International Forum of Allergy & Rhinology最新文献

{"title":"Prevalence of Cystic Fibrosis Carrier Status in Chronic Rhinosinusitis Without Nasal Polyp","authors":"Do-Yeon Cho, Adam J. Skelton, Jessica W. Grayson, Justin H. Turner, Bradford A. Woodworth","doi":"10.1002/alr.23549","DOIUrl":"10.1002/alr.23549","url":null,"abstract":"<p>Maintaining regulated mucociliary clearance is critical to the host defense mechanism, which depends on intact epithelial structure, ciliary beating, and the mucoviscous properties of the airway surface liquid (ASL) [<span>1, 2</span>]. The ASL is noticeably influenced by alterations in chloride transport and pH through the cystic fibrosis transmembrane conductance regulator (CFTR), as clearly exemplified in cystic fibrosis (CF) [<span>3</span>]. Mutations in CFTR form thick mucus and accumulate secretions across various organ systems, including the gastrointestinal (GI), reproductive, and respiratory tracts [<span>4</span>]. Individuals with a single CFTR mutation (CF carriers) have 50% of normal CFTR protein function, which is generally considered adequate to maintain health [<span>5</span>]. However, multiple studies have indicated that CF carriers may be at risk for subclinical laboratory abnormalities and a wide range of CF-like phenotypes (e.g., bronchitis, chronic rhinosinusitis (CRS), idiopathic chronic pancreatitis) [<span>5-7</span>]. A recent systematic review showed that the pooled prevalence of CFTR mutations in CRS (without CF) was below 6% (7.89%) in the United States [<span>6, 7</span>]. When approaching the diagnostic workup for recalcitrant CRS, there may be a higher prevalence of CFTR mutations in this CRS subgroup with nonallergic phenotypes. Therefore, this study aims to determine the prevalence of CFTR mutations in CRS patients without nasal polyposis (CRSsNP) at a tertiary care facility.</p><p>This study was approved by the Institutional Review Board of the University of Alabama at Birmingham (UAB). For this retrospective case-control study, all CRSsNP patients (≥ 15 years of age) visiting the UAB sinus clinic (D.Y.C., J.W.G., and B.A.W.) were recruited between August 2023 and January 2024 (6 months). Cases were diagnosed with CRSsNP according to the guidelines set forth by the International Consensus Statement on Allergy and Rhinology: rhinosinusitis 2021 [<span>8</span>]. All individuals had symptoms for longer than 12 weeks, with nasal endoscopy or findings of sinonasal mucosal thickening on computed tomography. Those with findings consistent with nasal polyposis/allergic fungal sinusitis or (unilateral) odontogenic sinusitis were excluded from this analysis. All patients were subjected to a screening blood test (Quest Diagnostics Inc. Secaucus, NJ) for > 90% of CF genetic mutations (detecting 32 mutations, including 23 core mutations) during their initial visit. Clinical data, including sinus cultures during these 6 months, were collected. Data were presented as a mean ± standard error. Chi-square test was performed using GraphPad Prism version 10.0 (San Diego, CA). Differences were considered statistically significant at <i>p</i> <  0.05.</p><p>Out of 115 patients with CRSsNP (52 males and 63 females; mean age = 53.6 ± 1.6 years, Caucasian: Non-Caucasian = 101:14), 10 (8.7%; 7 males and 3 females; mean age = 5","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 7","pages":"734-736"},"PeriodicalIF":7.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alr.23549","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correspondence to the Editor Regarding the Article Entitled, “Twelve-Month Outcomes Following Temperature-Controlled Radiofrequency Treatment of the Septal Swell Body for Nasal Airway Obstruction”","authors":"Smile Kajal, Youssef El Sayed Ahmad, Akaber M. Halawi, Mohammad Abraham Kazemizadeh Gol","doi":"10.1002/alr.23548","DOIUrl":"10.1002/alr.23548","url":null,"abstract":"","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 3","pages":"359-360"},"PeriodicalIF":7.