Introduction: Post-COVID-19 parosmia can be protracted and psychologically distressing. The effect of olfactory training (OT) on parosmia is still unclear. The primary objective was to investigate the effect of 3 months of OT on COVID-19-related parosmia. The secondary objectives were to study whether improvement in olfactory quantitative function and compliance to OT influenced improvement in parosmia. Methods: This prospective cohort study was conducted from October 5, 2022, to February 7, 2023, at a tertiary smell and taste clinic. Patients with persistent post-COVID-19 parosmia were instructed to perform OT twice daily for 3 months. Improvement in parosmia was measured using self-rated intensity and pleasantness scales, a structured parosmia questionnaire, and the Sniffin’ Sticks Parosmia Test (which measures hedonic direction and range). Quantitative olfactory function was measured with Sniffin’ Sticks to determine the threshold, discrimination, and identification (TDI) score. Pre- and post-OT assessment of parosmia and quantitative olfactory function was performed. Compliance to OT was calculated as a percentage of the number of OT sessions performed over the expected number of training sessions over 3 months. Results: Thirty-eight patients (mean age 41.8 [±13.3] years, 12 [31.6%] males) were recruited. After 3 months, 52.6% (n = 20) reported perceived improvement in parosmia. There was improvement in perceived pleasantness (−2.0 [−3.0 to −1.0] vs. −3.0 [−4.0 to −2.0], p = 0.027), hedonic range (2.4 [±1.3] vs. 1.9 [±1.6], p = 0.023), and TDI (27.9 [±7.4] vs. 25.2 [±7.2], p = 0.001) from baseline. All measures of parosmia did not differ significantly between patients who achieved the minimum clinically important difference of ≥5.5 in TDI scores versus those who did not. Patients who had >70% compliance to OT displayed more significant improvements in hedonic range (1.1 [±1.1] vs. 0.2 [±1.3] p = 0.04) compared to those who were less compliant. Conclusion: COVID-19-related parosmia and olfactory dysfunction improved with OT over 3 months. Improvement in olfactory function does not necessarily improve parosmia perception. However, compliance with OT appears to have an effect on improvement in parosmia.

Introduction: Despite significant changes over the past 5 years, the otolaryngology head and neck surgery (OHNS) residency application process remains highly competitive. This study assessed how applicant and medical school characteristics predict success in entering OHNS residency programs. Methods: 1,363 application files submitted to a single academic OHNS residency program during the 2019–2020, 2020–2021, and 2023–2024 cycles were reviewed. Applicant characteristics, Step scores, medical school rankings, geographic locations, and research productivity were analyzed. T-tests and chi-square tests were used for comparative analyses, while linear modeling identified match success predictors. Results: Applications declined in the 2023–2024 cycle compared to earlier cycles. Although mean Step 1 scores predicted success previously, they lost significance in 2023‒2024. Step 2 scores remained reliable predictors across cycles (p = 0.021), with matched applicants consistently scoring higher (e.g., 2023–2024 mean: 255.8 ± 11.4 vs. 249.1 ± 14.3, p < 0.001). Research productivity increased throughout cycles, with matched applicants demonstrating higher output (e.g., 2023–2024 mean publications: 5.4 ± 6.3 vs. 4.4 ± 7.3, p < 0.001). Research fellowships increased (26.6% in 2023–2024) and were notably linked to higher productivity, especially for applicants from lower ranked schools. Modeling indicated that Step 2 scores, medical school rankings, and research output significantly predict match success. Conclusion: Fewer applications were received in the 2023–2024 cycle, and Step 1 scores lost their predictive value, reflecting recent evaluation changes. Still, Step 2 scores and research productivity remain crucial for match success, suggesting their increasing relevance for applicants seeking OHNS residencies.

