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Dysphagia in patients with multiple sclerosis (MS) is associated with significant morbidity and has profound impact on the quality of life (QoL). This study aimed to analyze the dysphagia prevalence, attitudes, and dysphagia-related QoL in patients with MS, not at relapse. A prospective study of 108 consecutively recruited patients. The patients were asked to report dysphagia and completed a general dysphagia questionnaire (the Eating Assessment Tool-10, EAT-10), a disease-specific dysphagia questionnaire (the Dysphagia in Multiple Sclerosis, DYMUS), and a dysphagia-related QoL questionnaire (the Swallowing-Quality of Life). Twenty-six percent of the patients reported dysphagia. Many more were classified as dysphagic by the questionnaires (34.3% by EAT-10 and 44.4% by DYMUS). Overall, one out of four patients reported difficulties or choking while drinking fluids and eating food, cough related to eating, food sticking in the throat, need for food and drink segmentation, and repetitive swallows. The pleasure of eating was found to be moderately affected. The patients seem to cope well with the psychological and social impact of dysphagia. Serious consideration must be given to patients’ perceptions and attitudes towards dysphagia. Our patients reported very little fear associated with their swallowing difficulties and choking. Apparently, they do not perceive the severity of their symptoms as an actual danger, as they have developed coping strategies. Dysphagia is common in MS patients not at relapse, even with mild disease-related impairment. Swallowing should be systematically assessed with validated questionnaires in all patients with MS at the course of the disease.

Dysphagia is any impairment of swallowing that compromises the safety, efficiency, or adequacy of nutritional or liquid intake. It is common in children, especially in some clinical populations, and may result in failure to thrive and respiratory problems due to pulmonary aspiration. Swallowing disorders have a severe impact on children’s health, growth, and development, and on the quality of life of the child and family. Clinical evaluation cannot validly predict aspiration, which is mostly silent. A team management approach is advocated, including instrumental swallowing assessments. FEES has been proven to be safe and valid and is increasingly used in children of all ages. It allows the identification of structural abnormalities, assessment of the child’s diet with real-life food and liquids while the child holds the optimal or preferred position, examination during breastfeeding, and assessment of fatigue and treatment strategies. FEES is carried out following a protocol that comprises three parts: the evaluation of the anatomical and physiological parameters of swallowing, testing of food and liquids of a range of different consistencies, and evaluation of treatment methods. Pediatric FEES involves adaptations for infants, and special considerations about readiness for nutritive trials and the infant’s ability to sustain a coordinated feeding pattern. Varying consistencies and volumes of food or liquids are tried. Care of the dysphagic child involves team work. FEES, as a part of the assessment and management of dysphagia, enables the evaluation of the safety, efficiency, and adequacy of oral food and liquid intake. Future perspectives include standardized training in clinical FEES protocols to ensure clinical competency of the pediatric FESS team members and the development and validation of standardized examination and interpretation protocols for pediatric FEES.

Background and Objectives: Biofilm formation on cochlear implants (CIs) poses a major problem for surgeons, leading to a high incidence of explantation and revision surgery. Therefore, developing appropriate and cost-effective biofilm detection and prevention techniques is of the essence. In this systematic review, we sought to investigate the development of biofilm formation on CIs. We also elaborated on experimental preventative biofilm measures. Materials and Methods: We conducted a systematic search of both in vitro and in vivo literature published in PubMed, Scopus, and ScienceDirect, until 15 June 2024, for published studies evaluating the biofilm formation and strategies for inhibiting biofilm formation on CIs. Depending on the type of the included study, we assessed quality with the modified Consolidated Standards of Reporting Trials tool, the Joanna Briggs Institute Case Reports Critical Appraisal Tool, a modified Delphi technique, and the ROBINS-I tool. We synthesized the available information on biofilm formation on CIs and the infection prevention capacity of the included antibiofilm agents. Results: A total of 26 studies were included in this systematic review. Biofilms in CIs are usually localized in their recesses such as their removable magnet pocket as opposed to their smooth surfaces. S. aureus and P. aeruginosa are the most commonly isolated microorganisms, and they tend to be strong biofilm producers. The optimal treatment strategy for a biofilm-infected CI is explantation. Most of the examined biofilm prevention methods in CIs present sufficient antibiofilm activity. Conclusions: Biofilm formation in CIs is considered one of the most dreadful complications. There have been no specific guidelines for the treatment of those cases, with removal and/or replacement of the CI being the treatment of choice. Various experimental prevention methods provide promising antibiofilm activity both in vivo and in vitro.

Objective: Recent evidence has suggested that sialendoscopy should be the first-line treatment for chronic sialadenitis. This study aimed to assess the efficacy of steroid irrigation during sialendoscopy in non-lithiasic chronic sialadenitis. Methods: We conducted a systematic search of the databases of PubMed, Scopus, and Web of Science up to the 3rd of November 2024 for completed studies investigating the efficacy of steroid irrigation during sialendoscopy for chronic non-lithiasic sialadenitis. Primary outcomes were the number of patients with recurrence of sialadenitis symptoms and the number of patients who required a revision sialendoscopy. Secondary outcomes included the assessment of major complications of the procedure. Random-effect meta-analysis of proportion was conducted using Open Meta-Analyst software. Additionally, separate subgroup analyses linked to the underlying salivary gland disease were carried out. The quality of the included studies was evaluated utilizing the Moga tool and the ROBINS-I tool. Results: Thirty studies qualified for inclusion in the present systematic review. The weighted pooled proportion of recurrence after sialendoscopy by patient was 27.49% (95% CI: 21.04–34.45), whereas the revision rate was 10.64% (95% CI: 7.74–13.93). In every subgroup, the proposed intervention exhibited adequate efficacy for the symptomatic relief of patients, with similar rates of revision and repetition. The rate of major complications per patient was 0.77%. Conclusions: This study demonstrates that interventional sialendoscopy with intraductal steroid irrigation may yield therapeutic benefit for patients with chronic non-lithiasic sialadenitis and could be considered a safe treatment.

