Background Benign paroxysmal positional vertigo is the most common cause of peripheral vertigo and is predominantly treated by using manual repositioning maneuvers. Although effective, these techniques may be limited by patient tolerance, physical constraints, or difficulties in diagnosis. Aims/Objectives This study aimed to assess the clinical and practical advantages of using a repositioning chair for treating benign paroxysmal positional vertigo, compared with conventional techniques. Material and Methods A systematic review and meta-analysis were performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines across PubMed, Embase, and Web of Science. Study quality was evaluated using the Newcastle-Ottawa Scale and the PEDro scale, and the meta-analysis quantified the chair’s therapeutic efficacy. Results Twelve studies including 1,385 patients were analyzed. Complete resolution rates ranged from 54% to 100%. Meta-analysis of nine studies showed a pooled success rate of 71.5% after one session and 91.4% cumulatively. Disability improved significantly (SMD 1.56). Residual dizziness occurred in 16.1% of patients, and recurrence in 16%. Sensitivity analyses confirmed robust results despite heterogeneity, with overall moderate to high methodological quality. Conclusions and Significance Repositioning chairs appears to be effective tools for the management of benign paroxysmal positional vertigo, particularly in complex or refractory cases.

Background This study analysed the long-term outcomes of single, first-time radiofrequency ablation of the inferior turbinates (RFAIT) on nasal obstruction and patient satisfaction in chronic inferior turbinate hypertrophy (ITH). Aims/objectives The primary aim was to assess RFAIT effectiveness and patient satisfaction; secondary aims included recovery and harms. Material and methods The SNOT-22 and a specific questionnaire were sent to 165 patients who underwent their first RFAIT for nasal obstruction between June 2014 and June 2015 at the Department of Otorhinolaryngology–Head and Neck Surgery, Hyvinkää Hospital, Finland. Eligible patients had identifiable ITH and had used intranasal corticosteroids for at least three months without adequate relief. Patients with nasal polyposis, severe septal deviation, or uncorrected bleeding disorders were excluded. A total of 102 patients responded. The median follow-up was 15.2 months (range 8.0–24.2). Results Nasal obstruction improved in 58% of patients after one RFAIT, and 75% reported a positive impact on daily life. No major postoperative complications occurred. Temporary increased obstruction, crusting, and minor bleeding were the most common complaints. Smoking and allergies had no significant effect on outcomes. Conclusions and significance Single RFAIT appears to be a safe and effective outpatient treatment for chronic ITH with high patient satisfaction.

Background Radical surgery with free-flap reconstruction for advanced head and neck squamous cell carcinoma (HNSCC) carries a high risk of postoperative complications. Aims/Objectives To identify the complication most strongly associated with poor oncologic outcomes. Materials and Methods We retrospectively evaluated 346 patients who underwent free-flap reconstruction between January 2013 and December 2022. Postoperative complications were classified using Clavien–Dindo (CD) grading. Overall survival (OS), recurrence-free survival (RFS), hospital stay, and the surgery-to-postoperative radiotherapy (S-PORT) interval were evaluated. Results Surgical site infection (SSI) was the most common complication (n = 56). Patients with CD grade ≥ IIIa SSI showed significantly worse 5-year OS (hazard ratio [HR], 3.075; 95% confidence interval [CI], 1.605–5.892; p < 0.001) and RFS (HR, 2.095; 95% CI, 1.135–3.866; p = 0.018). Multivariate analysis confirmed CD grade ≥ IIIa SSI as an independent prognostic factor for OS (HR, 3.539; 95% CI, 1.786–7.012; p < 0.001) and RFS (HR, 2.095; 95% CI, 1.155–4.053; p = 0.016). These patients had significantly longer hospital stays, whereas S-PORT intervals showed no difference. Conclusions and Significance CD grade ≥ IIIa SSI independently predicts poor survival after free-flap reconstruction in HNSCC. Preventing and promptly managing SSIs are crucial to improving long-term outcomes.

