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Despite the high burden of hearing loss (HL) globaly, most countries in resource limited settings lack infant hearing screening programs(IHS) for early HL detection. We examined the feasibility of establishing an IHS program in this setting, and in this pilot program measured the prevalence of infant hearing loss (IHL) and described the characteristics of the infants with HL. We assessed feasibility of establishing an IHS program at a regional referral hospital in south-western Uganda. We recruited infants aged 1 day to 3 months and performed a three-staged screening. At stage 1, we used Transient Evoked Oto-acoustic Emissions (TEOAEs), at stage 2 we repeated TEOAEs for infants who failed TEOAEs at stage 1 and at stage 3, we conducted Automated brainstem responses(ABRs) for those who failed stage 2. IHL was present if they failed an ABR at 35dBHL. We screened 401 infants, mean age was 7.2 days (SD = 7.1). 74.6% (299 of 401) passed stage 1, the rest (25.4% or 102 of 401) were referred for stage 2. Of those referred (n = 102), only 34.3% (35 of 102) returned for stage 2 screening. About 14.3% (5/35) failed the repeat TEOAEs in at least one ear. At stage 3, 80% (4 of 5) failed the ABR screening in at least one ear, while 25% (n = 1) failed the test bilaterally. Among the 334 infants that completed the staged screening, the prevalence of IHL was 4/334 or 12 per 1000. Risk factors to IHL were Newborn Special Care Unit (NSCU) admission, gentamycin or oxygen therapy and prematurity. IHS program establishment in a resource limited setting is feasible. Preliminary data indicate a high prevalence of IHL. Targeted screening of infants at high risk may be a more realistic and sustainable initial step towards establishing IHS program s in a developing country like Uganda.

Background Many patients with head and neck cancer (HNC) often present with advanced disease. This may result from delay in deciding to seek care, delay in reaching the healthcare facility and or delay in accessing care in the healthcare facility. We therefore set out to determine the time to definitive diagnosis and factors associated with delayed diagnosis among patients with HNC at the Uganda Cancer Institute (UCI). Methods A cross-sectional study was conducted at UCI, patients with HNC were recruited. An interviewer administered questionnaire was used to collect data on sociodemographic factors and clinical characteristics, including timelines in months, from symptom onset to deciding to seek care, to reaching the health care facility and to definitive diagnosis. Multivariate Poisson regression analysis was used to calculate odds ratios (ORs) for the factors of association with delayed diagnosis. Results We recruited 160 HNC patients, and 134 patients were analyzed. The median age was 49.5 years (IQR 26.5), 70% (94 of 134) were male, 48% (69 of 134) had below secondary school education, 49% (65 of 134) had a household income < 54 USD. 56% (76 of 134) were sole bread winners, 67% (89 of 134) had good access road condition to the nearest health unit and 70% (91 of 134) presented with tumor stage 4. Median time from onset of symptoms to definitive diagnosis was 8.1 months (IQR 15.1) and 65% (87 of 134) of patients had delayed diagnosis. Good access roads (aOR: 0.26, p  = 0.006), secondary school education (aOR: 0.17, p  = 0.038), and household income > 136 USD (aOR: 0.27, p  = 0.043) were associated with lower odds of delayed diagnosis. Being the sole bread winner (aOR: 2.15, p  = 0.050) increased the odds of delayed diagnosis. Conclusion Most of HNC patients (65%) at UCI had delayed diagnosis. A national care pathway for individuals with suspected HNC should be established and consider rotation of Ear, Nose and Throat surgeons to underserved regions, to mitigate diagnostic delay.

Branchial cleft anomalies commonly present as branchial cleft sinuses, which are epithelialized tracts that communicate with the skin or pharynx. While these anomalies are often asymptomatic, they can become complicated by infection, resulting in abscess formation. The standard management of an infected branchial cleft sinus involves prompt incision and drainage (I&D) to alleviate symptoms and control infection. However, repeated I&D procedures without early definitive surgical intervention to address the underlying anomaly may lead to significant preventable complications such as sinus-to-fistula transformation, chronic discharge, and substantial psychosocial morbidity, particularly in children. This case series describes two children with a history of recurrent lateral neck swellings that initially lacked any external openings. Both underwent multiple I&D procedures before presenting with fluid extrusion from newly formed cutaneous openings, which led to social distress, including peer ridicule. Definitive surgical excision was performed via an external approach, resulting in complete symptom resolution at the six-month follow-up. Early recognition, timely specialist referral and definitive management are key to minimising physical and psychosocial morbidity in branchial cleft fistulae.

