World Journal of OtorhinolaryngologyHead and Neck Surgery最新文献

{"title":"Response to the Correspondence Regarding \"Cutaneous Metastasis From Papillary Thyroid Carcinoma Eight Years After Initial Surgery\".","authors":"Yi-Qing Gao, Xin-Lu Yin, Lu-Ying Zheng, Jia-Dong Wang","doi":"10.1002/wjo2.70175","DOIUrl":"10.1002/wjo2.70175","url":null,"abstract":"<p><p>We sincerely thank Dr. Sengul and colleagues for their insightful comments on our case report of skin metastasis in papillary thyroid cancer (PTC). They questioned the adequacy of local excision and suggested completion thyroidectomy to enable radioactive iodine (RAI) therapy or systemic therapy. We appreciate their perspective but explain our rationale, given the exceptional rarity of isolated cutaneous metastasis and limited evidence-based guidelines. Complete surgical excision may be appropriate for carefully selected patients with solitary cutaneous metastasis, whereas RAI or systemic therapy should be considered according to disease extent, iodine avidity, tumor biology, and patient-specific factors. We agree that TSH suppression alone does not explain the development of metastasis and that TERT promoter mutations may provide additional insight into the aggressive biological behavior of PTC. Despite the loss of thyroglobulin (Tg) expression in the metastasis, our multimodal surveillance-including ultrasonography and CT-has shown no recurrence, and we will offer functional imaging when clinical indicated. No evidence of recurrent or additional metastatic disease during follow-up, and per 2025 ATA guidelines, shared decision-making favored thyroid preservation with close follow-up. Future disease progression would prompt reconsideration of total thyroidectomy with RAI or targeted therapy.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correspondence of Papillary Thyroid Cancer With Cutaneous Metastasis in Thyroidology.","authors":"Ilker Sengul, Demet Sengul","doi":"10.1002/wjo2.70174","DOIUrl":"10.1002/wjo2.70174","url":null,"abstract":"<p><p>The recent report by Gao and colleagues highlights an infrequent yet clinically significant manifestation of papillary thyroid carcinoma, PTC: isolated cutaneous metastasis appearing 8 years post-resection. While the rarity of the case is undeniable, this critique explores the nuances of the diagnostic discordance observed-specifically the thyroglobulin, Tg, negativity in the metastatic lesion despite PAX-8 and TTF-1 positivity-and challenges the authors' hypothesis regarding the role of thyrotropin suppression. Furthermore, we examine the therapeutic decision to pursue conservative local excision over comprehensive systemic intervention. In high-stakes oncological management, the balance between functional preservation and radical eradication remains a subject of intense debate. This correspondence underscores the necessity for comprehensive molecular profiling, such as BRAF and TERT promoter analysis, to better understand the aggressive biological behavior of seemingly \"low-risk\" primary tumors and to refine follow-up protocols for early detection of atypical recurrence.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Success in Obstructive Sleep Apnea Patients Using Preoperative Drug-Induced Sleep Endoscopy and Awake Endoscopy Considering Disease Severity.","authors":"Nafil Arimbrathodi, Arif Nambillath, Noora Alhail, Labiba Abughazzah, Waheed Rahman, Abhishek Menon, Yousef Hudaib, Majid Alabdulla","doi":"10.1002/wjo2.70184","DOIUrl":"https://doi.org/10.1002/wjo2.70184","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is a prevalent disorder characterized by recurrent episodes of airway obstruction during sleep, leading to fragmented sleep and oxygen desaturation. Identifying the precise site and pattern of obstruction is essential for surgical success. Awake endoscopy with Müller's maneuver (AEMM) has long been used, but drug-induced sleep endoscopy (DISE) offers dynamic assessment under sleep-like conditions.</p><p><strong>Objective: </strong>To retrospectively compare surgical outcomes of OSA patients evaluated with DISE versus AEMM, stratified by disease severity, and to determine whether the comparative value of DISE over AEMM differs according to OSA severity as measured by AEMM (AHI).