Markedly elevated IgE in children is an important but nonspecific clue, particularly with early-onset atopic dermatitis, eosinophilia, and infections. We report a boy who developed generalized eczema at approximately 6 months of age and was repeatedly hospitalized during infancy for severe dermatitis, prolonged diarrhea, pneumonia, acute otitis media, and Staphylococcus aureus bacteremia. Early investigations showed eosinophilia, hypoalbuminemia, rapid IgE escalation, and lymphocyte subsets not suggestive of a clear T-, B-, or NK-cell deficiency. After 12 months, no further severe infections requiring hospitalization were documented, whereas chronic severe dermatitis, eosinophilia, markedly elevated IgE, and later asthma became dominant. Whole-exome sequencing identified two FLG variants; among these, Sanger sequencing confirmed a heterozygous FLG NM_002016.2:c.6950_6957del (p.Ser2317Ter) variant. This case highlights overlaps between severe barrier-related atopic dermatitis and hyper-IgE syndrome and emphasizes longitudinal follow-up, immunological evaluation, vaccine history, genetic interpretation, and gene-environment interactions.

Autoimmune inner ear disease (AIED) represents a rare yet potentially reversible cause of sensorineural hearing loss, characterized by immune-mediated damage to cochlear and vestibular structures. Unlike autoimmunity, which is driven by adaptive immune responses and autoantibodies, autoinflammation stems from innate immune system dysregulation, typically involving inflammasome hyperactivation. This review synthesizes recent advancements in biomarkers for the differential diagnosis of AIED, emphasizing their role in distinguishing it from conditions such as Meniere's disease (MD) and chronic otitis media (COM). Autoantibodies and cytokines, including anti-heat shock protein 70 (HSP70), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), antiphospholipid antibodies, anti-type II collagen, selective immunoglobulin A deficiency (sIgAD), and anti-cochlin antibodies, have a significant role in diagnostic sensitivity, specificity, and correlations with treatment responsiveness. Additionally, we discuss the utility of magnetic resonance imaging (MRI) in identifying inner ear enhancements and propose diagnostic algorithms to facilitate early detection. By integrating serological, immunological, and radiological insights, this work underscores the potential of these biomarkers to guide personalized therapeutic strategies, including corticosteroids and biologics, while addressing diagnostic challenges and the need for standardized criteria. Ultimately, enhanced biomarker utilization may improve outcomes in AIED by enabling timely intervention and reducing misdiagnosis.

Chronic otitis media with effusion (COME) is defined as an accumulation of nonpurulent fluid within the middle ear space without evidence of an acute infection. A primary factor in the development of COME is eustachian tube dysfunction. Tympanostomy tube insertion (TTI) has long been an established and effective means of treating OME; eustachian tuboplasty (ET) has emerged as another treatment measure. There are limited studies that combine TTI with ET and compare the effectiveness of combined treatments to TTI alone. The focus of this systematic review is to assess if the adjunctive treatment of ET with TTI is superior to TTI.

This review outlines a standardized diagnostic algorithm for balloon dilation of the Eustachian tube (BDET) in obstructive ETD. The algorithm prioritizes excluding differential diagnoses including patulous ETD, temporomandibular joint disorders, and superior canal dehiscence syndrome. Objective tests and patient-reported outcomes help when facing equivocal clinical findings. BDET is indicated for barochallenge-induced ETD, chronic otitis media with effusion, and tympanic membrane retraction pockets after failed medical management, and may adjunct tympanoplasty in adhesive otitis media. Contraindications include patulous ETD and significant Eustachian tube anatomical distortion. Rigorous patient selection remains essential for safe and effective outcomes.

To determine the frequency and nature of referrals for children with acute or chronic otorrhoea from primary care to secondary care ENT services in the UK.

Chronic suppurative otitis media (CSOM) remains a significant otologic condition in India, with possible intracranial and extracranial complications despite advances in therapy. Hence, this retrospective study evaluated 7,940 confirmed CSOM cases, identifying 92 (1.2%) with complications 69.6% intracranial and 47.8% extracranial, with 16 subjects presenting both types and a male-to-female ratio of 2:1. The 21-30 year age group showed the highest involvement (32.6%), with meningitis (32.6%) and subdural abscess (15.2%) as the leading intracranial and mastoiditis (37%) as the most common extracranial complication. Although improved antibiotic and surgical interventions have reduced overall incidence, mortality and morbidity remain elevated due to delayed diagnosis and intervention. Hence, we report the contemporary burden and patterns of CSOM related complications in the Indian population and emphasizing timely management to prevent severe outcomes.

KBG syndrome is typically characterized by macrodontia (especially of the upper central incisors), characteristic facial features (triangular face, brachycephaly, synophrys, widely spaced eyes, broad or bushy eyebrows, prominent ears, prominent nasal bridge, bulbous nose, anteverted nares, long philtrum, and thin vermilion of the upper lip), short stature, developmental delay / intellectual disability, and behavioral issues. Affected individuals may have feeding difficulties (particularly in infancy), skeletal anomalies (brachydactyly, large anterior fontanelle with delayed closure, scoliosis), hearing loss (conductive, mixed, and sensorineural), seizure disorder, and brain malformations. There is significant variability in the clinical findings, even between affected members of the same family.