Allergic rhinitis (AR), a prevalent global health concern, is increasingly recognized for its impact beyond physical symptoms, affecting mental health. This research examined the extent of AR's psychological burden and sleep disturbances. A systematic search of four databases yielded 49 studies reporting mental health problems in 18,269,265 individuals (15,151,322 AR patients and 3,117,943 controls). The primary outcomes included all mental health problems in AR patients. Subgroup analyses based on outcome and AR severity, country, AR diagnosis, recruitment setting, and age were performed. Secondary outcomes included the risk of these problems compared to controls (healthy or without AR). In AR, depression (25%), anxiety (25%), stress (65%), distress (57%), suicidal thoughts (14%) and attempts (4%), poor sleep quality (48%), insomnia (36%), sleep impairment (33%), and insufficient sleep duration <7 h (59%) were prevalent. The severity of these outcomes differed significantly. Patients' country, AR diagnostic method, recruitment method/setting, and age group were significant effect modifiers. Compared to controls, AR resulted in significantly higher risk of depression, anxiety, stress, suicidal attempts and thoughts, insomnia, and sleep impairment. AR patients had significantly lower sleep duration. Mental health problems are very common among AR patients, further exacerbating their sleep quality and duration and intention to suicide.

The removal of foreign bodies (FBs) from the airways of children is a critical procedure that can avert serious complications. While both flexible and rigid bronchoscopy techniques are employed for this purpose, their comparative efficacy and safety remain subjects of debate. Therefore, we conducted this investigation to compare between both procedures. Studies comparing flexible to rigid bronchoscopy (n = 14) were identified by searching PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar. We performed comparative meta-analyses of reported presentation characteristics and clinical outcomes, using fixed- and random-effects models. A diverse range of FB types and locations were identified. No difference was observed in the success rate of FB removal between flexible and rigid bronchoscopy (logOR = 0.27; 95%CI: −1.91:2.45). The rate of negative first bronchoscopy was higher in the flexible compared to the rigid group (logOR = 2.68; 95%CI: 1.68:3.67). Conversion rates to the alternative method were higher in the flexible bronchoscopy group. The overall complication rates were similar between both methods; however, the risk of desaturation was significantly lower with flexible bronchoscopy (logOR = −2.22; 95%CI: −3.36:−1.08). Flexible bronchoscopy was associated with a shorter length of hospital stay. The choice of bronchoscopy technique should be tailored to individual case characteristics.

To compare the diagnostic performance, safety, and procedural characteristics of fine-needle aspiration (FNA) versus core-needle biopsy (CNB) in patients with salivary gland tumors. A systematic search was conducted across PubMed, Scopus, Web of Science, and Google Scholar on April 8, 2025. Studies comparing FNA and CNB in salivary gland tumors were included. Extracted data included diagnostic metrics, repeat procedures, non-diagnostic rates, and complications. Pooled sensitivity, specificity, and accuracy were calculated using random-effects models. Subgroup and meta-regression analyses were performed to identify potential moderators. Risk of bias was assessed using QUADAS-2. Fifteen studies (3669 patients/4000 biopsies) were included. CNB demonstrated markedly higher sensitivity (≈99 %) compared to FNA (≈68 %), while specificity was similarly high for both modalities. FNA was associated with more non-diagnostic and repeat procedures, whereas CNB carried a slightly increased but rare risk of hematoma. Subgroup analyses identified operator background, tumor site, needle gauge, and procedural guidance as significant moderators of FNA performance but not CNB. Meta-regression confirmed that freehand technique and lower needle gauge significantly increased non-diagnostic rates in FNA. CNB provides superior diagnostic accuracy with fewer non-diagnostic and repeat procedures, while maintaining comparable safety to FNA. Beyond diagnostic performance, its higher first-pass yield may shorten time-to-diagnosis, reduce repeat visits, and improve patient confidence in management planning. Nevertheless, minor procedural risks such as hematoma and the need for trained operators should be considered. Overall, CNB is the preferred modality in most clinical settings, especially when histological diagnosis is essential or cytopathology support is limited.

