Objective: To explore Chat Generative Pretrained Transformer's (ChatGPT's) capability to create multiple‐choice questions about otorhinolaryngology (ORL).Study Design: Experimental question generation and exam simulation.Setting: Tertiary academic center.Methods: ChatGPT 3.5 was prompted: “Can you please create a challenging 20‐question multiple‐choice questionnaire about clinical cases in otolaryngology, offering five answer options?.” The generated questionnaire was sent to medical students, residents, and consultants. Questions were investigated regarding quality criteria. Answers were anonymized and the resulting data was analyzed in terms of difficulty and internal consistency.Results: ChatGPT 3.5 generated 20 exam questions of which 1 question was considered off‐topic, 3 questions had a false answer, and 3 questions had multiple correct answers. Subspecialty theme repartition was as follows: 5 questions were on otology, 5 about rhinology, and 10 questions addressed head and neck. The qualities of focus and relevance were good while the vignette and distractor qualities were low. The level of difficulty was suitable for undergraduate medical students (n = 24), but too easy for residents (n = 30) or consultants (n = 10) in ORL. Cronbach's α was highest (.69) with 15 selected questions using students' results.Conclusion: ChatGPT 3.5 is able to generate grammatically correct simple ORL multiple choice questions for a medical student level. However, the overall quality of the questions was average, needing thorough review and revision by a medical expert to ensure suitability in future exams.

Objective. Squamous cell carcinoma of the nasal vestibule (NV SCC) is a head and neck malignancy for which there is no established consensus on most aspects of clinical management. The purpose of this document is to give updated recommendations that incorporate recent evidence on its clinical characteristics and the high efficacy of brachytherapy as primary treatment modality. Methods. A working group consisting of the members of the Scientific Committee for Oncology and Reconstructive Surgery of the Italian Society of Otorhinolaryngology Head and Neck Surgery and radiation oncologists expert in brachytherapy was formed to achieve a consensus. Results. Consensus was reached on a set of recommendations, proposing a refined anatomical definition of the nasal vestibule, a novel T staging system of the NV SCC, and brachytherapy as standard of care, with a new method for catheter implantation. Conclusions. The Committee emphasises the critical role of an accurate classification in clinical practice and encourages further research to validate the novel staging system and further improve treatment strategies. Where appropriate, it is recommended that patients be referred to centres with specific experience in brachytherapy for NV SCC.

Purpose: To compare hearing results and complication rates between two groups of patients operated on by endoscopic stapes surgery (ESS) for otosclerosis, either with CO₂ fiber laser or microdrill. Methods: A case–control study was performed. All consecutive cases of CO₂ fiber laser ESS operated at a single center during the period 2017–2020 (case group) were matched to a control group of patients operated by traditional technique, according to year of surgery, preoperative mean air–bone gap, sex and age. Audiological data from preoperative and postoperative examinations and complication rates were compared. Results: 46 cases were included. Mean operative time was significantly longer in the laser cohort (65 min) than in the drill one (45 min) (p = 0.003). Similar results were found in the two groups regarding the mean postoperative BC-PTA. The high-frequency bone conduction resulted significantly higher in the laser group (p = 0.002), suggesting an overclosure effect in the laser group. Consistently, a significant improvement of the BC-PTA threshold at 2000 Hz postoperatively was found in the laser group (p = 0.034). The postoperative AC-PTA significantly improved in both groups at all frequencies (p < 0.05), except for the AC threshold at 8 kHz. Similar rates of complications were found in the two groups. Conclusion: This study is the first to compare hearing results and complications between CO₂ fiber laser and microdrill in ESS. Our results demonstrated similar functional outcomes between the two groups, confirming ESS as safe and effective, regardless of the technique used.

Ossiculoplasty (OPL) aims to restore ossicular chain continuity to improve hearing in patients with conductive or mixed hearing loss, often performed during tympanoplasty. The current training methods, including cadaveric temporal bone models, face challenges such as limited availability, high costs, and biological risks, prompting the exploration of alternative models. This study introduces a novel training platform for OPL using 3D-printed temporal bones and incudes, including a magnified (3:1) model to enhance skill acquisition. Sixty medical students were divided into two groups: one trained on magnified models before transitioning to real-sized ones, and the other used only real-sized models. Training performance was quantitatively assessed using post-remodeling cone-beam CT imaging and mesh distance analysis. The results showed a significant improvement in performance for students with preliminary training on magnified models (87% acceptable results vs. 37%, p = 0.001). Qualitative feedback indicated higher confidence and skill ratings in the magnified model group. This study highlights the effectiveness of scalable, anatomically accurate synthetic models for complex surgical training. While further validation is required with experienced trainees and broader scenarios, the findings support the integration of 3D printing technologies into otologic education, offering a cost-effective, reproducible, and innovative approach to enhancing surgical preparedness.

Understanding middle ear biomechanics is crucial for clarifying sound transmission and surgical techniques. Conventional interferometry-based techniques for motion quantification are highly sensitive but are often limited to small surfaces, while conventional microtomography is volumetric but cannot adequately resolve soft tissues and temporal dynamics. We used dynamic synchrotron-based X-ray phase-contrast microtomography on three fresh-frozen human temporal bones under acoustic stimulation at 128, 256, and 512Hz with sound pressure levels of 120, 126, 141, and 151dB. This method achieved micrometer spatial and kHz temporal resolution, allowing 4D visualization of the ossicles and tympanic membrane (TM). Non-rigid registration quantified micrometer-scale TM motion and was validated with anatomical landmarks. Displacement 'hot spots' were consistently observed in the posterosuperior quadrant of the TM and the pars flaccida, although their relative contributions varied between specimens. Displacement amplitudes also varied strongly between specimens, with peaks ranging from <0.15 to nearly 2 μm/Pa. The magnitude of displacement changed with the level and frequency of the sound pressure, while the motion patterns remained stable. These findings demonstrate that dynamic synchrotron-based X-ray phase-contrast microtomography is a reliable and powerful approach for studying the non-rigid motion of TM. The variability between samples underscores the need for correlative imaging to characterize both motion and tissue microstructure such as fiber orientation and density. Future studies should also investigate how the motion of the TM correlates with the movement of the umbo and entire ossicular chain to provide a more complete understanding of the mechanics of the middle ear.