World Journal of OtorhinolaryngologyHead and Neck Surgery最新文献

{"title":"The Use of Ambient Dictation Artificial Intelligence in Clinical Spaces in Surgery: A Scoping Review.","authors":"Orli Weiss, Alyssa Steinbaum, Carly Fiest, Lacy Brame, Alfred Marc Iloreta","doi":"10.1002/wjo2.70135","DOIUrl":"10.1002/wjo2.70135","url":null,"abstract":"<p><strong>Objective: </strong>To determine the current scope of knowledge regarding ambient listening artificial intelligence (AI) tools for documentation in surgical clinical environments.</p><p><strong>Data sources: </strong>Literature search was performed using EMBASE, PubMed (MEDLINE), CINAHL, SCOPUS, and Cochrane databases. Citation searching was utilized to identify additional studies.</p><p><strong>Methods: </strong>A scoping review regarding the use of ambient dictation artificial intelligence in clinical note generation in surgery was performed per PRISMA-ScR guidelines. Two reviewers independently performed title and abstract screening, full-text review, and data extraction. Inclusion criteria included studies describing the use of ambient listening AI tools for the generation of clinical documentation for surgery, with full-text available, in English or English-language translation.</p><p><strong>Results: </strong>Of 252 studies identified through database and citation searching, 12 met the inclusion criteria. Narrative reviews were most common (<i>n</i> = 8), followed by scoping reviews (<i>n</i> = 1), systematic reviews (<i>n</i> = 1), primary research (<i>n</i> = 1), and expert commentary (<i>n</i> = 1). Three studies provided original data: the primary research and expert commentary focused on the use of AI scribing technology in urology, and one narrative review also included survey data regarding the implementation of AI scribing in hand surgery. All three sources found positive clinician feedback following the implementation of AI scribing technology. All review articles meeting inclusion criteria expressed positive views regarding the implementation of AI scribing technology in surgical subspecialties, though most relied on sources describing AI scribing in nonsurgical subspecialties.</p><p><strong>Conclusion: </strong>Documentation burden is a common contributor to clinician burnout in the medical field. AI scribing technologies have the potential to promote clinic efficiency and decrease documentation burden. The current research landscape regarding the implementation of these tools in surgical specialties is sparse and warrants further primary research in the future.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971586","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":"AI-Based Automated Instrument Tracking During Endoscopic Skull Base Surgery: A Pilot Feasibility Study.","authors":"David R Grimm, Dhiraj Pangal, Danyal Z Khan, Margaux Masson-Forsythe, Kaan Duman, Ayesha Syeda, Jack Cook, Peter H Hwang, Jayakar Nayak, Zara M Patel, Noel Ayoub, Robert Dodd, Juan Fernandez-Miranda, Daniel Donoho, Michael T Chang","doi":"10.1002/wjo2.70162","DOIUrl":"10.1002/wjo2.70162","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic endonasal approaches (EEA) to skull base tumors are a technically challenging procedure for both surgeons and trainees. Artificial intelligence and computer vision (CV) may offer an objective analysis that provides surgical assessment on technique and enhanced educational feedback for surgeons of all levels.</p><p><strong>Methods: </strong>Patients undergoing EEA from a tertiary care center between January 2022 and January 2023 were retrospectively analyzed. A large, publicly available CV model fine-tuned on endoscopic surgical video in collaboration with Surgical Data Science Collective (SDSC) was used for frame-by-frame detection of 14 different surgical instruments. Tool usage was depicted across different surgical phases of EEA. Dice-Sørensen Similarity Coefficients (DICE) were used to identify similarities between tool motion patterns across patients.</p><p><strong>Results: </strong>Ten patients (5 male, 5 female, ages 52.1 ± 13.8 years) were included, with over 35 h of video footage analyzed encompassing over 1.9 million individual frames. The sellar phase accounted for the majority of the analyzed frames. Within the sellar phase, the most frequently identified tools included suction (661,785), drill (138,031), Rhoton dissector (116,823), and cotton patties (105,038). Overall, DICE with higher frequency use exhibited substantially increased DICE scores: 0.52 for drill, 0.63 for Rhoton dissector, 0.67 for cotton patties, and 0.74 for suction.