Introduction: Obstructive sleep apnea (OSA) is a worldwide health concern having been proved to be associated with air pollution. However, it remains unclear whether air pollution could also compromise the effect of OSA treatment, especially OSA surgery. This study investigated the impact of mid- to long-term ambient air pollution exposure on postsurgical outcomes of OSA patients. Methods: A total of 382 OSA patients who had failed conservative treatment first and received OSA surgery afterward were enrolled; the patients were then categorized into the severely (192 patients; 50.3%) and mildly (190 patients; 49.7%) air-polluted group based on the calculated average exposure of air particles according to the report of Taiwan Ministry of Environment. The relationships among the airborne particles and sleep indices changes were analyzed for determining the impact of air pollution on OSA surgery. Results: After a mid- to long-term exposure following OSA surgery, the results of the follow-up polysomnography showed that ΔAHI, ΔLSAT, and Δarousal index were significantly different between the two air-polluted groups. Pearson’s correlations revealed that the above sleep indices were significantly yet weakly associated with air quality index (AQI), SO2, NO2, CO, and O3. After adjusting the confounding factors, the multivariate analysis showed that different air pollution levels still had statistically significant influence on Δarousal index (β = −0.105, p = 0.045). Conclusion: Despite the effectiveness of OSA surgery, mid- to long-term exposure to ambient air pollution postoperatively may still have statistically significant association on OSA patients’ postsurgical outcomes, and thus could not be overlooked.

Introduction: This study aimed to evaluate hearing aid satisfaction and usage patterns across different age groups and to investigate the impact of hearing aids on quality of life. Material and Methods: Hearing aid satisfaction and perceived benefit were evaluated using the International Outcome Inventory for Hearing Aids (IOI-HA), administered via phone interview after at least 6 months of use. A total of 850 patients who were prescribed hearing aids for the first time at the Department of Otorhinolaryngology between January 2020 and January 2023 were retrospectively analyzed. Results: The mean age of participants was 65.4 ± 13.4 years, and the prevalence of sensorineural hearing loss increased significantly with age. Pure tone thresholds and word recognition scores (WRSs) were lower in the older age groups. However, no significant differences were found in IOI-HA scores across the age categories. The WRS was the only significant predictor of total IOI-HA scores (B = 0.016, p = 0.009, R2 = 0.010). Behind-the-ear hearing aids were more commonly used among older participants. Conclusions: Hearing aid satisfaction did not differ according to age, and the severity of hearing loss alone was not a strong determinant. Speech discrimination ability was identified as a consistent predictor of perceived benefit.

Background: Surgical interventions for nasal obstruction represent a significant proportion of everyday rhinology practice. Failure to improve patients’ symptoms may be due to incomplete assessment of co-morbidities, low sensitivity for nasal airflow, and inadequate therapeutic approaches. This narrative review summarizes the evidence on studies assessing the results of nasal obstruction surgery in relation to trigeminal function measurements. Focus was given to specific procedures such as septoplasty, endoscopic sinus surgery, and surgery of inferior turbinates. Summary: Current literature provides evidence that a significant proportion of patients have decreased intranasal trigeminal function before surgery. Most nasal surgeries conserve trigeminal nerve function, except when more aggressive techniques like inferior turbinate resection or excessive cautery are performed. Key Messages: Trigeminal function should be evaluated in patients presenting with nasal obstruction, especially in the absence of major anatomical blockage. Nasal trigeminal sensitivity may be a contributing factor to perceived obstruction that surgery alone cannot resolve.

Plain Language SummaryOur sense of smell is important for enjoying food, detecting dangers like smoke, and even forming memories or dealing with emotions. However, smell tests used by doctors can be difficult to perform and may take a long time. This study investigated a new, digital smell test called the MultiScent-IT. This test uses a tablet-like device that releases different smells. We wanted to see if this new test could accurately identify people with a poor sense of smell. We asked people with and without smell problems to take the MultiScent-IT. The test results showed that people with a poor sense of smell scored lower on the test. We also found that the lower a person scored on the MultiScent-IT, the more their smell loss affected their daily life. This new digital test could be a useful tool for doctors. It is quick to use, easy to understand, and does not require special training. This could help doctors identify people with smell problems more easily and track their progress over time. In the future, this type of technology might even be used with artificial intelligence to help diagnose and treat smell disorders more effectively.

