Clinical and Experimental Otorhinolaryngology最新文献

{"title":"Factors Affecting Visible Contamination of Positive Airway Pressure Devices in Patients With Obstructive Sleep Apnea.","authors":"Il-Youp Kwak, Kyung Soo Kim, Hyun Jin Min","doi":"10.21053/ceo.2025-00123","DOIUrl":"10.21053/ceo.2025-00123","url":null,"abstract":"","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"103-106"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Innate T Cells in Inflammatory Disorders in Asthma and Chronic Rhinosinusitis.","authors":"Myeong-Seok Lee, Dae Woo Kim, You Jeong Lee","doi":"10.21053/ceo.2025-00124","DOIUrl":"10.21053/ceo.2025-00124","url":null,"abstract":"<p><p>Chronic rhinosinusitis (CRS) and asthma frequently coexist and represent heterogeneous inflammatory disorders of the upper and lower airways, respectively. Type 2 inflammation, mediated by eosinophils and CD4 T cells, has long been recognized as a central driver of both CRS with nasal polyps (CRSwNP) and asthma pathogenesis. However, emerging evidence underscores the critical roles of innate T cells, such as invariant natural killer T (iNKT), mucosal-associated invariant T (MAIT), and γδ T cells, in airway inflammatory diseases. These innate T cells are enriched in sinonasal tissues and contribute to mucosal inflammation through cytokine production, exhibiting functional polarization that reflects local inflammatory cues. In particular, MAIT17 and Vγ1⁺ γδ T cells have been associated with tissue eosinophilia and disease severity in patients with eosinophilic CRSwNP, whereas iNKT cells display subset-specific distributions across eosinophilic and neutrophilic endotypes. In asthma, iNKT cells consistently contribute to disease development in murine models, whereas the functions of MAIT and γδ T cells remain controversial, showing both pro- and anti-inflammatory effects depending on anatomical location and disease context. This review summarizes current evidence on the contribution of innate T cells to the immunopathology of CRSwNP and asthma and discusses the challenges and future directions in reconciling discrepancies arising from methodological and biological variability.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"35-44"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synergistic Exacerbation of Allergic Inflammation by Combined Exposure to Air-Pollutants in a Murine Model of Allergic Rhinitis.","authors":"Joo-Hoo Park, Jee Won Moon, Yeong-In Jo, Hwa Eun Yang, Subin Cho, Hyeongguk Son, Hyun-Woo Yang, Dae Jin Song, Il-Ho Park","doi":"10.21053/ceo.2025-00170","DOIUrl":"10.21053/ceo.2025-00170","url":null,"abstract":"<p><strong>Objectives: </strong>Allergic rhinitis (AR) is a chronic inflammation of the nasal mucosa triggered by environmental allergens. Although its pathophysiology has been extensively investigated, the influence of environmental aggravating factors-particularly combined pollutant exposure-remains insufficiently characterized. This study aimed to assess the impact of coexposure to PM2.5, formaldehyde, and Zn on allergic inflammation in a murine AR model and to delineate the associated immunological and histopathological responses.</p><p><strong>Methods: </strong>Female BALB/c mice were sensitized with ovalbumin (OVA) and challenged intranasally to induce AR. On days 21-24, the mice were exposed to PM2.5, formaldehyde, and Zn, either individually or in combination with OVA. Allergic symptoms were evaluated through behavioral observation, while immune responses were assessed by analyzing nasal and bronchoalveolar lavage fluids (NALF and BALF), serum immunoglobulin levels, nasal histopathology, and cytokine profiles.</p><p><strong>Results: </strong>Combined exposure to PM2.5, formaldehyde, and Zn significantly intensified allergic inflammation compared with single exposures. Coexposure to PM2.5 and Zn led to synergistic increases in total and OVA-specific immunoglobulin E levels, eosinophilic infiltration, nasal rubbing, sneezing, and Th2/Th17 cytokine levels in NALF and BALF. Histological analysis demonstrated epithelial thickening and goblet cell hyperplasia after combined exposure. Other combinations, including PM2.5 with formaldehyde, also produced additive or modestly amplified inflammatory responses.