After genetic causes, congenital cytomegalovirus (cCMV) infection is the leading infectious cause of congenital and early childhood hearing loss. The 2025 German S2k guideline on prevention, diagnosis, and treatment of CMV infection in pregnant women and congenital CMV infection in neonates and children published by the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, AWMF; 093-003 [24]) provides corresponding recommendations and summarizes the current evidence. Hygiene counseling of pregnant women, targeted diagnostic testing during pregnancy and in neonates, and antiviral therapeutic options are important measures for prevention and treatment of congenital CMV infection. Universal newborn hearing screening (UNHS) is decisive for the diagnosis of congenital hearing loss. If abnormal results are revealed in the initial and follow-up testing, polymerase chain reaction (PCR) analysis of CMV DNA in urine (gold standard) or saliva should be performed immediately-as it should be in the case of other symptoms-preferably in the maternity or pediatric hospital and certainly not later than in the second to third week of life. In the case of symptomatic congenital CMV infection, causal treatment of congenital hearing loss can be offered as early as during the first 30 days of life-both for clinically symptomatic infants and for those with isolated hearing loss. Treatment may reduce the severity of hearing loss, stabilize hearing, or prevent progression. Long-term aftercare is essential to recognize progression or a late onset of hearing loss and to ensure adequate management. In addition to dissemination of these guideline recommendations, interdisciplinary cooperation-particularly between the maternity and neonatal departments performing UNHS and otorhinolaryngology and pediatric audiology departments-is essential.

To determine the minimal clinically important difference (MCID), patient-reported outcome measures (PROMs) are presented that cover the dimensions 1. subjective hearing ability, 2. hearing-specific quality of life, and 3. generic quality of life, which are largely mentioned in corresponding guidelines and recommendations for device provision and aural rehabilitation in Germany. In the absence of recognized MCID thresholds in the field of cochlear implant (CI) provision in Germany, a methodological framework for future clinical studies was developed based on a two-stage anchor-based retrospective survey (1. significant change and 2. extent of significant change; 6‑point Likert scale) in accordance with the three PROM dimensions. The aim is to determine MCID thresholds for three different severity groups in CI patients: single-sided deafness (SSD), asymmetric hearing loss (AHL), and symmetric hearing loss (SHL). It is proposed to first use pilot data to estimate the sample size and to consider the correlation (r) thresholds of the PROM with the anchor question at baseline (r < 0.1) and follow-up (r > 0.2). The correlation between the difference in the PROM in the pre-post comparison and the anchor question should be r > 0.5 to subsequently determine cut-off values using logistic regression/receiver operating characteristic (ROC) analysis. Minimal clinically important difference thresholds can be used in the future as a supplement for individual case decisions in the field of CI sound processor upgrade and provide guidance for optimized CI fitting and rehabilitation.

Professional singers are exposed to high levels of vocal strain, which leads to a high prevalence of voice disorders within this occupational group. As part of appropriate phoniatric and musicians' medicine care, particular attention must be paid to the prevention of voice disorders as early as during the university training stage. In the healthcare sector, prevention has taken on growing importance since the introduction of the Prevention Act in 2015. It seems sensible to embed the teaching of preventive measures within the curriculum for singers' university training. Drawing on their dual qualifications as phoniatricians and singers and based on their many years' teaching experience at universities of music, the authors present a curriculum for the subject 'voice physiology and vocal health', which equips students with a scientific understanding of the physiological mechanisms of the voice and enables them to practice active prevention in the field of vocal health. The modularized curriculum content of the subject is designed to impart physiological and acoustic knowledge of vocal function and hearing, as well as the fundamentals of vocal health, vocal hygiene and the prevention of vocal disorders. The module should be established as a compulsory component of the bachelor's degree programme in vocal performance and comprise in total thirty 45-minute teaching units over the course of one or two semesters. In addition to its inclusion in the curriculum, there is a need for continuous professional learning in this area, both for the specialist medical professions primarily responsible for patient care (phoniatrics/paedaudiology, otorhinolaryngology, musicians' medicine) and for singers.