Introduction: This study aimed to compare the effects of different types of concha bullosa (CB) on olfactory function using paranasal computed tomography (CT) findings and the Sniffin’ Sticks test. Methods: A total of 107 patients (69 women and 38 men) were evaluated. The study group included 79 patients with CB, while the control group comprised 28 patients without CB. CB cases were classified into three subtypes according to the Bolger classification: lamellar (n = 28), bulbous (n = 25), and extensive (n = 26). Paranasal CT scans were assessed by a radiologist to measure the olfactory cleft width, the distance between the turbinate and septum, and the volume of the turbinate bullosa. All participants completed the SNOT-22 and NOSE questionnaires. Olfactory function was evaluated using the Sniffin’ Sticks test, and examinations were conducted by an otolaryngology specialist. Results: There were no significant differences between the groups in terms of age and gender (p > 0.05). The Sniffin’ Sticks test score was significantly higher in the control group than in the CB group (p < 0.001). The control group had significantly higher odor scores than the lamellar and extensive groups (p = 0.002 and p = 0.042, respectively) but not the bulbous group (p = 0.133). The volume of the CB (vertical axis and horizontal axis of CB) was significantly greater in the extensive CB group than in the lamellar and bulbous groups (both p < 0.001). No significant differences were observed in the right, left, or total olfactory cleft widths among the four groups (p > 0.05). Conclusion: Olfactory function, as measured by the Sniffin’ Sticks test, was significantly better in the control group compared to the CB group. However, there were no significant differences in olfactory performance among the different CB subtypes. Additionally, olfactory cleft width did not differ significantly between groups. These findings suggest that while the presence of CB may be associated with reduced olfactory function, the subtype of CB and cleft width may not play a major role. Moreover, the reduction of olfactory function due to CB was minimal and not clinically meaningful.

Introduction: Olfactory training (OT) is known to be beneficial for olfactory disorders. The study aimed to explore whether the familiarity of odors influences the effectiveness of OT. Methods: Participants were divided into three groups: original training (OG), modified training with familiar odors to the Japanese population (FG), and modified training with unfamiliar odors to the Japanese population (UFG). Over 3 months, all participants completed OT. Olfactory function was evaluated using T&T olfactometry (combined odor detection threshold and odor recognition threshold test), intravenous olfactory test (retronasal olfactory test), and an open essence (OE) (odor identification test) before and after OT. Results: Sixty participants (mean age 53 years, SD 18) completed the study. Two participants were in the normosmic range, 10 were mild hyposmia, 14 were moderate hyposmia, 13 were severe hyposmia, and 21 were anosmia. Significant improvements were observed in olfactory detection threshold and recognition threshold function and retronasal olfactory function tests across all groups following OT. However, there was no significant effect observed on OE score. Furthermore, no significant differences were found among the OG, FG, and UFG groups. Conclusion: These findings suggest that regardless of odor familiarity, OT led to notable enhancements in olfactory function among participants. The study contributes to understanding the impact of odor familiarity on the effectiveness of OT, indicating that both familiar and unfamiliar odors yielded similar improvements. These results underscore the robustness of OT as a therapeutic approach for olfactory dysfunction, regardless of the familiarity of the odors used.

Plain Language SummaryChildren who get croup (a condition causing a barking cough and noisy breathing) multiple times per year sometimes undergo a procedure called an airway endoscopy. Ear, nose, and throat doctors perform this examination by using special cameras to look inside the child’s breathing passages while they are under anesthesia. This study looked at 62 such examinations performed at a children’s hospital over 5 years to determine how often they found significant problems that needed treatment. The study found that while about one-third of the examinations showed some changes in the airways, most of these changes were minor and did not require any treatment. Only one child needed a procedure to widen their airway. Two other children were found to have blood vessel abnormalities around their airways that required follow-up care. The researchers identified certain factors that made it more likely for doctors to find problems during the examination. These included younger age, being born premature, and having previously needed a breathing tube. However, the study suggests that many children with recurring may not need this examination procedure as serious problems requiring treatment were rare. Interestingly, the study also found that most children receiving these examinations were white and had private insurance, even though the hospital serves a diverse population. This suggests there might be differences in which children are getting referred for this procedure that need to be addressed.