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449022","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":"Metformin Use Reduces the Risk of Olfactory Dysfunction in Diabetic Patients: A 22-Year Follow-Up Study","authors":"Yu-Chun Chen, Chi-Hsiang Chung, Tsu-Hsuan Weng, Chun-Teng Tsai, Li-Hsiang Cheng, Wu-Chien Chien","doi":"10.1002/alr.23546","DOIUrl":"10.1002/alr.23546","url":null,"abstract":"","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 6","pages":"658-661"},"PeriodicalIF":7.2,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433111","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":"Olfactory Training: Recommendation Frequency amongst Rhinologists","authors":"Sherina R. Thomas, Vincent L. Nguyenkhoa, Jose L. Mattos, Steven D. Munger","doi":"10.1002/alr.23543","DOIUrl":"10.1002/alr.23543","url":null,"abstract":"<p>Olfactory dysfunction (OD) affects ∼22% of adults [<span>1</span>]. Characterized by reduced, absent, or distorted smell function, OD can negatively impact safety, diet, social relationships, mental health, and even lifespan [<span>2</span>]. Despite OD's prevalence and significant health burden, effective treatments are scarce and often limited to specific patient groups [<span>3</span>].</p><p>One potential therapy is olfactory training (OT) [<span>4</span>]. Although methodological variations exist for odor type, concentration, and timing, OT regimens typically involve focused sniffing of multiple odors twice daily for 3–6 months [<span>4-6</span>]. Numerous studies support OT's ability to improve olfactory function (and perhaps even cognition) in anosmic and hyposmic patients [<span>2-6</span>]. However, large, blinded studies remain necessary to clearly differentiate OT-dependent improvements in smell function from spontaneous recovery [<span>3</span>]. Compliance is challenging for patients [<span>7</span>], in part because of the lengthy commitment with uncertain benefit. Anecdotal evidence suggests that despite these challenges, OT is widely recommended by providers to patients with OD. To furnish a more rigorous estimate, we recruited a convenience sample for a survey-based study to determine how often, and under what conditions, otolaryngologists recommend OT to their patients with OD.</p><p>This study was approved by the University of Virginia (UVA) institutional review board. We distributed two invitations for an anonymous, 13-item survey (Supporting Information) to 844 members of the American Rhinologic Society (ARS) via email listserv. Interested participants were directed to a UVA REDCap server to complete a multiple-choice survey, with some questions offering text boxes for expanded responses. Questions assessed provider demographics including subspeciality and practice setting, OD diagnostic regimen, and OT recommendation habits. We received 95 responses over four weeks, yielding an 11.3% response rate.</p><p>Results are reported as raw numbers and percentages. Preliminary analyses prompted the assessment of two potential associations using chi-square tests (<i>df</i> = 1, <i>p</i> = 0.05). The first was to assess whether the use of psychophysical smell tests for OD diagnosis varied between otolaryngologists based on practice setting (private vs. hospital/academic) or subspeciality (rhinologists vs. general otolaryngologists). The second was to assess whether these same subsets differed in their likelihood to recommend OT to their patients with OD.</p><p>Of all respondents, 27.4% (<i>n</i> = 26) self-identified as general otolaryngologists, 71.6% (<i>n</i> = 68) as rhinologists, and 1.1% (<i>n</i> = 1) as another subspecialist (see Table S1 for all multiple choice and text box responses). The survey found that 60.0% (<i>n</i> = 57) of respondents practiced in an academic medical center, 13.7% (<i>n</i> = 13) in non-academic or","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 6","pages":"655-657"},"PeriodicalIF":7.2,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alr.23543","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twenty-Four-Month Outcomes Following Temperature-Controlled Radiofrequency Treatment for Septal Swell Body Hypertrophy: An Open-Label, Single-Arm Multicenter Study","authors":"Jordan Pritikin, Stacey Silvers, Jeffrey Rosenbloom, Bryan Davis, Anthony Del Signore, Ahmad R. Sedaghat, Bobby A. Tajudeen, Isaac Schmale, Rakesh K. Chandra","doi":"10.1002/alr.23541","DOIUrl":"10.1002/alr.23541","url":null,"abstract":"<p>The septal swell body (SSB) is a fusiform structure composed of vasoerectile tissue located on the septum, anterior to the middle turbinate and within the nasal airflow path. It plays a similar role to the inferior turbinates, affecting airflow and