RhinologyPub Date : 2025-05-23DOI: 10.4193/Rhin25.095
N Y M Chua, W K Lau, A L Chui, C L Ng, D Y Wang
{"title":"Chronic rhinosinusitis in nasopharyngeal carcinoma patients post- IMRT: a meta-analysis.","authors":"N Y M Chua, W K Lau, A L Chui, C L Ng, D Y Wang","doi":"10.4193/Rhin25.095","DOIUrl":"https://doi.org/10.4193/Rhin25.095","url":null,"abstract":"<p><strong>Background: </strong>Intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC) can cause chronic rhinosinusitis (CRS), an underexplored side effect. This review aimed to determine the incidence and severity of CRS in NPC patients post-IMRT.</p><p><strong>Methods: </strong>Electronic databases (PubMed, CINAHL, Embase, Cochrane Library, Web of Science) were searched for studies published from 2000 onwards. Eligible studies assessed CRS in NPC patients post-IMRT, using validated methods per EPOS 2020 (Lund-Mackay (LM) CT scoring, Lund-Kennedy (LK) endoscopic scoring, SNOT questionnaire). Meta-analysis was conducted using SPSS and R to quantify pooled CRS incidence and severity.</p><p><strong>Results: </strong>Nine studies (n=1,478) were included, revealing distinct patterns in CRS development and severity. Patients without prior sinusitis showed significantly increased likelihood of developing CRS post-IMRT, while those with prior sinusitis had reduced odds due to a ceiling effect, as CRS was already present in 100% of these patients before IMRT. Both groups showed significant increases in CRS severity pre- and post-IMRT, with the LK and LM scoring methods showing the most substantial changes.</p><p><strong>Conclusions: </strong>This review underscores the significant increases in both the incidence and severity of CRS in NPC patients post- IMRT. Clinicians should recognise the risk of CRS post-IMRT and recommend options to reduce the likelihood of CRS development.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128563","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}
RhinologyPub Date : 2025-05-23DOI: 10.4193/Rhin24.418
M Fieux, J Margier, S Bartier, M Chang, F Carsuzaa, P H Hwang, Z M Patel, S Tringali, V Favier, T Savary
{"title":"The extra cost of biologics as first-line treatment in uncontrolled chronic rhinosinusitis with nasal polyps with no previous sinus surgery is overwhelming: a budget impact analysis.","authors":"M Fieux, J Margier, S Bartier, M Chang, F Carsuzaa, P H Hwang, Z M Patel, S Tringali, V Favier, T Savary","doi":"10.4193/Rhin24.418","DOIUrl":"https://doi.org/10.4193/Rhin24.418","url":null,"abstract":"<p><strong>Background: </strong>Both surgery and biologics offer comparable control rates for patients with uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) but differ in terms of cost and complications. The aim was to assess the mean total direct cost per patient of biologics or surgery as first-line treatment in uncontrolled CRSwNP and to perform a budget impact analysis (BIA).</p><p><strong>Methods: </strong>An economic model was build based on pricing of March 2024, and on the theoretical French population to simulate both the 5-year mean direct cost per patient and the BIA. For the BIA, two scenarios were evaluated: in scenario 1 (the normal one), 18% of patients received biologics as first-line (vs 82% surgery) and in scenario 2 (the less likely one), 90% of patients received biologics as first-line (vs 10% surgery). Within both scenarios, two approaches were considered, the surgical one (when patients received surgery as first-line) and the biological one (when patients received biologics as first-line, no previous sinus surgery).</p><p><strong>Results: </strong>Over 5 years, the estimated mean direct cost per patient per year was significantly lower in the surgical approach compared to the biological one (60,026€). The BIA found that the estimated net overall incremental budget impact was 91,287,924€ in scenario 1 and 1,024,768,639€ in scenario 2. In both scenarios, the biological approach was the most expensive (+184% and +1048%, respectively).</p><p><strong>Conclusion: </strong>At current costs, if biologics were used as a first-line treatment (no previous sinus surgery) in patients with uncontrolled CRSwNP, the extra direct cost would be overwhelming.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128530","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}
