Research progress and clinical application of functional magnetic resonance imaging in otolaryngology-head and neck diseases.

Functional magnetic resonance imaging (fMRI) is a non-invasive tool that detects neural activity via BOLD signals. In otolaryngology-head and neck disorders, such as tinnitus, sudden sensorineural hearing loss, vestibular migraine, and olfactory dysfunction, fMRI reveals disease-specific neural pathophysiology, altered functional connectivity, and compensatory brain reorganization. It aids diagnosis and differential diagnosis by distinguishing abnormal regional activity patterns, predicts individual prognosis through connectivity-based biomarkers, monitors treatment response, and informs development of targeted therapeutics. Additionally, fMRI elucidates central mechanisms underlying sensory deficits and secondary psychological or cognitive disturbances, likely resulting from chronic symptom burden or maladaptive central neuroplasticity. This review summarizes recent advances and highlights fMRI's clinical relevance in elucidating neuropathological mechanisms, guiding personalized management, supporting precision medicine, and facilitating novel therapeutic strategies in otolaryngology.