Introduction Despite a recent drive to increase diversity, the global academic workforce is skewed in favor of authors from high‐income countries, and women are under‐represented in the published medical literature. Objectives To explore the trends in authorship of three high‐impact otolaryngology journals over a ten‐year period (2011–2020). Methods Journals selected: JAMA Otolaryngology–Head and Neck Surgery, The Laryngoscope and Rhinology. Articles were reviewed from four issues per journal per year, and data was collected on: time of publication; subspeciality; number of authors; sex of first and last authors; country of practice of first author and country where each study was conducted. Trends were examined though univariate and multivariate logistic regression models. Results 2998 articles were included. 93.9% of first authors and 94.2% of studies were from high‐income countries. Women were first authors in 31.5% (n = 912) and senior authors in 18.4% (n = 524) of articles. Female first authorship significantly increased between 2011 and 2020 however female senior authorship remained the same. There have been no significant changes in the proportion of published articles from low‐and middle‐income countries (LMIC) over time (p = .65). Amongst the LMIC articles, 72% came from Brazil, Turkey or China and there were no published papers from countries with a low‐income economy (gross national income per capita of $1085 or less). Conclusions Although female first authorship has increased in the last decade, there has been minimal other demographic change in authorship over this time. High‐impact otolaryngology journals poorly represent academia in low‐and‐middle income countries. There is a need for increased advocacy promoting gender and geographical research equity in academic medicine. Level of Evidence III. This study included 2998 articles from three high‐impact journals between 2011 and 2020 There has been no significant increase in the proportion of authors from low‐and ‐middle income countries (6.1%) during this time.Whilst the proportion of female first authors has significantly increased between 2011 and 2020 (OR 2.0, 95% CI 1.4–2.8) no change was observed in female senior authorship over time (18.4%).

Head and neck vascular tumors are common in children. Capillary hemangiomas are often easily confused with pyogenic granulomas due to histopathological resemblance. Furthermore, predisposing factors to pyogenic granulomas include an existing hemangioma, which may be co-existing entities. Surgical excision of large unsightly tumors causing functional deficits is a feasible management option. We report a case of a rapidly growing oral lesion in a toddler with feeding difficulties and anemia. It triggered a diagnostic dilemma as it was clinically consistent with a pyogenic granuloma but histologically diagnosed as a capillary hemangioma. It was successfully excised with no recurrence after 6 months.

Objective Availability of surgical equipment and access to essential clinical services remains an important barrier to surgical care delivery, particularly in low‐ and middle‐income countries (LMICs). This study aims to characterize the relative availability of essential equipment for otolaryngology‐head and neck surgery (OHNS) care across World Bank income groups. Methods We conducted a cross‐sectional survey on otolaryngologists' perceptions on the availability of surgical equipment and ancillary services in their respective practice settings per a 5‐point Likert scale ranging from never to always available. The study was disseminated online via professional societies, personal contacts, and social media. Eligible participants included otolaryngologists from 194 WHO‐recognized countries, which were grouped by World Bank income group classification and WHO region. Results The study involved 146 otolaryngologists, 69 (47%) from high‐income countries (HICs), and 77 (53%) from LMICs. LMIC respondents were predominantly from the African and South‐East Asian regions, which comprised 48% and 7.8% of all LMIC respondents, respectively. Results revealed significant differences in the availability of otologic, rhinologic, and endoscopic airway equipment between HICs and LMICs. Differences existed among commonly used equipment such as tympanomastoidectomy equipment and rigid bronchoscopy, to subspecialized equipment such as functional endoscopic sinus surgery equipment and cochlear implants (p < 0.05 each). Conclusions The study highlighted key disparities in the availability of essential equipment for baseline OHNS care, especially for pediatric airway and otologic conditions. These results can be used to guide investment and advocacy efforts to improve specialty‐specific surgical infrastructure relative to the global burden of OHNS diseases in low‐resource settings. Level of Evidence 3 We conducted a cross‐sectional survey to characterize the relative availability of essential equipment for otolaryngology‐head and neck surgery (OHNS) care across World Bank income groups. The study highlighted key disparities in the availability of essential equipment for baseline OHNS care, especially for pediatric airway and otologic conditions.

Importance Highlighting the global disparities in otolaryngology training and, ultimately, service delivery, emphasizing the need for equitable access to training resources and programs. Objective To describe the relationship between the quality, content, and location of otolaryngology–head and neck surgery training and education and the resulting impact on the delivery of otolaryngology care globally. Design An online cross‐sectional survey to otolaryngologists, gathering information on their training and education experiences, and factors influencing their choice of training location and practice. Setting The online survey was available in multiple languages, distributed via national and international professional otolaryngology societies, snowballing and social media. Participants The respondents were practicing otolaryngologists representing all seven World Health Organization regions. Exposures World Bank income groups classification. Main Outcomes and Measures Our expected outcome was that subspecialty training and access to educational resources were significantly readily available to respondents from high‐income countries, leading to more confidence in performing complex procedures post training. Results A total of 91 participants were included in the analysis, with 47 (52%) practicing in high‐income countries and 44 (48%) in low‐ and middle‐income countries. Sixty‐one participants (67%) were male. Subspecialty training and access to educational resources were significantly less available in low‐ and middle‐income countries, leading to lower confidence among low‐ and middle‐income countries physicians in performing complex procedures. High‐income country respondents reported better access to diverse training resources and felt more prepared for a broader range of procedures. Conclusion and Relevance Significant disparities exist in OHNS training resources and subspecialty training opportunities between high‐ and low‐middle‐income countries. There is a critical need to integrate complementary training and educational modalities into local systems. Addressing the shortage of educational resources and promoting open‐access initiatives in low‐middle‐income countries are essential steps toward enhancing surgical education and improving global otolaryngology healthcare outcomes. This study highlights critical disparities in otolaryngology training between high‐income countries (HICs) and low‐ and middle‐income countries (LMICs), which impact access to quality care globally. Due to limited training resources and subspecialty opportunities in LMICs, physicians in these regions often feel less prepared to handle complex cases, affecting patient outcomes and healthcare equity. Addressing these gaps by expanding educational access and implementing open‐access resources is essential for strengthening otolaryngology care worldwide, fostering a more equitable healthcare system, and improving patient outcomes in underserved regions.