PURPOSE OF REVIEW:This review summarizes the evidence supporting the use of immunotherapy across the full disease spectrum of head and neck squamous cell carcinoma (HNSCC) from early-stage, curative-intent settings to recurrent/metastatic disease. It also examines emerging data on swallowing outcomes and outlines the incidence and management of immune-related adverse events (irAEs). RECENT FINDINGS:Immunotherapy has become integral to the management of advanced HNSCC, and recent trials demonstrated promising benefits in resectable disease, although overall survival data remain immature. Early evidence also suggests that peri-operative immunotherapy may confer functional advantages by reducing the proportion of patients requiring postoperative chemoradiation, an important consideration given the well established impact of cisplatin-based chemoradiation on swallowing outcomes. As the use of immunotherapy widens, irAEs become more prevalent, necessitating early detection and refined management strategies. SUMMARY:A robust and growing evidence base supports the use of immunotherapy in HNSCC across both curative-intent and advanced settings. Further research is required to optimize patient selection, define optimal sequencing and combination strategies in early-stage disease, and incorporate functional outcomes, particularly swallowing, into future trial designs.
PURPOSE OF REVIEW:Difficulties swallowing medicines is common, even in those with no other swallow issues. Yet, for many, daily safe and optimized ingestion and absorption of medicines is critical. In this review, we explore current evidence regarding pill swallowing patterns and recommendations for optimising pill swallowing. RECENT FINDINGS:Pill swallowing difficulties are common and are associated with factors such as polypharmacy and larger dosage forms. Patient-reported screening tools for pill dysphagia are emerging as a valuable approach for identifying pill swallowing difficulties. However, the clinical evaluation and management of pill dysphagia remain variable, highlighting the need for standardized assessment protocols and clinical practice guidelines. Integrating pill swallow challenges into instrumental swallowing assessments will help to inform clinically appropriate management pathways. Dosage form characteristics, including pill size, shape, and formulation, remain key determinants of swallowing performance. Use of pill-swallowing aids such as lubricants may improve patients' perceived ease and confidence with pill intake. SUMMARY:Routine screening and integration of pill-swallowing assessments into dysphagia management should become standard practice. Future research should prioritize robust evaluation of pill characteristics, pill-swallowing aids and educational interventions focused on safe medication administration practices, to optimize pill swallowing safety, adherence, and therapeutic outcomes.
PURPOSE OF REVIEW:The objective of this article is to summarize recent advances in research regarding the pathophysiology of pepsin in EER and emerging technologies for EER management. RECENT FINDINGS:Recent research adds mechanistic support for pepsin-mediated injury during EER, including an emerging role in chronic pulmonary fibrotic diseases. Innovative diagnostics aim to measure pepsin activity and endocytosis, while novel biomarkers of gastroduodenal reflux highlight opportunities for multiplex diagnostic assays and personalized treatment approaches. Preclinical studies increasingly support direct pepsin inhibition by HIV protease inhibitors leading to an ongoing clinical trial to evaluate fosamprenavir for LPR. SUMMARY:Research continues to make strides towards EER-specific diagnostics and therapeutics. Areas of critical need remain, such as ICD-10-CM diagnostic codes for EER/LPR, a fit-for-purpose outcomes tool for regulatory approval of novel treatments, and drug delivery platforms such as a laryngopharyngeal inhaler to target EER disease sites.
PURPOSE OF REVIEW:This review summarizes nonviral genome-editing delivery platforms for hereditary hearing loss, focusing on lipid nanoparticles (LNPs) and engineered virus-like particles (eVLPs), and discusses their advantages over adeno-associated virus-based delivery, as well as the barriers to clinical translation. RECENT FINDINGS:Recent advances have established LNPs as a clinically advanced nonviral platform, although challenges related to inner ear biodistribution, cell type specificity, endosomal escape, and immunogenicity remain to be addressed. In parallel, eVLPs have undergone substantial technical evolution, progressing from early low efficiency systems to advanced base editor- and prime editor-eVLP architectures that enhance cargo loading and editing efficiency. Extracellular vesicle-based genome editing has also emerged as an additional platform, although issues related to reproducibility, loading efficiency, and scalability remain major hurdles. SUMMARY:Nonviral genome editing platforms expand the therapeutic toolkit for hereditary hearing loss by enabling transient delivery of genome editors with potential safety advantages. Future efforts should focus on characterizing biodistribution and immunogenicity, refining cell type-specific tropism, and establishing scalable manufacturing processes to enable successful clinical translation.
Purpose of review Optical coherence tomography (OCT) is a noninvasive optical imaging technique to image soft tissue and thin bony structures with high resolution, approaching that of histology. This review summarizes recent progress in the clinical application of OCT for tympanic membrane and middle ear disease. Recent findings Recent reports from clinical trials show that OCT is having a meaningful impact on the diagnosis of fluid in the middle ear. In parallel with this, numerous groups are obtaining previously unattainable normative data in vivo on human middle ear structures. OCT is also starting to be used for functional assessments of the middle ear in the clinical setting by detecting sound and pressure-evoked motion. Summary OCT allows real-time noninvasive radiation-free structural and functional imaging of the tympanic membrane and middle ear at the point of care. As artificial intelligence becomes more commonplace in medicine, it is likely that OCT will become a key technology for the otolaryngologist. The data provided by OCT can be used to train machine learning algorithms for the segmentation of ear structures, which will ultimately support the automated diagnosis of ear disease. This will also aid in objectively tracking disease progression over time. Thus, OCT presents much promise for our field by revolutionizing office-based otological diagnostics.
