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Background: Thyroid nodules are common incidental findings in ultrasound examinations. Early detection by ultrasound does not seem to have any patient-relevant benefits in terms of secondary prevention.

Objective: The current article provides an overview of international evidence for the benefits and harms of ultrasound in the secondary prevention of thyroid nodules.

Methods: A narrative review (PubMed search; 2010-2025) of guidelines (American Thyroid Association, ATA; American Association of Clinical Endocrinology, AACE/American College of Endocrinology, ACE; European Thyroid Association, ETA; United States Preventive Services Task Force, USPSTF; National Institute for Health and Care Excellence, NICE; German-language S3 guidelines), population-based studies (SHIP, KORA, SEER), and systematic reviews and meta-analyses was performed.

Results: The prevalence of thyroid nodules is high, but the proportion of clinically relevant or malignant findings is very low. Mortality from thyroid cancer is also low. Screening asymptomatic adults with ultrasound increases the incidence of mostly indolent papillary carcinomas without any reduction in mortality. The risk of overdiagnosis and subsequent overtreatment is substantial. Thus, international and national guidelines do not recommend screening for early detection of thyroid cancer. Standardized ultrasound risk classifications (e.g., European Thyroid Imaging Reporting and Data System, EU-TIRADS/American College of Radiology TIRADS, ACR TIRADS) are essential for targeted evaluation in cases of clinically suspected thyroid cancer.

Conclusion: Screening asymptomatic individuals using ultrasound is not recommended. The rate of overdiagnosis is high, and the benefits in terms of reducing morbidity or mortality have not been proven.

Background: The definition of normal hearing according to the DIN standard refers to the air conduction threshold of tympanometry. However, middle ear function is not specifically considered in this definition. The present study aimed to prospectively collect audiometric data for normal hearing that are based not only on tone audiometry but also supplemented by objective data on middle ear function.

Methods: The examinations were carried out in 84 ears of test subjects aged 18-25 years with normal hearing according to tone audiometry. Objective middle ear diagnostics were performed using classic tympanometry, broadband absorbance tympanometry, and stapedius reflex threshold measurement. A distortion product otoacoustic emission (DPOAE) measurement was also carried out.

Results: Compliance of more than 2 mmho was found in 7 of the 84 ears examined, which are considered separately in the following. The resonance frequency of these 7 ears was below the first quartile of the comparison group (759 Hz), and the absorbance of this group was above the third quartile of the absorbance of the group with regular compliance for frequencies up to 750 Hz. In the group with increased compliance, in more cases than in the comparison group (14% vs. 5%) were no DPOAEs detectable at at least one frequency. In 6 of the 7 ears with increased compliance, stapedius reflex thresholds were found within the whisker range of the group with regular compliance at all measured frequencies.

Conclusion: In the DIN standard for classification of normal hearing, the definition of normal hearing is based solely on tone audiometric parameterization. The reference values measured in this study with regard to compliance of the eardrum show clear inter-individual variance. Supplementing the assessment of middle ear function, such as by measuring compliance, resonance frequency, and/or absorbance curves, could provide additional information to confirm normal hearing.

Background: The proportion of older adults with head and neck cancer is steadily rising. Treatment planning in this population is often challenging due to more frequent comorbidities; reduced physiological reserves; and, at times, differing treatment goals. Additionally, older adults have been significantly underrepresented in pivotal radiotherapy trials, making evidence-based decision-making difficult.

Objective: This article strives to present current controversies in the radiotherapeutic management of older adults with head and neck cancer.

Methods: A selective literature search for studies addressing radiotherapy in elderly head and neck cancer patients was conducted via PubMed and ClinicalTrials.gov.

Results: Geriatric screening tools such as the G8 test are associated with treatment adherence and survival but are still rarely implemented in routine clinical practice. The SENIOR cohort study (NCT05337631) demonstrated a survival benefit for the combination of radiotherapy with concurrent chemotherapy in older patients with good performance status and few comorbidities, but not for the combination with cetuximab. Current studies are investigating hypofractionated radiotherapy regimens and novel agents for patients with contraindications to cisplatin. For patients ineligible for curative treatment, effective palliative radiotherapy concepts with shortened overall treatment duration are available.

