{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:01:13Z","timestamp":1790686873399,"version":"4.1.0"},"reference-count":10,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Disease classification in otolaryngology remains rooted in anatomical frameworks from the 18th and 19th centuries, predating modern histopathology and pathophysiology. This anatomically driven approach may inadequately capture disorders that transcend anatomical boundaries, such as laryngopharyngeal reflux disease, vestibular migraine, neurosensory hearing, disorders, and granulomatosis with polyangiitis. The transanatomical presentations of some disorders contribute therefore to documented underdiagnosis, diagnostic delays, and substantial healthcare costs. This commentary proposes a paradigm shift toward a histophysiological classification system organized by tissue type, cellular mechanisms, and pathophysiological dysfunction rather than anatomical compartments alone. Such a framework would reframe currently labeled \u201cnon\u2010specific symptoms\u201d as tissue\u2010specific presentations. That may improve recognition of transanatomical disease patterns, aligning otolaryngology with precision medicine trends already transforming oncology, gastroenterology, and pulmonology. This complementary classification layer does not replace anatomy but enhances diagnostic reasoning. Prospective multicenter studies comparing diagnostic accuracy and outcomes between frameworks are needed to validate this approach.<\/jats:p>","DOI":"10.1002\/ohn.70477","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:43:03Z","timestamp":1790685783000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Redefining Disease Classification and Teaching in Otolaryngology"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0845-0845","authenticated-orcid":false,"given":"J\u00e9r\u00f4me R.","family":"Lechien","sequence":"first","affiliation":[{"name":"Department of Surgery UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons) Mons Belgium"},{"name":"Department of Otolaryngology Elsan Hospital Paris France"},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Foch Hospital, School of Medicine, UFR Simone Veil, Universit\u00e9 Versailles Saint\u2010Quentin\u2010en\u2010Yvelines (Paris Saclay University) Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"issue":"2","key":"e_1_2_5_2_1","doi-asserted-by":"crossref","first-page":"91","DOI":"10.3109\/02813432.2015.1030166","article-title":"Symptoms as the main problem in primary care: a cross\u2010sectional study of frequency and characteristics","volume":"33","author":"Rosendal M","year":"2015","journal-title":"Scand J Prim healthcare"},{"issue":"2","key":"e_1_2_5_3_1","first-page":"P28","article-title":"Challenging problems in clinical otology","volume":"145","author":"Micco AG","year":"2011","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"4","key":"e_1_2_5_4_1","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1002\/lary.31134","article-title":"The Dubai definition and diagnostic criteria of laryngopharyngeal reflux: the IFOS consensus","volume":"134","author":"Lechien JR","year":"2024","journal-title":"Laryngoscope"},{"issue":"17","key":"e_1_2_5_5_1","doi-asserted-by":"crossref","DOI":"10.3390\/jcm11175192","article-title":"Do otolaryngologists over\u2010 or underestimate laryngopharyngeal reflux symptoms and findings in clinical practice? A comparison study between the true prevalence and the otolaryngologist\u2010estimated prevalence of symptoms and findings","volume":"11","author":"Lechien JR","year":"2022","journal-title":"J Clin Med"},{"issue":"8","key":"e_1_2_5_6_1","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1097\/MAO.0000000000001900","article-title":"The epidemiology of vestibular migraine: a population\u2010based survey study","volume":"39","author":"Formeister EJ","year":"2018","journal-title":"Otol Neurotol"},{"issue":"1","key":"e_1_2_5_7_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.21053\/ceo.2016.9.1.8","article-title":"Granulomatosis with polyangiitis in otolaryngologist practice: a review of current knowledge","volume":"9","author":"Wojciechowska J","year":"2016","journal-title":"Clin Exp Otorhinolaryngol"},{"key":"e_1_2_5_8_1","doi-asserted-by":"crossref","DOI":"10.3389\/fbioe.2018.00112","article-title":"Systems medicine disease: disease classification and scalability beyond networks and boundary conditions","volume":"6","author":"Berlin R","year":"2018","journal-title":"Front Bioeng Biotechnol"},{"issue":"7","key":"e_1_2_5_9_1","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/S2468-1253(18)30096-7","article-title":"Eosinophilic oesophagitis endotype classification by molecular, clinical, and histopathological analyses: a cross\u2010sectional study","volume":"3","author":"Shoda T","year":"2018","journal-title":"Lancet Gastroenterol Hepatol"},{"issue":"1","key":"e_1_2_5_10_1","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1177\/0194599820939964","article-title":"Role of biologics in chronic rhinosinusitis with nasal polyposis: state of the art review","volume":"164","author":"Kim C","year":"2021","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"6","key":"e_1_2_5_11_1","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1038\/ajg.2013.69","article-title":"High economic burden of caring for patients with suspected extraesophageal reflux","volume":"108","author":"Francis DO","year":"2013","journal-title":"Am J Gastroenterol"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70477","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ohn.70477","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70477","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:43:04Z","timestamp":1790685784000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.70477"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":10,"alternative-id":["10.1002\/ohn.70477"],"URL":"https:\/\/doi.org\/10.1002\/ohn.70477","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"assertion":[{"value":"2026-04-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ohn.70477"}}