This systematic review aims to evaluate the role of biopsies in non-oropharyngeal subsites in patients with cervical metastasis from head and neck squamous cell carcinoma of unknown primary (HNSCCUP)....

The surge in scarlet fever and invasive group A streptococcal infection in England during winter, 2022–23,1 has stimulated the consideration of optimal sore throat management, as point-of-care tests for diagnosis are not routinely used. Clinical prediction scores can identify patients who are most likely to benefit from antibiotics; however, balance is required between optimising clinical outcome, antimicrobial stewardship, cost-effectiveness, and reducing transmission.2,3 Ideally, interventions should be appraised on these wider public health merits.

We read the NATTINA study by Janet A Wilson and colleagues,1 which supports the immediate tonsillectomy approach for adults with recurrent acute tonsillitis. Although we acknowledge that Wilson and colleagues have provided a comprehensive explanation of the study's limitations, several concerns remain. First, the study enrolled patients between May, 2015, and April, 2018, with the primary outcome being the number of sore throat days observed over a 24-month period. However, some participants might have experienced the impact of the COVID-19 pandemic during the early months of 2020.