Redefining Disease Classification and Teaching in Otolaryngology

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 "non-specific symptoms" as tissue-specific 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.