International Forum of Allergy & Rhinology最新文献

{"title":"Functional Specialization of Respiratory and Olfactory Mucus Revealed by Proteomic Profiling.","authors":"Anna Kristina Hernandez, Karoline Lantzsch, Romain Topalian, Nadine Gunder, Philipp Hubel, Katharina Schindowski, Jens Pfannstiel, Thomas Hummel","doi":"10.1002/alr.70257","DOIUrl":"https://doi.org/10.1002/alr.70257","url":null,"abstract":"<p><strong>Background: </strong>Mucus overlies the nasal mucosa in the respiratory and olfactory regions, which perform distinct physiological functions. However, proteomic differences between respiratory mucosa (RM) and olfactory cleft (OC) mucus remain unclear.</p><p><strong>Methods: </strong>Mucus samples were collected from the RM and OCs of 25 healthy participants (mean age: 24.8 years [SD 4.16]; 12 women, 13 men) using cotton and viscose strips. Proteomic profiling was performed using nano liquid chromatography-electrospray ionization tandem mass spectrometry (nanoLC-MS/MS), and enriched proteins were analyzed for functional associations. Olfactory testing was performed using the Sniffin' Sticks odor identification test.</p><p><strong>Results: </strong>RM mucus contained a greater number of enriched proteins, including complement components (e.g., C3, C4), neutrophil antimicrobial proteins (e.g., myeloperoxidase, neutrophil elastase, S100 proteins), and coagulation-related/proteolytic proteins (e.g., fibrinogen, plasminogen, vitronectin, alpha-2-macroglobulin). These proteins were associated with immune defense, coagulation, and regulatory pathways. OC mucus contained fewer enriched proteins, including aldehyde dehydrogenase family 3 member B1, chloride intracellular channel protein 6, long-chain fatty acid transport protein 2, and stromelysin-2, supporting epithelial maintenance, ionic homeostasis, and odorant metabolism. Overrepresented processes in OC mucus were linked to ciliary structure/motility and epithelial maintenance.</p><p><strong>Conclusions: </strong>Proteomic profiles reflect regional specialization: RM mucus is optimized for immune response, whereas OC mucus maintains a microenvironment conducive to sensory function and epithelial integrity. Collectively, the results highlight how regional mucus proteomic differences parallel the distinct physiological roles of the respiratory and olfactory epithelia and provide a foundation for investigating proteomic changes in olfactory dysfunction or nasal inflammatory disease.</p>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predominance of the Partially Penetrant CFTR Intronic 5T Allele Variants in Refractory Chronic Rhinosinusitis With Nasal Polyps.","authors":"Judd H Fastenberg, Michael T Werner, Peter S Giannaris, Nikki Kimura, Luke D Powers, Sarah van Der Elst, Janice Wang, Aron Z Pollack, Mark B Chaskes, Charles C L Tong, Blanka Kaplan","doi":"10.1002/alr.70255","DOIUrl":"https://doi.org/10.1002/alr.70255","url":null,"abstract":"","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Activity Changes Following Sinus Surgery: A Multi-Center Apple Health Wearable Technology Pilot Study.","authors":"Justina R Varghese, Aakash Agarwal, Akshay R Prabhakar, Cameron Keehn, Corinne Negvesky, Raffaello Cutri, Linda Liu, Stephanie Camey, Roger Neuberger, Renjie Hu, Ron L Moses, Masayoshi Takashima, Arthur Wu, Dennis Tang, Omar G Ahmed","doi":"10.1002/alr.70254","DOIUrl":"https://doi.org/10.1002/alr.70254","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic rhinosinusitis (CRS) has been consistently associated with reduced quality of life, including limitations in mobility and daily activities. Wearable technology has demonstrated utility in tracking physical activity after surgical interventions, with limited studies on activity levels after sinus surgery.</p><p><strong>Methods: </strong>We performed a retrospective review of Apple Health data from participants diagnosed with CRS who underwent sinus surgery at two tertiary academic centers. Daily activity metrics were aggregated over 12 months preoperatively and 2-13 months postoperatively following a 1-month washout period. Metrics analyzed included average daily steps, and other ambulatory activity elements. Pre- and post-surgical values were compared using Wilcoxon signed-rank tests.</p><p><strong>Results: </strong>Among 51 CRS patients (mean age 37.7 ± 11.2 years), average daily step count significantly increased following surgery, from 7501.4 ± 4119.9 to 8843.5 ± 5107.3 per day (p = 0.003). Daily active energy burned rose from 335.5 ± 210.7 to 383.4 ± 244.8 kilocalories (p = 0.025), and daily distance walking or running increased (3.25 ± 1.88 to 3.80 ± 2.29 miles, p = 0.006). Daily exercise minutes and flights climbed also improved (p = 0.014 and p = 0.022, respectively). SNOT-22 scores demonstrated significant postoperative reductions, decreasing from 43.46 ± 24.18 to 21.15 ± 18.83, p < 0.001.