</p><p><strong>Methods: </strong>Records of 102 OSA patients undergoing sleep surgery between January 2022 and December 2024 at Hamad Medical Corporation were reviewed. Patients were grouped into AEMM-only (<i>n</i> = 54) and DISE (<i>n</i> = 48). Surgical success was defined as postoperative AHI < 15 events/hour and at least 50% reduction from baseline. Statistical analysis included independent and paired <i>t</i>-tests, chi-square tests, and the Johnson-Neyman procedure to identify AHI-based thresholds of DISE benefit.</p><p><strong>Results: </strong>DISE group had higher surgical success compared to AEMM (62.5% vs. 40.7%, <i>p</i> = 0.114). Preoperative and postoperative AHI changes were significant in both groups (<i>p</i> < 0.001). Stratification revealed that moderate-to-severe OSA patients (AHI > 16.7) had significantly better outcomes when surgery was based on DISE (<i>p</i> < 0.001). In patients with mild OSA (AHI < 16.7), DISE conferred no additional benefit over AEMM.</p><p><strong>Conclusion: </strong>DISE-based surgical planning improves outcomes in moderate-to-severe OSA, while AEMM remains adequate for mild OSA cases. Disease severity should guide the choice of preoperative airway assessment method.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Where Eastern Medicine Meets Western Medicine: A World Review of the Management of Chronic Cough.","authors":"Thomas Zheng Jie Teng, Zhi Xuan Koh, Justin Yi Shen Lim, Kavimalar Ravi, Jin Wayne Kyler Ong, Christina Hui Lee Ng","doi":"10.1002/wjo2.70185","DOIUrl":"10.1002/wjo2.70185","url":null,"abstract":"<p><strong>Purpose: </strong>To summarize current Western and Eastern approaches to the evaluation and management of chronic cough, with particular emphasis on etiology-directed therapy, cough hypersensitivity, behavioral interventions, neuromodulators, procedural treatments, and traditional remedies.</p><p><strong>Methods: </strong>A literature search of PubMed, Web of Science, CNKI, and Ovid Medline was conducted on February 1, 2024. Adults with chronic cough lasting at least 8 weeks were eligible. Pediatric studies, studies involving immunocompromised patients, smokers or patients with lung cancer, animal studies, and non-English or non-Mandarin publications were excluded. Because of substantial heterogeneity in etiologies, interventions, study designs, and outcome measures, findings were synthesized narratively rather than quantitatively. Twenty-three primary studies were included in the final narrative synthesis.</p><p><strong>Results: </strong>Chronic cough commonly reflects cough hypersensitivity involving vagal sensory pathways and receptors including TRPV1, TRPA1, and P2X3. Common clinical contributors included upper airway cough syndrome, gastro-esophageal reflux disease, and cough-variant asthma. Management was most appropriately organized as a stepwise approach involving identification and treatment of the underlying cause, behavioral cough suppression therapy, and selected pharmacological treatment. Gabapentin and P2X3 antagonists may benefit refractory cough, although adverse effects and limited long-term data remain important limitations. Superior laryngeal nerve block and antireflux surgery may be considered in carefully selected patients. Acupuncture and selected traditional preparations may provide adjunctive benefit, but the evidence remains heterogeneous and should not replace standard evaluation or treatment.</p><p><strong>Conclusion: </strong>Chronic cough should be managed using a personalized, stepwise strategy that combines etiology-directed treatment with interventions targeting cough hypersensitivity. Traditional therapies may have a complementary role, but further well-designed comparative studies are required.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TGF-β1 Induced Methylation to Regulate SOCS3 Expression in Abnormal Activation of Vocal Fold Fibroblasts.","authors":"Hai-Zhou Wang, An-Qi Zhao, Xue-Yan Li, Rong Hu, Wen Xu","doi":"10.1002/wjo2.70167","DOIUrl":"10.1002/wjo2.70167","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effect of TGF-β1 on vocal fold fibroblasts (VFFs) phenotype and the expression of DNA methyltransferase 1 (DNMT1), and to reveal the putative mechanism by which TGF-β1 regulates SOCS3 and its potential role in abnormal VFFs activation after vocal fold injury.