</p><p><strong>Conclusion: </strong>CV models reliably identified surgical instruments and can be used to capture both high-frequency patterns and deviations from common patterns in instrument usage across cases of endoscopic surgery.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913633","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":"Multi-Sequence Fusion MRI Deep Learning Models for Discrimination of Recurrent Nasopharyngeal Carcinoma and Osteoradionecrosis.","authors":"Wen-Tao Gong, Xue-Li Liu, Xiao Chen, Zhen Li, Ming-Yan Qiu, Shang Shi, Xuan-Yu Zhao, Li Wang, Quan Liu, Xi-Cai Sun, Yu-Xuan Shi, Hong-Meng Yu","doi":"10.1002/wjo2.70165","DOIUrl":"10.1002/wjo2.70165","url":null,"abstract":"<p><strong>Objectives: </strong>To develop a multi-sequence fusion model based on MRI images to differentiate between recurrent nasopharyngeal carcinoma (rNPC) and osteoradionecrosis (ORN) in patients with nasopharyngeal carcinoma (NPC) after radiotherapy, and to evaluate its diagnostic performance.</p><p><strong>Methods: </strong>We retrospectively reviewed 370 patients with pathologically confirmed recurrent nasopharyngeal carcinoma (rNPC) or osteoradionecrosis (ORN). After screening, 346 patients (207 rNPC and 139 ORN) with both axial T1-weighted contrast-enhanced imaging (T1C) and T2-weighted imaging (T2WI) were included and randomly split into a training set (<i>n</i> = 212), validation set (<i>n</i> = 61), and test set (<i>n</i> = 73). A dual-branch 3D-ResNet-50-based fusion model was developed to integrate multi-sequence MRI features. Model performance was evaluated using AUC, accuracy, sensitivity, specificity, precision, and F1 score.</p><p><strong>Results: </strong>On the test set, the proposed 3D-ResNet-Fusion model achieved an AUC of 0.86 and an accuracy of 84%, with a sensitivity of 91%, specificity of 72%, precision of 83%, and an F1 score of 0.87. Based on AUC comparisons, the fusion model outperformed comparator models based on EfficientNet (0.77, <i>p</i> = 0.20) and DenseNet (0.70, <i>p</i> = 0.02), as well as single-sequence 3D-ResNet models trained on T1C alone (0.71, <i>p</i> = 0.02) or T2WI alone (0.73, <i>p</i> = 0.046). In the human-AI comparison experiment, the proposed AI model achieved a 3% higher ACC than the senior otolaryngologist (<i>p</i> = 0.83), and outperformed the two junior otolaryngologists by 15% (<i>p</i> = 0.05) and 22% (<i>p</i> < 0.01), respectively.</p><p><strong>Conclusion: </strong>The proposed AI model effectively integrates information from multiple MRI sequences, significantly improving classification performance in distinguishing rNPC from ORN.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907569","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":"Progress and Prospects in Otorhinolaryngology-Head and Neck Surgery in Ethiopia.","authors":"Daniel G Eyassu, Eliyas Asfaw, Christian Schaaff, Cody L Messick, Assaye Nibret, Seid Temam, Nardos Getachew Bulfeta, Kassaw Ketemaw, Gebrewahd Alemu, Michael Kebede, Joshua P Wiedermann","doi":"10.1002/wjo2.70157","DOIUrl":"10.1002/wjo2.70157","url":null,"abstract":"<p><strong>Introduction: </strong>This paper aims to explore the current state of otorhinolaryngology-head and neck surgery (ORL-HNS) training and practice in Ethiopia, identify major barriers to development, and also highlight the optimistic prospects for the future, with strategies to build a self-sustaining ORL-HNS specialty capable of meeting the growing needs of the Ethiopian population.</p><p><strong>Methods: </strong>This study employed a mixed-methods approach, combining quantitative data from a cross-sectional survey, qualitative data from semi-structured interviews with otolaryngologists practicing in Ethiopia, and quantitative data from a review of relevant literature and publicly available datasets.</p><p><strong>Results: </strong>A total of 53 otolaryngologists practicing in Ethiopia participated in the survey. Head and neck surgery has progressed, with all major oncology surgeries now performed. Training opportunities for higher specialization are limited. Generally, there is a shortage of ORL-HNS clinical and surgical care equipment, outdated equipment, and poor maintenance availability.