</p><p><strong>Conclusion: </strong>Coexposure to PM2.5, formaldehyde, and Zn aggravated allergic inflammation in an OVA-induced murine model, with PM2.5+Zn yielding the strongest synergistic effects. These findings emphasize the role of pollutant-pollutant interactions in allergic airway diseases and highlight the need for further research to clarify long-term health effects and relevance to human disease.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"86-96"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activation of the Gamma-Aminobutyric Acid (GABA)ergic Neural Circuit in Salicylate-Induced Tinnitus: the Inferior Colliculus to the Medial Geniculate Body.","authors":"Xu-Yuan Peng, Jiang Wang, Ming-Yue Gong, Li-Yuan Zhang, Min Zhang, Zhi-Bin Chen, Zheng-Quan Tang, Lei Cheng","doi":"10.21053/ceo.2025-00027","DOIUrl":"10.21053/ceo.2025-00027","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the regulatory functions of gamma-aminobutyric acid (GABA)ergic neural circuits from the inferior colliculus (IC) to the medial geniculate body (MGB) in salicylate-induced tinnitus.</p><p><strong>Methods: </strong>Mice were treated with salicylate to induce tinnitus, and tinnitus-like behaviors were evaluated via gap prepulse inhibition of acoustic startle. Using combined viral tracing methodologies, we identified and mapped the pathways and connections from the IC to the MGB. Furthermore, we employed Gq-coupled human M3 designer receptors exclusively activated by designer drugs (DREADDs) and Gi-coupled human M4 DREADDs to achieve targeted excitation or suppression of GABAergic neurons in the IC and MGB. Following the administration of clozapine N-oxide, which binds to these receptors, we modulated these neural circuits to assess their impact on tinnitus severity in a mouse model.</p><p><strong>Results: </strong>Our findings demonstrated that mice exposed to salicylate exhibited tinnitus-like behaviors. GABAergic neurons projecting retrogradely from the MGB to the IC were primarily concentrated in the external nucleus of the IC. After clozapine N-oxide administration, chemogenetic activation of IC-MGB GABAergic neurons aggravated salicylate-induced tinnitus. Additionally, activation of GABAergic neurons between the IC and MGB induced the perception of tinnitus even without salicylate. However, chemogenetic inhibition of the IC-MGB GABAergic circuit did not reverse salicylate-induced tinnitus.</p><p><strong>Conclusion: </strong>These findings suggest that activation of the IC-MGB GABAergic neural circuit may contribute to tinnitus generation through a mechanism distinct from that of salicylate-induced tinnitus. This study provides novel insights into the mechanisms underlying tinnitus.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"55-69"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Fat Graft Myringoplasty Combined With Platelet-Rich Plasma for Managing Chronic Tympanic Membrane Perforations: A Systematic Review and Meta-Analysis.","authors":"Yun Jin Kang, Gulnaz Stybayeva, Se Hwan Hwang","doi":"10.21053/ceo.2025-00157","DOIUrl":"10.21053/ceo.2025-00157","url":null,"abstract":"<p><strong>Objectives: </strong>Platelet-rich plasma (PRP) is an autologous product derived from whole blood through the process of gradient density centrifugation. Autologous PRP has been shown to be safe and effective in promoting natural wound healing processes. This study assessed the efficacy of fat graft myringoplasty combined with PRP in tympanic membrane (TM) healing in dry TM perforation due to chronic otitis media and compared it to that of fat graft myringoplasty.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of prospective or retrospective studies was conducted, with database searches (PubMed, Cochrane Library, Embase, Web of Science, Scopus, and Google Scholar) performed through April 2025. The outcomes included the success rate (complete closure of the TM postoperatively) and changes in air-bone conduction gap (ABG) (preoperatively and postoperatively) in the audiogram.