24 Apr 2026 22:25:16 -0700

Clinical Otolaryngology, EarlyView.

Treatment‐Related Adverse Event Claims in Otorhinolaryngology—Head and Neck Surgery: A Nationwide Finnish Review (2012–2023)

Tue, 21 Apr 2026 01:22:58 -0700

ABSTRACT

Background

This study investigated the frequency and characteristics of patient injuries related to Otorhinolaryngology—head and neck surgery (ORL-HNS) in Finland from 2012 to 2023, with a focus on common complications, trends in injury frequency and comparisons with previous studies.

Methods

Data were obtained from the Patient Insurance Centre (PIC) of Finland, encompassing all ORL-HNS-related patient injury cases from 2012 to 2023. The study reviewed 1153 claims, of which 317 (27.5%) were compensated. The analysed variables included patient demographics, procedure types, complications and healthcare settings. Descriptive statistics were used to summarise the data.

Results

Most compensated injuries (66.6%) were due to surgical or procedural complications, followed by inadequate management (24.3%). Most cases occurred at university hospitals (40.1%) or regional hospitals (38.8%) and were handled by specialists (69.7%). Endoscopic sinus surgery and septoplasty had compensation ratios of 0.7 and 0.72 per 1000 procedures, respectively. The likelihood of compensation decreased with patient age but was not correlated with hospital type. Among subspecialties, rhinology (31%) and head and neck surgery (30%) had the highest frequency of compensated claims.

Conclusions

This study corroborates previous findings that ORL-HNS patient injuries are relatively rare, with many occurring during routine surgeries performed by specialists. These results challenge the assumption that surgical errors stem primarily from inexperience. The greater number of reported complications in university hospitals may reflect the trend towards centralising complex procedures.

Level of Evidence

Short‐Term Complications Are Rare After Cholesteatoma Surgery

Agnes Modée Borgström, Cecilia Engmér Berglin, Johan Knutsson, Åsa Bonnard — Tue, 21 Apr 2026 00:39:53 -0700

ABSTRACT

Objective

To evaluate the incidence and nature of short-term complications following cholesteatoma surgery in a heterogeneous cohort.

Design

A retrospective cohort study including complete coverage of cholesteatoma surgery in a Swedish region between 1 January 2005 and 31 December 2015. A total of 966 patients were followed for 6 weeks postoperatively. Severe complications were defined as facial palsy, thromboembolic events, cerebrospinal fluid (CSF) leakage, serious postoperative infection, or death within 6 weeks of surgery.

Results

Severe complications were uncommon, occurring in 14 patients (1.4%). Thromboembolic events were observed in five patients (0.5%), two of which (0.2%) resulted in postoperative mortality—one following cardiac arrest in the postoperative care unit and one due to a thromboembolic event approximately 3 weeks after surgery. Serious infections occurred in five patients (0.5%): three retroauricular abscesses, one case of meningitis, and one infected preauricular fistula with abscess formation. Additional severe complications included three cases of facial palsy and one case of CSF leakage.

Conclusion

Cholesteatoma surgery demonstrates a low rate of severe short-term complications, underscoring its overall safety with risks mainly attributable to general surgical or medical causes rather than cholesteatoma-specific factors. The present cholesteatoma-specific data constitute a solid basis for preoperative counselling and benchmarking within otology.