Rhinology最新文献

{"title":"Remission in chronic rhinosinusitis with nasal polyps (CRSwNP).","authors":"P W Hellings, E De Corso, V Backer, M Bernal-Sprekelsen, Y Chan, D M Conti, M E Cornet, W J Fokkens, P Gevaert, J Han, C Hopkins, B N Landis, S Lau, S Lee, V J Lund, J Mullol, A Peters, S Schneider, B Senior","doi":"10.4193/Rhin24.457","DOIUrl":"https://doi.org/10.4193/Rhin24.457","url":null,"abstract":"<p><p>Remission has recently been proposed as the new goal of care in CRSwNP or Nasal Polyp Syndrome by the European Forum for Research and Education in Allergy and Airway Diseases / European Position Paper on Rhinosinusitis and Nasal Polyps (EUFOREA/EPOS) (1,2) as well as by global leaders in Rhinology (3). In CRSwNP, remission is defined as a prolonged state of control, without bothersome symptoms reported by the patient for at least 12 months, without the need for either oral corticosteroids or endoscopic sinus surgery (ESS), and without endoscopic signs of active disease (1). This new goal of care is to be encouraged by the ENT community and CRSwNP patients as persistent symptoms unalleviated by historical approaches (4,5) can be reduced by new therapies including biologics. The goal of therapy for CRSwNP has long been to achieve control, with Visual Analogue Scale (VAS) and Sino-Nasal Outcome Test (SNOT-22) scores guiding physicians towards a step-up treatment aiming for control (6,7).</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468909","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":"Analysis of clinical characteristics of fungus ball based on the number of involved sinuses.","authors":"T Yang, C Liu, Y Wang, J Zhou, Y Li, H Wei","doi":"10.4193/Rhin23.501","DOIUrl":"https://doi.org/10.4193/Rhin23.501","url":null,"abstract":"<p><strong>Background: </strong>Fungus ball (FB) typically presents unilaterally, with the maxillary sinus being the most commonly affected site.Multi-sinus FB cases are seldom discussed.</p><p><strong>Methodology: </strong>A retrospective study involving 1709 FB patients categorized them into single sinus fungus ball (SSFB), double sinus fungus balls (DSFB), and multiple sinus fungus balls (MSFB) groups for clinical analysis.</p><p><strong>Results: </strong>The SSFB group comprised 1596 patients (93.39%), the DSFB group 111 patients (6.50%), and the MSFB group two patients (0.12%). The prevalence of diabetes mellitus in the DSFB group was higher than that in the SSFB group. A female prevalence was noticed and there was no difference in the sex ratio by age group. On computed tomography (CT), maxillary sinus FB group had higher intralesional hyperdensity than sphenoid sinus FB group. Oppositely, sphenoid sinus FB group had higher lateral sinus wall sclerosis than maxillary sinus FB group.</p><p><strong>Conclusions: </strong>DSFB occurs in a minority of cases but needs to be investigated especially in diabetics given the link between diabetes mellitus and increased DSFB risk. A female predominance is seen in both pre- and postmenopausal women. On CT, the presence of intralesional hyperdensity and lateral sinus wall sclerosis correlates with the location of the FB.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468908","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":"Radial intralesional linear calcifications and focal hyperostosis: key points for diagnosis, extension and point of origin identification of sinonasal inverted papilloma.","authors":"E Granell, A Cardesin, D Pallarés, R Sánchez, J R Gras","doi":"10.4193/Rhin24.379","DOIUrl":"https://doi.org/10.4193/Rhin24.379","url":null,"abstract":"<p><p>Sinonasal inverted papilloma (IP) often appears as a unilateral sinonasal soft-tissue mass with varying enhancement, often accompanied by bone remodelling, intralesional calcifications, focal hyperostosis, and cone-shaped bone thickening (observed in 60 to 80% of cases) (1,2). A non-contrast sinonasal CT scan may reveal a soft tissue polypoid mass that closely resembles inflammatory polyps (Figure 1 A-D). While hyperostosis is recognized as a marker of the tumor's point of origin (1), intralesional calcifications are less frequently described but may offer valuable insights. Early studies, such as those by Lund and Lloyd (1984), highlighted the presence of intralesional calcifications as a distinct feature of inverted papilloma, a finding later supported by studies emphasizing the role of bone morphogenic proteins in calcification development (4-7).