</p><p><strong>Results: </strong>Five studies (n=522) were included. Fat myringoplasty with PRP resulted in greater improvement in ABGs (standardized mean difference [SMD], 0.329; 95% CI, 0.132 to 0.527) and higher success rates (odds ratio [OR], 3.129; 95% CI, 1.882 to 5.203) compared to fat myringoplasty alone. In medium-sized perforations, combination therapy demonstrated superior outcomes in both success rate (OR, 3.179; 95% CI, 1.891 to 5.343) and ABG (SMD, 0.357; 95% CI, 0.128 to 0.586). However, no significant differences were observed in cases involving small and medium-sized perforations (success rate: OR, 2.154; 95% CI, 0.174 to 26.672 and changes in ABG: SMD, 0.249; 95% CI, -0.141 to 0.638). Both liquid and gel PRP significantly improved ABGs and TM closure rates, with no significant difference between types.</p><p><strong>Conclusion: </strong>This study demonstrated a higher success rate and greater hearing improvement with PRP-assisted fat myringoplasty, especially in medium-sized perforations. Both liquid and gel PRP forms were effective, with no significant difference between them.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"70-78"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of margin to depth of invasion ratio on oncologic outcome in locally advanced oral cancer undergoing surgery and chemoradiotherapy.","authors":"Ming-Hsien Tsai, Yu-Tsai Lin, Hui-Ching Chuang, Chao-Hui Yang, Tai-Lin Huang, Hui Lu, Wen-Ling Tsai, Chih-Yen Chien, Fu-Min Fang","doi":"10.21053/ceo.2025-00339","DOIUrl":"https://doi.org/10.21053/ceo.2025-00339","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the prognostic value of the margin-to-depth of invasion ratio (MDR) in patients with locally advanced oral squamous cell carcinoma (LAOSCC) who underwent curative surgery followed by adjuvant concurrent chemoradiotherapy (CCRT).</p><p><strong>Methods: </strong>We analyzed 422 consecutive LAOSCC patients treated at a single institute between 2007 and 2017. The MDR was defined as the ratio of the closest surgical margin (mm) to tumor depth of invasion (DOI, mm). Survival outcomes, including overall survival (OS), cancer-specific survival (CSS) and relapse-free survival (RFS) were assessed. The optimal MDR cutoff was determined by X-tile analysis and validated using repeated k-fold cross-validation.</p><p><strong>Results: </strong>The optimal MDR cutoff for predicting survival was 0.35. Patients with MDR ≥ 0.35 (high MDR, n = 205) demonstrated significantly better 5-year OS (66.1% vs. 47.6%, p < 0.001), CSS (77.5% vs. 57.4%, p < 0.001), and RFS (71.5% vs. 53.8%, p = 0.001) compared with those with MDR < 0.35 (low MDR, n = 217). In multivariate analysis, low MDR remained an independent adverse prognostic factor for OS (HR = 1.61, p = 0.005), CSS (HR = 2.05, p = 0.001) and RFS (HR = 1.50, p = 0.033). Among patients with adequate margins (≥5 mm), MDR retained significant prognostic value (OS, p = 0.008; CSS, p = 0.001; RFS, p = 0.015). Cross-validation confirmed the robustness of the MDR threshold value of 0.35 across all survival endpoints.</p><p><strong>Conclusion: </strong>MDR is an independent prognostic marker in LAOSCC treated with surgery and adjuvant CCRT. A cutoff of 0.35 effectively stratifies survival risk, even among patients with adequate surgical margins. Incorporating MDR into postoperative assessment could refine risk stratification and guide individualized follow-up and adjuvant treatment planning.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146003284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Pcdh15 Deficiency on Cellular Energy Metabolism and Oxidative Stress, and Its Role and Mechanism in Hearing Loss.","authors":"Ying Lan, Yang Wu, Shijie Zhao, Jun Tang, Xingming Liang, Tao Hou, Lu Peng, Yongpeng Li, Xinxing Zhao, Shihua Yin","doi":"10.21053/ceo.2025-00263","DOIUrl":"https://doi.org/10.21053/ceo.2025-00263","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the role of the Pcdh15 gene in hearing maintenance, observe the effects of its deficiency on cochlear structure, function, and hearing loss in mice.</p><p><strong>Methods: </strong>We used CRISPR/Cas9 to generate Pcdh15 knockout (KO) mice. Auditory function was assessed via hearing tests, while histological were used to observe morphological changes in cochlear hair cells and spiral ganglion neurons (SGNs). RNA-seq analyzed cochlear tissue from P18 wild-type (WT) and Pcdh15 KO mice to identify differentially expressed genes (DEGs). DEGs underwent functional annotation and pathway analysis, focusing on oxidative phosphorylation. Reactive oxygen species (ROS) levels were measured using flow cytometry and DCFH-DA assays.