Background: Otitis media with effusion (OME) is a highly prevalent pediatric condition and a leading cause of conductive hearing loss in children. Its pathogenesis remains uncertain, and diagnostic and therapeutic challenges make management difficult. Objectives: This review evaluates current evidence on the middle ear microbiome in pediatric OME, focusing on the diagnostic value of 16S ribosomal ribonucleic acid (16S rRNA) gene sequencing and its potential clinical implications. Methods: A literature review was conducted using the PubMed database, including studies published between 2006 and 2026. Eligible studies involved pediatric patients with OME and examined the sources and characteristics of microbiota potentially involved in disease pathogenesis. Microbiome analysis was performed using next-generation sequencing (NGS) techniques. Results: Growing evidence indicates that OME is associated with microbial dysbiosis and biofilm formation rather than a sterile inflammatory process. The most frequently detected genera include Haemophilus, Moraxella, Streptococcus, and Alloiococcus, although substantial variability exists between studies. Pathogens are believed to reach the middle ear through the Eustachian tube from two main reservoirs: the nasopharynx and the adenoids. The potential role of Helicobacter pylori infection and gastroesophageal reflux disease (GERD) in OME pathogenesis remains uncertain and requires further investigation. NGS methods, including 16S rRNA sequencing, demonstrate higher sensitivity than conventional culture techniques, enabling the detection of fastidious and previously unrecognized microorganisms. Evidence also highlights the limited effectiveness of antibiotic therapy in OME, the persistent issue of antibiotic overuse, and the relative advantages of conservative management and microbiome-modulating approaches compared with antibiotics and surgical interventions. Conclusions: Current evidence suggests that OME is closely associated with microbiota dysbiosis and bacterial biofilm formation. Given the limited efficacy of antibiotics, microbiome-focused strategies—particularly probiotics—should be further explored. Molecular diagnostic methods, especially NGS, show clear advantages over traditional culture-based techniques. Future research should further evaluate microbiome modulation as a potential adjunctive or preventive strategy.

Diabetes is known to affect metabolic, vascular, and nervous systems, although its influence on auditory function in children remains poorly defined. Understanding this association is essential due to its implications for cognitive, language, and social development. Numerous studies have found that children with Type 1 Diabetes Mellitus (T1DM) exhibit higher hearing thresholds at high frequencies (4000–8000 Hz) and lower speech understanding scores compared to healthy controls. Poor glycemic control and longer disease duration are consistently associated with worse auditory outcomes. The proposed mechanisms include microangiopathy and diabetic neuropathy affecting the auditory pathway. Many affected children do not report noticeable auditory symptoms, indicating a risk of underdiagnosis. Early identification is crucial, as hearing difficulties in children may be related to underlying diabetic conditions and are likely associated with poor glycemic control. Regular audiometric screening should be incorporated into the routine care of pediatric diabetes patients to identify hearing deficits before they affect communication and cognitive development.

Acne vulgaris is one of the most prevalent dermatological conditions, affecting up to 85% of individuals aged 11–30 years. Clascoterone cream is the first topical androgen receptor inhibitor approved by the U.S. Food and Drug Administration (FDA) for the treatment of acne vulgaris in patients aged 12 years and older, and the first agent in this class approved for use in both male and female patients. The aim of this narrative review is to summarize the current evidence regarding the efficacy, safety profile, and potential future applications of clascoterone in the treatment of acne vulgaris. A comprehensive literature search was conducted in PubMed/MEDLINE and ClinicalTrials.gov databases up to April 2026. Search terms included “clascoterone,” “cortexolone 17α-propionate,” and “androgen receptor inhibitor acne.” Eligible publications included randomized controlled trials, meta-analyses, open-label extension studies, retrospective analyses, case reports, and relevant review articles published in English. Clinical trial registries and regulatory agency announcements were also searched for ongoing studies and recent approval decisions. Phase 3 trials and meta-analyses demonstrate that twice-daily application of clascoterone 1% cream significantly reduces inflammatory and non-inflammatory lesion counts compared to vehicle, with efficacy sustained up to 12 months of treatment. The safety profile is favorable, with adverse events limited predominantly to mild and transient local skin reactions. Subgroup analyses have shown no significant sex-related differences in efficacy or safety, and the safety profile appears comparable between adolescents and adults. In an exploratory pooled subgroup analysis, lesion-count reductions were greater in adults than in adolescents, whereas the adjusted between-group comparison of IGA success was not statistically significant. Because no formal treatment-by-age interaction test was reported, these findings should be considered hypothesis-generating. Emerging but still incomplete data suggest potential applications in androgenetic alopecia and mild hidradenitis suppurativa. Clascoterone represents a novel addition to the therapeutic armamentarium for acne vulgaris, offering a unique mechanism of action with a favorable safety profile. Further research is warranted to establish its role in combination therapies and in other androgen-dependent dermatoses.