Rhinology最新文献

{"title":"Real-world dupilumab treatment reduced healthcare resource utilization and medication use in patients with CRSwNP.","authors":"J K Han, S E Lee, A T Peters, Z Soler, N Kamal, S Nash, M Corbett, A Radwan, J Levy","doi":"10.4193/Rhin25.714","DOIUrl":"10.4193/Rhin25.714","url":null,"abstract":"<p><strong>Background: </strong>Evidence of dupilumab’s real-world effectiveness in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) in US clinical practice is limited.</p><p><strong>Objective: </strong>To investigate healthcare resource utilization (HCRU) and medication use in patients with CRSwNP before and after dupilumab initiation in real-world US clinical practice.</p><p><strong>Methods: </strong>This retrospective observational study included adults with CRSwNP who initiated dupilumab 300 mg every 2 weeks between June 2019 and June 2022. Data including claims and electronic health records were extracted from the OM1 Real-World Data Cloud and Reg-ENT Registry. Medication use, healthcare visits, sinus procedures, and imaging were assessed during the 12 months before (baseline) and after (follow-up) dupilumab initiation.</p><p><strong>Results: </strong>The study comprised 1,016 patients (mean age 53.8 years, 46.1% female). Annual mean [standard deviation] number of visits per patient was lower during follow-up vs baseline for outpatient (5.0 [5.2] vs 7.1 [6.0]), otolaryngologist (3.7 [6.7] vs 4.0 [6.1]) and emergency department visits (0.1 [0.6] vs 0.2 [0.6]). The proportion of patients prescribed oral corticosteroids for any reason was lower during follow-up (28.7% vs 68.1%, respectively. Fewer patients were prescribed antibiotics (31.8% vs 64.6%) and CRSwNP related oral corticosteroids (17.7% vs 59.1%), and fewer patients underwent nasal endoscopy (47.5% vs 71.2%) and CT scan (4.5% vs 22.1%) during follow-up than at baseline.</p><p><strong>Conclusions: </strong>These findings suggest an association between dupilumab treatment and reductions in HCRU and medication use in patients with CRSwNP, and provide supportive evidence of dupilumab’s real-world effectiveness.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":"64 5","pages":"627-635"},"PeriodicalIF":5.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224620","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":"Baseline EPOS 2020 eligibility and real-world outcomes of dupilumab in CRSwNP: a longitudinal cohort study.","authors":"N J Campion, D P Petsiou, F Fally, K Berbalk, N Melamed, A Tu, C Morgenstern, M Zghaebi, F A Kidane, L Liu, M Pan, T J Bartosik, V Stanek, K Gangl, J Eckl-Dorna, S Schneider","doi":"10.4193/Rhin25.687","DOIUrl":"10.4193/Rhin25.687","url":null,"abstract":"<p><strong>Background: </strong>Chronic rhinosinusitis with nasal polyps (CRSwNP) is often a type 2-driven inflammatory disease that markedly impairs quality of life. Dupilumab offers major therapeutic benefit but at high cost, underscoring the need for accurate patient selection. EPOS2020 introduced indication criteria for biologic therapy, yet their real-world predictive validity remains underexplored.</p><p><strong>Methods: </strong>This study screened 224 CRSwNP patients treated with dupilumab between November 2019 and May 2025. Outcomes included Total Polyp Score (TPS), 22-item Sinonasal Outcome Test (SNOT-22), olfactory performance, and serum biomarkers. Patients were stratified into EPOS-eligible and ineligible groups based on EPOS2020 criteria, and responses were evaluated using minimal clinically important difference (MCID) thresholds and EPOS/EUFOREA response criteria. Predictors of adequate response were analyzed with logistic regression, and treatment trajectories with linear mixed-effects models.</p><p><strong>Results: </strong>EPOS2020 criteria could be assessed in 177 patients, of whom 76 met them at baseline. EPOS-eligible patients achieved greater improvements in TPS, SNOT-22, and olfaction, and were more likely to reach MCID for TPS. EPOS-eligible patients also had higher composite EPOS response scores, although \"adequate EUFOREA response\" rates did not differ. Non-steroidal anti-inflammatory drug exacerbated respiratory disease independently predicted adequate response, while higher baseline serum IgE was associated with faster improvement trajectories.</p><p><strong>Conclusions: </strong>EPOS2020 criteria provide an effective framework for dupilumab allocation, although markers of active type 2 inflammation may better predict response than categorical eligibility alone.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":"617-626"},"PeriodicalIF":5.