Purpose: This study evaluates the efficacy of two advanced Large Language Models (LLMs), OpenAI’s ChatGPT 4 and Google’s Gemini Advanced, in providing treatment recommendations for head and neck oncology cases. The aim is to assess their utility in supporting multidisciplinary oncological evaluations and decision-making processes. Methods: This comparative analysis examined the responses of ChatGPT 4 and Gemini Advanced to five hypothetical cases of head and neck cancer, each representing a different anatomical subsite. The responses were evaluated against the latest National Comprehensive Cancer Network (NCCN) guidelines by two blinded panels using the total disagreement score (TDS) and the artificial intelligence performance instrument (AIPI). Statistical assessments were performed using the Wilcoxon signed-rank test and the Friedman test. Results: Both LLMs produced relevant treatment recommendations with ChatGPT 4 generally outperforming Gemini Advanced regarding adherence to guidelines and comprehensive treatment planning. ChatGPT 4 showed higher AIPI scores (median 3 [2–4]) compared to Gemini Advanced (median 2 [2–3]), indicating better overall performance. Notably, inconsistencies were observed in the management of induction chemotherapy and surgical decisions, such as neck dissection. Conclusions: While both LLMs demonstrated the potential to aid in the multidisciplinary management of head and neck oncology, discrepancies in certain critical areas highlight the need for further refinement. The study supports the growing role of AI in enhancing clinical decision-making but also emphasizes the necessity for continuous updates and validation against current clinical standards to integrate AI into healthcare practices fully.

Purpose of Review: This paper aims to evaluate the evolution and current status of partial laryngeal surgery in the treatment of advanced laryngeal cancer (LC). Specifically, recent progress in the selection of both patients and tumors, together with surgical and rehabilitation innovations, have contributed to balancing oncological control with the maintenance of quality of life in naïve and radiorecurrent patients. The main aspect is represented by the recognized role of open partial horizontal laryngectomies (OPHLs) in this new era of laryngeal cancer treatment. Recent Findings: Recent advancements highlight OPHLs’ efficacy for conservative management of intermediate to advanced stages of LC. Innovations such as supratracheal partial laryngectomy have expanded surgical options, offering a modular approach to complex cases. Improved understanding of tumor biology, enhanced imaging techniques, and more precise preoperative planning have led to better patient outcomes, emphasizing the importance of a conservative function-preserving surgical treatment. These advancements reflect a broader trend towards individualized treatment plans that prioritize both survival and quality of life. Summary: OPHLs play an important role in current management of intermediate/advanced LC, effectively balancing oncological control with the preservation of laryngeal functions. Critical factors include meticulous patient and tumor selection, the impact of surgical and technological refinements on functional outcomes, and the necessity of a multidisciplinary approach in treatment planning. Current evidence justifies the use of these interventions in many intermediate T-stage laryngeal tumors, even at risk of upstaging on pathological examination. The oncological results, the preservation of laryngeal function and the laryngectomy-free survival achieved with OPHLs appear to be highly competitive with those of non surgical organ-preservation protocols, aiming to introduce a new standard in the LC treatment.

Different surgical techniques have been proposed for parapharyngeal space tumors, including transcervical, transparotid, trans-mandibular, infratemporal, and transoral. The choice of the correct approach depends on the size, localization and nature of the tumor. The transoral approach can be used for benign prestyloid masses, such as tumors of the deep lobe of the parotid gland. It guarantees a short hospitalization without skin scars. The narrowed access represents the main limitation of this technique. This review will summarize and analyze the current knowledge about the transoral approach to parotid lesions. Thirty-seven studies were included in a qualitative and quantitative synthesis. The novelty of this review is the quantitative analyses of the clinical data reported in the included studies.