</p><p><strong>Methods: </strong>The normal VFFs group (Control), injured VFFs group (Injured), normal VFFs+TGF-β1 group (Control+TGF-β1), and injured VFFs+TGF-β1 group (Injured+TGF-β1) were set, and 5-aza, a DNA methyltransferase inhibitor that reduces DNMT1 protein levels via covalent trapping and degradation, was added to block DNA methylation. Methylation-specific PCR (MSP) was used to detect the methylation level of the SOCS3 promoter. The methylation level of the SOCS3 promoter, and the protein and mRNA expressions of Type I collagen (COL1), α-smooth muscle actin (α-SMA), DNMT1, SOCS3, JAK2, and STAT3 were detected before and after the addition of TGF-β1 and 5-aza.</p><p><strong>Results: </strong>Compared to the Control group, the expressions of COL1, α-SMA, and DNMT1 were elevated in the Injured, Control+TGF-β1, and Injured+TGF-β1 groups. After 5-aza addition, no significant changes occurred in the Control group; however, the above markers were significantly decreased in the Injured, Control+TGF-β1, and Injured+TGF-β1 groups. The methylation level of the SOCS3 promoter was significantly increased, and SOCS3 expression was markedly downregulated in the Injured, Control+TGF-β1, and Injured+TGF-β1 groups, while the SOCS3 promoter was not significantly methylated in the Control group. After 5-aza addition, the methylation level of the SOCS3 promoter was significantly decreased in the Injured, Control+TGF-β1, and Injured+TGF-β1 groups, and concomitantly, SOCS3 mRNA and protein expression were significantly upregulated. The expressions of JAK2 and STAT3 were significantly increased in the Injured, Control+TGF-β1, and Injured+TGF-β1 groups, whereas a significant decrease was observed after adding 5-aza, with the changes positively correlated with SOCS3 upregulation.</p><p><strong>Conclusion: </strong>TGF-β1 is proposed to promote abnormal activation of VFFs, which may be associated with DNA methylation-mediated regulation of SOCS3. Specifically, TGF-β1 may downregulate SOCS3 expression via DNMT1-mediated promoter DNA methylation, and this process is speculated to participate in abnormal VFFs activation by relieving the inhibitory effect of SOCS3 on the JAK2/STAT3 signaling pathway.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence-Optimized Image Biomarker Identification for Sinonasal Inverted Papilloma Diagnosis Using Image-Enhanced Versus White-Light Endoscopy.","authors":"Zhen-Xiao Huang, Cheng Li, Min Li, Ying-Hong Zhang, Gui-Min Zhang, Qian Huang, Zu-Fei Li, Michael T Chang, Bing Zhou","doi":"10.1002/wjo2.70179","DOIUrl":"10.1002/wjo2.70179","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to compare image feature identification and diagnostic performance between artificial intelligence-aided image-enhanced endoscopy (using the Storz Professional Image Enhancement System, SPIES) and conventional white-light endoscopy (WLE) for sinonasal inverted papilloma (SIP).</p><p><strong>Methods: </strong>A total of 163 patients were investigated using Storz Professional Image Enhancement System (SPIES) endoscopy (SPIES Spectral A[SA]/Spectral B[SB]) and WLE. From each patient, one or two images (only in the presence of bilateral lesions) were obtained, and a large number of potential features were extracted from WLE, SA, and SB. Independent t-tests and LASSO methods were used to feature selection. Machine learning (ML) models were trained and evaluated for each channel of images.</p><p><strong>Results: </strong>The Random Forest (RF) algorithm on SPIES SB mode achieved superior performance: accuracy = 0.86, sensitivity = 0.89, specificity = 0.83, AUC = 0.86, and Kappa = 0.71. SB significantly outperformed SA (accuracy = 0.77) and WLE (accuracy=0.75). ROC analysis confirmed SB's diagnostic superiority (area under curve [AUC]: SB = 0.86 vs. SA = 0.77, WLE = 0.75).</p><p><strong>Conclusions: </strong>SPIES SB mode demonstrated the highest diagnostic accuracy and AUC for SIP identification, highlighting its potential as a superior imaging modality. SPIES endoscopy exhibits superior diagnostic accuracy and predictive performance compared to conventional WLE in the diagnosis of SIP. However, the single-center design and limited sample size necessitate validation through multicenter studies with larger cohorts.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Persistence and Factors Associated With Discontinuation in Real-World Biologic Therapy for Chronic Rhinosinusitis With Nasal Polyps.","authors":"Hen Chaushu, Yuval Presman, Roni Vass, Narin Nard Carmel-Neiderman, Liyona Kampel, Forsan Jahashan, Nidal Muhanna, Eiman Abu Bandora, Avraham Abergel","doi":"10.1002/wjo2.70183","DOIUrl":"10.1002/wjo2.70183","url":null,"abstract":"<p><strong>Background: </strong>Biologic therapies are effective for severe, uncontrolled CRSwNP, yet real-world data on treatment persistence remain limited.