Purpose: The purpose of this study is to determine the magnitude of change that is clinically meaningful in the EORTC QLQ-C30 and EORTC QLQ-HN35 instruments in head and neck cancer patients. Methods: Two hundred and twenty-two patients completed the EORTC QLQ-C30 and EORTC QLQ-HN35 at baseline and follow-up one to two months later. Minimal clinically important differences (MCIDs) were calculated through anchor- and distribution-based methods for improvement and deterioration. Karnofsky Performance status (KPS) was used as the anchor to determine meaningful change. Results: In the group of patients who deteriorated, more scales and symptoms demonstrated statistically significant meaningful change. EORTC QLQ-C30 meaningful change values for deterioration with KPS anchor ranged from 7.2 (physical functioning) to 16.7 units (Global Health Status), and for improvement ranged from 10.0 (role functioning) to 16.7 units (Global Health Status). Conclusions: We report—for the first time, to the best of our knowledge—MCID for EORTC QLQ-C30 and QLQ-HN35 in head and neck cancer patients. Knowledge of meaningful change in these questionnaires allows physicians to assess patient change over time, along with evaluating the impact of treatment on quality of life.

Anatomical preservation and functional integrity of the facial nerve (FN) are the main concerns of parotid surgery. Even though a variety of anatomical landmarks have been proposed and widely utilized, temporal or permanent postoperative FN palsy is still a significant comorbidity of parotid surgery. Therefore, the literature must fully elucidate the consistency of the anatomical relationship between the FN and the retromandibular vein (RMV). We conducted a cadaveric study of 24 hemifaces to map the relationship between the FN and the RMV. Three distinct patterns were identified. Fourteen of the hemifaces were males, and 10 were females. Thirteen cadaveric dissections were performed on the right side and 11 on the left side. Our study found three distinct patterns and proposed a classification system. Type I (66.7%) is when the nerve lies exclusively lateral to the RMV. Type II (29.2%) is when the FN lies superficial to the RMV, but its mandibular branch lies deep to the anterior branch of the RMV, and type III (4.1%) is when the FN lies exclusively medial to the RMV. The FN and RMV relationship is not constant, and surgeons should be aware of every anatomical variation. Especially in cases where the FN is estimated to lie more in-depth to the level of the RMV, a retrograde approach may be required to avoid a FN injury.

Facial nerve integrity is the cornerstone of parotid surgery. Although a variety of anatomical landmarks have been employed, facial nerve injury still happens causing devastating functional and cosmetic sequelae. The retromandibular vein is considered one of the most consistent structures lying just deep into the facial nerve. In our cadaveric study, we found a fenestrated retromandibular vein lying superficial to the bifurcation of the facial nerve. This rare anatomical variation would have been a challenge for a hypothetic parotidectomy. Surgeons should be aware of both anterograde and retrograde dissection of the facial nerve and choose the most proper approach to preserve the integrity of the facial nerve.

Early failure of silicone voice prostheses resulting from fungal colonization and biofilm formation poses a major concern in modern ear nose throat surgery. Therefore, developing new infection prevention techniques to prolong those implants’ survivorship is crucial. We designed an in vitro laboratory study to include nanomaterial-enhanced polymer coating with a plasma spraying technique against Candida albicans growth to address this issue. The anti-biofilm effects of high- and low-dose Al2O3 nanowire and TiO2 nanoparticle coatings were studied either alone or in conjunction with each other using checkerboard testing. It was demonstrated that both nanomaterials were capable of preventing fungal biofilm formation regardless of the anti-fungal agent concentration (median absorbance for high-dose Al2O3-enhanced polymer coating was 0.176 [IQR = 0.207] versus control absorbance of 0.805 [IQR = 0.381], p = 0.003 [98% biofilm reduction]; median absorbance for high-dose TiO2-enhanced polymer coating was 0.186 [IQR = 0.024] versus control absorbance of 0.766 [IQR = 0.458], p < 0.001 [93% biofilm reduction]). Furthermore, synergy was revealed when the Bliss model was applied. According to the findings of this work, it seems that simultaneous consideration of Al2O3 and TiO2 could further increase the existing antibiofilm potential of these nanomaterials and decrease the likelihood of localized toxicity.

Over the recent years, an increased alertness for thorough knowledge of anatomical variants with clinical significance has been recorded in order to minimize the risks of surgical complications. We report a rare case of bilateral strap-like sternalis muscle of the anterior chest wall in a female cadaver. Its presence may evoke alterations in the electrocardiogram or confuse a routine mammography. The incidental finding of a sternalis muscle in mammography, CT, and MRI studies must be documented in a patient's medical records as it can be used as a pedicle flap or flap microvascular anastomosis during reconstructive surgery of the anterior chest wall, head and neck, and breast. Moreover, its presence may be misdiagnosed as a wide range of benign and malignant anterior chest wall lesions and tumors.