RhinologyPub Date : 2025-05-23DOI: 10.4193/Rhin25.132
S D Le Bon, J Plojoux, Y Coattrenec, B N Landis
{"title":"Concomitant cystic fibrosis and NSAID-exacerbated respiratory disease.","authors":"S D Le Bon, J Plojoux, Y Coattrenec, B N Landis","doi":"10.4193/Rhin25.132","DOIUrl":"https://doi.org/10.4193/Rhin25.132","url":null,"abstract":"<p><p>Chronic rhinosinusitis (CRS) with nasal polyps occurs in 6-57% of individuals with cystic fibrosis (CF) (1). According to the EPOS 2020 guidelines, CF-related CRS is classified as secondary diffuse, non-type-2 CRS (2). In contrast, most nasal polyposis in the general population is associated with primary, type-2 CRS. This educationally-oriented classification system facilitates the categorization of CRS in distinct groups. However, it may suggest that each type of CRS is caused by a single underlying mechanism, potentially leading clinicians to overlook that, in reality, multiple factors can drive CRS development. The incidence of CRS stemming from multiple etiologies remains currently underexplored. We report an illustrative case of a CF patient with concomitant NSAID-Exacerbated Respiratory Disease (NERD), necessitating two distinct targeted therapies to achieve effective symptomatic relief.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128564","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}
RhinologyPub Date : 2025-05-19DOI: 10.4193/Rhin25.044
D-P Petsiou, D Spinos, A Martinos, J Muzaffar, G Garas, C Georgalas
{"title":"Effectiveness of Artificial Intelligence in detecting sinonasal pathology using clinical imaging modalities: a systematic review.","authors":"D-P Petsiou, D Spinos, A Martinos, J Muzaffar, G Garas, C Georgalas","doi":"10.4193/Rhin25.044","DOIUrl":"https://doi.org/10.4193/Rhin25.044","url":null,"abstract":"<p><strong>Background: </strong>Sinonasal pathology can be complex and requires a systematic and meticulous approach. Artificial Intelligence (AI) has the potential to improve diagnostic accuracy and efficiency in sinonasal imaging, but its clinical applicability remains an area of ongoing research. This systematic review evaluates the methodologies and clinical relevance of AI in detecting sinonasal pathology through radiological imaging.</p><p><strong>Methodology: </strong>Key search terms included \"artificial intelligence,\" \"deep learning,\" \"machine learning,\" \"neural network,\" and \"paranasal sinuses,\". Abstract and full-text screening was conducted using predefined inclusion and exclusion criteria. Data were extracted on study design, AI architectures used (e.g., Convolutional Neural Networks (CNN), Machine Learning classifiers), and clinical characteristics, such as imaging modality (e.g., Computed Tomography (CT), Magnetic Resonance Imaging (MRI)).</p><p><strong>Results: </strong>A total of 53 studies were analyzed, with 85% retrospective, 68% single-center, and 92.5% using internal databases. CT was the most common imaging modality (60.4%), and chronic rhinosinusitis without nasal polyposis (CRSsNP) was the most studied condition (34.0%). Forty-one studies employed neural networks, with classification as the most frequent AI task (35.8%). Key performance metrics included Area Under the Curve (AUC), accuracy, sensitivity, specificity, precision, and F1-score. Quality assessment based on CONSORT-AI yielded a mean score of 16.0 ± 2.</p><p><strong>Conclusions: </strong>AI shows promise in improving sinonasal imaging interpretation. However, as existing research is predominantly retrospective and single-center, further studies are needed to evaluate AI's generalizability and applicability. More research is also required to explore AI's role in treatment planning and post-treatment prediction for clinical integration.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102494","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}
RhinologyPub Date : 2025-04-30DOI: 10.4193/Rhin24.528
M Lazzeroni, P Kemp, W J Fokkens, S Reitsma