contributing to resistance at the nasal valve [<span>1</span>]. Although multiple factors contribute to nasal obstruction (NAO), SSB hypertrophy is often overlooked as a cause of breathing difficulty. Despite its potential to affect nasal airflow, the SSB's role in NAO has historically received little attention. Recent studies highlight its impact on nasal airflow, particularly its relationship with the nasal valve and its vasoerectile nature [<span>2-4</span>]. Temperature-controlled radiofrequency (TCRF) treatment of the SSB has emerged as a minimally invasive NAO treatment option [<span>5</span>]. The 3- and 12-month outcomes of this study demonstrated significant improvements in SSB size and NAO symptoms, with high responder rates and sustained relief across patient-reported outcomes such as the nasal obstruction symptom evaluation (NOSE) scale and numeric rating scale (NRS) ease of breathing [<span>6, 7</span>]. This paper presents the long-term follow-up results of the study, evaluating TCRF's durability in treating the SSB for NAO.</p><p>This study reports 24-month results as a follow-up to an earlier multicenter, open-label TCRF study on severe NAO from SSB hypertrophy [<span>6, 7</span>]. The TCRF device, comprised of the VivAer Stylus (Aerin Medical, Mountain View, CA), was used with the Aerin Console. During the procedure, local anesthesia was administered, followed by bilateral TCRF treatment targeting the SSB. The treatment was performed at 60°C, 4 W, with 18 s of active treatment and 12 s of cooling. Treatment of other nasal structures (e.g., nasal valve area and inferior turbinate) was not allowed.</p><p>Eligible participants were adults with a baseline NOSE score of ≥55, and SSB hypertrophy presents limiting middle turbinate visualization and symptomatic relief observed after SSB decongestion [<span>6, 7</span>]. Exclusion criteria included recent nasal surgery (within 6 months) and other structural abnormalities like severe septal deviation or turbinate hypertrophy deemed the primary NAO cause. (See Table S1 for full inclusion/exclusion criteria.)</p><p>Outcome measures included NOSE scores, NRS ease of breathing, and the 22-item Sino-Nasal Outcome Test (SNOT-22) scores that are analyzed against baseline. Data analysis followed 12-month analysis methods [<span>7</span>]. In brief, paired <i>t</i>-tests compared baseline and follow-up scores. Responder analysis was defined as a ≥20% NOSE score reduction (or improvement in 1 severity category) from baseline. Demographic data were summarized with means and percentages. Adverse events (AEs) were tracked for 24 months via telephone follow-up, evaluating symptom changes, medication use, and NAO-related interventions. Patients undergoing a","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 6","pages":"651-654"},"PeriodicalIF":7.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alr.23541","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mediation of LPS-Induced Inflammation With Pro-Resolving Treatment in Human Nasal Polyps: A Pilot Study","authors":"Peyton Z. Robinson, Cristina Delgado, Khalid Khan, Daniel N. Frank, Vijay R. Ramakrishnan","doi":"10.1002/alr.23542","DOIUrl":"10.1002/alr.23542","url":null,"abstract":"<p>Chronic rhinosinusitis (CRS) shares a common pathophysiology with other chronic inflammatory diseases, including periodic acute exacerbations and altered wound-healing processes [<span>1</span>]. A healthy sinonasal mucosal barrier relies on immune function to appropriately respond to airborne insults while choreographing a temporally regulated resolution of the acute physiological inflammatory response [<span>2</span>]. When this spatiotemporal response is disrupted, chronic inflammation may result as a potential contribution to etiopathogenesis or sustenance of inflammation in CRS. Nuclear factor-kappa B (NF-κB) signaling is one of several important contributors in the modulation of important inflammatory responses. It is recognized as an important transcription factor in the expression of various pro-inflammatory genes in chronic inflammatory diseases including CRS [<span>3</span>].</p><p>Lipid-derived molecules known as specialized-pro-resolving mediators (SPMs) [<span>4</span>] have recently been described as active components in temporal modulation of acute airway inflammatory responses and may play some role in the CRS disease process [<span>5-7</span>]. SPMs influence development, recruitment, and function of several inflammatory cells, including macrophages, dendritic cells, neutrophils, and lymphocytes [<span>8</span>].