Background Cochlear implantation (CI) is a standard intervention for congenital severe to profound sensorineural hearing loss. However, postoperative auditory and speech outcomes vary considerably across patients, and the developmental status of the cochlear nerve is considered a major determinant of rehabilitation efficacy. Objective This study aimed to assess the correlation between cochlear nerve cross-sectional area (CNCSA) and outcomes after cochlear implantation (CI). Methods We retrospectively analyzed 136 bilateral CI recipients, comparing auditory and speech rehabilitation results over 2 years postoperatively with bilateral CNCSA. Patients were grouped based on average CNCSA. Results A significant positive correlation was observed between CNCSA and scores on the IT-MAIS, MUSS, CAP, and SIR at 2 years post-CI. Patients with bilateral CNCSA >0.87 mm2 had significantly better speech rehabilitation outcomes than those with one or both nerves below this threshold. Conclusions CNCSA is correlated with post-CI rehabilitation outcomes in patients with severe-to-profound sensorineural hearing loss, and may serve as a predictor for auditory and speech rehabilitation success.

Background No randomized trials confirm the efficacy of concurrent chemoradiotherapy (CCRT) in platinum-ineligible patients with locally advanced head and neck squamous cell carcinoma (LAHNSCC) post-induction chemotherapy (IC). Objectives This study evaluates the efficacy of platinum-based versus taxane-based CCRT after IC in LAHNSCC patients, excluding nasopharyngeal carcinoma, to assess the viability of taxanes as a platinum alternative. Materials and Methods A retrospective analysis was conducted on 215 LAHNSCC patients treated with IC using nab-paclitaxel/docetaxel, cisplatin, and fluorouracil (AP/APF or TP/TPF). During CCRT, patients were divided into platinum and taxane groups. Survival rates, and safety profiles of nab-paclitaxel versus docetaxel were compared. All patients received Helical tomotherapy and Intensity-modulated radiotherapy at 60–70 Gy. Results No significant differences were observed in CR rates, 3-year progression-free survival (PFS) (75.2 vs. 84.8%), or overall survival (OS) (72.1 vs. 84.1%) between taxane and platinum groups. Within the taxane group, CR rates and 3-year PFS showed no significant difference. However, the nab-paclitaxel group demonstrated significantly improved 3-year OS (80.9 vs. 67.6%) and disease-specific survival (DSS) (94.09 vs. 70.72%) compared to the docetaxel group. Conclusions Taxane-based CCRT after IC is as effective as platinum-based treatment with manageable toxicity. Nab-paclitaxel surpassed docetaxel in 3-year OS and DSS.

Background The use of ChatGPT in the field of otolaryngology is increasing; however, there are not enough studies related to cochlear implants. Aim/Objectives To assess the accuracy and reproducibility of ChatGPT (GPT-4o) responses to questions about cochlear implantation, evaluating its potential role in patient education. Material and Methods A total of 104 questions across five categories (basic, preoperative, surgical, postoperative care, postoperative expectations) were selected from reliable online sources. Each was posed twice to ChatGPT-4o in separate sessions. Responses were graded by two reviewers for accuracy (comprehensive/correct, partially correct, misleading, or incorrect/irrelevant). Reproducibility was assessed based on consistency across sessions. Discrepancies were resolved by a third expert reviewer. Results Of 104 responses, 84.6% were correct, 5.8% partially correct, 6.7% misleading, and 2.9% incorrect. Reproducibility was 88.4% overall and 100% in the surgery category. No significant differences were found between question categories for accuracy (p = 0.829) or reproducibility (p = 0.348). Conclusion and Significance ChatGPT provided highly accurate and reproducible responses to cochlear implant-related questions, supporting its use as an educational tool. Nonetheless, expert review remains essential for complex or critical topics.

Background Large language models (LLMs) are increasingly used in clinical decision-making and patient education, including in complex specialties such as head and neck cancer (HNC). Objective To evaluate the performance of ChatGPT-4o and DeepSeek-V3 in answering HNC-related clinical questions. Methods A set of 154 questions across six clinical categories was submitted twice to both models. Responses were independently graded by head and neck surgeons using a four-point accuracy scale. Accuracy, reproducibility, and inter-model agreement were assessed. Results ChatGPT-4o and DeepSeek-V3 provided ‘’comprehensive/correct’’ answers in 92.2% and 89.6% of cases, respectively (p = .42). The accuracy ratings of both models’ responses overlapped in 85.1% of cases; however, the statistical agreement between them remained low (Cohen’s κ = 0.12; ICC = 0.21, p = .006). DeepSeek-V3 outperformed ChatGPT in Treatment category (96.3% vs. 81.5%, p = .08), while ChatGPT excelled in Recovery, Complications, and Follow-up (95.0% vs. 82.5%, p = .08); however, these differences did not reach statistical significance. Reproducibility was high for both models (ChatGPT-4o: 96.1%; DeepSeek-V3: 96.8%). Conclusions Both models demonstrated strong accuracy and consistency in HNC-related queries. Significance LLMs hold promise as reliable tools in clinical decision-making and patient education within HNCs when used with careful consideration of their inherent limitations.

