30-Second Takeaway
- Three months of intranasal saline resolves symptoms in about half of children with OSDB, without added benefit from steroids.
- IL-4Rα–targeting biologics provide the strongest overall benefits for CRSwNP, with safety comparable to placebo.
- Frozen section for HPV-positive SCCUP shows high sensitivity and perfect specificity for occult primary localization.
Week ending January 24, 2026
Actionable updates in pediatric sleep, rhinology, head and neck, and skull base practice
Intranasal saline is an effective first-line therapy for pediatric OSDB
This double-blind RCT enrolled 150 children aged 3–12 years with obstructive sleep-disordered breathing from specialist clinic waitlists. After 6 weeks of once-daily intranasal saline, symptoms resolved in about 30% of children before randomization. Among 93 children with persistent symptoms, adding mometasone 50 µg daily for 6 weeks offered no benefit over continued saline for symptom resolution. Secondary outcomes, including behavior, quality of life, and parental perception of surgical need, did not differ between steroid and saline groups.
IL-4Rα biologics lead efficacy rankings for CRSwNP in network meta-analysis
This Bayesian network meta-analysis included 16 randomized trials and 2,034 patients with chronic rhinosinusitis with nasal polyps. Eight biologics targeting IL-4Rα, IgE, IL-5, or TSLP all significantly reduced Nasal Polyp Score compared with placebo. The IL-4Rα inhibitor stapokibart ranked best for polyp reduction and nasal congestion relief, while dupilumab provided the greatest SNOT-22 improvement. Stapokibart and dupilumab both improved UPSIT smell scores, indicating meaningful recovery of olfaction.
Frozen section accurately localizes occult primaries in HPV-positive SCCUP
This two-institution retrospective cohort evaluated 77 patients with p16-positive squamous cell carcinoma of unknown primary undergoing diagnostic surgery. Occult primaries were identified in 82% of patients, with a mean tumor size of 1.1 cm. Overall frozen-section performance showed 86% sensitivity, 100% specificity, 100% positive predictive value, and 86% negative predictive value. Direct laryngoscopy biopsies achieved 100% sensitivity and negative predictive value, whereas TORS excisions had 77% sensitivity and negative predictive value.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.