</p><p>In this study, we seek to understand SPM regulatory effects on NF-κB-associated pro-inflammatory genes using a fresh sinus tissue explant model. We hypothesize that SPM, resolvin D2 (RvD2), will mitigate lipopolysaccharide (LPS)-induced inflammation.</p><p>In the NF-κB microarray, the physiologically relevant genes with the highest fold-changes after LPS exposure were MYD88, CXCL1, and G-CSF. RvD2 treatment was also found to significantly alter expression of these genes (<b>Figure</b> 1). QPCR validation illustrated that G-CSF expression increased in response to LPS stimulation and was abolished with RvD2 treatment (<i>p</i> < 0.01; <b>Figure</b> 2). MYD88 and CXCL-1 were inconsistent in their expression response patterns. CXCL-1 and MYD88 exhibited no significant increase in expression at 24 h with LPS exposure compared to control, limiting experimental potential for beneficial effects of RvD2 treatment on these target genes.</p><p>CRS remains enigmatic in its pathophysiology, time course, and idiosyncratic responses to various treatments. Prior studies show that defects in the production of pro-resolving mediators, such as RvD2, have been implicated in the pathophysiology of airway disease [<span>9</span>]. Actions of pro-resolving mediators may offer a novel approach to treating the inflammatory processes that facilitate disease chronicity via attenuation of NF-κB effects in numerous cell types. In a PCR microarray, ex vivo polyp tissue treated with LPS for 24 h demonstrated a significant inflammatory response in G-CSF, MYD88, and CXCL1 expression, mitigated with concomitant RvD2 treatment. We attempted to","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 6","pages":"645-647"},"PeriodicalIF":7.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alr.23542","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left-Digit Bias in Surgical Management of Chronic Rhinosinusitis in Young Adults","authors":"Alexander Z. Wang, Ringo K. Leung, Christopher R. Roxbury","doi":"10.1002/alr.23544","DOIUrl":"10.1002/alr.23544","url":null,"abstract":"<p>Previous concerns about the effects of endoscopic sinus surgery (ESS) on facial development, which have subsequently been disproven, may lead to withholding of surgical therapy in teens [<span>1-3</span>]. This potential withholding of surgery may be further compounded by a phenomenon known as left-digit bias (LDB).</p><p>LDB is a psychological phenomenon in which people tend to focus on the leftmost digit of a number [<span>4</span>]. Previous work has shown LDB impacting clinical decision-making in many fields, but there are no studies assessing LDB in the surgical management of chronic rhinosinusitis (CRS) [<span>5-7</span>]. Therefore, this study seeks to describe the impact of LDB on ESS rates in teens and young adults with CRS.</p><p>The Merative MarketScan Commercial Claims & Encounters Database Outpatient Services Table (CCAEOST) is a collection of deidentified US commercial insurance claims for medical services provided in an outpatient facility for individuals not eligible for Medicare.</p><p>We compiled all claims with a primary diagnosis of CRS, as defined by ICD-10-CM codes. For all patients in a given year, only the earliest claim in which the primary diagnosis was ICD-10-CM codes J32.0 (chronic maxillary sinusitis), J32.1 (chronic frontal sinusitis), J32.2 (chronic ethmoidal sinusitis), J32.3 (chronic sphenoidal sinusitis), J32.4 (chronic pansinusitis), J32.8 (other chronic sinusitis), and J32.9 (chronic unspecified sinusitis) was included in our analytic sample. We calculated patients’ Charlson comorbidity index (CCI) using a modified version of the code created by Beyrer et al. [<span>8</span>]. Initial screening and CCI calculation were performed in SAS Software Version 9.4 (SAS Institute Inc.).</p><p>After this initial screen, we only included claims with a primary procedure code in level 1 of the Healthcare Common Procedure Coding System (HCPCS), which includes codes in the Current Procedural Terminology (CPT). Patients were categorized as receiving ESS if their primary procedure code was one of the codes in Table S1. Using a regression discontinuity design, we analyzed the difference in rates of ESS for CRS by age, while adjusting for sex, comorbidities CCI, and primary diagnosis. Secondary screening and analysis were conducted in Stata Version 18 (StataCorp).