European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery最新文献

{"title":"Efficacy and safety of superior laryngeal nerve block in neurogenic cough: A systematic review and meta-analysis.","authors":"Amal Binhazzaa","doi":"10.1007/s00405-025-09582-8","DOIUrl":"https://doi.org/10.1007/s00405-025-09582-8","url":null,"abstract":"<p><strong>Background: </strong>Neurogenic cough is a chronic condition characterized by persistent coughing that is unresponsive to conventional treatments. It is thought to result from sensory neuropathy of the laryngeal nerves, leading to heightened cough reflex sensitivity. Current management strategies include neuromodulating medications and speech therapy, but these are often ineffective or associated with significant side effects. Superior laryngeal nerve (SLN) block has emerged as a minimally invasive alternative, hypothesized to modulate sensory feedback and disrupt maladaptive cough signaling pathways. This systematic review and meta-analysis aimed to assess the efficacy and safety of SLN block in the treatment of neurogenic cough.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using PubMed, Web of Science, and Scopus from inception to January 2025. Eligible studies included randomized controlled trials (RCTs) and observational studies evaluating SLN block for neurogenic cough. Outcomes analyzed included the Cough Severity Index (CSI), Leicester Cough Questionnaire (LCQ) scores, improvement rates, and incidence of serious adverse events. Data synthesis was performed using a random-effects model, and heterogeneity was assessed using the I² statistic.</p><p><strong>Results: </strong>Nine studies (eight retrospective and one RCT) with sample sizes ranging from 16 to 209 patients were included. SLN block resulted in a significant reduction in CSI scores (MD = -11.2, 95% CI: -15.32, -7.08) and a significant improvement in LCQ scores (MD = 2.23, 95% CI: 0.6, 3.85, p = 0.007). The intervention showed a high incidence of symptom improvement (effect estimate = 0.803, 95% CI: 0.722, 0.883) with a low rate of serious adverse events (effect estimate = 0.015, 95% CI: 0.0001, 0.03).</p><p><strong>Conclusion: </strong>SLN block is a promising and safe intervention for neurogenic cough, demonstrating significant symptom relief and minimal adverse effects. However, further RCTs are needed to confirm long-term efficacy and establish standardized treatment protocols.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary study on cervical vestibular-evoked myogenic potentials tuning changes in acute low-tone sensorineural hearing loss.","authors":"Ji Hyeok Choi, Min Young Lee, Jae Yun Jung, Ji Eun Choi","doi":"10.1007/s00405-025-09661-w","DOIUrl":"10.1007/s00405-025-09661-w","url":null,"abstract":"<p><strong>Background: </strong>Acute low-tone sensorineural hearing loss (ALHL) is frequently associated with endolymphatic hydrops. Cervical vestibular-evoked myogenic potentials (cVEMP) have been used to detect saccular hydrops, especially in Meniere's disease, but their role in ALHL is unclear.</p><p><strong>Objective: </strong>To preliminarily investigate whether cVEMP tuning frequency shifts are associated with hearing outcomes in patients with ALHL.</p><p><strong>Methods: </strong>This retrospective study analyzed medical records from 29 patients diagnosed with unilateral ALHL between 2016 and 2021. cVEMP testing utilized 500 Hz and 1000 Hz tone bursts, and frequency tuning shifts were assessed using the 1000/500 Hz amplitude ratio. Hearing recovery and recurrence were evaluated during follow-up.</p><p><strong>Results: </strong>Of 29 patients, 11 (37.9%) exhibited cVEMP tuning shifts (1000/500 Hz ratio ≥ 0.943). Hearing recovery without recurrence occurred in 55% of patients with tuning shifts versus 72% of patients without shifts; however, this difference was not statistically significant (p > 0.05). Multivariable analysis identified older age as the only significant predictor associated with poorer hearing recovery (B = 0.175, SE = 0.081, p = 0.031, OR = 1.191).</p><p><strong>Conclusions: </strong>This preliminary study found no statistically significant relationship between cVEMP tuning shifts and hearing outcomes in ALHL. However, patients with tuning shifts appeared to have lower hearing recovery rates, which may warrant further investigation in larger prospective studies.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of cocaine-induced midline lesion (CIMDL) extended to skull base: a case report and systematic review.","authors":"Bright Oworae Howardson, Benjamin Vérillaud, Philippe Herman, Morgane Marc","doi":"10.1007/s00405-025-09612-5","DOIUrl":"10.1007/s00405-025-09612-5","url":null,"abstract":"<p><strong>Purpose: </strong>Cocaine-induced midline destructive lesions (CIMDL) represent a rare but severe consequence of intranasal cocaine abuse, occasionally progressing to skull base involvement with life-threatening complications. The aim of this manuscript is to describe an exceptional case of CIMDL with clival destruction and brainstem exposure, and to review current management strategies based on a systematic literature review.