Neonatal hearing screening (NHS) is a critical public health measure for early identification of hearing loss, ensuring timely access to interventions that can dramatically improve a child’s language development, cognitive abilities, and social inclusion. Beyond clinical benefits, NHS provides long-term advantages in education and quality of life. Given that congenital hearing loss affects approximately 1–2 in every 1000 newborns worldwide, the case for universal screening is clear. Countries like the United States and Australia have successfully implemented NHS, leading to earlier diagnoses, improved language development, and better educational outcomes. In Europe, while many nations have adopted NHS, consistency remains a challenge. Countries such as Norway and the United Kingdom stand out for their well-established systems, whereas others, like Greece, have made notable progress but have yet to mandate NHS nationwide. This highlights the need for cohesive national policies across Europe to ensure universal coverage. Screening methods such as Transient Evoked Otoacoustic Emissions (TEOAE) and Automated Auditory Brainstem Response (AABR) are established tools for detecting hearing impairments in neonates. Despite their demonstrated efficacy, NHS remains inconsistent globally, particularly in low- and middle-income regions that lack mandatory policies or access to reliable screening technologies. This perspective advocates for the urgent need to make NHS mandatory in all countries, emphasizing its societal benefits and cost-effectiveness. Early diagnosis supports prompt intervention, like hearing aids or cochlear implants, which are most effective when implemented before six months. It also empowers families to make informed decisions, fosters educational inclusion, and mitigates the social and emotional challenges of undiagnosed hearing loss. Policymakers, healthcare providers, and international organizations must prioritize universal NHS to ensure no child is left behind due to unaddressed hearing loss.

Background and Clinical Significance: Choanal atresia is a rare congenital obstruction of the posterior nasal aperture, with an estimated incidence of one in 5000 to one in 8000 live births. Bilateral disease typically presents as a neonatal emergency, whereas unilateral disease is more frequent and may remain undiagnosed for years or decades, presenting in adolescence or adulthood with chronic unilateral nasal obstruction and ipsilateral mucopurulent rhinorrhoea. Optimal surgical management remains debated, particularly with regard to mucosal-flap reconstruction and the choice of postoperative stent. Case Presentation: A 22-year-old male was referred for chronic left-sided nasal obstruction, persistent ipsilateral mucopurulent rhinorrhoea and reduced ipsilateral olfaction. Nasal endoscopy and high-resolution computed tomography demonstrated an isolated, non-syndromic, mixed bony–membranous left choanal atresia. The patient underwent transnasal endoscopic choanoplasty with posterior septectomy and removal of the atretic plate and posterior vomer. An ipsilateral superiorly based septal mucoperichondrial flap was raised first and later transposed over the sphenoid rostrum; following drilling, the contralateral septal mucosa was approached and incised horizontally to generate a superior and an inferior leaflet, which were rotated to cover the corresponding portions of the residual posterior septal ridge. A bioabsorbable mometasone-furoate-eluting sinus implant (PROPEL^®, Medtronic) was deployed across the neo-choana. The follow-up endoscopy at two months demonstrated a widely patent, well-mucosalized neo-choana with complete resolution of symptoms. Conclusions: Transnasal endoscopic posterior septectomy combined with mucosal-flap reconstruction and a bioabsorbable steroid-eluting stent is a technically feasible and biologically rational approach to adult unilateral CA. To our knowledge, this is among the first reports describing the off-label intraoperative use of a PROPEL^® stent in a young adult with isolated unilateral choanal atresia.