</p><p>Our analytic sample included 1,483,163 claims. Note that 38.7% (<i>n</i> = 574,294) of patients were male. Patients spanned all ages from 0 to 65 (mean: 39.7). The most common diagnosis was chronic unspecified sinusitis (<i>n</i> = 1,001,059), followed by chronic maxillary sinusitis (<i>n</i> = 214,143). The average CCI for the entire cohort was 0.19 (range: 0–15). Note that 20,523 patients received ESS for CRS (1.38%). Patients diagnosed with chronic unspecified sinusitis received surgery at the lowest rate (0.30%), whereas those with chronic sphenoidal sinusitis received surgery at the highest rate (6.26%). Table 1 summarizes our cohort characteristics, s","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 6","pages":"648-650"},"PeriodicalIF":7.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alr.23544","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert Consensus on Surgical Management of Primary Diffuse Type 2-Dominant Chronic Rhinosinusitis","authors":"Manon Blauwblomme,&nbsp;Christos Georgalas,&nbsp;Shahzada Ahmed,&nbsp;Isam Alobid,&nbsp;Paolo Battaglia,&nbsp;Paolo Castelnuovo,&nbsp;Jannis Constantinidis,&nbsp;Iacopo Dallan,&nbsp;Anne-Sophie Eeckels,&nbsp;Marco Ferrari,&nbsp;Philippe Gevaert,&nbsp;Jessica Grayson,&nbsp;Richard Harvey,&nbsp;Philippe Herman,&nbsp;Iordanis Konstantinidis,&nbsp;Darlene Lubbe,&nbsp;Cem Meco,&nbsp;James Palmer,&nbsp;Zara M. Patel,&nbsp;Agnieszka Strzembosz,&nbsp;Benjamin Verillaud,&nbsp;Bradford A. Woodworth,&nbsp;Thibaut Van Zele","doi":"10.1002/alr.23538","DOIUrl":"10.1002/alr.23538","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic rhinosinusitis (CRS) poses significant challenges in surgical management due to the lack of clear guidelines, particularly in type 2 CRS. This review focuses on surgical approaches for primary diffuse type 2-dominant CRS, emphasizing preoperative and intraoperative strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A consensus group, comprising experts from Europe, United Kingdom, Australia, South Africa, North and South America, was assembled. Using a modified Delphi method, 67 statements were formulated following a literature review, with an additional statement added in the second iteration. Final recommendations were discussed during a consensus meeting in Santorini, Greece, in October 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of the 68 proposed statements, consensus was achieved on 45. Most (34) statements received a median score of 7 (strongly agree), and 11 had a median score of 6 (agree). The finalized recommendations cover the indications, timing, extent of surgery, and intraoperative management for both primary and revision surgery in primary diffuse type 2-dominant CRS. A key focus is on complete sinus surgery, which involves creating a neo-sinus cavity by removing bone partitions in the ethmoid and opening the frontal and sphenoidal sinuses as needed. Adequate primary and revision surgery includes clearing all nasal polyps and diseased mucosa while ensuring ideal conditions for topical therapy. Additionally, there was consensus on performing complete sinus surgery before considering monoclonal antibody therapies, unless contraindicated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These 45 consensus statements, derived from both current evidence and expert opinion, provide valuable guidance for clinicians in the surgical management of primary diffuse type 2-dominant CRS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 3","pages":"303-316"},"PeriodicalIF":7.