Background: Unilateral vocal fold paralysis (UVFP) significantly impairs vocal function, affecting patients’ quality of life. Injection laryngoplasty, a primary treatment modality for UVFP, varies in effectiveness based on the material used, injection volume, and procedural nuances. This study aims to systematically analyze how these factors influence treatment outcomes to optimize intervention strategies. Materials and methods: The authors conducted a comprehensive meta-analysis and meta-regression using data extracted from 82 studies identified through a robust literature search on databases including PubMed, Scopus, and Web of Science, up to 13 February 2024. Eligible studies were single-armed observational or experimental that reported pre and postoperative data on UVFP patients undergoing their first injection laryngoplasty. The primary outcomes analyzed included maximum phonation time, harmonics-to-noise ratio, fundamental frequency, jitter, shimmer, and subjective voice measures such as the Voice Handicap Index and GRBAS scale components. Results: The meta-analysis revealed significant improvements in maximum phonation time (MPT) and harmonics-to-noise ratio (HNR) post-injection, with variability in outcomes influenced by injection material and procedural techniques. Meta-regression identified the injection volume and the timing of the procedure as significant predictors of MPT and HNR outcomes, respectively. Materials such as polydimethylsiloxane (PDMS) and autologous fat significantly improved MPT and reduced the grade of dysphonia and roughness, respectively. The type of injection material, volume, and approach was crucial in reducing symptoms of voice handicap and enhancing the overall vocal quality. Conclusions: Injection laryngoplasty significantly improves vocal outcomes in UVFP patients. The choice of injection material, volume, and timing of the intervention play pivotal roles in determining the effectiveness of the procedure. Tailored treatment approaches based on these factors are recommended to enhance therapeutic efficacy and patient satisfaction.

Background: Rhinoplasty is a common plastic surgery procedure with evolving surgical techniques. This systematic review and meta-analysis compares the outcomes of piezosurgery versus conventional osteotomy in rhinoplasty. Methods: A comprehensive search of six databases yielded 12 randomized controlled trials (RCTs) comparing piezosurgery (292 cases) to conventional osteotomy (338 cases) in rhinoplasty patients. The examined outcomes included postoperative edema, ecchymosis, complications, pain (using the Visual Analogue Scale—VAS), and operative time. Subgroup analyses were conducted based on the assessment timepoint, surgical approach, and outcome grade. The risk of bias was evaluated using the revised Cochrane tool. Results: Piezosurgery showed a significant reduction in the degree of postoperative edema (second and seventh postoperative days) and ecchymosis (second, fourth, and seventh postoperative days). The external approach in piezosurgery demonstrated greater benefits for both outcomes. Piezosurgery was associated with a significant reduction in overall complications, especially mucosal injuries, compared to conventional osteotomy, with no significant difference regarding postoperative hemorrhage. A significant reduction in pain scores and the need for analgesia was observed with piezosurgery. No significant difference was found in operative time. Conclusions: Piezosurgery offers significant benefits in patient outcomes, with similar operative time between both techniques. However, long-term investigations are still needed.

Background/Objectives: Human papillomavirus (HPV) is a known etiologic agent in oropharyngeal cancers, but its role in oral cavity squamous cell carcinoma (OCSCC) remains unclear. This systematic review and meta-analysis aimed to estimate the global prevalence of HPV in OCSCC and explore variation by clinicodemographic and tumor characteristics. Methods: We systematically searched multiple databases for studies reporting HPV prevalence in OCSCC. Pooled prevalence estimates were calculated, and subgroup analyses examined differences by age, gender, cancer stage, anatomical site, histologic subtype, region, and HPV type (HPV-16 and HPV-18). Heterogeneity and publication bias were assessed using standard meta-analytic techniques. Results: A total of 122 studies involving 16,311 patients were included. The pooled HPV prevalence in OCSCC was 25.8% (95% CI: 20.4–31.2), with HPV-16 and HPV-18 detected in 52.4% and 30.3% of positive cases, respectively. Prevalence varied geographically, from 73% in Singapore to 7.7% in South Korea. Younger patients (70 years, 23.8%). Early-stage cancers (stage I) showed higher HPV prevalence (41.8%) than advanced-stage cancers (stage IV, 10.4%). Verrucous carcinoma had the highest HPV positivity (34.1%), and moderately differentiated tumors the lowest (23.4%). HPV prevalence was highest in the lower alveolus (29.5%) and lips (25%), and lowest in the upper gingiva (3.9%). Conclusions: HPV prevalence in OCSCC demonstrates significant heterogeneity across regions and clinical subgroups. These findings emphasize the need for standardized diagnostic approaches and further research into the role of HPV in OCSCC pathogenesis and treatment.