Otolaryngology (ENT)

High‑yield pT3–4N0 oral cavity neck dissections may not need elective neck irradiation

In 156 patients with pT3–T4N0 oral cavity SCC and high‑yield elective neck dissection (≥18 nodes), regional failure was uncommon over long follow‑up. Elective neck irradiation did not improve regional recurrence‑free survival or overall survival versus no neck irradiation. Outcomes were similar whether postoperative radiotherapy targeted the primary alone or the primary plus neck. These data support omitting routine elective neck irradiation in adequately dissected pN0 necks, potentially reducing toxicity without compromising control. 1

Long‑term dupilumab lowers background medication use in CRSwNP

This real‑world cohort followed 224 CRSwNP patients on dupilumab for up to 4.5 years at a tertiary center. Patients started with a mean 1.6 concomitant drugs, mainly intranasal steroids and inhaled asthma therapies. Over time, dupilumab was associated with significant reductions in total concomitant medications, nasal sprays, asthma drugs, and other disease‑related medications. Patient‑reported outcomes for sinonasal and asthma control also improved in parallel. These findings suggest dupilumab can sustainably reduce pharmacologic burden while maintaining or improving disease control. 2

Neoadjuvant immunochemotherapy improves wound outcomes after oral cancer surgery

This retrospective study of 692 locally advanced oral SCC patients compared neoadjuvant immunochemotherapy, neoadjuvant chemotherapy, and upfront surgery. Major wound complications within 90 days were significantly lower after neoadjuvant immunochemotherapy than after chemotherapy or upfront surgery. Immunochemotherapy was independently associated with reduced complication risk and faster complete wound sealing on multivariable analysis. Patients receiving immunochemotherapy also had shorter hospital stays, fewer readmissions, and earlier adjuvant radiotherapy initiation. Within the immunochemotherapy group, poor pathologic response, short treatment‑to‑surgery intervals, heavy smoking, free flaps, and high blood loss predicted complications. 3

Tele‑otoscopy can approach in‑person diagnostic performance for pediatric otitis media when well implemented

This scoping review synthesized 52 studies from 18 countries on telehealth approaches for pediatric otitis media. Asynchronous store‑and‑forward tele‑otoscopy was most common, often using images captured by trained personnel and reviewed by experienced clinicians. When image acquisition and reviewer expertise were high, diagnostic agreement with in‑person microscopy was substantial, with sensitivities around 72%–94% and specificities 93%–98%, where reported. Diagnostic performance dropped when parents or nonspecialists had minimal training or only written instructions. These findings support tele‑otoscopy within structured programs emphasizing training, image quality, and clear care pathways. 4