To report a case of cutaneous tumour seeding following core biopsy of a thyroid malignancy.

This paper presents a case report of cutaneous tumour seeding following core biopsy and a review of the literature concerning the role, and risks, of fine needle aspiration and core biopsy in the diagnostic evaluation of neck lumps.

A 75-year-old woman presented with a left-sided level IV neck lump adjacent to the left lobe of the thyroid. Fine needle aspiration revealed that the neck lump contained follicular epithelial cell groups; however, nuclear grooves and pseudo-inclusions could not exclude a diagnosis of papillary thyroid carcinoma. Subsequent core biopsy confirmed features of a thyroid neoplasm, although abundant necrosis and limited lesional cells within the specimen made histological diagnosis difficult. The patient underwent total thyroidectomy and left-sided selective neck dissection for symptom control. A superficial nodule overlying the core biopsy site was noted at operation and excised; it was found to contain cells of poorly differentiated papillary carcinoma identical to the subsequently confirmed thyroid primary.

This case highlights a rare but important risk associated with sampling neck lumps. Nevertheless, ultrasound-guided sampling is an essential investigative step with great diagnostic accuracy and patient acceptability.

This article aimed to summarize the clinical characteristics and our experience with the diagnosis and management of laryngocele. We offer our perspectives for cases associated with laryngeal cancer.

A retrospective study of 14 patients with laryngocele was accomplished from June 2014 to June 2024. Clinical data were analyzed through descriptive statistical methods.

A total of 14 laryngocele patients were divided into internal type (n = 11; 78.6 per cent) and combined type (n = 3; 21.4 per cent). Nine laryngocele patients (n = 9; 64.3 per cent) were accompanied by laryngeal cancer. The transoral approach was applied in 11 internal laryngocele patients with no post-operative complications or recurrences.

Laryngoscopy and imaging examination are helpful for diagnosis especially to exclude laryngeal cancer. The transoral approach is effective for the internal type, and the key is to resect the anterior part of the false vocal fold. For patients with concomitant laryngeal cancer, the laryngocele should be promptly managed.

Various methods have been described for laryngeal reconstruction after different kinds of neck trauma.

A method of laryngeal reconstruction in a case with severe penetrating destruction of the larynx is presented.

A titanium mesh plate was used in reconstruction to restore the laryngeal framework.

At thirty-six months’ follow up, the reconstruction proved to be adequate, and the patient was free of complaints, with good voice quality and normal swallowing.

Cochlear implantation is a groundbreaking surgical procedure offering significant benefits to individuals with severe hearing impairments. Correct placement of the electrode array within the cochlea is crucial for optimal device functionality and auditory outcomes. Our study describes four cases of electrode misplacement along with the factors causing it and discusses solutions for the same.

Eight hundred cochlear implant cases were reviewed in three tertiary care centres in India, spanning 2011 to 2023.

Four cases of electrode misplacement requiring reimplantation were identified.

This paper discusses the implications of electrode misplacement, the factors contributing to it and the critical role of multidisciplinary approaches in managing such complications. By addressing these issues, we aim to improve surgical techniques and outcomes in cochlear implant procedures.

Paediatric ear and hearing services in the UK are currently facing significant challenges leading to increased waiting times for patients. This letter aims to explore teleotology, focusing on ear health care delivered via telemedicine, as a potential solution to alleviate service pressures and improve care delivery.

The current state of paediatric ear and hearing services in the UK was reviewed and the potential for teleotology to improve service delivery by reducing face-to-face consultations and improving triage processes was explored.

Evidence from studies conducted in adults in the UK suggests that teleotology can optimise the allocation of resources, ensure timely treatment, and enhance the quality of care, aligning with the NHS Long Term Plan and recommendations from the GIRFT report.

The findings from adult teleotology are encouraging, but further research is required to demonstrate the efficacy of teleotology for children and young people in NHS settings.

Bone-conduction hearing devices provide good hearing outcomes for conductive/mixed hearing losses. Complications post-insertion can lead to additional procedures. Identifying factors that may increase likelihood of developing complications can mitigate risk and inform patients.

A retrospective cohort analysis of 166 adults receiving bone-anchored hearing aid connect operations from 2016–2021 was performed assessing complication rate and contributing factors causing revision procedures.