</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450106","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":"Real-world treatment of chronic rhinosinusitis with dupilumab and omalizumab: results from the Korean National Health Insurance Service database.","authors":"S A Han, J Yoon, B H Kim, J H Park, Y-S Lim, Y B Kim, C G Cho, S-W Park, J Y Kim","doi":"10.4193/Rhin24.209","DOIUrl":"https://doi.org/10.4193/Rhin24.209","url":null,"abstract":"<p><strong>Background: </strong>Biological treatment has proven effective for the treatment of chronic rhinosinusitis with nasal polyps (CRSwNP) and is increasingly prescribed. However, in the real-world, strict adherence to the recommended dose may not be feasible and studies on the actual administration patterns of biologics are limited. This study aimed to evaluate the patterns of real-world use of biologics for CRS in Korea, through the National Health Insurance Service (NHIS).</p><p><strong>Methods: </strong>We analysed data from the NHIS database from January 2010 to March 2024. Patients with CRS or nasal polyp defined by the ICD-10 codes, who had undergone computed tomography, and had a history of being prescribed dupilumab or omalizumab were identified. A total of 808 patients were analysed for their administration patterns and systemic corticosteroid use.</p><p><strong>Results: </strong>Twelve weeks after initiation of therapy, 46.2% of patients received dupilumab at 2-weekly intervals and 53.9% of patients on omalizumab patients were receiving treatment at 2- or 4-week intervals. The annual expense of CRS patients treated with biologics was greater than for those receiving other treatments. The average annual usage of systemic steroids was decreased from 33.0 days to 12.7 days after using biologics.</p><p><strong>Conclusions: </strong>The results of this study which analysed real-world data in a large population, suggest a discrepancy between the recommended dose and real-world administration of biologics. Further studies are warranted on feasible administration schedules that reflect various patient factors and healthcare costs.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450109","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":"Is nasal closure an effective treatment for severe refractory epistaxis in HHT? A scoping review and narrative synthesis.","authors":"R Bickerton, R Gera, T Ross, C Rennie","doi":"10.4193/Rhin24.448","DOIUrl":"https://doi.org/10.4193/Rhin24.448","url":null,"abstract":"<p><strong>Introduction: </strong>Hereditary haemorrhagic telangiectasia (HHT) is an uncommon genetic disorder characterised by recurrent, severe epistaxis which poses significant management challenges. Nasal closure has emerged as a treatment for refractory cases, however there is limited research on its outcomes. We aim to consolidate existing evidence to assess its efficacy and safety.</p><p><strong>Methods: </strong>We conducted a systematic search of the Cochrane library, EMBASE, PubMed and non-indexed publications from the past 30 years. Two independent reviewers extracted data and assessed bias from included studies. Findings were summarised via narrative synthesis due to heterogeneity of included studies.</p><p><strong>Results: </strong>192 patients from ten studies underwent nasal closure. Frequently used outcome measures were validated epistaxis severity scores, Glasgow Benefit Inventory and haemoglobin trends. Surgery improved quality of life and reduced epistaxis severity post-operatively. Partial dehiscence is a frequently reported complication which is usually successfully treated with revision surgery.</p><p><strong>Conclusions: </strong>Nasal closure reduces epistaxis severity, improving quality of life in patients with severe, refractory HHT-related epistaxis, providing a valuable treatment option for the most challenging cases. The strength of our conclusions is limited by the heterogeneity of outcome measures. To our knowledge, this is the largest pooled database of patients who have undergone nasal closure.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189463","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":"Relationship between mode of delivery and the development of allergic rhinitis: a systematic review and meta-analysis.","authors":"M P Hoang, K Seresirikachorn, J Samuthpongtorn, W Chitsuthipakorn, K Snidvongs","doi":"10.4193/Rhin24.262","DOIUrl":"10.4193/Rhin24.262","url":null,"abstract":"<p><strong>Background: </strong>Delivery mode can influence infant microbial diversity, cause immune dysregulation, and potentially increase the risk of allergic rhinitis (AR).