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alr.23538","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Travel Costs and Carbon Savings Associated With Telemedicine in a Tertiary Care Rhinology Center","authors":"Hunter Kellerman,&nbsp;Jess C. Mace,&nbsp;Kara Y. Detwiller,&nbsp;Mathew Geltzeiler,&nbsp;Timothy L. Smith,&nbsp;Vivek C. Pandrangi","doi":"10.1002/alr.23540","DOIUrl":"10.1002/alr.23540","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Healthcare-associated costs as well as carbon dioxide (CO₂) emissions are rising, and identifying means to mitigate these may provide direct benefits to patients as well as overall population health, especially among patients with chronic sinonasal disease. This study aimed to assess potential personal travel costs and CO₂ emissions saved due to telemedicine visits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective review of patients within Oregon presenting for telemedicine visits at a tertiary rhinology center from July 2022 to July 2023. Distance from patient's address to clinic (miles), as well as estimated average travel time (min), travel costs (USD), and CO₂ emissions (kg), were calculated per round trip prevented by providing care at a distance. Area deprivation indices (ADI) were obtained based on nine-digit zip codes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 354 included visits, the mean ± standard deviation (SD) age was 57.03 ± 16.58 years. Chronic rhinosinusitis (CRS) was the most common diagnosis (55.4%). The majority of visits were follow-up (65.5%) or preoperative (26.8%). Approximately 64,977.00 miles and 66,988.67 min (∼1,116 h) of roundtrip travel were saved, reducing CO₂ emissions by 26,705.55 kg (equivalent to 3,005 gallons of gasoline consumed or 5.6 homes’ electricity use for 1 year). Patients within the highest ADI quartile (<i>Q</i>), indicating highest socioeconomic disadvantage, had the highest travel costs saved (median [interquartile range]; Q1, $12.24 [$18.36]; Q2, $134.33 [$274.38]; Q3, $256.69 [$191.52]; Q4, $364.42 [$154.28]; <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Telemedicine may facilitate reduction in the carbon footprint associated with healthcare as well as reduce indirect healthcare costs associated with travel.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 7","pages":"692-698"},"PeriodicalIF":7.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364496","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":"Hyaluronic Acid for Sinonasal Surgery: A Systematic Review and Meta-Analysis","authors":"Esther Yanxin Gao,&nbsp;Benjamin Kye Jyn Tan,&nbsp;Joie Yi Yun Teo,&nbsp;George Shiyao He,&nbsp;Claire Jing-Wen Tan,&nbsp;Brian Sheng Yep Yeo,&nbsp;Andy Jian Kai Chua","doi":"10.1002/alr.23537","DOIUrl":"10.1002/alr.23537","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hyaluronic acid has gained widespread attention for its potential role in sinonasal surgery, especially functional endoscopic sinus surgery (FESS), due to its wound healing and anti-inflammatory properties. However, clinical evidence on its efficacy remains inconclusive. This meta-analysis aims to clarify the efficacy of hyaluronic acid in improving both objective and subjective outcomes after sinonasal surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two blinded reviewers searched PubMed, Embase, and Scopus databases, then selected randomized controlled trials (RCTs) on hyaluronic acid use in sinonasal surgery compared to routine post-operative care. The risk of bias was graded using the Cochrane Risk of Bias 2 (RoB 2) tool. Data was analyzed using random-effects models to pool risk ratios for dichotomous outcomes and the ratio of means (RoM) for continuous outcomes. Publication bias was assessed via funnel plots and the trim-and-fill method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 244 records, 15 RCTs—13 on FESS and two on septoplasty and inferior turbinoplasty—were selected, with 789 participants. Meta-analysis for the 13 studies on FESS was performed. Hyaluronic acid significantly reduced synechiae formation (relative risk [RR] 0.65, 95% confidence interval [CI] 0.44–0.94), improved epithelialization (RR 0.48, 95% CI 0.27–0.86), and decreased post-operative edema (RR 0.70, 95% CI 0.50–0.97) compared to routine post-FESS care. All included studies had a low to moderate risk of bias, and there was no substantial publication bias. There were no adverse events reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Hyaluronic acid dressings are safe and may reduce synechiae, edema, and improve epithelialization after sinonasal surgery. Hyaluronic acid may be considered as an adjunct after FESS to optimize post-operative outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 6","pages":"616-625"},"PeriodicalIF":7.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364487","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}