</p><p><strong>Discussion: </strong>Even with remarkable workforce growth, training for audiologists, speech therapists, and fellowship-trained otolaryngologists in the country is needed. Sustainable advancement and access to safe and affordable surgery will require strong collaborative efforts from multiple fronts, including improvements in the surgical supply chain, access to affordable surgical equipment, and institutional-level horizontal funding.</p><p><strong>Conclusion: </strong>Despite strides over the past two decades, significant deficits remain in Ethiopia's capacity to provide otolaryngologic care. Efforts aimed at bridging these disparities must focus not only on providing general and advanced training opportunities for local physicians but also on expanding access to basic resources and equipment needed for practice and making care more widely available outside of major population centers.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881700","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":"The Global Airways Unit: A Multidisciplinary Strategy for Early Diagnosis and Comorbidity Detection.","authors":"Diego M Conti, Eduardo J Correa, Alfonso Del Cuvillo, José D Abdullatif, Francisco J Alvarez-Gutiérrez, Remedios Cárdenas Contreras, Stefan Cimbollek, Rocío Corrales Millán, Ana Gómez-Bastero Fernández, Daniel Pérez-Chada, Francisco Pérez-Grimaldi, Alberto E Rabino, Maria A Romero-Falcón, Marcela Soria, José Gregorio Soto-Campos, Rosario B Spuches, Juan Maza-Solano","doi":"10.1002/wjo2.70166","DOIUrl":"10.1002/wjo2.70166","url":null,"abstract":"<p><strong>Background: </strong>Chronic respiratory diseases impose a large global burden of morbidity, mortality, and cost. The concept of a global airway has become increasingly supported by epidemiologic, mechanistic, and clinical evidence. However, clinical care often remains fragmented between ear, nose, and throat (ENT), allergy, and pulmonology.</p><p><strong>Methods: </strong>A multidisciplinary expert panel composed of allergists, pulmonologists, and otolaryngologists from multiple tertiary care centres was convened. Experts were selected using predefined criteria encompassing clinical experience, academic output, geographic and institutional diversity, and gender balance. The panel performed a structured synthesis of current international guidelines and high-impact literature, using a modified Delphi consensus process over 3 rounds, with a predefined agreement threshold of ≥ 80% to define the scope of diseases, diagnostic approach, and interdisciplinary care model.</p><p><strong>Results: </strong>The Global Airways Unit (GAU) framework prioritizes multidisciplinary teamwork, early detection of comorbidities, phenotype‑directed investigations, streamlined imaging, and assignment of a lead specialty with scheduled follow‑up. Expected benefits include earlier diagnosis, improved disease control and quality of life (QoL), reduced duplication of testing, and potential cost‑savings for patients and health systems.</p><p><strong>Conclusions: </strong>The GAU operationalises the unified airway hypothesis into a reproducible clinical model. We propose the formation of a GAU to coordinate the management of patients with inflammatory airway diseases. Prospective real‑world evaluation of GAU implementation is the next critical step to validate clinical and economic outcomes.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881706","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":"Current Advances of Treatments, Therapeutic Targets, Biomarkers, Novel Drugs, and Machine Learning for Hypopharyngeal Squamous Cell Carcinoma.","authors":"Ce Li, Rui Guan, Rui-Jie Jiao, Zhi-Jie Bi, Yang Fu, Yin Wang, Chen-Yang Xu, Ye Qian, Ran Wei, Sheng-Da Cao, Wen-Ming Li, Dong-Min Wei, Da-Peng Lei","doi":"10.1002/wjo2.70152","DOIUrl":"10.1002/wjo2.70152","url":null,"abstract":"<p><p>Hypopharyngeal squamous cell carcinoma (HSCC) is an aggressive subtype of head and neck squamous cell carcinoma with insidious onset, early metastasis, and dismal prognosis. Conventional multimodal therapy achieves limited survival benefit, highlighting an urgent need for refined precision strategies. This review systematically summarizes the latest progress in HSCC, covering epidemiological characteristics, imaging diagnosis, prognostic prediction, surgical and non-surgical treatment advances, as well as coding and non-coding therapeutic targets, biomarkers, and candidate drugs. It further introduces the application of multi-omics and machine learning in HSCC research, analyzes current challenges and future directions, and provides a theoretical reference for precise diagnosis, individualized treatment, and prognostic evaluation of HSCC.