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Hearing loss is the most common sensory deficit in the elderly, and it is becoming a severe social and health problem. Especially in the elderly, hearing loss can impair the exchange of information, thus significantly impacting everyday life, causing loneliness, isolation, dependence, and frustration, as well as communication disorders. Due to the aging of the population in the developed world, presbycusis is a growing problem that has been reported to reduce quality of life (QoL). Progression of presbycusis cannot be remediated; therefore, optimal management of this condition not only requires early recognition and rehabilitation, but it also should include an evaluation of QoL status and its assessment.

The obstructive sleep apnea syndrome (OSAS) represents only part of a large group of pathologies of variable entity called respiratory sleep disorders (RSD) which include simple snoring and increased upper airway resistance syndrome (UARS). Although the etiopathogenesis of adult OSAS is well known, many aspects of this syndrome in children are still debated. Its prevalence is about 2% in children from 2 to 8 years of age, mostly related to the size of the upper airways adenoid tissue. Several risk factors linked to the development of OSAS are typical of the pediatric age. The object of this paper is to analyze the state of the art on this specific topic, discussing its implications in terms of diagnosis and management.

Autoimmune inner ear disease (AIED) has been defined as a condition of bilateral sensorineural hearing loss (SNHL), caused by an ‘uncontrolled’ immune system response. The inner ear can be the direct target of the immune response, but it can be additionally damaged by a deposition of circulating immune complexes or by systemic immune-mediated diseases. The clinical expression of immune-mediated inner ear disease shows a progressive bilateral and asymmetric SNHL profile, which typically benefits from a steroid and immunosuppressive therapy. The onset of AIED is between 3 and 90 days. Cochlear symptoms can be associated with vestibular disorders and in 15%–30% of cases, AIED occurs in the contest of a systemic autoimmune disease. Currently, the onset of immune-mediated SNHL is not a well-understood process and the pathogenetic mechanisms of AIED remain unclear. Furthermore, there are no standardized diagnostic criteria or reliable diagnostic tests for the diagnosis of AIED. Hence, the definition of immune-mediated cochleovestibular disorders is a challenging diagnosis based on exclusion. A close collaboration between otolaryngologists, audiologists and rheumatologists is recommended, in order to achieve the multidisciplinary management of this rare entity, since an early AIED identification and a prompt medical treatment might result in acceptable hearing outcomes. The paper describes the clinical features of AIED and offers a diagnostic flow-chart to use in the clinical assessment of this condition.

Background/Objectives: Malignant tumors of the sinonasal tract are rare, accounting for approximately 3–5% of all head and neck tumors. Despite recent advances in therapy, overall survival in sinonasal cancer remains limited, with local recurrence representing the leading cause of treatment failure. Consequently, the preoperative identification of patients at higher risk of recurrence or developing more aggressive tumors is of critical importance to guide treatment strategies and improve outcomes. The aim of this review is to analyze the results of the most recent literature studying the use of radiomics in malignant sinonasal tumors. Methods: A comprehensive literature review was conducted using the PubMed/MEDLINE, EMBASE and Cochrane Library databases, in accordance with the PRISMA review criteria (from 2020 to July 2025). Results: The final analysis comprised a total of five articles and 629 patients. At present, radiomics in sinonasal cancer is mainly applied to the prediction of Ki-67 expression, the early assessment of recurrence risk, and the evaluation of response to induction chemotherapy. Conclusions: The results of this review indicate that radiomics has the potential to play an important role in the management of sinonasal malignant tumors. However, further research is necessary to confirm these findings.

Malignant tumors of the salivary glands are rare, accounting for approximately 1–7% of all head and neck tumors. The parotid gland is the most commonly affected gland. An accurate preoperative diagnosis distinguishing between malignant and benign tumors is necessary for the appropriate management of patients. The aim of this review is to analyze the results of the most recent literature studying the use of radiomics in malignant tumors of the parotid gland. A comprehensive literature review was performed using the PubMed/MEDLINE, EMBASE and Cochrane Library databases, in accordance with the PRISMA review criteria (from 2020 to July 2025). The final analysis comprised a total of six articles and 560 patients. Four studies evaluated the role of Magnetic Resonance Imaging (MRI), one of Computed Tomography (CT) and one of Positron Emission Tomography/Computed Tomography (PET/CT). Radiomics models achieved good overall diagnostic performance, with AUC values ranging from 0.769 to 0.952 across studies, although methodological heterogeneity prevented data pooling. The results of this review indicate that radiomics has the potential to play an important role in the management of malignant tumors of the parotid gland. Nevertheless, the absence of clear and standardized protocols does not allow the comparison of results. Further studies are necessary to confirm these findings.

Background/Objectives: Chiari malformation (CM) type I is an uncommon condition that can be associated with a variety of neurological and otoneurological symptoms, including sensorineural hearing loss. The aim of this paper is to analyze the association between type I CM and hearing loss. Methods: A review of the literature was performed using PubMed/MEDLINE, EMBASE, and Cochrane Library databases, according to PRISMA criteria for scoping review (from 2000 to April 2025). Results: A total of 8 articles and 139 patients with type I CM have been included; the majority of studies focused on women, with a mean age of 38.5 years (range: 10–44 years). In two cases, surgery was necessary for restoring normal hearing thresholds. Conclusions: To date, the pathophysiological mechanisms related to type I CM and hearing loss are not fully understood yet; further studies are necessary to clarify these features and to evaluate the correct management of these patients.