Conductive hearing loss (CHL) results from impaired mechanical transmission of sound through the external or middle ear and is commonly associated with conditions such as otosclerosis, cholesteatoma, ossicular discontinuity, congenital malformations and trauma. Less frequently, it may arise from vascular or neoplastic lesions. Imaging plays a central role in the evaluation of CHL, with high-resolution CT (HRCT) regarded as the gold standard for initial assessment because of its superior spatial resolution in detecting bony pathologies, including fenestral otosclerosis, ossicular chain defects, third-window lesions and trauma-related disruptions. MRI complements HRCT by providing excellent soft tissue contrast, facilitating the detection of postoperative cholesteatoma via non-echo-planar diffusion-weighted imaging and the characterisation of vascular tumours such as glomus tympanicum. CT angiography (CTA), while not routinely indicated, can be valuable for identifying vascular anomalies and aiding surgical planning in selected cases. Technical considerations, such as optimised scan parameters, strategies for radiation dose reduction in paediatric patients and the integration of multiple imaging modalities, are essential for accurate diagnosis and effective treatment planning. Collectively, HRCT, MRI and CTA provide a structured, evidence-based framework for the comprehensive evaluation and management of CHL. Contribution: This review synthesises current evidence on HRCT, MRI and CTA in the assessment of CHL, emphasising their complementary roles, protocol optimisation and multimodal integration to enhance diagnostic accuracy and surgical guidance in both paediatric and adult populations.

Background and Clinical Significance: Tympanostomy tubes (TTs) are normally extruded into the external auditory canal within 6–18 months, whereas medial migration into the middle ear is a rare complication. Medialized tubes have been associated with otalgia, otorrhea, conductive hearing loss, granuloma and perilymphatic fistula, yet may remain clinically silent; no consensus exists on whether asymptomatic medialized tubes should be removed. Case Presentation: A 24-year-old man attended a routine otorhinolaryngological examination without otological complaints. He had undergone bilateral TT insertion at four years of age for otitis media with effusion, with complete resolution and no further otological procedures. Otoscopy demonstrated an intact tympanic membrane through which a round, blue structure was visible within the posteroinferior quadrant of the tympanic cavity; otoendoscopy confirmed a foreign body in contact with the middle ear mucosa. Tympanometry showed a type A curve and pure-tone audiometry showed normal, symmetrical thresholds. High-resolution computed tomography showed an aerated middle ear cleft, well pneumatized mastoid cavities, an intact ossicular chain and no radiological features of chronic otitis media. Conservative management was adopted, with clinical and audiological review planned at 6–12-month intervals; at the most recent review, three months after diagnosis, the patient remained asymptomatic. Conclusions: A medially migrated TT may be retained within the middle ear for two decades without inflammation, structural damage or hearing loss. In selected patients with an intact tympanic membrane, normal audiometry and unremarkable imaging, structured observation is a defensible alternative to removal, provided the patient is counseled about the symptoms that should prompt review.

Background and Clinical Significance: Fibrolipoma is an uncommon histological variant of lipoma characterized by mature adipose tissue with a significant fibrous component. Intraoral lipomas are rare (only about 1–4% of all lipomas) and lipomas arising in the buccal fat pad (buccal space) are particularly uncommon. Case Presentation: A 47-year-old male presented with a painless, slowly enlarging swelling in the left cheek region. Physical examination revealed a soft, non-tender mass in the buccal space, causing mild bulging of the cheek. Contrast-enhanced computed tomography and magnetic resonance imaging demonstrated a well-circumscribed lesion within the left buccal fat pad suggestive of a lipoma. The tumor was excised entirely via an intraoral approach under general anesthesia. Histopathological examination showed lobules of mature adipocytes interspersed with dense fibrous connective septa consistent with a diagnosis of a fibrolipoma. The postoperative course was uneventful. Conclusions: This case highlights that fibrolipoma, while rare in the maxillofacial region, should be included in the differential diagnosis of buccal space tumors. Imaging studies can aid in identifying the fatty nature and extent of such lesions, but definitive diagnosis relies on histopathology. The buccal fat pad’s anatomy allows an intraoral surgical approach in appropriate cases, providing direct access and excellent cosmetic outcomes. Complete excision is curative in benign fibrolipomas, and careful surgical technique prevents injury to adjacent structures.