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CLINICAL QUESTION Do non-opioid pain medications offer adequate pain control compared to opioids, following rhinoplasty? BOTTOM LINE There was no difference between opioid and non-opioid pain medications in post-operative pain control after rhinoplasty, suggesting that non-opioid medications may offer adequate pain control in rhinoplasty.

CLINICAL QUESTION How might proposed Medicare coverage restrictions on botulinum toxin injections affect patients with hemifacial spasm, facial dystonia, and nonflaccid facial paralysis? BOTTOM LINE The proposed Medicare policy could restrict individualized botulinum toxin treatment by limiting reimbursable injection sites and initial dosing.

Facial nerve (cranial nerve VII) paralysis is a common condition encountered by otolaryngologists and facial plastic surgeons. Management often requires a multidisciplinary approach involving ophthalmology, neurology, head and neck surgery, and facial reanimation specialists. Protecting the ocular surface is the immediate priority, as lagophthalmos and impaired blink can lead to exposure keratopathy, corneal ulceration, stromal scarring, and permanent vision loss if left untreated.

CLINICAL QUESTION Can intracochlear DB-OTO gene therapy restore natural acoustic hearing in children with profound congenital deafness caused by biallelic OTOF variants? BOTTOM LINE In this first-in-human, open-label study, DB-OTO improved hearing in most children with OTOF-related deafness. At 24 weeks, nine of 12 participants met the primary efficacy endpoint, six could hear soft speech without assistive devices, and three achieved average normal hearing sensitivity.

CLINICAL QUESTION Does the Arms Race Control Score (ARCS) provide a more effort-sensitive assessment of research productivity than raw publication counts among matched otolaryngology residency applicants? BOTTOM LINE ARCS may provide a fairer, more consistent measure of research quality and effort, discourage superficial publishing, and promote meaningful scholarship in applicant evaluation.

CLINICAL QUESTION Can a wearable augmented reality (AR)–based system feasibly perform standardized oculomotor/nystagmus testing in patients with vertigo compared with conventional video-oculography? BOTTOM LINE This small, randomized crossover usability study showed that a wearable AR-based nystagmus examination system was feasible and well tolerated, with moderate preliminary diagnostic agreement compared with conventional video-oculography.

CLINICAL QUESTION What are the long-term rates of recurrence, residual dizziness, falls, and quality-of-life impairment after successful treatment of benign paroxysmal positional vertigo (BPPV)? BOTTOM LINE Despite successful initial treatment, BPPV was associated with substantial long-term morbidity.

CLINICAL QUESTION Is retinal vein occlusion associated with a higher prevalence of tinnitus, hearing loss, vertigo, or sudden deafness? BOTTOM LINE Patients with retinal vein occlusion had modest but statistically significantly higher odds of tinnitus and hearing loss compared with matched comparison patients. No significant association was found between retinal vein occlusion and vertigo or sudden deafness.

CLINICAL QUESTION Which contemporary airway techniques and planning principles are most relevant to routine and emergency otolaryngology and head and neck surgery? BOTTOM LINE Modern ENT airway management depends on multidisciplinary planning, specialized equipment, and procedure-specific expertise; however, difficult-airway guidelines are still developed mainly within anesthesiology because otolaryngology-specific literature remains limited.

INTRODUCTION Current assessment techniques for laryngeal clefts are highly variable, both across and within pediatric institutions. Previous reports have shown a discrepancy in the definitions of, and differentiation across, a normal larynx, deep interarytenoid notch (DIN), and Benjamin-Inglis type I laryngeal cleft (T1C).