Objective We evaluated the outcomes of endoscopic cartilage myringoplasty according to lesion location in the repair of chronic dry tympanic membrane (TM) perforations. Methods and materials The local lesion was defined as visible keratinized/cornified epithelium, keratin debris, adhesive tissue, or cholesteatoma involving the TM remnant or mesotympanum without extension to the attic, tympanic antrum, or mastoid cavity. The perforation was classified into TM remnant type, umbo type, and tympanic cavity type according to lesion location. In total, 29 chronic TM perforations with a local lesion underwent endoscopic cartilage underlay myringoplasty. Graft success, hearing improvement, and cholesteatoma recurrence were assessed at 24 months postoperatively. Results Of the 29 patients, mastoid cavity opacification was present in 7 patients, a pneumatized mastoid cavity in 7 patients, a sclerotic mastoid in 4 patients, and a history of prior mastoidectomy in 11 patients. TM remnant type was identified in 7 patients, umbo type in 11 patients, and tympanic cavity type in 11 patients. The graft success rate was 100.0% in the TM remnant type, 90.9% in the umbo type, and 72.7% in the tympanic cavity type. The mean air-bone gap improvement was 17.9 ± 3.0 dB (95% confidence interval [CI], 15.1–20.7 dB) in the TM remnant type, 16.6 ± 3.5 dB (95% CI, 14.2–19.0 dB) in the umbo type, and 10.1 ± 5.8 dB (95% CI, 6.2–14.0 dB) in the tympanic cavity type. Conclusions The outcomes of endoscopic cartilage myringoplasty for chronic dry perforation repair differed according to lesion location in the remnant TM and tympanic cavity. However, these findings should be interpreted with caution because of the small sample size for each subtype and the substantial subgroup differences.
A female neonate with prenatally diagnosed congenital nasolacrimal duct cyst developed respiratory distress from nasal obstruction shortly after birth. Ultrasound, CT, and MRI showed a bilobed cyst comprising a dilated lacrimal sac and an intranasal component; endoscopic marsupialization restored a patent airway, with no recurrence at 3-month follow-up.
BackgroundWhile the clinical potential of Large Language Models (LLMs) is increasingly recognised, their safety in morphologically rich languages remains debated. This exploratory study comparatively examines the ability of two recent artificial intelligence models, ChatGPT 5.2 and Gemini 3 Pro, to evaluate simulated otorhinolaryngology (ENT) cases across urgent, priority, and elective triage categories in Turkish and English.MethodsThe study was designed around 30 standardised clinical scenarios covering frequent ENT pathologies. Gold standard diagnosis and disease management decisions were determined by expert consensus. Model performance was evaluated in terms of three-category triage accuracy, clinical safety scores, and emergency-detection performance, using expert consensus decisions as the reference standard. Cohen's Kappa, Wilcoxon Signed Ranks, and McNemar tests were applied to measure inter-model and inter-language agreement.ResultsAll 120 model-generated primary diagnoses were confirmed as correct by the two ENT specialists. Correct triage classifications were obtained in 55/60 (91.7%) responses for ChatGPT 5.2 and 58/60 (96.7%) responses for Gemini 3 Pro. Agreement with expert-defined triage decisions was almost perfect (κ = 0.813-0.938). No statistically significant differences in the evaluated paired comparisons of triage accuracy or clinical safety scores were detected (all p > 0.05). Gemini 3 Pro correctly identified all 18 emergency scenarios in both language conditions.ConclusionsBoth models demonstrated high observed diagnostic and triage accuracy in a limited set of simulated ENT scenarios spanning different acuity levels. Although no statistically significant differences were detected in the evaluated comparisons, these findings do not establish equivalence between models or languages. These encouraging findings, particularly the high performance observed in Turkish, support further investigation of large language models as potential adjunctive clinical decision-support tools, while larger and more diverse clinical studies remain necessary before routine clinical implementation.
Background The posterior-lateral nasal cavity has been used as a target for locoregional anesthetic block for primary headache. Anecdotal observations of improved migraine frequency and severity in patients treated with radiofrequency ablation for rhinitis have suggested the potential of this treatment for chronic migraine. Objective To explore the impact of impedance-controlled posterior nasal nerve radiofrequency ablation on headache frequency, symptoms, and quality of life in adults with chronic migraine. Methods This is a prospective, single-arm, multicenter, feasibility clinical study of bilateral impedance-controlled posterior nasal nerve radiofrequency ablation in adults with chronic migraine with or without chronic rhinitis symptoms. Participants completed follow-up visits at 2, 4, and 6 months after the procedure. Daily headache logs were completed. Outcome measures included mean monthly migraine headache days (MMHD), 50% responder rate (MMHD-50), mean monthly headache days, Headache Impact Test (HIT-6), Migraine-specific Quality of Life Questionnaire (MSQ), and Sinonasal Outcome Test (SNOT-22). Results Six investigational centers enrolled 24 participants with 21 participants completing the 6-month follow-up. The MMHD change from baseline was –5.2, –6.1, –7.1, –7.3, –7.5, and –6.0 at 1, 2, 3, 4, 5, and 6 months, respectively (all p <0.001). The MMHD-50 responder rate ranged from 58.3% to 77.3%. Mean monthly headache days were significantly reduced from baseline for each month ( p <0.0001). Reductions from baseline for the HIT-6 ranged from –14.2 to –16.5, with 17 of 21 participants (81%) achieving a minimum clinically important difference in HIT-6 at 6 months. Statistically significant improvements ( p <0.001) were observed at all time periods for the overall MSQ score and total SNOT-22 score. Conclusions A single bilateral treatment of impedance-controlled radiofrequency ablation of the posterior nasal nerves was associated with significant improvement in migraine frequency, quality of life, and migraine-related burden through 6 months after the procedure in adults with chronic migraine.
