Antwerp University Hospital

To address the current lack of standardized protocols for vestibular infant screening (VIS), this clinical consensus aims to establish a clinical consensus on VIS in infants aged 0-12 months. Given a frequent co-occurrence of vestibular dysfunction in children with sensorineural hearing loss (SNHL) and the significant impact of vestibular dysfunction on early development, early identification and management are critical. This clinical consensus was developed by a panel of 28 international experts in pediatric otolaryngology and vestibular disorders through a structured, multi-round Delphi process. Panelists were selected based on clinical and academic expertise, representing 26 institutions across Asia and Europe. A comprehensive literature review (2000-2024) informed the initial draft of consensus statements. The consensus was reached through three iterative rounds of anonymous rating and feedback, followed by virtual discussions. Statements achieving ≥ 80% agreement were retained in the final consensus, which focused on screening tools, target populations, optimal timing, and standardized cVEMP recording protocols for infants. The expert panel reached consensus on key recommendations in four domains: screening tool, target screening population, timing of vestibular function screening, and recording protocol for cervical vestibular evoked myogenic potential (cVEMP). This clinical consensus provides foundational guidance for the implementation of VIS in infants, advocating for standardized protocols to improve early diagnosis and intervention. Widespread adoption of these recommendations may enhance developmental outcomes by enabling timely detection and management of vestibular dysfunction in early childhood.

E-cigarette use has risen sharply among young never-smokers, largely driven by the availability of several thousand appealing flavours. This narrative review synthesises evidence on the health effects of vaping, flavour toxicology and attractiveness, designs and outcomes of flavour bans, and complementary measures. Peer-reviewed publications and institutional reports (up to January 2026) were retrieved from PubMed, Web of Science, Google Scholar, and reference lists of included articles. Evidence from about 200 references was synthesised by a multidisciplinary working group. Although flavouring substances are generally considered safe for ingestion, their inhalation toxicity remains uncertain. In vitro and in vivo studies have reported oxidative stress, inflammation, cytotoxicity, impaired ciliary function, transcriptomic changes, genotoxicity, and DNA damage. These findings-along with the strong youth appeal of fruit/sweet flavours, the inconclusive effects of flavours on smoking cessation, and persisting uncertainties-support banning non-tobacco e-cigarette flavours under the precautionary principle. Flavour bans can reduce e-cigarette use and initiation, especially among young adults, although partial substitution towards combustible cigarettes has been reported in some U.S. states. Policy success requires effective enforcement, prevention of industry circumvention, curbing cross-border sales, and closing regulatory loopholes-ideally at the international level (e.g., EU-wide). E-cigarette flavours may increase vaping toxicity and strongly appeal to youth, justifying flavour bans to prioritise youth protection. To maximise effectiveness, accompanying measures and sustained investment in tobacco prevention, youth education, and accessible evidence-based smoking cessation support are essential.

SummaryTrigeminal nerve injury can lead to chronic and difficult-to-treat orofacial neuropathic pain. Here, we uncover a key role for the cation channel TRPM3 in the chronic constriction injury of the infraorbital nerve (IoN-CCI) mouse model of trigeminal neuropathic pain. Wild-type (WT) mice develop spontaneous pain and mechanical allodynia for up to 6 weeks following IoN-CCI, whereas Trpm3−/− mice do not develop such symptoms. Using longitudinal RNA sequencing (RNA-seq) analysis, we obtain a detailed time course of transcriptome alterations in trigeminal ganglia during progression of the IoN-CCI model; notably, gene expression regulation is not different between WT and Trpm3−/− mice. Two structurally distinct TRPM3 antagonists, primidone and isosakuranetin, effectively reverse spontaneous pain and mechanical allodynia, whereas mavatrep, a potent TRPV1 antagonist, is without analgesic effect. These data indicate that TRPM3 is essential for ongoing pain and allodynia following trigeminal nerve injury, making it a potential target for treating trigeminally mediated neuropathic pain.

Evidence on the effect of intramuscular injections of botulinum neurotoxin (BoNT) treatment on non-motor symptoms (NMS) and quality of life (QoL) in Cervical Dystonia (CD) remains scarce and inconsistent. To determine the effect of intramuscular BoNT injections on NMS and QoL. A prospective cohort study was conducted with adult CD patients attending treatment at Antwerp University Hospital, Belgium (UZA) and a specialized private physiotherapy practice. Depression and anxiety were measured using the Beck Depression inventory (BDI-II) and the Beck Anxiety Inventory (BAI-II), respectively. Sleep quality was measured using Pittsburgh Sleep Quality Index (PSQI). QoL was measured using EuroQol-5 dimensions (EQ-5D). Paired T-test and Wilcoxon signed rank test was used for baseline and post treatment comparison. A total of 29 CD patients were included. The mean age was 61.6 ± 9.25 years. The mean ± standard deviation (SD) score of the global PSQI score decreased from 10.1 ± 4.6 at baseline to 7.41 ± 4.7 post treatment. The mean (SD) BAI-II score decreased slightly from 13.5 ± 9.43 at baseline to 12.52 ± 10.2 post treatment. The median (IQR) of BDI-II score changed from 7 (5-19) to 8 (2.5-20). There was significant improvement of PSQI following BoNT treatment (MD = 2.65, P < 0.001). BoNT injection significantly improved sleep quality. However, no statistical difference was observed in depressive and anxiety symptoms. The persistence of psychiatric symptoms highlights the necessity of complementary therapy. Furthermore, additional controlled studies with larger samples are warranted to characterize the effect of BoNT on NMS.

In the neonatal intensive care unit, premature neonates often are in need of respiratory support, which is provided via several plastic medical devices (PMDs). These devices can be a potential source of plasticizers (phthalates and alternative plasticizers [APs]), which increase the flexibility and durability of PMDs. The aim of this study was to investigate the contribution of respiratory support as a source of plasticizer exposure in neonates by analyzing the concentrations of nine phthalates and 11 APs in nine PMDs commonly used for invasive and noninvasive respiratory support administration using LC-MS/MS and GC-MS. Additionally, a pilot exvivo experiment mimicking mechanical ventilation was set up to assess plasticizer content in breath condensate. First, we showed that tris-(2-ethylhexyl) trimellitate (TOTM), di-(2-ethylhexyl) terephthalate, and di-(2-ethylhexyl) phthalate (DEHP) are present in relevant amounts in PMDs used for respiratory support. Breath condensate collected after circulation through a ventilation circuit with three different endotracheal tubes containing either TOTM, DEHP, or no significant plasticizers all showed substantial concentrations for DEHP and diethyl phthalate. This work provides novel evidence that respiratory medical devices used in neonatal intensive care units can be a significant source of plasticizer exposure, and introduces an exvivo leaching model that simulates invivo ventilation conditions to assess clinical migration behavior of both phthalate and alternative plasticizers.