Bone-anchored hearing implants, such as the Osia® system (Cochlear Deutschland GmbH, Hanover, Germany), are used to rehabilitate conductive hearing loss, mixed hearing loss, and single-sided deafness. The surgical technique presented anchors the OSI300 supraauricularly and subperiosteally over the squama temporalis, thereby avoiding the creation of an implant bed in the mastoid and reducing cosmetic contour deformity. Cranial-parietotemporal placement allows bypassing absent or previously operated bone mastoid structures. Postoperatively, the implant was proved to be stable and inconspicuous, with a significant improvement in hearing outcomes. In selected cases, this technique represents a functional and esthetic alternative to standard implant placement, particularly in patients with a history of multiple temporal bone surgeries.

Rare tumor entities in the head and neck region are biologically heterogeneous, frequently only investigated in small cohorts, and therapeutically challenging. The current article critically contextualizes clinically relevant studies presented at the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting on salivary gland, thyroid, and nasopharyngeal cancer and cutaneous squamous cell carcinoma. In adenoid cystic carcinoma, several molecularly targeted strategies have shown early activity, including MYB degradation, NOTCH inhibition, and a B7-H4-directed antibody-drug conjugate. In other salivary gland cancers, HER2-directed therapy and androgen receptor blockade were relevant. In thyroid cancer, selective tyrosine kinase inhibition and multimodal concepts for anaplastic carcinoma confirmed the importance of molecular diagnostics and repeated assessment of operability. In nasopharyngeal cancer, cadonilimab in combination with chemotherapy prolonged progression-free survival after failure of immunotherapy. In cutaneous squamous cell carcinoma, definitive irradiation with cemiplimab and adjuvant immunotherapy were investigated. Overall, the data support biomarker-based and interdisciplinary treatment pathways; however, given the small, often single-arm studies, the data should be interpreted with caution.

At the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting, once again, only a small number of presentations focused primarily on surgery. Nevertheless, surgical questions could be seen to be becoming increasingly important within perioperative multimodal treatment concepts. The most relevant contributions were secondary analyses of the phase III KEYNOTE-689 and NIVOPOSTOP trials. These data showed that, despite a higher rate of documented R0 resection and a lower frequency of pathological high-risk features after neoadjuvant immunotherapy, no reduction in the extent of resection could yet be justified and that oncologically indicated neck dissection should not be limited when postoperative immunotherapy was planned. Randomised data on adjuvant radiotherapy after adequately performed surgery for pT1-2 pN0 oral cavity cancer further emphasised the importance of clearly defined surgical quality criteria. New data on mandibular, laryngeal and pharyngeal preservation after neoadjuvant treatment reported high rates of R0 resection and organ preservation. However, small cohorts, the absence of control groups and insufficiently standardised indications for surgery preclude changes in clinical practice. Histological analyses demonstrated heterogeneous regression patterns with residual tumour islands after neoadjuvant immunotherapy and argued against reducing surgical margins solely based on radiological response. Ongoing randomised trials of neck dissection, sentinel lymph node biopsy and salvage surgery were still recruiting.

Tinnitus can impair cognitive functions, such as attention, working memory and executive control. Pathophysiologically, this is explained by maladaptive neural plasticity, in which central auditory and nonauditory networks (e.g., prefrontal and limbic structures) become overactive or dysfunctional. Altered activity patterns in the frontoparietal control network and the default mode network (DMN) are associated with increased attention to the ear noise and reduced cognitive capacity in tinnitus patients. In addition, dysfunctional cortico-subcortical interactions (including with the limbic system) exacerbate emotional stress, which further impairs cognitive resources. These mechanisms are used to explain why tinnitus is often associated with reduced cognitive performance, increased distractibility and increased mental fatigue. In some studies, the negative impact of tinnitus is stronger than that of the accompanying reduced hearing ability or psychological comorbidities such as stress or depression/anxiety. The pathophysiological links between tinnitus and cognitive impairment require multidimensional therapeutic approaches. Treatment should aim to reduce maladaptive plasticity and optimize cognitive control. An interdisciplinary approach that combines neurological, psychological and audiological interventions therefore appears necessary in order to sustainably reduce both tinnitus perception and the associated cognitive impairments.

The recently published German S3 guideline on salivary gland tumors provides an overview of the current evidence as well as recommendations for managing salivary gland tumors. A distinctive feature compared to other oncology guidelines is that it addresses both benign and malignant tumors. This article aims to highlight the most important aspects of the guideline for practicing otorhinolaryngologists and to outline the corresponding recommendations for management of salivary gland tumors.