{"title":"Eosinophilic complications during dupilumab therapy for type 2 diseases: a systematic review.","authors":"M Lazzeroni, P Kemp, W J Fokkens, S Reitsma","doi":"10.4193/Rhin24.528","DOIUrl":"https://doi.org/10.4193/Rhin24.528","url":null,"abstract":"<p><strong>Background: </strong>Dupilumab shows promising results in the management of several type 2 disorders. However, it often leads to transient, early increases in blood eosinophil count (BEC). This has led to awareness of possibly associated eosinophilic complications, such as eosinophilic granulomatosis with polyangiitis (EGPA) and hypereosinophilic syndrome (HES). Aim of the current work was to collect all eosinophilic complications reported in literature.</p><p><strong>Methodology: </strong>PubMed, Embase, Scopus, and Web of Science were systematically searched for papers reporting on eosinophilic complications of dupilumab therapy for type 2 disorders.</p><p><strong>Results: </strong>While around one million patients are treated with dupilumab globally, we identified a total of 35 reports on 53 patients. The most common complications were EGPA: 24 patients, eosinophilic pneumonia: 15, and HES: 6. Complications developed after a median of 9 (range: 0-71) weeks and the median eosinophilic count at the moment of diagnosis was 6.38x109 cells/L (IQR 3.13- 9.08). Most complications were treated with systemic corticosteroids. Of all patients, 89% discontinued dupilumab therapy and no deceased patients were reported.</p><p><strong>Conclusions: </strong>Reported eosinophilic complications during dupilumab therapy are extremely rare and mostly develop during the first months of treatment, challenging the need for (prolonged) BEC monitoring during dupilumab therapy. No patient patterns or predictors were identified.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979051","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}
RhinologyPub Date : 2025-04-30DOI: 10.4193/Rhin23.499
M Kawabata, E Mori, N Yanagi, M Tei, N Otori
{"title":"Olfactory disorder after COVID-19 vaccination.","authors":"M Kawabata, E Mori, N Yanagi, M Tei, N Otori","doi":"10.4193/Rhin23.499","DOIUrl":"https://doi.org/10.4193/Rhin23.499","url":null,"abstract":"<p><p>This systematic review examines 16 reported cases of olfactory disorders occurring after COVID-19 vaccination. Symptoms such as anosmia, parosmia, hyposmia, ageusia, and dysgeusia appeared within one week of vaccination. Among the 16 patients (12 women, 4 men; mean age 38 years), 9 received the Pfizer mRNA vaccine, 6 received the AstraZeneca viral vector vaccine, and 1 received the Moderna mRNA vaccine. Symptoms persisted from 4 days to 18 months, with varying degrees of severity. Diagnoses were made using Sniffin' Sticks tests and T&T olfactometry, mosty revealing mild hyposmia. Treatment included vitamin B12, multivitamins, olfactory training, Kampo formula, and, in some cases, corticosteroids. The hypothesized mechanism involves inflammatory responses triggered by spike protein interaction with the α7 nicotinic acetylcholine receptor on macrophages. Given the lack of definitive diagnostic methods, careful clinical evaluation is essential to rule out other causes such as subclinical COVID-19 infection. While olfactory disorders have been reported after vaccination, no direct causal relationship has been established. Further research is needed to clarify underlying mechanisms and contributing factors.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032686","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}
RhinologyPub Date : 2025-04-30DOI: 10.4193/Rhin24.541
R J Schlosser, M J Gregoski, M A Eckert, A Benitez, Z M Soler