</p><p><strong>Conclusion: </strong>We observed CRS patients post-sinus surgery to have significant increases in activity metrics as measured by wearable technology. This pilot study suggests that postoperative recovery may extend beyond symptom relief to measurable changes in daily physical activity.</p>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Improvement and Immune Signatures Following Platelet-Rich Plasma Therapy for Post-Viral Olfactory Dysfunction.","authors":"Vivienne M Li, Jennifer S Lee, Arwa Kurabi, Thomas Zhou, Farhoud Faraji, Carol H Yan","doi":"10.1002/alr.70250","DOIUrl":"https://doi.org/10.1002/alr.70250","url":null,"abstract":"<p><strong>Background: </strong>Platelet-rich plasma (PRP) has emerged as a promising therapy for post-viral olfactory dysfunction (PVOD) though its biological mechanisms remain unclear. This study evaluated clinical outcomes and targeted proteomic changes following PRP for refractory PVOD.</p><p><strong>Methods: </strong>Adults with PVOD ≥ 6 months refractory to standard therapies underwent a single bilateral PRP injection into the olfactory clefts. Demographics, subjective olfactory ratings, and psychophysical assessment using the University of Pennsylvania Smell Identification Test (UPSIT) were obtained at baseline and follow-up. Paired olfactory cleft mucus samples were analyzed using the Olink Target 48 immune panel, and baseline cytokine profiles were compared with normosmic controls.</p><p><strong>Results: </strong>Nineteen subjects were enrolled; 17 completed follow-ups. The mean baseline UPSIT was 19 with a median PVOD duration of 27 months. At a mean follow-up of 45 days, 47% reported subjective improvement and 53% achieved minimal clinically important difference. Mean UPSIT improved by +3.1 points (SD 6.0). Compared with controls, PVOD was associated with increased IL-18 and CCL13 expression. Following PRP, paired comparisons demonstrated increased CSF2 and IL-1β, and decreased IL-6 and IL-33. Pathway enrichment showed increased immune cell recruitment and tissue remodeling. Responders demonstrated increased oncostatin M (OSM) and a greater reduction in IL-17F, with concurrent within-subject increases in VEGFA and decreases in IL-6 and IL-33.</p><p><strong>Conclusion: </strong>PRP for refractory PVOD was associated with modest clinical improvement. Responder-specific analyses suggest PRP may promote coordinated immune remodeling characterized by reduction of inflammatory and epithelial stress signaling and activation of reparative pathways. These findings support biological plausibility and warrant further investigation.</p>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nasal Lavage IL-4 and IL-13 in Cystic Fibrosis-Related Chronic Rhinosinusitis: Associations With Disease Severity and Potential Implications for Targeted Therapies.","authors":"Elisabetta Bigagli, Alberto Minzoni, Luca Mazzetti, Miriam Todaro, Lorenzo Cinci, Cosimo Nardi, Pietro Orlando, Silvia Bresci, Giandomenico Maggiore, Cristina Luceri","doi":"10.1002/alr.70245","DOIUrl":"https://doi.org/10.1002/alr.70245","url":null,"abstract":"<p><strong>Background: </strong>Chronic rhinosinusitis (CRS) is highly prevalent in patients with cystic fibrosis (CF) and has traditionally been considered a predominantly neutrophilic condition. Emerging evidence, however, suggests that type-2 inflammatory pathways may contribute to disease heterogeneity. Data linking local inflammatory mediators with objective sinonasal disease severity and olfactory dysfunction in CF-associated CRS remain limited.</p><p><strong>Methods: </strong>In this cross-sectional study, 42 adults with CF-associated CRS (22 with nasal polyps and 20 without) underwent assessment of disease severity using the nasal polyp score (Meltzer classification) (NPS-MS), modified Lund-Kennedy score (mLKS), and Lund-Mackay score (LMS), together with olfactory testing (Sniffin' Sticks Identification Test) and quality-of-life evaluation (22-item Sinonasal Outcome Test [SNOT-22]). Nasal lavage concentrations of IL-4, IL-13, and IL-8 were quantified by ELISA.