</p><p><strong>Methods: </strong>We report a unique case of a 39-year-old woman with CIMDL extending to the clivus, resulting in encephalocele with basilar artery and brainstem exposure. Surgical repair was performed using a temporo-parietal fascia flap (TPFF), followed by a secondary repair with a free omental flap. A systematic review of the literature was conducted according to PRISMA guidelines, including all relevant cases of skull base involvement in CIMDL.</p><p><strong>Results: </strong>Of 337 studies screened, 12 met inclusion criteria. Among these, surgical approaches varied widely, with a subset of patients managed conservatively, and no clearly preferred surgical strategy emerging. Outcomes highlight the feasibility and limitations of each approach and the importance of individualized surgical planning.</p><p><strong>Conclusion: </strong>This report emphasizes the importance of early multidisciplinary intervention and provides practical insights for the management of potentially fatal cases in selected CIMDL with skull base destruction. Moreover, it exposes the need for individualized surgical planning and reconsideration of conventional abstinence-based timing criteria in selected high-risk cases. This review also highlights the challenges in the development of standard management guidelines due to the rarity nevertheless heterogeneous scenarios of these clinical entities.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translational investigations in the HN1901 phase II window-of-opportunity study investigating the biological activity of an IDO1 (IO102) and PD-L1 (IO103) immune-modulatory peptide cancer vaccines in squamous cell carcinoma of the head and neck.","authors":"Simon Beyaert, Axelle Loriot, Michèle Magremanne, William Renwart, Pierre Mahy, Thierry Duprez, Pamela Baldin, Elena Benidovskaya, Nicolas Huyghe, Hajar Dahou, Vincent Stroobant, Tiphanie Gomard, Jean-Pascal Machiels, Sandra Schmitz","doi":"10.1007/s00405-025-09655-8","DOIUrl":"10.1007/s00405-025-09655-8","url":null,"abstract":"","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review on oncological outcomes, functional results, and laryngeal preservation in vertical partial laryngectomies vs. transoral laser microsurgery for early stage glottic cancer.","authors":"Sara Bassani, Rogerio Aparecido Dedivitis, Gabriele Molteni, Erica Zampieri, Cecilia Dalmazzini, Mario Augusto Ferrari de Castro, Luiz Paulo Kowalski","doi":"10.1007/s00405-025-09657-6","DOIUrl":"10.1007/s00405-025-09657-6","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the oncological and functional outcomes of transorallaser microsurgery (TLM) and vertical partial laryngectomy (VPL) in earlystageglottic carcinoma (T1-T2).</p><p><strong>Methods: </strong>A systematic review following PRISMA guidelines analyzedcomparative studies from 2000 to 2024 in PubMed, EMBASE, and Web ofScience. Outcomes included local control, recurrence rates, larynxpreservation, survival, voice quality, and complications.</p><p><strong>Results: </strong>Eight studies met inclusion criteria. TLM and VPL showed comparablesurvival rates for T1 tumors, but VPL provided better local control and larynxpreservation in T2 and anterior commissure involvement cases. TLM had higherrecurrence risk but superior functional outcomes, including better voicepreservation, shorter hospital stays, and lower complication rates.</p><p><strong>Conclusion: </strong>Both techniques are viable, but TLM is preferred for T1 tumors,while VPL should be considered for T2 lesions because of higher local controlrates. Patient priorities and tumor characteristics should guide surgical choice.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facial paralysis and vestibular Schwannoma surgery: new classification system for assessing non-total tumor resection.","authors":"Montserrat Asensi-Diaz, Carlos Martin-Oviedo, Monica Rueda Vega, Raquel de Lama Bermejo, Roberto Sanz Garzon, Miguel Aristegui","doi":"10.1007/s00405-025-09659-4","DOIUrl":"https://doi.org/10.1007/s00405-025-09659-4","url":null,"abstract":"<p><strong>Objective: </strong>To compare the outcomes of vestibular schwannoma surgeries over the past decade, focusing on surgical approach, facial nerve function, tumor recurrence, and to standardize a classification system for the extent of tumor resection.</p><p><strong>Study design: </strong>A retrospective cohort study involving 197 patients who underwent vestibular schwannoma surgery between January 2014 and December 2023.