</p><p><strong>Results: </strong>Pcdh15 KO mice showed progressive sensorineural hearing loss, worsening to profound deafness by P18. Notably, cochlear hair cells and SGNs exhibited significant loss and morphological abnormalities, particularly in the basal high-frequency region. RNA-seq identified 1,359 DEGs (1,024 downregulated, 335 upregulated). Analysis revealed that Pcdh15 deficiency was associated with inhibition of the oxidative phosphorylation pathway, which may disrupt mitochondrial respiratory chain complexes I, III, IV, and V, thereby potentially impairing energy production and ATP metabolism. Moreover, early-stage cochleae in KO mice showed elevated ROS activity and oxidative stress, suggesting redox imbalance may contribute to hearing damage.</p><p><strong>Conclusion.: </strong>Pcdh15 is crucial for hearing maintenance. Its deficiency is associated with severe hearing loss and cochlear abnormalities, linked to the inhibition of oxidative phosphorylation, disruption of energy metabolism, and exacerbation of oxidative stress. These findings provide new insights into hearing loss mechanisms and potential therapeutic targets.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Comparison of Long-term Outcomes and Nodal Recurrence for Persistent and Recurrent Differentiated Thyroid Cancer.","authors":"Yung Jee Kang, Ji-Hoon Kim, Ji Ye Lee, Sun Wook Cho, Young Joo Park, Kyu-Eun Lee, Su-Jin Kim, Hanaro Park, Sung Joon Park, Soon-Hyun Ahn, Eun-Jae Chung","doi":"10.21053/ceo.2025-00305","DOIUrl":"https://doi.org/10.21053/ceo.2025-00305","url":null,"abstract":"<p><strong>Objective.: </strong>Differentiated thyroid cancer (DTC) has a favorable prognosis. As indeterminate nodes are common, distinguishing recurrent and persistent DTC remains challenging. Previous studies have not specifically focused on prognosis between recurrent and persistent DTC. Thus, we aimed to compare prognosis and oncologic characteristics of two groups.</p><p><strong>Methods.: </strong>This retrospective cohort study was conducted at a single tertiary care institution, enrolling 265 patients (recurrent: 109, persistent: 156) who underwent re-operation from November 1, 1999 to August 31, 2018 due to structural diseases. Those with distant metastasis at the time of initial diagnosis were excluded. Clinical and oncologic characteristics, patterns of lymph node (LN) metastasis, disease-free survival (DFS), and overall survival (OS) were compared between two groups. The time zero used for DFS is the time of the second operation.</p><p><strong>Results.: </strong>Recurrent DTC exhibited higher incidence of central LN metastasis (p-value = 0.003), infield recurrence (p-value < 0.001), and distant metastasis (p-value < 0.001). In contrast, persistent DTC showed more lateral LN metastasis (p-value = 0.003) and outfield recurrence (p-value < 0.001). The most common site of neck LN metastasis was ipsilateral level VI/VII (51.4%) for recurrent DTC and ipsilateral level IV (43.0%) for persistent DTC. Ten-year DFS was significantly lower for recurrent DTC (41.0%) than for persistent DTC (67.9%) (p-value < 0.001). Recurrent DTC, older age, higher total metastatic LN at the second operation (first re-operation), and R1/R2 resection at the second operation were associated with decreased DFS. OS isn't significantly different between recurrent and persistent DTC (p-value = 0.160).</p><p><strong>Conclusion.: </strong>: Recurrent DTC has poorer DFS than persistent DTC, although OS isn't significantly different.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of intranasal insulin in the treatment of post viral persistent olfactory dysfunction: a systematic review.","authors":"Do Hyun Kim, David W Jang, Se Hwan Hwang","doi":"10.21053/ceo.2025-00252","DOIUrl":"https://doi.org/10.21053/ceo.2025-00252","url":null,"abstract":"<p><strong>Objectives.: </strong>To evaluate the therapeutic efficacy of intranasal insulin for treating persistent and refractory olfactory dysfunction following viral infections.