Otolaryngology (ENT)

Proximal hypoglossal nerve stimulation benefits PAP-intolerant moderate–severe OSA

In this 7‑month randomized trial at 23 U.S. centers, 104 adults with moderate–severe OSA received proximal hypoglossal nerve stimulation implantation and were randomized 2:1 to active therapy versus control. At month 7, 58.2% of treated patients versus 13.5% of controls met the AHI response endpoint (>50% reduction and AHI <20 events/h). A ≥25% reduction in oxygen desaturation index was more frequent with active therapy, and Epworth Sleepiness Scale scores improved only in the treatment arm. No serious procedure-related adverse events occurred over short follow-up, though the trial was unblinded with limited duration. 1

EBV C-promoter methylation triage refines nasopharyngeal carcinoma screening

Among 55,682 individuals in two southern China cohorts, high-risk serology-positive participants underwent nasopharyngeal swab Epstein–Barr virus C-promoter methylation quantification (E-CpMQ) triage. In the single-center cohort, E-CpMQ identified 91.7% of nasopharyngeal carcinoma cases with 91.7% specificity, reducing specialist referrals by 85.3%. In the six-center cohort, sensitivity reached 100% with 96.1% specificity, cutting referrals by 91.9%. Compared with EBV DNA load triage, E-CpMQ maintained equivalent sensitivity but higher specificity, reducing referrals needed per cancer case from 10–14 to about 2. 2

Simultaneous bilateral cochlear implantation improves adolescent localization

This cross-sectional study assessed 37 adolescents and young adults implanted bilaterally before age 2.5 years and using cochlear implants for roughly 15 years. Simultaneous bilateral implantation (n = 17) yielded significantly better sound localization accuracy than short-delay sequential implantation (n = 20), with a moderate effect size (Cohen’s d = 0.58). Speech recognition in quiet and in masking speech was comparable between simultaneous and sequential groups. Both cochlear implant groups underperformed normal-hearing peers on spatial-hearing tasks despite early bilateral implantation and long-term use. 3

Amoxicillin equals amoxicillin–clavulanate for uncomplicated acute sinusitis

This nationwide new-user cohort compared standard-dose amoxicillin–clavulanate with standard-dose amoxicillin in 234,608 propensity-matched adults aged 18–64 years with outpatient acute sinusitis. Treatment failure within 14 days occurred in about 3% of patients overall, with no meaningful difference between regimens and very low emergency or inpatient utilization. Rates of antibiotic-associated adverse events were similar, but secondary infections were higher with amoxicillin–clavulanate, including yeast and Clostridioides difficile infections. These real-world data indicate that standard-dose amoxicillin is as effective as amoxicillin–clavulanate for uncomplicated acute sinusitis in adults. 4