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881576","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":"Unveiling Otolith Mystery: Contemporary Testing Approaches and Their Clinical Significance.","authors":"Shun Zhou, E Tian, Hua-Jing Yang, Jun Wang, Zhao-Qi Guo, Jing-Yu Chen, Wan-Di Xu, Jia-Qi Guo, Zhang-Hong Zhou, Shi-Yu Shi, Xi-Xi Yu, Xin-Bo Gao, Ni Zhai, Xin Ma, Qing Zhang, Yi-Sheng Lu, Su-Lin Zhang","doi":"10.1002/wjo2.70151","DOIUrl":"10.1002/wjo2.70151","url":null,"abstract":"<p><strong>Objective: </strong>Otolith is a critical component of the peripheral vestibular system responsible for detecting linear acceleration. Dysfunction of the otolith organs can lead to vertigo, balance disturbances, and gaze instability. By elucidating the physiological foundations and evaluating both current and emerging methods for assessing otolith function, this review aims to provide a comprehensive resource for researchers and clinicians in the field of vestibular science, contributing to improved diagnostic accuracy and the development of more effective therapeutic strategies.</p><p><strong>Data sources: </strong>The databases of PubMed, Embase, and Cochrane Library were systematically searched for the articles.</p><p><strong>Methods: </strong>The information of physiological mechanism and clinical significance were extracted from each article.</p><p><strong>Results: </strong>Vestibular-evoked myogenic potentials (VEMPs) are valuable for evaluating saccule and utricle function, with clinical applications in diagnosing several diseases. Subjective visual vertical (SVV) has clinical value in the diagnosis of peripheral and central vestibular diseases, with recent advancements in smartphone Apps and VR devices providing more accessibility. The ocular counter-roll (OCR) examination has a superior application prospect, but standardization including the normal range and duration of recovery, was incomplete. The off-vertical axis rotation (OVAR) can be used to explore motion sickness. The test of linear acceleration perception is limited by device, site and result instability, so it is difficult to apply clinically. Balance-related tests have been applied clinically, but the isolation of otolith components that determine balance is an unfinished task.</p><p><strong>Conclusion: </strong>The review emphasizes the need for more precise and standardized otolith function tests to enhance diagnostic accuracy and therapeutic strategies, ultimately improving patient outcomes in vestibular disorders.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881729","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":"The Usefulness of Machine Learning Models to Predict Patient-Reported Outcome Measures in Chronic Rhinosinusitis With Nasal Polyps.","authors":"Yang Shen, Pan-Hui Xiong, Bo-Wen Zheng, Chen-Xi Li, Jun-Liang Chen, Yue Gu, Yan-Han Yang, Tao Lu, Yu-Cheng Yang","doi":"10.1002/wjo2.70144","DOIUrl":"10.1002/wjo2.70144","url":null,"abstract":"<p><strong>Background and objective: </strong>The treatment available for chronic rhinosinusitis with nasal polyps (CRSwNP) has remained unsatisfactory. Patient-reported outcome measures (PROMs), capturing patient-perceived health status and well-being, are vehicles for measuring and improving the efficacy of care. This study aimed to establish machine learning (ML) models to predict PROMs in CRSwNP patients using minimally invasive and easily acquired clinical data.</p><p><strong>Methods: </strong>We collected commonly available clinical predictive data from 437 patients and established four separate ML models in the training set: a least absolute shrinkage and selection operator (LASSO)-based Logistic regression, a random forest (RF) regression, a gradient-boosted decision tree (GBDT), and a deep neural network (DNN). In the test and independent external validation sets, the predictive performance of these models was measured by calculating C statistics, expected prediction results, and decision curves. A feature-ranking analysis was performed using the ML algorithm. We then developed a predictive nomogram using LASSO-based Logistic regression.</p><p><strong>Results: </strong>The models performed well on an independent external validation set, with no statistically significant differences in generalization ability metrics between groups. LASSO regression identified key features of the predictive PROMs. A nomogram was created based on multivariate Logistic regression with LASSO regularization.