{"title":"The 4 item Concise Aging adults Smell Test (4CAST) to screen for olfactory-related comorbidities.","authors":"R J Schlosser, M J Gregoski, M A Eckert, A Benitez, Z M Soler","doi":"10.4193/Rhin24.541","DOIUrl":"https://doi.org/10.4193/Rhin24.541","url":null,"abstract":"<p><strong>Background: </strong>Olfactory dysfunction (OD) is associated with numerous comorbidities, including cognitive decline and depression. Age-related OD is one of the most common causes of smell loss, but it is often underrecognized. In previous research the 4 item Concise Aging adults Smell Test (4CAST) accurately predicted psychophysical olfactory function in over 80% of older adults. This study examined the relationship of 4CAST to olfactory-related comorbidities.</p><p><strong>Methods: </strong>A community-based cohort of adults over 50 years of age completed the 4CAST. Its association with olfactory-related comorbidities was assessed using: 1) National Institutes of Health Toolbox -Cognition Battery; 2) Questionnaire for Olfactory Disorders-Negative Statements (QOD-NS); 3) Patient Health Questionnaire 9 (PHQ9); 4) DeJong Giervald (DJG) social isolation scale; and 5) Mini-Nutritional Assessment (MNA).</p><p><strong>Results: </strong>Participants who failed the 4CAST had worse median scores for all measures of fluid cognition, QOD-NS, and PHQ9. Of participants who failed the 4CAST, 24-39% had cognition scores suggestive of possible cognitive impairment. Participant's 4CAST results did not differ in crystallized cognition (Picture Vocabulary Test), total DJG and MNA scores.</p><p><strong>Conclusion: </strong>The 4CAST is a quick screening instrument that may indicate psychophysical OD in older adults and identify olfactory-related comorbidities (i.e. cognitive decline, depression) that may merit further in-depth assessments.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995932","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}
RhinologyPub Date : 2025-04-25DOI: 10.4193/Rhin10.4193/Rhin24.369
A L Winter, S Henecke, E Thunell, M Swartz, J Martinsen, P Sahlstrand Johnson, J N Lundström
{"title":"Olfactory training using nasal inserts is more effective due to increased adherence.","authors":"A L Winter, S Henecke, E Thunell, M Swartz, J Martinsen, P Sahlstrand Johnson, J N Lundström","doi":"10.4193/Rhin10.4193/Rhin24.369","DOIUrl":"https://doi.org/10.4193/Rhin10.4193/Rhin24.369","url":null,"abstract":"<p><strong>Background: </strong>The recommended treatment for hyposmia (a clinically reduced sense of smell) is olfactory training using odor containers that the patients smell twice a day for several weeks. Adherence to the olfactory training regimen is, however, generally low. We aimed to investigate if a new form of odor delivery, using scented nasal inserts, could enhance adherence to olfactory training by allowing participants to be mobile during the training and thereby lower the perceived intrusion on everyday life.</p><p><strong>Methods: </strong>Using a randomized controlled parallel-group design, individuals (N = 116) with hyposmia underwent 8 weeks of olfactory training. One group was assigned olfactory training using scented nasal inserts (nasal devices that retain nasal patency) while the other group was assigned the standard care regimen currently recommended by the Swedish healthcare system. We assessed objective and subjective olfactory ability before and after olfactory training as well as adherence to training.</p><p><strong>Results: </strong>Both groups significantly improved both their objective and subjective olfactory abilities, and training with nasal inserts produced similar improvement as standard care in overall treatment outcome. However, there was a significantly greater increase in discrimination performance and lower dropout rate (6.7%) in the nasal insert compared to the standard care group (23.2%). Critically, after exclusion of the drop-out participants, the nasal insert group still showed significantly higher adherence to the training regimen.</p><p><strong>Conclusions: </strong>Olfactory training with nasal inserts could serve as a more effective form of treatment for hyposmia due to patients' improved adherence to protocol and increased tendency to finish their treatment regimen.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031452","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}
RhinologyPub Date : 2025-04-21DOI: 10.4193/Rhin24.331
B van Dijk, E M Postma, W M Boek, D M A Kamalski, S Boesveldt
