Radiofrequency ablation (RFA) has gained recognition as a highly effective and safe minimally invasive alternative treatment for well-selected patients with benign thyroid nodules and recurrent thyroid cancer. Despite the well-known efficacy of RFA, head and neck surgeons have had minimal involvement in both establishing clinical evidence and developing most RFA guidelines. This is partly due to the challenges surgeons face in understanding and applying these imaging-guided interventions. However, head and neck surgeons possess extensive knowledge of surgical anatomy and have significant clinical experience with the anatomical relationships of surrounding structures, which could enhance the safety and effectiveness of RFA. Their expertise allows for better management of rare but serious complications such as bleeding, airway compression, recurrent laryngeal nerve paralysis, and tumor rupture. Drawing from my experience as a head and neck surgeon with RFA, this article aims to elucidate the principles, indications, preparation, and procedure of RFA for benign and malignant thyroid tumors.

Ectopic thyroid is thyroid tissue found in places other than the anterolateral aspect of the second to fourth tracheal ring. Mediastinal ectopic thyroid is rare and only few cases have been reported. The authors experienced a case of 41-year-old female patient with an anterior neck mass. The patient had mild chest discomfort when breathing with no other symptoms. Imaging studies suggested tumor of thymic tissue origin and surgical excision was done. The mass was successfully removed and histopathologically determined to be thyroid tissue. We hereby report with a review of literature a case of ectopic thyroid found in the mediastinum, which was successfully removed by transcervical incision.

Background and Objectives: This study aimed to analyze postoperative performance and mapping characteristics of cochlear implants (CIs) by comparing patients with autism spectrum disorder (ASD) to those without ASD, and to suggest CI mapping solutions in patients with ASD.Subjects and Method This retrospective study enrolled 10 children with ASD and hearing disabilities, who received simultaneous bilateral CI (ASD group), and 20 children with bilateral hearing disabilities, who received simultaneous bilateral CI at the same age (control group). CI performance was analyzed using speech perception tests (categorical auditory performance score and monosyllable, bisyllable, and Ling’s 6 tests) and a sound field test. The mapping characteristics focused on variables related to stimulus intensity and fine-tuning. Results: The performance of the ASD group was significantly poorer than that of the control group in all speech perception and sound field tests. At the comfortable (C) and threshold (T) levels, the ASD group scored significantly lower than the control group. The dynamic range of ASD group was significantly narrower than the control group. The ASD group had significantly lower pulse width, sensitivity, and volume than control group. Conclusion CI mapping in the ASD group showed practical limitations. To avoid overstimulation in patients with ASD, the dynamic range should be set narrow, or the C/T level should be set lower than normal. Key control factors, such as pulse width, sensitivity, and volume, should be set lower than the control group. Although lower performance from CI is generally expected in the ASD group, CI mapping in the ASD group requires a long-term approach with dedicated efforts and patience.

Background and Objectives: Dupilumab is approved for the treatment of uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) and has been shown to be relatively safe and effective in randomized controlled trials. As such, real-world effectiveness and safety data should be obtained.Subjects and Method We performed a retrospective review of patients with CRSwNP who received monthly treatment of dupilumab between January 2022 and June 2023. Reviewed for the study were the following: demographic data, comorbidities, the visual analogue scale (VAS) for nasal obstruction and sense of smell, identification scores of the Korean version Sniffin’ stikc II (KVSS II) test, nasal polyp score (NPS), and serum eosinophil count. Statistical analyses were performed for each clinical variable. Results: A total of 76 patients (49 male, 27 female) were included in this study. The VAS scores decreased from 7.17 at the baseline to 4.51 at month 6; the KVSS II identification scores increased from 6.71 to 8.47, and the NPS decreased from 3.82 to 0.44. The sino-nasal outcome test-22 scores decreased from 36.29 at the baseline to 8.22 at month 6. The correlations between all clinical variables were statistically significant. Conclusion Monthly treatment of dupilumab is effective and safe for patients with CRSwNP. Further research is required to determine the predictive parameters for treatment responses and adverse events.

Background and Objectives: The purpose of this study was to compare and analyze the 18- year change in the relative value scale (RVS) in otolaryngology in relation to other surgical departments so as to help make future policy decisions.Subjects and Method Data on RVSs and addition rates, the deparments of main managed care, frequency of practice, and number of specialists were collected for all surgeries and procedures conducted in 2004, 2008, 2013, 2018, and 2022. Among these, an analysis was conducted for nine surgical departments. The number of surgeries and procedure items, the median value of the RVS, and the usage amount (i.e., RVS of all items multiplied by the frequency of surgeries and procedures) were calculated. Results: Over the past 18 years, the increase in the number of surgeries, procedure items and RVS in otolaryngology has grown smaller than that in other surgical departments, and the usage has decreased very sharply; in essence, the usage per specialist has actually decreased compared to 18 years ago. Conclusion Compared to other departments, RVS in otorhinolaryngology has shown very little change over the past period of 18 years. It is necessary to reasonably increase the currently undervalued RVS in otorhinolaryngology, particularly focusing on surgeries and procedures.

In frontal sinus surgery, stenosis of the frontal sinus opening after surgery remains a challenge for many surgeons. Different surgical approaches such as Lynch procedure, Draf type II, and extended modified Lothrop procedure may decrease adverse surgical results but also accompany inherent complications. The use of various kinds of stents have been also suggested to prolong the patency of the frontal sinus opening. However, no definite consensus has been reached about frontal stents use. Here we introduce the experience of using a new omega shaped silicon stent, which has shown promising results in keeping the frontal sinus opening patent.

Beckwith-Wiedemann syndrome (BWS) is a genetic overgrowth disorder presenting with various clinical manifestations, including macroglossia, visceromegaly, gigantism, neonatal hypoglycemia, and anterior abdominal wall defects. Most patients with BWS suffer from swallowing and respiratory difficulty due to macroglossia, which requires surgical intervention. However, the tongue has a complex neuromuscular anatomy which is closely related to swallowing, phonation, and respiration. Therefore, care should be taken when performing reduction glossectomy for BWS patients to minimize complication after surgery. This case report describes a successful surgical intervention for macroglossia in a 3-month-old female infant diagnosed with BWS, who presented respiratory and swallowing difficulty. The keyhole shape glossectomy was performed and the patient was orally fed without respiratory difficulty 3 weeks following the surgery.