Chronic postsurgical pain (CPSP) is a complication of cataract surgery. It is underrecognized and may be misdiagnosed as dry eye disease (DED). This retrospective case series presents three patients with no history of DED who developed CPSP after cataract surgery, but were misdiagnosed with DED for months or years. Despite these patients continuing to complain of persistent eye pain, their symptoms were dismissed as DED, delaying appropriate management. These cases highlight the challenges in recognizing CPSP and detrimental consequences of misdiagnosis as DED. In addition, these cases demonstrate that International Classification of Diseases codes for DED can serve as proxies allowing retrospective identification and investigation of CPSP in large databases, which in turn, may contribute to identification of risk factors, improved use of resources, and better outcomes for patients with CPSP after cataract surgery.

Hyperacusis is a troubling loudness hypersensitivity disorder occasionally involving pain around ear and face. The neural origins of hyperacusis and conditions that evoke it are poorly understood. To gain insights into the neural mechanisms that might give rise to hyperacusis, a pharmacovigilance analysis was conducted on 3833 case reports in which hyperacusis was listed as a drug-induced adverse event in the United States Food and Drug Administration Adverse Event Reporting System (FAERS). The 10 drug classes ranked by the number of reported hyperacusis cases were selective (1) serotonin reuptake inhibitors (e.g., paroxetine), (2) fluoroquinolone antibiotics (e.g., ciprofloxacin), (3) serotonin-norepinephrine reuptake inhibitors (e.g., venlafaxine), (4) benzodiazepines (e.g., clonazepam), (5) anticonvulsant-mood stabilizers (e.g., valproate), (6) central nervous system stimulants, (7) atypical antipsycnotics, (8) corticosteroid/glucocorticoid (e.g., prednisolone), (9) anticonvulsant-GABA analogue (e.g., pregabalin) and (10) anticonvulsants (e.g., topiramate). Approximately 70% of hyperacusis cases were females, possibly due to a reporting bias. The most prevalent comorbidities were headache, photophobia, nausea, fatigue, dizziness, anxiety, insomnia, tinnitus and depression. The mechanisms of action and side effects of the 25 drugs in which hyperacusis was listed as an adverse event are discussed along with study limitations such as correlational analysis. The results provide a foundation for future drug-related research on hyperacusis, including studies in animal models to determining which of these drugs can dose-dependently induce hyperacusis.

Acupuncture at traditional Chinese medicine (TCM) sites used to treat low milk supply has been claimed to cause release of prolactin and oxytocin, although published studies have found mixed results on serum prolactin. In one study, acupuncture did not affect prolactin hyperresponsiveness after stimulation with metoclopramide in women with amenorrhea-galactorrhea syndrome. Galactorrhea has been reported following acupuncture for pain treatment. No adverse effects on milk production were seen among lactating women who received acupuncture for postpartum sciatica.[1] Acupuncture has been well described in TCM for treating insufficient milk supply,[2,3] and is also recommended in some Western countries.[4] Numerous studies found acupuncture at CV 17 (also referred to as Ren 17, Danzhong or Shanzong; located at the center of the sternum), SI 1 (Shaoze; on the little finger), ST 18 (Rugen; lower breast margins), Zusanli (ST 36), and Taichong (LR 3) to benefit women with a low postpartum milk supply.[5] These studies generally do not meet current evidence-based guidelines, partly because of the extreme difficulty in double-blinding and placebo-controlling acupuncture studies. However, 2 studies did find a better response to electroacupuncture applied at a traditional site for lactation stimulation (SI 1) than electroacupuncture applied at a site unrelated to milk production (LI 1). Electroacupuncture increased serum prolactin, infant weight and maternal perception of milk production more than domperidone alone.[6] None of the studies reported to date have made an attempt to optimize maternal nursing technique before acupuncture. Although less studied, acupressure at milk acupuncture sites has had similar effects. A systematic review concluded that acupuncture and acupressure are effective in increasing breastmilk volume.[7] Acupuncture therapy has been used to treat breastfeeding for milk stasis (engorgement). Randomized, nonblinded studies in an outpatient Swedish lactation clinic compared routine care (including oxytocin spray) to routine care plus acupuncture at 2 or 3 points for treating milk stasis.[8,9] A meta-analysis concluded that women who received acupuncture were less likely to develop an abscess, had less severe symptoms on day five, and had a lower rate of fever than women in the usual care group However, there is insufficient evidence from published trials to justify widespread implementation.[10] A survey of 50 Swedish maternity units in 2007 found that 60% of hospitals used acupuncture to treat milk stasis, 18% used acupuncture to treat mastitis, and 2.2% each used it for painful breastfeeding or to improve milk supply. The authors felt that this extensive use was not justified based on the limited evidence for most of these uses.[11] Acupuncture and acupressure have also been used successfully as a treatment for breast engorgement.[7,12] Auricular therapy uses stimulation of acupoints on the ear corresponding to various anatomical sites and functions of the body for the diagnosis, treatment, and prevention of disease. All studies applied Vaccaria seeds to press on ear acupoints. Two systematic reviews on auricular therapy to increase milk supply have come to differing conclusions. One review found a positive effect on milk production, onset of lactation, serum prolactin, breast fullness, neonate states, and frequency of newborn urination and defecation.[13] A more recent review found varying efficacy between studies and poor methodology that did not allow for a definitive conclusion on efficacy as a galactogogue.[14] No adverse effects were reported in any studies.

