An unusual presentation: temporomandibular tissue herniation through congenital foramen of Huschke.

BACKGROUND: The herniation of temporomandibular tissue through the foramen of Huschke into the external auditory canal is a rare clinical anomaly. This paper describes one such case and provides an overview of the relevant literature. This paper elaborates upon the aetiology, clinical assessment, management and associated complications. CASE REPORT: A 54-year-old woman presented with a 3-month history of right ear pain and a polypoid lesion in her right ear canal. This lesion expanded during a Valsalva manoeuvre, and imaging demonstrated a defect in the antero-superior aspect of the canal with herniation of soft tissue. The patient was managed conservatively as the symptoms resided. CONCLUSION: Ear canal lesions that protrude or change in size with a Valsalva manoeuvre could be due to a persistent foramen of Huschke. In symptomatic cases needing surgical intervention, a variety of materials may be used to close the defect. Titanium mesh, with or without cartilage overlay, appears to be the most popular choice.

Building a competitive application: exploring the entry routes and educational choices of otolaryngology higher surgical trainees in the UK.

BACKGROUND: This cross-sectional study investigates the educational background and entry routes of otolaryngology higher surgical trainees in the UK. METHOD: A survey was disseminated to trainees through training programme directors and 60 responses were received. RESULTS: Most trainees decided to pursue otolaryngology early in their training, with 50 per cent making the decision four or more years before applying for a higher surgical traineeship. Similarly, 68.3 per cent of trainees undertook otolaryngology-themed core surgical training, while two-thirds had an otolaryngology rotation during their foundation training. Most trainees (86.7 per cent) were accepted into core surgical training on their first attempt, and 71.7 per cent gained entry to higher surgical training on their first attempt. CONCLUSION: The findings highlight the importance of early exposure to otolaryngology and the pursuit of themed core surgical training programmes for building a competitive application. However, unsuccessful first attempts at core surgical training or higher surgical training should not discourage candidates from pursuing a career in otolaryngology.

Bilateral Warthin's tumour of the parotid gland: a 16-year retrospective analysis and systematic review.

OBJECTIVE: Warthin's tumours are the second most common benign parotid tumours in the UK. The World Health Organization states that 5-14 per cent of patients have bilateral Warthin's tumours. This study aimed to: assess the presence of contralateral Warthin's tumours in patients who underwent surgery over the past 16 years at a head and neck unit in England, and perform the first systematic literature review on bilateral Warthin's tumours. METHODS: A retrospective analysis was conducted on patients diagnosed with Warthin's tumour based on histology between 2005 and 2020. Additionally, a systematic review (International Prospective Register of Systematic Reviews ('PROSPERO') registration number: CRD42022326846) was performed using PubMed and the Cochrane Library. RESULTS: Among 290 patients diagnosed with Warthin's tumours based on histology following surgery, 24.5 per cent had bilateral Warthin's tumours. The systematic review identified 157 papers, with 14 meeting the inclusion criteria. CONCLUSION: This study revealed that 24.5 per cent of patients had bilateral Warthin's tumours, deviating from the suggested range. These findings are of interest to surgeons discussing the disease with patients.