</p><p><strong>Methods: </strong>This retrospective single-center study included 95 adults with CRSwNP who initiated dupilumab (88.4%), mepolizumab, or omalizumab between 2021 and 2025. The primary outcome was persistence with the index biologic therapy. Discontinuation was a permanent cessation, switching, or a ≥ 90-day dosing gap. Switching ended index-biologic persistence but not biologic therapy overall. Response was graded with European Position Paper on Rhinosinusitis and Nasal Polyps/European Forum for Research and Education in Allergy and Airway Diseases (EPOS/EUFOREA) criteria. Kaplan-Meier and Cox analyses were performed.</p><p><strong>Results: </strong>Twenty-one patients (22.1%) discontinued their index biologic over a median follow-up of 18 months. Eight switched agents, so 13 (13.7%) stopped biologic therapy altogether. Index-biologic persistence was 82.3% (95% CI: 71.9%-89.2%) at 12 months and 71.7% (95% CI: 58.2%-81.5%) at 30 months. Among discontinuers, the median observed time to discontinuation was 9.4 months. Adverse events were the leading cause (57.1%), most commonly arthralgia and ocular symptoms. Early discontinuation was driven predominantly by adverse events, whereas adverse events and insufficient efficacy contributed equally later. In exploratory univariable Cox analyses, adverse events during therapy (HR = 4.32, 95% CI: 1.73-10.79) and a general history of allergy (HR = 3.07, 95% CI: 1.24-7.58) were most strongly associated with discontinuation, as were female sex, diabetes mellitus, and lower EPOS/EUFOREA response scores.</p><p><strong>Conclusion: </strong>In this real-world cohort, discontinuation of the index biologic was driven mainly by adverse events and insufficient response. Early follow-up focused on tolerability and later review on disease control may be warranted.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Turbinoplasty Versus Medical Treatment for Allergic Rhinitis: A Systematic Review and Meta-Analysis.","authors":"Noof Albannai, Hajar Alismail, Abdullah N Aladwani, Abdur Rehman, Abdullah AlShuaib, Retaj Alawadhi, Jassim AlMusaileem, Meshal T Alshammari, Omar Bader Alharbi, Bader A Alasoosi, Sarah S Alenezi, Abdullah M Alharran, Ebraheem Albazee","doi":"10.1002/wjo2.70182","DOIUrl":"10.1002/wjo2.70182","url":null,"abstract":"<p><strong>Objective: </strong>Allergic rhinitis is a common chronic condition affecting up to 30% of adults worldwide, with nasal obstruction being the most bothersome symptom. Inferior turbinate hypertrophy is a major contributor to nasal obstruction in allergic rhinitis, and surgical reduction techniques have been developed for cases refractory to medical therapy. This systematic review and meta-analysis evaluated the efficacy of inferior turbinate reduction procedures compared with medical therapy alone in patients with allergic rhinitis.</p><p><strong>Data source: </strong>PubMed, Embase, Web of Science, Scopus, and Cochrane Library.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, Web of Science, Scopus, and Cochrane Library from inception to March 2026 for comparative studies comparing inferior turbinate reduction versus medical therapy in patients with allergic rhinitis and inferior turbinate hypertrophy. R software was used for meta-analysis using a random-effects model.</p><p><strong>Results: </strong>Six studies comprising 574 participants were included. For rhinorrhea, the pooled effect of studies comparing turbinoplasty versus medical treatment was nonsignificant with high heterogeneity. Sneezing showed no significant difference. Itching also demonstrated a nonsignificant effect. Turbinoplasty alone improved nasal obstruction compared to medical treatment.</p><p><strong>Conclusions: </strong>Turbinoplasty may improve nasal obstruction in patients with allergic rhinitis refractory to medical therapy. The evidence for other nasal symptoms (rhinorrhea, sneezing, itching) is less consistent due to substantial heterogeneity. These findings should be considered preliminary and future trials are needed to validate them.