</p><p><strong>Methodology: </strong>A systematic review and meta-analysis were performed to assess the association between distinct modes of delivery and the development of AR in childhood and adulthood. The primary comparison was vaginal (VD) versus cesarean delivery (CD). Secondary comparisons were specified CD (elective, emergency) versus specified VD (spontaneous, abnormal) and nonmicrobiota-exposed versus microbiota-exposed deliveries. The outcomes were subsequent risks of AR presenting as odd ratios and 95% confidence intervals.</p><p><strong>Results: </strong>Thirty-seven studies were analyzed. Compared to VD, CD, and its specified modes were associated with higher subsequent risks of AR in the population under age 18. The quality of evidence supporting these effects is rated as very low to low following GRADE. Spontaneous VD was associated with lower AR risk compared to CD, but there was no significant difference between abnormal VD and CD. The distinction between non-microbiota-exposed and microbiota-exposed deliveries did not affect AR risk significantly.</p><p><strong>Conclusions: </strong>The estimated odds ratios demonstrated a positive association between cesarean section and AR up to 18 years of age. A comprehensive categorization of delivery mode is necessary to interpret the existing evidence thoroughly.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":"2-12"},"PeriodicalIF":4.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807924","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":"Normative data for the lateralization task in the assessment of intranasal trigeminal function.","authors":"Y Mai, A K Hernandez, I Konstantinidis, A Haehner, T Hummel","doi":"10.4193/Rhin24.063","DOIUrl":"10.4193/Rhin24.063","url":null,"abstract":"<p><strong>Aim: </strong>To provide normative data for the lateralization task in the assessment of intranasal trigeminal function, as well as to investigate potential effects of age, sex and olfactory function.</p><p><strong>Methods: </strong>The lateralization task using eucalyptus as target stimulus was performed to assess intranasal trigeminal function. Data were collected from: 360 healthy adult participants (mean age 37.5 ± 17.4) for the 40-trial version; 284 participants (mean age 32.6 ± 4.1) for the 20-trial version; and 418 participants (mean age 42.6 ± 15.6) for the 10-trial version. The \"Sniffin Sticks\" test was used to measure olfactory function.</p><p><strong>Results: </strong>The mean scores were 35.46 ± 4.50 for the 40-trial version, 15.64 ± 3.65 for the 20-trial version, and 8.14 ± 2.16 for the 10-trial version. In the reference group aged 18-25 years, the 10th percentiles were 33 for the 40-trial version, 11 for the 20-trial version, and 6 for the 10-trial version. Significant effects of age and odor discrimination score were observed on lateralization performance.</p><p><strong>Conclusions: </strong>We provide reference scores for the lateralization task, in large sample of healthy participants. Among the three examined tasks (40, 20 and 10), the 40-trial task yielded the most reliable information. For the 40-trial version, scores equal or higher to 33 points indicate a normal lateralization ability, whereas scores between 27 and 32 may warrant further assessment. Scores below 27 possibly point towards a decreased trigeminal function. The lateralization task serves as surrogate marker of intranasal trigeminal functions and further studies with pathological cases are needed to explore its clinical usefulness.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":"92-102"},"PeriodicalIF":4.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392934","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 endoscopy score thresholds to trigger consideration of chronic rhinosinusitis treatment escalation and implications for disease control.","authors":"A R Sedaghat, R A Cotter, I Alobid, S Alsaleh, W T Anselmo-Lima, M Bernal-Sprekelsen, R K Chandra, J Constantinidis, W J Fokkens, C Franzese, S T Gray, A A Halderman, E H Holbrook, C Hopkins, P H Hwang, E C Kuan, B N Landis, V J Lund, E D McCoul, V Niederberger-Leppin, E K O'Brien, C M Philpott, S D Pletcher, M A Pynnonen, S Reitsma, J Rimmer, S Toppila-Salmi, E W Wang, M B Wang, S K Wise, B A Woodworth, W C Yao, K M Phillips","doi":"10.4193/Rhin24.291","DOIUrl":"10.4193/Rhin24.291","url":null,"abstract":"<p><strong>Background: </strong>In the absence of direct evidence supporting how to use nasal endoscopy findings to judge chronic rhinosinusitis (CRS) disease control, experts' practice patterns could provide guidance.