Background Primary squamous cell carcinoma (SCC) of the major salivary glands is a rare malignancy with poor prognosis. Histological variants may differ in clinical presentation and outcomes. Objectives To clarify the clinicopathological features and prognostic impact of SCC variants in the major salivary glands using a large population-based dataset. Patients and methods We analysed 3581 patients with primary salivary gland SCC. Variants included conventional SCC, lymphoepithelial carcinoma (LEC), basaloid SCC (BSCC), and spindle cell carcinoma (SpCC). Overall survival (OS) and disease-specific survival (DSS) were evaluated by the Kaplan–Meier method and Cox regression analyses. Results Conventional SCC accounted for 92.7% of cases, followed by LEC (3.7%), BSCC (1.7%), and SpCC (1.3%). The 5-year OS rates were 39.0% for conventional SCC, 76.4% for LEC, 51.5% for BSCC, and 41.8% for SpCC (p < 0.001). The corresponding DSS rates were 60.0%, 85.6%, 62.7%, and 64.9% (p < 0.001). In multivariate analysis, LEC was independently associated with superior survival, with hazard ratios of 0.50 (95% confidence interval (CI) 0.36–0.71) for OS and 0.46 (95% CI 0.28–0.74) for DSS, whereas BSCC and SpCC showed outcomes comparable to conventional SCC. Conclusions Histological variant is a significant prognostic factor in salivary gland SCC. LEC showed favourable survival.

Background Age-related immunosenescence, also known as ‘inflammageing’, may impact the elderly’s ability to mount immune responses against cancers and compromise the effectiveness of immune checkpoint inhibition (ICI). In this context, data on tonsillar cancer (TC), a subset of head and neck squamous cell cancer (HNSCC), are lacking. Aims/objectives To compare the presence/distribution and features of immune cells in TC, and of bulk RNA-seq in HNSCC, between the young and the elderly. Material and methods TC tissue microarrays (TMAs) characterised by GeoMx digital spatial profiling were revisited and analysed, focusing on quantification and location of CD8+ and CD11c+ immune cells. De novo analyses of the TMAs targeted CD68+/CD163+ macrophages. Bulk RNA-seq and clinical data from patients with HNSCC were sourced from the Cancer Genome Atlas (TCGA). For all data, patients were stratified into age groups. Results Immune-cell characteristics in TC were similar across young and elderly individuals, although the elderly exhibited higher PD-1 levels. TCGA data revealed increased immune checkpoint molecules PD-L1 and LAG-3 in the elderly, alongside immunosuppression. Conclusion and significance In the elderly, key immune cells are present in TC, and immune checkpoint molecules are overexpressed. This may be relevant to the stratification of patients for ICI.

Background MicroRNAs play a critical role in laryngeal carcinogenesis, yet their stage-dependent dysregulation in tumor and peritumoral mucosa remains unclear. Objectives To evaluate expression of miR-144 and miR-145 in tumor and peritumoral mucosa of early- and advanced-stage laryngeal carcinoma, and assess their association with stage progression and field cancerization. Methods Expression levels of miR-144 and miR-145 were analyzed by qPCR in tumor and matched peritumoral mucosa from 91 patients (26 early-stage glottic and 60 advanced-stage laryngeal carcinomas). Results In early-stage tumors, miR-144 was downregulated in 32% and miR-145 in 36% of cases, with a subset showing upregulation. Peritumoral mucosa displayed similar dysregulation. Distinct stage-associated patterns emerged: peritumoral miR-144 was significantly reduced in advanced versus early disease (p = 0.013), whereas tumor miR-145 was significantly lower in advanced tumors (p = 0.004). No stage-related differences were detected for tumor miR-144 or peritumoral miR-145. miR-144 and miR-145 expression correlated moderately in both compartments (ρ = 0.40 tumor; ρ = 0.37 peritumor). ROC analysis revealed modest discriminatory potential (AUC 0.62–0.64). Conclusions miR-144 and miR-145 exhibit distinct, stage-dependent dysregulation in laryngeal carcinoma. Tumor miR-145 and peritumoral miR-144 alterations support a dynamic model of field cancerization, suggesting potential biomarker roles in disease progression and risk assessment.

Background Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder causing transient episodes of vertigo. While canalith repositioning maneuvers are effective, the influence of physical activity levels on treatment response remains unclear. Aims/Objectives To examine the correlation between post-maneuver benefit and physical activity frequency in BPPV patients. Material and Methods Sixty-six patients diagnosed with BPPV at Başkent University Audiology Clinic were included. The International Physical Activity Questionnaire (IPAQ) and Physical Activity Habit Assessment Questionnaire (PAHAQ) were used to assess physical activity over the past week and year, respectively. Canalith repositioning maneuvers were repeated until full recovery. Significance was set at p < 0.05. Results No significant association was found between maneuver count and IPAQ scores. However, PAHAQ scores were significantly lower in patients requiring multiple maneuvers, suggesting that long-term physical inactivity may impact treatment response. Conclusions and Significance Short-term activity did not affect BPPV treatment outcomes, while low long-term activity levels were linked to increased maneuver requirements. Identifying such modifiable risk factors may enhance recovery and reduce healthcare burden.

Background Transoral robotic surgery (TORS) is performed for both benign as malignant diseases. It has been suggested that patients treated for benign indications may report higher postoperative pain, though supporting evidence is limited. Aims/Objectives To evaluate which factors are associated with acute postoperative pain severity following TORS. Material and methods A retrospective observational cohort study was conducted in patients undergoing TORS. Maximum postoperative pain scores (numerical rating scale, NRS 0–10) were recorded for postoperative day (POD) 1,2,3. Clinically well-controlled pain was defined as NRS < 3. Variables including surgical indication (benign or malignant), gender, age, BMI, analgesic use, chronic pain and antidepressant use were analysed. Univariable and multivariable regression analysis were performed for NRS ≥ 3. Results Of the 119 cases, the mean maximum POD1 pain score was 2.7 (SD 1.89). Univariable analysis showed higher POD1 were associated with benign disease, chronic pain, pain relief, female gender and age. On multivariable regression analysis, only female gender was significantly associated with NRS ≥3. Conclusions and significance Female gender was found to be the only independent predictor of higher postoperative pain, other factors, including surgical indication were not.