</p><p><strong>Conclusions: </strong>All four ML models demonstrated similar performance in predicting PROMs in CRSwNP patients from which a clinical nomogram was developed. Early prediction of the subjective treatment response is crucial, as it influences clinician decisions and facilitates effective doctor-patient communication preoperatively; this could lead to more precise and personalized treatment for CRSwNP patients.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867064","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":"Safety, Efficacy, and Mechanism of Action of Budesonide in Rhinitis and Rhinosinusitis: A Systematic Review.","authors":"David W Kennedy, Lei Cheng, De-Yun Wang","doi":"10.1002/wjo2.70114","DOIUrl":"10.1002/wjo2.70114","url":null,"abstract":"<p><strong>Objective: </strong>Budesonide is a corticosteroid with unique pharmacokinetic and pharmacodynamic properties that has been a frontline treatment for patients with allergic rhinitis (AR) and chronic rhinosinusitis (CRS) since the 1990s. As research on budesonide continues to produce new insights, our aim was to synthesize recent investigations and provide up-to-date information on safety, clinical, and mechanism of action (MOA) outcomes.</p><p><strong>Data sources: </strong>Searches were restricted to PubMed from 2014/01/01 to 2025/02/26. Clinical investigations in the primary therapeutic area of rhinitis, sinusitis, or rhinosinusitis with adult patients receiving budesonide were included.</p><p><strong>Review methods: </strong>Results were screened, and findings from eligible articles were assessed for safety, efficacy, and/or MOA outcomes.</p><p><strong>Results: </strong>Overall, 31 articles were included. CRS was the primary indication in 19 studies and rhinitis in 12 (predominantly AR). Six studies investigated hypothalamic-pituitary-adrenal (HPA) axis suppression, and 2 studies assessed intraocular pressure; budesonide did not adversely affect either outcome, even with long-term, high-dose, high-volume nasal irrigations. Twelve studies of budesonide monotherapy generally showed improved efficacy outcomes. Eight studies of budesonide combination therapies, predominantly in patients with moderate-to-severe AR, generally showed improved efficacy versus budesonide monotherapy. MOA data were reported across seven studies, with anti-inflammatory alterations observed across the nasal mucosa, nasal secretions, nasal polyps, and peripheral blood after budesonide treatment.</p><p><strong>Conclusions: </strong>Safety outcomes were favorable across various budesonide delivery systems, including high-dose, high-volume nasal irrigations, with no evidence of HPA axis suppression after long-term budesonide use. Budesonide demonstrated consistent efficacy that was underpinned by MOA data on its potent anti-inflammatory effects.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841434","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":"Current Advances in Spatial Pathology of Nasal Polyps: Challenges, Opportunities for Artificial Intelligence, and Future Directions.","authors":"Zi-Xuan Hua, Xin Luo, Ning Kang, Ze-Zhi Guo, Man-Hou Chao, Hua-Mei Yan, Wan-Xin Zhang, Tong Wu, Zi-Qi Zhang, Xue-Kun Huang, Ya-Na Zhang, Zhao-Hui Shi, Qin-Tai Yang","doi":"10.1002/wjo2.70145","DOIUrl":"10.1002/wjo2.70145","url":null,"abstract":"<p><p>Chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by inflammatory heterogeneity, epithelial hyperplasia, and tissue remodeling, with spatial pathology critical for deciphering pathological mechanisms and guiding clinical practice. Conventional histopathological techniques rely on subjective visual evaluation, limited by inadequate spatial resolution of molecular markers and imprecise quantitative analysis. Recent advances show that spatial transcriptomics reveals nasal polyps (NP) inflammatory heterogeneity; deep learning enables automated inflammatory subset identification and precise endotype prediction; artificial intelligence (AI)-integrated frameworks transform assessment of tissue remodeling, angiogenesis, and fibro-inflammatory niches. AI-enabled spatial pathology bridges morphological and molecular signatures, refines NP endotyping, and paves the way for targeted biologic therapies and precision care. This review summarizes progress in conventional and emerging spatial pathology approaches for NP, focusing on AI-enabled tools and their clinical translation potential.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841312","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}