Conclusion: The management of older adults with head and neck cancer remains challenging and requires further prospective research. Advanced age alone should not be considered a contraindication to curative radiotherapy, including concurrent chemotherapy. For patients not eligible for curative treatment, various palliative radiotherapy regimens are available.

Neck dissection is an essential part of surgical treatment for head and neck malignancies. In recent years, the extent of neck dissection required for optimal oncological results has been increasingly reduced and, in some cases, replaced by alternative procedures such as sentinel lymph node biopsy. However, this is only possible with precise staging. Improved imaging, molecular markers, and artificial intelligence are used for this purpose. Particularly in light of immunotherapy, which has now also been approved for neoadjuvant use, the preservation of functional lymphatic structures is relevant, as this has a positive effect on the response to treatment. Ultimately, histological examination of the cervical lymph nodes remains the gold standard for assessing prognosis and planning adjuvant therapy.

Skull base surgery is a highly specialized interdisciplinary field, the importance of which has grown significantly in recent decades. It requires a high level of technical equipment, specialized personnel, and interdisciplinary cooperation, and, due to its complexity, it can often only be performed adequately at university hospitals or high-volume centers. The ability to perform skull base surgery requires many years of complex surgical training. Certified interdisciplinary skull base centers are being developed nationally and internationally to provide patients with the highest level of care. The aim of this review is to give an overview of the current situation based on the most common clinical challenges in order to discuss the common typical "unmet clinical needs" and the future perspectives of skull base surgery.

This article examines various legal aspects of outpatient surgery performed by different medical practitioners and institutions in Germany. In addition to outlining the legal basis for the respective practitioners, it also addresses current reform efforts. Due to the need for patient safety, the legal requirements of practice are high. Intersectoral cooperation is encouraged, although it comes with limitations due to compliance concerns. The constant advancement of the model of day surgery in times of limited healthcare and financial resources blurs sectoral boundaries, ultimately exacerbating competition between medical practitioners and institutions.

Background: The COVID-19 pandemic led to physical illness, mental health disorders, social problems, and ongoing societal conflicts that have not yet been entirely resolved. Among the inflammatory processes associated with the virus, organic otorhinolaryngologic diseases occurred, resulting in functional impairments such as voice disorders caused by laryngeal affections. This study focused on the subjective suffering caused by functional dysphonia during the pandemic in patients who had not been affected by COVID-19. The underlying assumption was that the overall pandemic situation would alter both the healthcare-seeking behavior of affected individuals as well as their subjective assessments compared to the periods before and after the pandemic.

Materials and methods: The study was based on clinical routine data collected from the phoniatric and pedaudiologic specialist practice of the second author covering the second quarter of 2019 through to the second quarter of 2023. A total of 972 adult patients who presented for the first time with functional dysphonia were included. Assessment tools were the Voice-Related Quality of Life (VRQoL) questionnaire and the Depression Anxiety Stress Scales (DASS) that measure depression, anxiety, and stress.

Results: In the quarter preceding the first lockdown, the number of patients was higher than the average of all other quarters, while it was lower during the quarter of the first lockdown. For the remainder of the observation period, patient numbers fluctuated without statistical significance. Across all measured domains, no significant differences were observed when comparing the periods before and after the pandemic.

Conclusion: No pandemic-related changes were found in the subjective experience of suffering from functional dysphonia, neither in terms of voice-specific dysfunction nor in emotional domains.

This case report describes a patient with localized laryngeal immunoglobulin light chain (AL) amyloidosis. The larynx is one of the most common sites of manifestation of localized amyloidosis. Amyloidosis leads to benign, tumor-like lesions caused by the deposition of insoluble protein aggregates, so-called fibrils. The current patient presented with the main symptom of hoarseness. Amyloidosis is most commonly treated by surgical resection of the mass. However, depending on the extent and course of disease, other therapeutic approaches are also feasible, which are discussed in this review.