</p><p><strong>Results: </strong>IL-4 and IL-13 were significantly associated with objective measures of sinonasal disease severity, including NPS-MS and LMS (all p < 0.05), whereas IL-8 did not show consistent associations with disease severity. In multivariable models, IL-4 remained independently associated with mLKS (p = 0.025), LMS (p = 0.047), and olfactory dysfunction (p = 0.002). IL-13 was primarily associated with NPS-MS (p = 0.007) and LMS (p = 0.005). Lung transplantation modified cytokine-severity relationships. Exploratory analyses showed lower IL-4 levels in elexacaftor/tezacaftor/ivacaftor-treated patients (p = 0.036), with no significant effects for IL-8 or IL-13.</p><p><strong>Conclusions: </strong>CF-associated CRS exhibits a heterogeneous inflammatory profile in which type-2 cytokines, particularly IL-4 and IL-13, are linked to disease severity and olfactory dysfunction. Nasal lavage cytokines may represent promising compartment-specific biomarkers to support inflammatory endotyping and targeted therapeutic strategies.</p>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Endoscopic Repair of Traumatic Skull Base Dural Injuries: Challenging the Dogma of Conservative Management.","authors":"Jessica W Grayson, Madeline P Bald, Lauren McLeod, Adam J Skelton, Nicolaus D Knight, Do-Yeon Cho, Justin Turner, Hari Jeyarajan, Kristen O Riley, Bradford A Woodworth","doi":"10.1002/alr.70238","DOIUrl":"https://doi.org/10.1002/alr.70238","url":null,"abstract":"<p><strong>Introduction: </strong>Traditional management of traumatic skull base dural injury has often favored observation and conservative therapy, despite the risk of delayed intracranial complications. This paradigm originated when operative intervention required craniotomy and carried significant morbidity. The objectives of this study were to evaluate outcomes of early endoscopic repair for traumatic skull base dural injury and to assess whether radiographic evidence of dural violation, including pneumocephalus, may support consideration of early intervention.</p><p><strong>Methods: </strong>A retrospective review was performed of 385 patients with traumatic skull base injury and evidence of dural disruption. Patients with congenital, spontaneous, or neoplastic etiologies were excluded. Endoscopic repair was performed in all patients with clinical or radiographic evidence of dural violation, including pneumocephalus, regardless of the presence of overt cerebrospinal fluid (CSF) leak. Outcomes, prior management, and complications were analyzed.</p><p><strong>Results: </strong>Among 385 patients, 219 (56.9%) presented with CSF leak and 254 (66.0%) with pneumocephalus. The ethmoid (244), frontal (212), and sphenoid (157) sinuses were most involved. Primary endoscopic repair success was achieved in 97.4% (375/385), increasing to 99.0% (381/385) following endoscopic revision. One hundred and two patients had prior conservative management, with 34 (33.3%) developing meningitis or intracerebral infection. Patients requiring multiple interventions were predominantly those with penetrating trauma.</p><p><strong>Conclusion: </strong>Early endoscopic repair was highly effective for traumatic skull base dural violation. Pneumocephalus should be recognized as an important marker of dural disruption, even without overt CSF leak, and may justify early definitive repair in selected patients. Morbidity after conservative management supports reconsideration of observation-based algorithms.</p>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Longitudinal Evaluation After Regimen Stop (CLEAR) of Dupilumab in Chronic Rhinosinusitis With Nasal Polyps (CRSwNP).","authors":"Patrick Huber, Manuel Lasch, Veronika Volgger, Clemens Stihl, Philipp Teupe, Fabienne Oettgen, Sophia Gantner, Moritz Gröger","doi":"10.1002/alr.70241","DOIUrl":"https://doi.org/10.1002/alr.70241","url":null,"abstract":"<p><strong>Background: </strong>Long-term management strategies for severe chronic rhinosinusitis with nasal polyps (CRSwNP) increasingly include biologic therapy targeting Type 2 inflammation. However, data on outcomes after complete discontinuation of dupilumab following sustained disease control are scarce.</p><p><strong>Methods: </strong>In this single-center, retrospective real-world study, adult CRSwNP patients who discontinued dupilumab after ≥ 2 years of treatment and sustained good-to-excellent disease control were included. Disease control at cessation was defined according to EPOS/EUFOREA-aligned criteria (bilateral nasal polyp score [NPS] ≤ 2; SNOT-22 < 20). Patients were followed for up to 12 months. Outcomes included SNOT-22, visual analog scale (VAS), NPS, olfactory function (SSIT-12), relapse timing, and reinitiation of therapy.