{"title":"Prevalence and recovery rate of persistent olfactory dysfunction in COVID-19: the COVORTS study.","authors":"B van Dijk, E M Postma, W M Boek, D M A Kamalski, S Boesveldt","doi":"10.4193/Rhin24.331","DOIUrl":"https://doi.org/10.4193/Rhin24.331","url":null,"abstract":"<p><strong>Background: </strong>Olfactory dysfunction is a well-recognized symptom of COVID-19 infection. However, prevalence and recovery rate of these persistent symptoms differ across reports. Here, we report prevalence and recovery rate of psychophysically measured quantitative olfactory dysfunction, qualitative complaints, and subjective olfactory functioning up to 15 months after infection.</p><p><strong>Methodology: </strong>The COVORTS cohort included 76 patients between 18-60 years with recent (1 month) olfactory dysfunction. The (extended) Sniffin' Sticks test was performed at baseline (T1), and 3 months, 6 months, 9 months, and 12 months later (T13). Monthly online questionnaires were completed on self-reported overall olfactory functioning and qualitative complaints.</p><p><strong>Results: </strong>Prevalence of quantitative olfactory dysfunction was 89.5% at baseline, and 69.1% at T13. Clinically relevant recovery was achieved by 29.4% of patients at T13. Prevalence of parosmia remained around 50%, while phantosmia slowly decreased from 43.4% to 23.5%. Subjective olfactory functioning slowly improved over time before levelling out at around half of pre-illness ability. At T13, 37.9% of patients reported an improvement of at least 80% of pre-COVID function. Fluctuations were observed within individuals for all three measurements.</p><p><strong>Conclusions: </strong>Irrespective of measurement method, prevalence of olfactory dysfunction remains high up to 15 months after infection, and recovery rate is low. Individual fluctuations were observed between timepoints, indicating that recovery is not stable. Acknowledgement of symptoms, knowledge of fluctuations, and longer follow-up to evaluate further recovery are crucial to improve patient management.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981327","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}
RhinologyPub Date : 2025-04-18DOI: 10.4193/Rhin24.420
G Ottaviano, G Roccuzzo, T Saccardo, L G Locatello, S De Rossi, A De Massimi, E Rigoni, R Marangoni, L Lora, L Calvanese, M Schiappoli, L Pierotello, S Munari, M Baldovin, F Corlianò, I Barbarino, S Santini, S Zampollo, K Pacaj, B Scarpa, P Nicolai
{"title":"Mepolizumab in severe uncontrolled CRSwNP: a real-life multicentre study in Northeast Italy.","authors":"G Ottaviano, G Roccuzzo, T Saccardo, L G Locatello, S De Rossi, A De Massimi, E Rigoni, R Marangoni, L Lora, L Calvanese, M Schiappoli, L Pierotello, S Munari, M Baldovin, F Corlianò, I Barbarino, S Santini, S Zampollo, K Pacaj, B Scarpa, P Nicolai","doi":"10.4193/Rhin24.420","DOIUrl":"https://doi.org/10.4193/Rhin24.420","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to evaluate the efficacy of mepolizumab as add-on therapy to intranasal corticosteroids for the treatment of severe, uncontrolled Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) in a real-life setting in the Triveneto region of northeast Italy.</p><p><strong>Methods: </strong>Patients with severe CRSwNP receiving mepolizumab were followed up at 1, 3, 6, 9 and 12 months from the first administration. At baseline and at each follow-up, patients underwent nasal endoscopy, completed the Sinonasal Outcome Test 22, Visual Analogue Scales for smell, nasal obstruction, rhinorrhoea and facial pain, the Nasal Congestion Score and the Asthma Control Test. Peak nasal inspiratory flow, Sniffin' Sticks Identification Test and blood eosinophil count were also evaluated.</p><p><strong>Results: </strong>Ninety patients from twelve different rhinological units were enrolled in the study. Both patient- and physician- derived outcome measures significantly improved within the first month after biological treatment initiation, maintaining the benefit at subsequent follow-ups. Nine percent of patients discontinued the treatment due to lack of benefit within the first year. No major adverse events were reported.</p><p><strong>Conclusions: </strong>Mepolizumab is effective in improving nasal obstruction and the sense of smell in patients with severe uncontrolled CRSwNP, based on both patient- and physician derived outcome measures.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044906","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}