The Application and Diagnostic Accuracy of Artificial Intelligence in Rhinology: A Review.

Artificial intelligence (AI) technologies, including machine learning (ML), deep learning, and large language models, are increasingly applied in medical diagnostics. In rhinology, these tools are being evaluated for tasks such as image interpretation, cytology classification, and clinical decision support. To systematically evaluate the application and diagnostic accuracy of AI technologies in rhinology, with a focus on clinical utility and implementation barriers. This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Seventeen full-text studies were screened based on predefined eligibility criteria, focusing on AI applications with diagnostic metrics in rhinology. Data on AI type, diagnostic task, performance outcomes, and study quality were extracted and synthesized narratively. Twelve studies met the inclusion criteria. Image-based diagnostic tools using convolutional neural networks demonstrated high accuracy (81%-99%) in nasal polyp detection, cytology classification, and computed tomography (CT) scan interpretation. ML models using patient-reported data achieved accuracies of 74.5%-85.5% for chronic rhinosinusitis prediction. Large language models like ChatGPT and Gemini were evaluated for clinical question answering, with performance exceeding 80% in some domains. Risk of bias was moderate in most primary studies, and none reported clinical integration beyond prototype stages. AI exhibits promising diagnostic accuracy across several applications in rhinology. However, significant challenges persist, including limited validation, methodological heterogeneity, and lack of clinical implementation. Future research should focus on prospective trials, explainability, and regulatory frameworks to ensure safe integration into clinical workflows.