Background Surgical management of chronic ear diseases, particularly middle ear cholesteatoma and chronic otitis media, often results in significant skin defects in the external auditory canal (EAC) and auricular region. Objectives To evaluate the clinical efficacy and safety of xenogeneic acellular dermal matrix (xeno-ADM) in repairing ear skin defects following surgical resection of middle ear pathologies. Material and methods A prospective cohort study was conducted from March 2024 to April 2025 at a single tertiary care center. One hundred and twelve consecutive patients with ear skin defects underwent reconstruction using xeno-ADM. Primary outcomes included epithelialization time, functional recovery (ear canal patency, hearing improvement), and postoperative complications. Secondary outcomes included surgical difficulty, patient satisfaction, and physician evaluation. Air conduction threshold changes were measured pre- and postoperatively. Pain was assessed using Visual Analog Scale. Results Mean epithelialization time was 36.0 days. All patients achieved complete epithelialization with 100% ear canal patency. Hearing improved significantly with mean air conduction threshold reduction of −13.32 ± 14.67 dB, with 94% of patients showing improvement or stability. Postoperative pain was minimal. Complications were rare: mild exudate in 75.0%, local infection in 0.9%, partial membrane loss in 13.4% (successfully managed with reapplication). No rejection reactions occurred. Patient satisfaction was 100% for both appearance and function. Conclusions and significance Xeno-ADM demonstrates excellent efficacy and safety for ear skin defect repair, offering rapid epithelialization, significant hearing improvement, minimal pain, and high patient satisfaction during the mean follow-up of 6 months. However, the absence of a control group limits the strength of these conclusions, and long-term outcomes remain unknown due to the limited follow-up duration.

Background: No reports have been identified comparing the treatment outcomes of tympanoplasty using autologous tissue and fibrin glue with those of tympanic membrane regeneration therapy based on basic fibroblast growth factor. Aims/Objectives To compare the surgical outcomes in relation to tympanic membrane regeneration therapy and myringoplasty for tympanic membrane perforation. Material and methods The present study comprised a total of 23 ears of tympanic membrane regeneration therapy and 8 ears of myringoplasty, as performed at our hospital between January 2022 and December 2024. Gender, age, anesthetic method, operative time, tympanic membrane perforation closure rate, and postoperative hearing improvement in ears with perforation closure were compared between the two groups. Furthermore, in the regenerative therapy group, postoperative satisfaction was subjectively assessed using the Visual Analog Scale (VAS). Results In comparison with tympanoplasty, tympanic membrane regeneration therapy demonstrated a statistically significant reduction in operative time. However, no other statistically significant differences were observed. The VAS results indicate an average hearing improvement of 62.7, and an average overall satisfaction with the surgery of 77.5. Conclusions and significance Regenerative therapy has the potential to become a new treatment option because it is less invasive than myringoplasty.

Background Deep neck space abscesses (DNSA) are rare but can be life-threatening due to their rapid progression and variable presentation. Effective management requires prompt diagnosis, appropriate antimicrobial therapy, and timely surgical intervention. Objective To explore the clinical and microbiological characteristics of DNSA and their impact on treatment decisions. Methods This retrospective study analyzed 108 patients with DNSA treated at Eye & ENT Hospital, Fudan University from April 2013 to May 2021. Patient demographics, medical history, clinical symptoms, white blood cell count, imaging results, antibiotic use, and microbiological findings were collected. All patients underwent contrast-enhanced CT, and bacterial cultures guided antibiotic therapy. Results Recurrence of DNSA was strongly associated with undiagnosed branchial cleft fistulas, highlighting the need for thorough etiological evaluation. Larger abscesses were more likely to have detectable pathogens. Streptococcus was the most common pathogen; however, there was no significant correlation between abscess size and Streptococcus infection, suggesting that its pathogenic potential is similar to that of other bacteria. Conclusion and Significance This study emphasizes the importance of timely surgical drainage, individualized antimicrobial therapy, and etiological investigation, particularly for branchial cleft fistulas, in managing DNSA.

Background Vestibular dysfunction is prevalent in severe/profound unilateral idiopathic sudden sensorineural hearing loss (ISSNHL) and may influence hearing recovery. This study investigates associations between vestibular function (cVEMP/oVEMP, vHIT, caloric tests) and short-term auditory outcomes. Aims To evaluate whether vestibular test abnormalities predict treatment response in severe/profound ISSNHL and identify independent prognostic factors. Material and Methods Retrospective analysis of 133 patients (mean age 53.58 ± 18.56 years) treated with steroids/hyperbaric oxygen. Vestibular tests (cVEMP, oVEMP, vHIT, caloric) were performed pre-treatment. Outcomes were categorized as effective (complete/marked recovery) or ineffective (mild/no recovery). Results The ineffective group had higher vertigo prevalence (65/93 vs 14/40, p < 0.001) and older age (55.98 ± 17.85 vs 48.00 ± 19.22 years, p = 0.022). Univariate analysis showed abnormal vestibular tests (oVEMP/cVEMP/vHIT/caloric) correlated with outcomes (p < 0.05). Multivariate analysis identified three independent predictors of poor outcome: vertigo (OR 0.367), abnormal caloric test (OR 0.339), and abnormal vHIT (OR 0.316). cVEMP/oVEMP abnormalities were not independently associated (p > 0.05). Conclusions Vertigo, abnormal caloric/vHIT results predict poorer short-term hearing recovery in severe/profound ISSNHL. Vestibular assessment aids prognosis but should not be used alone. Larger studies are needed for validation.