PurposeThe aim of our randomized clinical trial is to produce stronger evidence supporting barbed repositioning pharyngoplasty (BRP) as a therapeutic option for the treatment of obstructive sleep apnea (OSA).MethodsThe trial was a single-center prospective controlled trial with two parallel arms (group A: BRP; group B: observation) and randomization. Baseline and 6-month polygraphy evaluating the apnea hypopnea index (AHI), oxygen desaturation index (ODI), and lowest oxygen saturation (LOS) were performed. To test the differences among groups of Student’s t test, the role of each factor (univariate analysis) and their independent effect (multivariate analysis) was explored using logistic regression model as appropriate. Linear regression was also conducted.ResultsA significant reduction of AHI, ODI, LOS, and Epworth Sleepiness Scale (ESS) values was recorded in the BRP group. BRP showed to be more effective than observation. Logistic regression showed that preoperative AHI is related significantly to postoperative AHI within the BRP group. A linear regression showed that higher baseline AHI predicts more significant postoperative absolute AHI reduction.ConclusionsBRP appears to be a promising technique and might be included within the surgical armamentarium of a sleep surgeon. Patients affected by severe OSA may benefit from this surgery with more significant reduction of AHI values.

Background The elongation of the styloid process is historically associated with two variants of the Eagle syndrome. The classic one, mainly characterized by pain and dysphagia, and the carotid variant characterized by pain and sometimes by cerebral ischemia. We observed a further variant characterized by a styloid elongation coursing adjacent to the transverse process of C1, causing significant compression of the internal jugular vein. Methods We reviewed all the cases of Eagle syndrome, including the jugular variant, admitted in our Hospital in the last six years. We compared symptomatology, associated comorbidities and imaging. Data were statistically analyzed. Results Overall 23 patients were admitted to the Hospital for symptomatic elongation of the styloid process, 11 male and 12 females. The jugular variant of the Eagle syndrome is clinically delineated by significant differences, as compared to the classic variant and carotid variants. Headache was the more prominent symptom ( p  < .009) as well as a documented peri-mesencephalic hemorrhage was the more significant comorbidity ( p  < .0003). The group classic-carotid variant was characterized by ipsilateral pain respect to the jugular variant (p < .0003). CT angiography with venous phase extended to the neck veins and imaging reconstruction is highly recommended as imaging technique, complemented by color-Doppler ultrasound. Conclusions The elongation of the styloid process may have different paths which creates compression on the surrounding anatomical structures. There may be a possible association of jugular impingement by an elongated styloid process with symptoms. Trial registration Protocol n°45–2013.

PurposeThe aim of this study is to evaluate the prognostic value of pre-treatment advanced lung cancer inflammation index (ALI) in patients with HPV-negative HNSCC undergoing up-front surgical treatment.MethodsThe present multi-centre, retrospective study was performed in a consecutive cohort of patients who underwent upfront surgery with or without adjuvant (chemo)-radiotherapy for head and neck squamous cell carcinoma (HNSCC). Patients were stratified by ALI, and survival outcomes were compared between groups. In addition, the prognostic value of ALI was compared with two other indices, the prognostic nutritional index (PNI) and systemic inflammatory index (SIM).ResultsTwo hundred twenty-three patients met the inclusion criteria (151 male and 72 female). Overall and progression-free survival were significantly predicted by ALI < 20.4 (HR 3.23, CI 1.51–6.90 for PFS and HR 3.41, CI 1.47–7.91 for OS). Similarly, PNI < 40.5 (HR = 2.43, 95% CI: 1.31–4.51 for PFS and HR = 2.40, 95% CI: 1.19–4.82 for OS) and SIM > 2.5 (HR = 2.51, 95% CI: 1.23–5.10 for PFS and HR = 2.60, 95% CI: 1.19–5.67 for OS) were found to be significant predictors. Among the three indices, ALI < 20.4 identified the patients with the worst 5-year outcomes. Moreover, patients with a combination of low PNI and low ALI resulted to be a better predictor of progression (HR = 5.26, 95% CI: 2.01–13.73) and death (HR = 5.68, 95% CI: 1.92–16.79) than low ALI and low PNI considered alone.ConclusionsOur results support the use of pre-treatment ALI, an easily measurable inflammatory/nutritional index, in daily clinical practice to improve prognostic stratification in surgically treated HPV-negative HNSCC.

Background/Objectives: Tinnitus is a complex auditory phenomenon with multifactorial origins, often involving both peripheral and central auditory pathways. Given the multifactorial nature of tinnitus, this review specifically focuses on the auditory brainstem as it represents the first central relay for auditory input and a key site of abnormal synchrony and central gain, which may generate or modulate tinnitus even when peripheral hearing appears normal. Several studies suggest a potential role of brainstem dysfunction in its pathogenesis, even among patients with normal hearing thresholds. Although the physiopathological data provide evidence for the role of brainstem in the generation and magnification of tinnitus, the diagnostic tools are still unclear. This systematic review aimed to investigate the diagnostic relevance of brainstem-level abnormalities in individuals with tinnitus. Methods: Following PRISMA guidelines, a literature search was conducted using PubMed, Scopus, and Web of Science from January 2000 to June 2025. Studies were included if they addressed the diagnostic relationship between tinnitus and brainstem involvement. Data on auditory brainstem response (ABR), otoacoustic emissions (used to differentiate peripheral from central auditory abnormalities), neuroimaging, and electrophysiological markers were extracted. Results: Twenty studies were included. Most used ABR as a diagnostic tool, revealing significant amplitude and latency alterations in tinnitus patients compared to controls, particularly in wave V and V/I amplitude ratios. Imaging studies supported altered brainstem–cortical connectivity and localized changes in inferior colliculus (IC) activity. Additional techniques, such as middle-latency evoked potentials and gap-in-noise detection, showed potential but lacked consistent clinical utility. Conclusions: Evidence suggests that brainstem dysfunction may contribute to tinnitus generation or persistence. ABR and advanced imaging represent specific diagnostic tools, though standardization and high-quality studies are still needed to improve clinical applicability.