</p><p><strong>Methods: </strong>Data on demographics, tumor characteristics, surgical approach, and facial nerve function were collected. Facial nerve function was monitored intraoperatively, and facial palsy was graded using the House-Brackmann scale. Postoperative MRI was used to assess residual tumor and guide follow-up care. Tumor volumes (preoperative and postoperative) were estimated by measuring the largest diameters in the axial, coronal, and sagittal planes A new classification for the extent of tumor resection was proposed, incorporating both the surgeon's intraoperative impression and post-surgery MRI results. Statistical analysis was performed using SPSS v.25. A p-value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Of the 197 patients, 84.8% had total resection, and 15.2% had non-total resections. Non-total resections were associated with better facial nerve outcomes. Tumor regrowth occurred in 6 patients (3%). Statistical analysis showed that the extent of resection (p = 0.004), preoperative tumor volume (p = 0.018), and year of surgery (p = 0.005) were significant predictors of facial paralysis.</p><p><strong>Conclusions: </strong>Our policy remains focused on total tumor resection; however, when the tumor is attached to the facial nerve, we advocate for a non-total resection to preserve the integrity of the facial nerve. Based on our study, this approach does not increase the risk of tumor recurrence or the need for revision surgeries in our population.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of inflammatory and radiologic markers in pediatric bell's palsy: a retrospective study.","authors":"Cem Çelik, Belgin Tutar, Güler Berkiten, Tolgar Lütfi Kumral, Yavuz Atar, Hüseyin Sarı, Melis Ece Arkan Anarat, Sabire Sitare Sarıçam, Yavuz Uyar","doi":"10.1007/s00405-025-09653-w","DOIUrl":"10.1007/s00405-025-09653-w","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the prognostic significance of inflammatory markers, computed tomography (CT)-based facial nerve measurements, and clinical parameters in pediatric patients with Bell's palsy.</p><p><strong>Methods: </strong>In this retrospective study, 136 patients aged 4-18 years diagnosed with Bell's palsy were evaluated. Clinical data included age, sex, affected side, initial House-Brackmann (HB) grade, recovery grades at one month and final follow-up, presence of pain, and treatment timing. Inflammatory markers-mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein-to-albumin ratio (CAR)- were calculated from laboratory data obtained at admission. Facial nerve-to-facial canal (FN/FC) ratios were measured via CT in five regions. The control group included 70 age-matched children with normal CT scans obtained for non-specific complaints such as headache. Recovery was categorized as full (HB 1), partial (improved but not grade 1), or poor.</p><p><strong>Results: </strong>Initial HB grade was significantly correlated with both one-month (r = 0.67, p < 0.001) and final recovery (r = 0.33, p < 0.001). CAR was weakly correlated with one-month recovery (r = 0.224, p = 0.0089) but not long-term outcome. MPV, NLR, and PLR showed no significant prognostic value. FN/FC ratios were significantly higher in the labyrinthine, geniculate, and tympanic regions on the paralyzed side compared to both the control group and non-paralyzed side. However, no correlations were found between FN/FC ratios and recovery. A moderate correlation was observed between initial HB grade and tympanic FN/FC ratio (r = 0.321, p = 0.001).</p><p><strong>Conclusion: </strong>Initial clinical severity best predicts recovery in pediatric Bell's palsy. Inflammatory and radiologic parameters offer limited prognostic value and warrant cautious interpretation.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fanconi anemia patients with head and neck squamous cell carcinoma - a multi-center study.","authors":"Nir Tsur, Anner Moskovitz, Yehuda Zadik, Ehud Even-Or, Narin Nard Carmel Neiderman, Elchanan Zloczower, Omry Frig, Orna Steinberg-Shemer, Hannah Tamary, Noga Kurman, Inna Ospovat, Eyal Yosefof","doi":"10.1007/s00405-025-09466-x","DOIUrl":"10.1007/s00405-025-09466-x","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the presentation, treatment, and outcomes of head and neck squamous cell carcinoma (HNSCC) in patients with Fanconi anemia (FA), a rare genetic disorder characterized by increased cancer risk and treatment complications.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 11 FA patients diagnosed with HNSCC across five XXX medical centers from 2014 to 2023. Data on patient demographics, tumor characteristics, treatment modalities, complications, recurrences, and survival outcomes were analyzed using descriptive and survival statistics.</p><p><strong>Results: </strong>FA patients developed HNSCC at a median age of 31.5 years, primarily in the oral cavity. Surgical treatment was the primary treatment modality; however adjunct radiotherapy resulted in severe complications, such as high-grade mucositis in 75% of cases. Median overall survival was 28.7 months, with 36.4% of patients succumbing within 12 months of diagnosis. Recurrences were noted in three patients, split equally between local and distant sites, and 36% developed secondary malignancies up to 17 years post-initial diagnosis.