Twenty-nine per cent of patients had post-operative complications. In total, 17.5 per cent needed additional procedures. Skin overgrowth/infection, granulation and traumatic extrusion were most common reasons. No difference was found in complication rate between different surgical techniques, surgeon grade or general versus local anaesthetic. More complications were observed in decreasing age, male gender and severity of skin reaction.

Revision procedure and complication rates are similar to those reported in published literature. Patient characteristics are important in identifying those likely to develop complications. Non-patient factors did not seem to affect complication rate.

This study compared endoscopic and microscopic tympanoplasty regarding surgical duration and clinical outcomes for chronic suppurative otitis media.

Retrospective study included patients who underwent either endoscopic or microscopic tympanoplasty at King Abdullah Medical City between January 2020 and May 2022. It compared the groups’ surgical duration, residual perforation incidence, post-operative pain and audiological outcomes.

The study included 58 patients, 29 of whom underwent endoscopic and 29 underwent microscopic tympanoplasty. Endoscopic tympanoplasty had a significantly shorter average surgical duration (75.46 ± 21.04 minutes) than microscopic (126.66 ± 34.27 minutes). Non-significant differences were detected between groups regarding residual perforation, post-operative pain or hearing improvements.

Both procedures resulted in non-significant differences regarding hearing and surgical complications. However, endoscopic tympanoplasty had a significantly shorter surgical duration, making it a preferable option due to reducing time required. Further randomized studies should be conducted to answer which approach is superior.

Toxic shock syndrome is an uncommon but lethal infectious disease. To date, toxic shock syndrome related to otological surgical procedures has rarely been reported.

A 43-year-old man was admitted for surgery for a discharging ear with chronic otitis media. Gelfoam and tela iodoform were used to pack the mastoid cavity. Twelve hours post-operatively, he developed a high fever, dramatic gastrointestinal symptoms, and subsequent shock without local signs of infection or meningeal irritation. Culture of ear discharge grew methicillin-resistant Staphylococcus aureus. A macular rash was noted 2 days post-operatively. The patient received aggressive fluid resuscitation, antibiotics and intensive life-sustaining treatment, and the mastoid cavity was opened to facilitate drainage. However, his condition deteriorated promptly and he died of septic shock. Multiple blood cultures showed negative results.

Clinicians should be vigilant for toxic shock syndrome in patients after surgery for a discharging ear with chronic otitis media, even without local signs of infection.

To evaluate the efficacy and safety of the dumbbell-shaped tragal cartilage–perichondrium air-filled chamber technique versus the gelatine sponge packing method for small–medium tympanic membrane perforations.

A retrospective analysis of 68 patients (39 air-filled chamber, 29 gelatine sponge) treated between January 2020 and September 2024. Pre- and post-operative assessments included pure tone audiometry, air–bone gap, tympanic membrane healing, and visual analogue scale scores.

Healing rates were similar (89.7 per cent vs 93.1 per cent, p = 0.959). At six months, pure tone audiometry and air–bone gap improvements were comparable (p > 0.05). At one month, the air-filled chamber group showed better hearing recovery (pure tone audiometry: 19.71 vs 24.27 dB HL; air–bone gap: 7.28 vs 12.28 dB HL; both p < 0.05) and lower pain scores (1.13 vs 1.59, p = 0.022). Complications and operative times were similar.

The air-filled chamber technique is a safe and effective alternative, offering superior early hearing recovery, reduced discomfort, and comparable long-term outcomes to the gelatine sponge method.

Patients undergoing total laryngectomy who have chronic obstructive pulmonary disease are unable to use dry-powder inhalers due to the anatomical changes after surgery and are therefore at greater risk of post-operative pulmonary complications. In our practice, we identified a scarcity of resources available to help clinicians decide on a suitable alternative. Hence, we sought to provide a solution that would address this issue.

Within our head and neck centre, we worked with the respiratory team and specialist pharmacists to create a simple conversion table to help clinicians identify alternatives to dry-powder inhalers.

A table was designed that shows which metered-dose inhalers when connected to a spacer and an infant face mask overlying the laryngeal stoma can be used.

Our table can be used as a resource by clinicians to improve the perioperative and long-term care of patients who cannot use dry-powder inhalers.