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707566","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 real-world confounders on the accuracy of an AI model to support read out of skin prick automated test results.","authors":"K Roux, S F Seys, V Hox, A M Chaker, P W Hellings, G de Greve, W Lemmens, A L Poirrier, R Daems, D Loeckx, S Gorris, L van Gerven","doi":"10.4193/Rhin25.634","DOIUrl":"10.4193/Rhin25.634","url":null,"abstract":"<p><p>Skin prick testing (SPT) is the gold standard for diagnosing allergic sensitization in individuals with a suspected airborne allergy (1). Skin tests are used as first option in 90% of individuals suffering from respiratory allergies and almost two-third of all types of allergies (2).</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":"707-709"},"PeriodicalIF":5.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151106","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 endoscopic indocyanine green fluorescence imaging guided surgery for recurrent nasopharyngeal carcinoma.","authors":"T Liang, J Li, X Hu, Y He, X Li, Z Zhu, K He, H Zhang, C Yu","doi":"10.4193/Rhin25.558","DOIUrl":"10.4193/Rhin25.558","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the feasibility and diagnostic value of indocyanine green (ICG) fluorescence imaging in the surgical treatment of recurrent nasopharyngeal carcinoma (rNPC).</p><p><strong>Methodology: </strong>A retrospective analysis was conducted on clinical data of patients who presented to our department between January 2024 and January 2026, and underwent endoscopic surgery guided by ICG fluorescence imaging system intraoperatively. These patients had previously received radiotherapy for NPC and were found to have suspected recurrence during follow-up examinations. ICG fluorescent agent was administered preoperatively or intraoperatively, and tumours were resected under real-time fluorescence endoscopic monitoring. The fluorescence imaging effects of the tumours and the pathological results of fluorescence-positive lesions were recorded and analysed.</p><p><strong>Results: </strong>This study included 82 patients with suspected recurrence on preoperative evaluation who underwent ICG fluorescence imaging. Patients were stratified based on pathological findings into tumour group (n=46) and non-tumour group (n=36). Statistical analysis demonstrated a significant correlation between ICG fluorescence localization and pathological diagnosis. The sensitivity of ICG for tumour detection was 89.1%, specificity was 72.2%, positive predictive value was 80.4%, negative predictive value was 83.9%, and overall accuracy was 81.7%. ROC curve analysis yielded an area under the curve (AUC) of 0.88 for ICG fluorescence in distinguishing tumours.</p><p><strong>Conclusions: </strong>This study is the first to systematically validate the feasibility and diagnostic value of ICG fluorescence imaging in the complex clinical scenario of rNPC surgery, providing a new tool to improve the radicality and safety of surgery for rNPC.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":"669-677"},"PeriodicalIF":5.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536714","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":"Anterior superior alveolar nerve dysfunction after lateral nasal wall surgery: a prospective observation.","authors":"A Machado, M Castelo-Branco Sousa, H R Briner, D Simmen","doi":"10.4193/Rhin26.046","DOIUrl":"10.4193/Rhin26.046","url":null,"abstract":"<p><p>The anterior superior alveolar nerve (ASAN), a branch of the infraorbital nerve, provides sensory innervation to the anterior maxilla, lateral nasal wall, and maxillary dentition. Owing to its anatomical proximity to the anterior maxillary wall and piri-form aperture, the ASAN is vulnerable during lateral nasal wall surgery. Although postoperative sensory disturbances such as gingival hypoesthesia or dental numbness are frequently re-ported, prospective data combining subjective symptoms with objective sensory testing across different surgical techniques remain limited .</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":"704-706"},"PeriodicalIF":5.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663073","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 with multisensory stimulation: neural insights into cross-modal integration.","authors":"Y T Chao, Y C Liao, T C Kao, M Y Lan, J F Lirng, T Hummel","doi":"10.4193/Rhin25.519","DOIUrl":"https://doi.org/10.4193/Rhin25.519","url":null,"abstract":"<p><strong>Background: </strong>Olfactory training (OT) has emerged as a first-line non-pharmacological treatment for olfactory dysfunction. This study aimed to determine whether multisensory stimulation during OT improves olfactory recovery and to explore the underlying neurobiological mechanisms.