</p><p><strong>Methodology: </strong>Participants consisted of a diverse group of twenty-nine rhinologists. Participants were presented with every possible combination of bilateral nasal endoscopy findings represented by the modified Lund-Kennedy (MLK; range: 0-12) endoscopic scoring system and Nasal Polyp Score (NPS; range: 0-8). Reflecting the practical consequence of CRS disease control assessment, participants were asked whether they would consider CRS treatment escalation based on each scenario in the absence of any CRS symptoms, and how strongly they considered escalating therapy. The same scenarios were then presented in the context of 1 burdensome CRS symptom and participants again were asked whether they would consider treatment escalation.</p><p><strong>Results: </strong>The median threshold total MLK score for considering treatment escalation was ≥ 4 and 75.9% of participants' MLK thresholds were within 1 point of 4. The median threshold total NPS for considering treatment escalation was ≥ 3 and 62.5% of participants' NPS thresholds were within 1 point of 3. Endoscopy score thresholds decreased in the presence of 1 burdensome symptom and generally increased when requiring stronger affirmation for considering CRS treatment escalation.</p><p><strong>Conclusion: </strong>Reflecting the practice patterns of a diverse group of rhinologists, MLK score ≥ 4 or NPS ≥ 3 may serve as thresholds for considering CRS treatment escalation. Alternatively, MLK score under 4 or NPS under 3 may serve as endoscopic goals of CRS treatment. These results provide guidance for using nasal endoscopy findings as a criterion of CRS disease control.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":"54-62"},"PeriodicalIF":4.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396974","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":"The Lamella Ostium Extent Mucosa (LOEM) system: a new classification for endoscopic sinus surgery.","authors":"S Sanchez-Gomez, R Moreno-Luna, D Martin-Jimenez, J Maza-Solano, A Del Cuvillo, J-M Villacampa-Auba, J Gonzalez-Garcia, R Fernandez-Liesa, I Alobid, M Bernal-Sprekelsen","doi":"10.4193/Rhin24.370","DOIUrl":"10.4193/Rhin24.370","url":null,"abstract":"<p><p>In the last decades, various types of endoscopic sinus surgery (ESS) have emerged as treatments for chronic rhinosinusitis (CRS), particularly with the development of personalized, endotype-driven approaches targeting mucosal inflammation and remodeling. Despite these advancements, the literature reports heterogeneous and often divergent outcomes, leaving the actual benefit of more extensive surgical approaches in CRS control a matter of ongoing debate. This discrepancy stems from inconsistent definitions of surgical techniques, leading to variations in osseous and mucosal resections depending on patient phenotype, disease severity and surgeon preference. To address this inconsistency, the Japanese Rhinology Society introduced a classification based on procedure extent, but it lacks details on anatomical structures and mucosal treatment. Similarly, the ACCESS system measures ESS extent with postoperative CT-scans but overlooks mucosal interventions.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":"125-128"},"PeriodicalIF":4.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506999","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":"The evaluation of therapeutic outcomes of biologics in allergic fungal rhinosinusitis: a systematic review and meta-analysis.","authors":"H J Aljubran, O A Bamalan, A A Alfayez, R M Abdulhameed, T M Almuhaimid, M Al Bar, A A Almomen, M S Alahmari","doi":"10.4193/Rhin24.397","DOIUrl":"10.4193/Rhin24.397","url":null,"abstract":"<p><p>Allergic fungal rhinosinusitis (AFRS) is a localized inflammatory, hypersensitivity reaction affecting the nasal cavity and its sinuses secondary to fungal colonization. The burden of surgical revisions and recurrence rates in this disease led to a recent hypothesized advancement in the medical management being experimented, which is the use of biologics. Therefore, this systematic review analyzed nine articles to highlight the significance of biologics in the management of AFRS through a comprehensive strategy, as seen in Supplementary Methods Section.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":"118-120"},"PeriodicalIF":4.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558652","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}