</p><p><strong>Results: </strong>A total of 46 patients were included (median treatment duration 189.7 weeks). At discontinuation, disease control was excellent (mean SNOT-22 10.1 ± 6.1; NPS 0.2 ± 0.5). Within 3 months, a marked and statistically significant deterioration occurred across all major outcomes (SNOT-22 36.4 ± 20.0; VAS 5.0 ± 2.7; NPS 1.5 ± 1.9; all p < 0.001). Median time to first symptom worsening was 7.6 weeks. Most The majority of patients (87.0%) reinitiated dupilumab within 12 months, primarily due to nasal symptom recurrence. Retreatment led to rapid and significant clinical improvement. Six patients remained off therapy, but demonstrated progressive objective and/or subjective worsening over time.</p><p><strong>Conclusions: </strong>Complete discontinuation of dupilumab after long-term disease control appears feasible in only a minority of patients and is associated with early relapse in most cases. These findings support the concept of dupilumab as a disease-controlling rather than disease-modifying or curative therapy and favor individualized dose tapering over full cessation in severe Type 2-driven CRSwNP.</p>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148712325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healing Following Endoscopic Reconstruction of the Anterior Skull Base in Patients With Sinonasal Malignancies.","authors":"Giacomo Contro, Leonardo Calvanese, Piergiorgio Gaudioso, Stefano Taboni, Mosè Sozzi, Gloria Schiavo, Alessandra Sordi, Isabelle Dohin, Francesca Mularoni, Giuseppe Roccuzzo, Ester Orlandi, Barbara Vischioni, Gianluca Dalfino, Carlotta Pessina, Roberto Maroldi, Mario Turri-Zanoni, Cesare Piazza, Paolo Battaglia, Maurizio Bignami, Paolo Castelnuovo, Davide Mattavelli, Piero Nicolai, Marco Ferrari","doi":"10.1002/alr.70232","DOIUrl":"https://doi.org/10.1002/alr.70232","url":null,"abstract":"<p><strong>Background: </strong>Healing dynamics after anterior skull base (ASB) reconstruction following transnasal endoscopic surgery (TES) for sinonasal malignancies remain poorly characterized. This study aimed to describe the postoperative healing process, quantify time to healing, identify factors influencing healing, and assess radiologic evolution over time.</p><p><strong>Methods: </strong>This multicenter retrospective study included adult patients undergoing TES with craniectomy and ASB reconstruction for sinonasal malignancies between 2016 and 2024. Serial endoscopic examinations were reviewed using a novel stage-based classification system. Postoperative contrast-enhanced magnetic resonance imaging (MRI) was analyzed to evaluate reconstruction layers, enhancement patterns, thickness changes, and brain sagging. Cumulative incidence analysis, multistate modeling, and uni- and multivariable analyses were performed to identify factors associated with healing.</p><p><strong>Results: </strong>A total of 173 patients were included. Complete endoscopic healing was achieved in 15.9% of patients at 6 months, 69.9% at 12 months, and 94.4% at 24 months. Local pedicled flap reconstruction was associated with faster healing, with complete healing achieved in 89.4% of patients at 12 months compared with 60.7% in graft-based reconstructions (p < 0.001). Adjuvant radiotherapy (RT), particularly intensity-modulated proton therapy, was independently associated with delayed healing. MRI showed progressive reduction in reconstruction thickness, decreased visibility of adipose tissue and the outer graft layer, and increased brain sagging over time. RT was associated with greater remodeling changes, whereas flap-based reconstruction appeared to mitigate these effects.</p><p><strong>Conclusions: </strong>Healing after ASB reconstruction following TES is a prolonged and dynamic process influenced mainly by reconstruction technique and adjuvant RT. Local vascularized flaps promote faster and more stable healing and may be particularly advantageous in patients requiring postoperative RT.</p>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of an Allergic Rhinitis Instrument That Synergizes With the Sino-Nasal Outcome Test.","authors":"Selena K Zhang, Sapideh Gilani, Allen Zhou, Sana Alkhatib, Anthony Prince, Stacey T Gray, Carleton Eduardo Corrales, Jennifer J Shin","doi":"10.1002/alr.70227","DOIUrl":"https://doi.org/10.1002/alr.70227","url":null,"abstract":"<p><strong>Background: </strong>Allergic rhinitis (AR) and chronic rhinosinusitis (CRS) frequently co-occur with shared symptomatology, such that evaluating both entities concurrently yet discretely is of help. Previously validated options, however, may require more than 45 questions and introduce redundant content at each administration. We thus assessed whether a novel AR-specific instrument, which has synergy with the Sino-Nasal Outcome Test (SNOT-22/26/29) used in CRS, is valid for research and clinical care.