</p><p><strong>Conclusions: </strong>HNSCC in FA patients presents distinct challenges, including a younger onset age, high rates of severe treatment complications, and poor survival outcomes. Tailoring treatment strategies to minimize radiotherapy exposure and implementing rigorous, long-term surveillance for second malignancies are essential for managing these high-risk patients.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":"4745-4754"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113074","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":"Proposal of a standardized testing protocol for BPPV: Using 3D simulations for insights into movement of otoliths during positional tests.","authors":"Rajneesh Bhandari, Anita Bhandari, David Samuel Zee, Daniele Nuti, Herman Kingma, Raymond van de Berg","doi":"10.1007/s00405-025-09400-1","DOIUrl":"10.1007/s00405-025-09400-1","url":null,"abstract":"<p><strong>Background: </strong>Benign Paroxysmal Positional Vertigo (BPPV) is a common vestibular disorder caused by displaced otolith debris in the inner ear. This study explored the order effect related to the sequence of performing different diagnostic positional maneuvers.</p><p><strong>Methods: </strong>3D simulations of the Supine Roll Test (SRT), Dix-Hallpike maneuver (DHM), and Deep head hanging tests, performed in the standardized prescribed way, were used to study various types of horizontal, posterior, and anterior canal BPPV. The simulations allowed visualization of the movement of the otolith debris and the resulting nystagmus patterns. The results of the sequence of tests and the starting side of the tests (from left or right) were observed.</p><p><strong>Results: </strong>Simulations of the SRT on horizontal canal BPPV (hc-BPPV) showed different patterns of nystagmus: direction changing, direction fixed, and unilateral (only elicited in one position) nystagmus. These patterns depended on the position of the debris within the horizontal canal and the side from which the SRT began. Simulations of the DHM showed that the test procedure could displace debris in the horizontal canal. The SRT, however, caused no movement of debris in the vertical canals. The deep head hanging test could displace debris in all canals.</p><p><strong>Conclusion: </strong>An order effect can occur when performing diagnostic maneuvers for BPPV. The maneuvers can displace debris in the semicircular canals into new positions that may influence the findings in subsequent maneuvers and confound interpretation. A standardized testing protocol, starting with the SRT first, can decrease the order effect and simplify the interpretation of test results and in turn improve diagnostic accuracy and outcomes in the management of BPPV.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":"4621-4629"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218552","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 head and neck cancer staging and treatment planning: guideline-based study.","authors":"Burcu Vural Camalan, Sumeyra Doluoglu, Nazlim Hilal Taraf, Mehmet Murat Gunay, Samet Ozlugedik","doi":"10.1007/s00405-025-09524-4","DOIUrl":"10.1007/s00405-025-09524-4","url":null,"abstract":"<p><strong>Purpose: </strong>This prospective simulation study was conducted to evaluate and compare the performance of ChatGPT (o1, 2023) and DeepSeek (V3, 2024) in staging and treatment planning for head and neck cancers.</p><p><strong>Methods: </strong>This prospective simulation study was conducted in March 2025 to evaluate and compare the performance of two advanced artificial intelligence (AI) models, ChatGPT (o1, 2023) and DeepSeek (V3, 2024), in clinical decision-making for head and neck malignancies. A total of 50 hypothetical, guideline-based clinical scenarios were carefully designed in English by two otorhinolaryngologists in alignment with the National Comprehensive Cancer Network® (NCCN®) Guidelines Version 2.2025.</p><p><strong>Results: </strong>In the overall analysis of treatment planning performance, DeepSeek (V3, 2024) demonstrated statistically superior accuracy compared to ChatGPT (o1, 2023) (p = 0.04). Both models showed comparable performance in tumor staging (p = 0.83). Both DeepSeek (p = 0.0001) and ChatGPT (p = 0.02) were statistically successful in respect of staging accuracy and providing fully correct answers on the subject of treatment.</p><p><strong>Conclusion: </strong>Although DeepSeek V3 demonstrated promising capability for clinical decision support in head and neck oncology, these artificial intelligence tools cannot replace multidisciplinary tumor boards. However, they can significantly streamline clinical workflows by rapidly organizing patient data, thereby enhancing board efficiency. Future efforts should prioritize the development and integration of secure, institution-specific, local large language models tailored for oncological decision-making.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":"4815-4824"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311214","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}