Background and aims Human papillomavirus (HPV) is the main cause of the rapidly increasing incidence of oropharyngeal squamous cell carcinoma (OPC) in high-income countries, particularly in men. Studies have shown a lower awareness of HPV-associated cancers, particularly OPC, in men. This study assessed the information provided by health authorities on HPV-induced OPC in multiple high-income countries. Materials and methods A standardized search for HPV information was conducted on health authority websites. Webpages were categorized as high, moderate-to-low or no awareness according to the extent of patient information that was provided on the link between HPV and OPC. Results Seven health authorities demonstrated high awareness of the link between HPV and the development of OPC, 24 showed moderate-to-low awareness, and three exhibited no awareness. In European Medicines Agency Member countries, only 17.4% of the population had access to the high awareness content through their public health bodies. Conclusion and significance Only seven out of the 39 health authorities analyzed provided high awareness content on the link between HPV and OPC. This demonstrates the general lack of public awareness of this important link, suggesting public health bodies currently fail to prioritize this matter and do not provide relevant information to the public.

Background Bilateral vestibulopathy (BVP) is a rare disorder that markedly reduces quality of life through impaired vestibulo-ocular reflex and related symptoms. Aims/Objectives This study aimed to describe the etiological features of BVP and assess functional outcomes using subjective and objective tools. Material and Methods A retrospective review was conducted in 31 patients with BVP. Demographic data, etiologies, and comorbidities were analyzed. Functional outcomes were evaluated with Dizziness Handicap Inventory (DHI) and video Head Impulse Test (vHIT). Statistical analyses examined correlations between these measures. Results The mean age was 55 ± 16 years. Idiopathic cases comprised 19.4%, while ototoxicity was the most frequent cause (41.9%), mainly aminoglycosides (29%). Advanced age and comorbidities were risk factors for ototoxicity. Mean DHI score was 59 ± 21, with highest scores in ototoxic cases. Mean vHIT gains were 0.37 ± 0.17 (right) and 0.36 ± 0.20 (left), with lowest values in ototoxicity. A significant negative correlation existed between vHIT gains and DHI scores (r=-0.616, p < 0.001). Conclusions and Significance In our retrospective cohort, ototoxic medications appear to be the leading cause of BVP, especially among older patients with comorbidities. The inverse relationship between vHIT and DHI highlights the need to integrate both assessment methods for comprehensive evaluation. These findings emphasize ototoxicity awareness and validate complementary use of objective and subjective assessments.

Background Otosclerosis is a primary osteodystrophy of the otic capsule that causes conductive or mixed hearing loss. High-resolution computed tomography (HRCT) is the preferred imaging tool, but its sensitivity varies and depends on radiologist expertise. Artificial intelligence (AI) may improve diagnostic accuracy by identifying subtle features. Objective To evaluate the diagnostic accuracy of a convolutional neural network (CNN) in detecting otosclerosis on temporal bone CT scans. Methods This retrospective study included CT scans from 53 surgically confirmed otosclerosis patients and 36 healthy controls. After augmentation, the dataset comprised 74 otosclerosis and 74 control images. A CNN with three convolutional layers, dropout, and a fully connected dense layer was developed. Model performance was assessed using accuracy, sensitivity, specificity, precision, F1-score, and area under the receiver operating characteristic curve (AUC). Results The CNN achieved 98% training and 87.5% maximum validation accuracy. In validation, sensitivity was 80.0%, specificity 84.6%, precision 85.7%, F1-score 82.8%, and AUC 0.847. Learning curves showed stable convergence without overfitting. Conclusion and Significance AI-based CT analysis demonstrated promising diagnostic performance in otosclerosis, especially in cases initially reported as normal. Integration of AI into otologic imaging may enhance diagnostic reliability, surgical planning, and patient management.