</p><p><strong>Methods: </strong>Patients who prospectively completed the proposed AR-specific and SNOT instrument variations, the Mini-Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ), and a general health assessment were included. Factor analysis was performed on 3566 consecutive responses, and 598 patients had allergy testing. Discriminant validity was assessed among patients with positive and negative allergy test results. Convergent validity was assessed using the MiniRQLQ and general health scores. Intra-rater reliability and responsiveness to change were quantified.</p><p><strong>Results: </strong>The AR-specific test supported concurrent yet discrete evaluation of AR and CRS with 26 questions (instead of 46 from SNOT-22+MiniRQLQ) and no repetition (SNOT22+RCAT/RQLQ repeat query content, e.g., patients asked about sneezing twice). The AR instrument discriminated between patients with positive or negative allergy tests (difference in means 1.22 [95% CI: 0.36-2.09]). Convergence with MiniRQLQ (Spearman's rho: 0.346-0.736) and PROMIS (Spearman's rho: -0.118 to -0.264) was observed. Intra-rater reliability (Cohen kappa: 0.802-0.829; Spearman's rho: 0.918-0.935) and responsiveness to change (difference in means -0.28 [95% CI: -0.52 to -0.05]) were demonstrated.</p><p><strong>Conclusions: </strong>This synergistic approach offers a novel, concise, efficient, and validated method to assess AR and CRS concurrently yet discretely.</p><p><strong>Key points: </strong>This allergic rhinitis instrument offers a novel, concise, efficient, and validated method to assess AR and chronic rhinosinusitis (CRS) discretely yet concurrently with the Sino-Nasal Outcome Test, while reducing redundancy and response burden. The allergic rhinitis-specific items demonstrate internal consistency, discriminant and convergent validity, strong intra-rater reliability, and responsiveness to clinical change. Five-, six-, and seven-item versions can function as AR-specific assessments that can be used independently or alongside other Sino-Nasal Outcome Test domains.</p>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Dysplasia on Inverted Papilloma Recurrence: A Systematic Review and Meta-Analysis","authors":"Peter Giannaris,&nbsp;Tristan Tham,&nbsp;Eric Giannaris,&nbsp;Kirsten Wohlars,&nbsp;Alexis Kim,&nbsp;Brendan Plann-Curley,&nbsp;Hannah Lee,&nbsp;Aron Z. Pollack,&nbsp;Mark B. Chaskes,&nbsp;Judd H. Fastenberg,&nbsp;Charles C. L. Tong","doi":"10.1002/alr.70215","DOIUrl":"10.1002/alr.70215","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sinonasal inverted papilloma (SNIP) is a benign but locally aggressive tumor that has demonstrated a propensity to recur. Multiple anatomic and surgical factors have been proposed to influence recurrence; dysplasia has recently emerged as a predictor, yet its prognostic significance remains unclear. Clarifying its role may improve postoperative risk stratification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis were performed following PRISMA guidelines and registered with PROSPERO (CRD420251140223). PubMed, Embase, Scopus, and Web of Science were queried for studies reporting recurrence outcomes stratified by dysplasia status. Studies with extractable recurrence data for dysplasia and non-dysplasia SNIP were included. Fixed-effects meta-analysis was performed using the inverse variance method to calculate pooled odds ratios (OR) with 95% confidence intervals (CIs). Heterogeneity was assessed using <i>I</i>² and Cochran's <i>Q</i> statistics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirteen studies comprising 1893 patients were included. Based on reported data, mean age ranged from 48.3 to 58.0 years. The cohort was predominantly male (1172/1720; 68.1%). Of 283 patients with dysplasia, 104 experienced recurrence (36.7%), compared with 302 of 1346 patients without dysplasia (22.4%). Dysplasia was significantly associated with increased recurrence risk (pooled OR 3.42; 95% CI, 2.45–4.78; <i>p</i> &lt; 0.001) with low–moderate heterogeneity (<i>I</i>² = 20.33%). Mean follow-up was 39.8 months. Findings were robust on leave-one-out sensitivity analysis and trim-and-fill adjustment (adjusted OR 3.05; 95% CI 2.21–4.22).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Dysplasia is a significant independent predictor of recurrence in SNIP, conferring 3.4 times increased odds of recurrence. Standardized dysplasia reporting and risk stratification protocols are needed to optimize surveillance strategies in SNIP patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"16 8","pages":"841-851"},"PeriodicalIF":4.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}