</p><p><strong>Methods.: </strong>A comprehensive literature search was performed across PubMed, SCOPUS, Embase, Web of Science, Google Scholar, and the Cochrane Database, covering all indexed articles up to July 2025. Studies were included if they evaluated changes in olfactory scores in patients receiving intranasal insulin, either compared with a control group (placebo or no treatment) or between pre- and post-treatment measurements. Secondary outcomes, including serum glucose and insulin levels and the proportion of patients achieving significant olfactory recovery, were also assessed.</p><p><strong>Results.: </strong>Eight studies including 457 participants were reviewed. Intranasal insulin was generally associated with improvements in olfactory scores. Delivery via absorbable materials may enhance both threshold and discrimination outcomes, whereas self-administration showed minimal benefit. Some studies also reported higher rates of substantial olfactory recovery with absorbable material-based delivery. Combination therapy with intranasal insulin and budesonide was suggested to further improve threshold scores. Overall, treatment was well tolerated, with no major changes in serum glucose levels, though one study reported a mild hypoglycemic event.</p><p><strong>Conclusion.: </strong>Current evidence suggests that intranasal insulin, particularly via absorbable material-based delivery, may offer therapeutic benefit for persistent post-viral olfactory dysfunction, with possible additional gains from corticosteroid coadministration. These findings remain preliminary and require confirmation in larger, well-controlled studies.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harnessing Machine Learning for Personalized Care of Idiopathic Sudden Sensorineural Hearing Loss: A Multicenter Cohort Study.","authors":"Yen-Ting Guo, Ching-Ting Tan, Chen-Chi Wu, Chun-Ying Wang, Chein-Yu Huang, Tzu-Hsiang Yang, Ting-Yi Lee, Ting-Hua Yang, Tien-Chen Liu, Pey-Yu Chen, Pei-Hsuan Lin","doi":"10.21053/ceo.2025-00084","DOIUrl":"https://doi.org/10.21053/ceo.2025-00084","url":null,"abstract":"<p><strong>Objectives.: </strong>Idiopathic sudden sensorineural hearing loss (ISSNHL) is a significant cause of hearing loss. Intratympanic steroid injection (ITSI) is commonly used as an initial or salvage treatment; however, the lack of a standardized treatment protocol has caused inconsistencies in clinical practice. Furthermore, no efficient prediction model exists to guide personalized management. Therefore, in this study, we aimed to develop tailored management strategies for ISSNHL using a machine-learning model.</p><p><strong>Methods.: </strong>This retrospective multicenter cohort study was conducted between January 2015 and December 2020, with data analysis conducted between January 2021 and March 2024. Patients were selected based on the International Classification of Diseases, 10th Revision for ISSNHL, alongside the relevant medication and procedure codes. Patients with pure-tone audiogram not meeting ISSNHL criteria, better initial hearing in the affected ear, identifiable etiology, no post-treatment audiogram, or delayed treatment (>6 weeks) were excluded. We recruited 770 patients who were diagnosed with ISSNHL and received ITSI. The primary outcome was the area under the receiver operating characteristic curve for predicting performance. Recovery status was defined based on the last pure-tone audiogram. Modeling was conducted on the Quanta for Medical Care AI platform using five machine learning algorithms with a nested cross-validation framework, where feature selection and hyperparameter tuning were performed in the inner folds and model performance was evaluated in the outer folds.</p><p><strong>Results.: </strong>A random forest classifier outperformed other models in predicting hearing outcomes, reaching an area under the receiver operating characteristic curve of 0.7884. The time to ITSI was the most critical treatment-related factor, with ITSI administered within 10 days of hearing loss being associated with better outcomes. This model can provide personalized prognosis under different treatment protocols.</p><p><strong>Conclusion.: </strong>The machine-learning-based prediction model enables personalized strategies and timely adjustments of treatment for ISSNHL, optimizing the likelihood of complete recovery.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}