Background/Objectives: Laryngeal squamous cell carcinoma (LSCC) is one of the most prevalent and challenging malignancies of the head and neck. Clinical staging (cTNM) plays a pivotal role in therapeutic decision-making. However, current imaging modalities often fall short, resulting in discrepancies between cTNM and pathological staging (pTNM). This systematic review aimed to critically evaluate the existing literature on the concordance between clinical and pathological staging of LSCC, quantifying staging inaccuracies and highlighting the prevalence of both under- and overstaging at diagnosis. Methods: A comprehensive search of the English-language literature was conducted across multiple databases, including PubMed, Embase, Scopus, the Cochrane Library, and Web of Science. Eligibility was limited to retrospective case series and observational studies reporting sufficient data to directly correlate individual patients’ cTNM and pTNM classifications. Results: Thirty-one studies comprising 7939 patients met the inclusion criteria. The overall concordance rate between cT and pT was approximately 86.43%. The concordance rates between cT and pT were 82.41%, 82.03%, 78.14%, and 89.64% for cT1, cT2, cT3, and cT4, respectively. Most discordant cases in cT2 and cT3 involved understaging at clinical diagnosis. Conclusions: The limited accuracy of clinical staging in reflecting the true extent of disease remains a critical challenge in the management of LSCC. The inability of current imaging techniques to reliably detect the subtle invasion of key anatomical structures contributes to both under- and overstaging, with significant clinical implications. For patients undergoing non-surgical organ-preservation strategies, these inaccuracies may adversely affect oncologic outcomes.

Background: The present systematic review aims to investigate the survival rates and surgical outcomes of patients with treatment‐naïve, intermediate (T3) to early advanced (T4a) laryngeal squamous cell carcinoma (LSCC) managed with open partial horizontal laryngectomies (OPHLs).Methods: A systematic literature search was conducted in PubMed, Embase, and Scopus for studies published between January 2000 and December 2023. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Inclusion criteria were: patients with histopathological confirmed LSCC; tumor classified as T3 or T4a stage according to the American Joint Committee on Cancer (AJCC) staging system; having undergone OPHL as the primary treatment without any prior therapy; availability of at least one of the following outcomes: overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), local control (LC), locoregional control (LRC), laryngectomy-free survival (LFS), and laryngo-esophageal dysfunction-free survival (LEDFS).Results: A total of 16 studies were deemed eligible for the qualitative analysis. The cumulative number of patients was 1473. The sample size ranged from 17 to 390 patients. The follow-up period ranged from 0 to 198 months. In patients treated with OPHL for T3, the overall five-year pooled proportions were OS 0.82, DSS 0.88, DFS 0.80, and LFS 0.86, whereas for the T4a case series, they were OS 0.77, DSS 0.89, DFS 0.74, and LFS 0.78.Conclusions: OPHL for selected T3 and low extralaryngeal volume T4a LSCC can guarantee a high rate of oncological success. Accurate patient selection is paramount to differentiate advanced diseases that is amenable to conservative surgery.

Maxillary sinusitis is a recognized complication following dental procedures, but its occurrence after orthognathic surgery, such as Le Fort osteotomies, remains less documented. This case report presents a 58‐year‐old female who developed unilateral maxillary sinusitis 23 years post‐orthognathic surgery. The patient was asymptomatic, aside from occasional cacosmia, and was incidentally found to have sinus opacification on a computed tomography (CT) scan performed for implant‐prosthetic rehabilitation. Nasal endoscopy revealed purulence and mucosal edema, prompting endoscopic sinus surgery (ESS). Intraoperatively, purulent material and fungal debris were removed from the maxillary sinus, confirming bacterial sinusitis with a concurrent fungal ball. S. salivarius and Klebsiella species were identified from the cultures. The patient's condition improved following the removal of both the sinus contents and the retained titanium plates and screws. This case underscores the potential for maxillary sinusitis to develop long after orthognathic surgery, particularly in the presence of retained dental hardware. It highlights the importance of thorough imaging and endoscopic evaluation in patients with a history of dental or facial surgeries presenting with sinonasal symptoms. Additionally, it raises questions about the role of retained hardware in the persistence or recurrence of infection and the possible association with fungal ball formation. The need for further research to establish guidelines for the management of sinusitis in such contexts, particularly regarding the removal of facial hardware, is emphasized.