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ChatGPT Versus DeepSeek in Resectability Categorization of Chronic Rhinosinusitis: A Comparison Based on EPOS 2020.","authors":"Jia-Hong Lao, Shu-Yi Huang, Fei-Tong Jian, Rong-Rong Ge, Yu Jiang, Xue-Kun Huang, Zhao-Hui Shi, Qin-Tai Yang, Shuo Wu","doi":"10.1002/wjo2.70180","DOIUrl":"10.1002/wjo2.70180","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate and compare the performance of ChatGPT-5.5 (2026) and DeepSeek-V3 (2026) in classifying CRS resectability according to the EPOS 2020 guidelines, employing various prompting strategies.</p><p><strong>Methods: </strong>In this retrospective study, 150 chronic rhinosinusitis cases were reviewed, and three rhinology experts classified resectability according to the EPOS 2020 criteria. GPT-5.5 and DeepSeek-V3 were evaluated using default-knowledge, in-context, and chain-of-thought (CoT) prompting based on accuracy, sensitivity, specificity, PPV, NPV, and F1 score. Prespecified subgroup analyses were conducted according to nasal polyp status and surgical eligibility to assess the consistency of prompting-strategy effects. ENT resident performance was compared with and without AI assistance. Statistical analyses included chi-square or Fisher's exact, Student's <i>t</i> or Mann-Whitney <i>U</i>, and ANOVA tests.</p><p><strong>Results: </strong>DeepSeek-V3 achieved higher accuracy than GPT-5.5 under default-knowledge (81.3% vs. 72.7%, <i>p</i> < 0.05) and in-context prompting (86.7% vs. 78.0%, <i>p</i> < 0.01). Notably, CoT prompting significantly improved both models, yielding comparable peak accuracies (95.3% vs. 96.0%, <i>p</i> = 1.00). Subgroup analyses revealed consistent effects across GPT-5.5 subgroups, whereas DeepSeek-V3 exhibited heterogeneous response patterns. Furthermore, CoT-assisted ENT residents demonstrated significantly greater accuracy than unassisted peers (GPT-5.5: 97.3% vs. 72.8%, <i>p</i> < 0.001; DeepSeek-V3: 98.0% vs. 72.8%, <i>p</i> < 0.001), alongside a 43.0% reduction in completion time (95% CI: 41.5%-44.4%; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>ChatGPT-5.5 and DeepSeek-V3, when using the CoT prompting strategy, achieved similarly high accuracy in resectability categorization. While AI-generated reports improved surgeons' accuracy and efficiency, these models should be further validated as support tools before widespread clinical implementation.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of the Middle Ear Microbiome in Meniere's Disease by 16S rRNA Gene Sequencing Compared to Chronic Suppurative Otitis Media.","authors":"Yu-Ting Tao, Lin Wang, Hong-Wei Zheng, Li-Sheng Yu","doi":"10.1002/wjo2.70169","DOIUrl":"10.1002/wjo2.70169","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the middle ear microbiome in Meniere's disease (MD) patients.</p><p><strong>Methods: </strong>Middle ear smears from 10 MD patients (ME group) and 10 chronic suppurative otitis patients (OE group) were collected during surgery and processed via 16S rRNA gene sequencing.</p><p><strong>Results: </strong>The ME group demonstrated significant differences in alpha diversity (Shannon/Simpson index, <i>p</i> < 0.01) and beta diversity (ANOSIM/PERMANOVA, the Bray-Curtis distance matrix, <i>R</i> = 0.144, <i>p</i> < 0.05; <i>R</i> ² = 0.107, <i>p</i> < 0.05) compared to OE group, and the PERMDISP showed lower heterogeneity in the ME group (<i>p</i> < 0.01). <i>Ruminococcus, Ochrobactrum</i>, and <i>Halomonas</i> at the genus level were enriched in the ME group, and the difference reached marginal significance. The linear discriminant analysis effect size analysis (LefSe) identified <i>Bacteroides, Halomonas</i>, and <i>Prevotella</i> as significantly enriched in ME, while <i>Neisseriales</i> was downregulated (|LDA| > 2, <i>p</i> < 0.05). BugBase phenotype analysis revealed that facultatively anaerobic bacteria and bacteria containing mobile genetic elements were significantly reduced in the ME group compared to the OE group (<i>p</i> < 0.05). The proportion of anaerobes was higher in the ME group (<i>p</i> = 0.123). Nine KEGG metabolic pathways were enriched in the ME group, though the difference was not significant after correction.</p><p><strong>Conclusion: </strong>These findings suggested that inner ear inflammation resulted from middle ear dysbiosis may contribute to MD pathogenesis, offering novel perspectives for MD etiology and therapies.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}