Sleep disorders are considered a significant risk factor for the onset and development of temporomandibular disorders (TMDs); additionally, sleep disorders contribute to generating a proinflammatory state and central sensitization, which can cause temporomandibular joint (TMJ) pain. A 50-year-old female patient reported pain near the left ear to the dental clinic. Her medical history includes a sleep disorder, stress, and anxiety. After analyzing her medical records, clinical findings, and imaging studies, an inflammatory-degenerative process was diagnosed in the left TMJ. The treatment administered was arthrocentesis, which relieved the pain for a period of 13 months. This clinical case report is aimed at highlighting the association between sleep disorders and TMDs, to generate multidisciplinary and transdisciplinary clinical protocols that lead to accurate diagnosis and efficient treatment plans.

Small-cell lung carcinoma (SCLC) is a rare cause of Pancoast syndrome. We present a 54-year-old man with shoulder pain, arm weakness, and a middle ear mass, leading to a diagnosis of SCLC at the lung apex. This case highlights the importance of considering SCLC in the differential diagnosis of Pancoast syndrome. Early recognition and a comprehensive diagnostic approach are crucial for optimizing patient outcomes.

Foreign bodies in the esophagus and pharynx are common acute emergencies in otolaryngology - head and neck surgery. Most foreign bodies remain lodged in the lumen and can be removed via fiber laryngoscopy, esophagoscopy, or electronic gastroscope. However, a minority of sharp foreign bodies may perforate the wall, leading to wandering neck abscesses. Migratory thyroid foreign bodies are relatively rare, especially when the onset interval exceeds six months. This report presents a case of a 43 - year - old female patient who was admitted due to severe neck pain. After comprehensive examinations, she was diagnosed with a migrated thyroid foreign body and was cured and discharged after open neck surgery.

Background/Objectives: Head and neck sarcomas account for 11% of all soft tissue and 9% of all bone sarcomas in the UK. Diagnostic delays are common, with non-specific symptoms and histological misdiagnosis reported in up to 42% of cases. This study aims to evaluate the association between presenting symptoms, symptom duration, and tumour size to inform a tailored HNS diagnostic strategy for early referral to a tertiary centre. Methods: We analysed a retrospective cohort of 425 adult and paediatric patients referred to the London Sarcoma Service between 2002 and 2025. Results: Our cohort analysis identified a median tumour size of 44.00 mm and symptom duration of 3 months. Although symptom duration did not predict tumour size (β = 0.63, p = 0.76), non-specific symptoms (swelling, pain, nasal/oral changes) were significantly associated with larger tumours (OR 1.96-3.66), alongside systemic symptoms (β = 22.90 mm, p = 0.044). Each 1 mm increase in tumour size was also associated with a 2.60% increased chance of a higher-grade sarcoma (OR = 1.03 per mm, p < 0.001). Conclusions: To our knowledge, this is the largest cohort study to characterise diagnostic patterns in HNS. Our findings reveal three critical insights: 1. Current size-based referral thresholds are inadequate. 2. Non-specific symptoms, such as nasal or oral symptoms, are frequently overlooked. 3. The anatomical complexity of the HN region demands early tailored diagnostic strategies. We propose a hypothesis-generating '1-2-1' framework to support earlier clinical suspicion, which requires prospective validation.