</p><p><strong>Methodology: </strong>Individuals aged 18-80 years with post-viral or idiopathic olfactory dysfunction lasting for at least one month were recruited. Participants were allocated to either multisensory OT (MOT, odor-congruent video clips during OT) or conventional OT (COT) for three months. A subset of participants underwent resting-state fMRI at baseline and post-training to evaluate changes in olfactory network connectivity, using the piriform cortex and orbitofrontal cortex as the predefined seed regions. Statistical analyses were performed using repeated-measures ANOVA to evaluate changes over time and between groups.</p><p><strong>Results: </strong>Ninety-five patients (MOT=51, COT=44) were included. Significant improvements in odor discrimination and composite TDI scores were observed across participants without significant session x group interaction. In the MOT group, pre-post gains were observed in odor discrimination, identification, and TDI. In the MRI subgroup (MOT=21, COT=18), MOT was associated with reduced functional connectivity between the right orbitofrontal cortex and the superior occipital, superior temporal, and postcentral gyri.</p><p><strong>Conclusions: </strong>MOT was associated with olfactory improvement over the training period. Although between-group differences were not statistically significant, exploratory neuroimaging findings suggest post-MOT functional reorganization between olfactory and visual, auditory, and somatosensory regions. Incorporating multisensory stimulation into OT warrants further investigation as a potential strategy for olfactory rehabilitation.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991216","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 dysfunction in post-acute COVID-19: clinical characterization, hedonic asymmetry, and machine-learningbased predictor identification.","authors":"M Engelhardt, J A Stelzer, R Herold, E Hanc, E Morawa, Y Erim, J Freiherr","doi":"10.4193/Rhin26.029","DOIUrl":"https://doi.org/10.4193/Rhin26.029","url":null,"abstract":"<p><strong>Background: </strong>Olfactory dysfunction (OD) is among the most prevalent features of post-acute sequelae of COVID-19 (PASC) and frequently co-occurs with cognitive and neuropsychiatric symptoms. The specific predictors of objective olfactory impairment severity and its relation to systematic shifts in hedonic odor perception remain underexplored. Here, we used data-driven approaches to identify and rank predictors of objective OD severity and examined hedonic valence ratings in patients with and without olfactory impairment.</p><p><strong>Methodolgy: </strong>We examined 144 patients with confirmed PASC diagnoses at 15-63 months post-infection using psychophysical testing (Sniffin' Sticks), standardized cognitive tests for verbal fluency, working memory, attention, and working speed, and patient-reported outcome measures for other symptoms of PASC. Predictors were identified using LASSO regression with voting and random forest variable importance ranking. Hedonic valence ratings from the identification subtest were examined at the group and individual odor level.</p><p><strong>Results: </strong>Olfactory function was significantly below normative population values. Verbal fluency emerged as the most robust predictor of olfactory dysfunction severity, converging across both LASSO regression and random forest analyses, and remained significant after controlling for respiratory symptoms. Parosmia, respiratory symptoms, working memory, and somatic symptom burden were also consistently selected. Hyposmic patients showed significantly reduced maximal valence ratings independent of parosmia and anhedonia, while minimal ratings were preserved, with garlic and coffee remaining significant after correction.</p><p><strong>Conclusions: </strong>Verbal fluency emerged as the strongest predictor of OD severity in long-term PASC patients. Beyond reduced olfactory sensitivity, hyposmic patients showed asymmetric hedonic impairment, pointing to differential involvement beyond peripheral olfactory loss.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866753","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":"International consensus statement on nasal septal perforation.","authors":"I Alobid, O Garaycochea, M J Rojas-Lechuga, S Bansberg, P Castelnuovo, J R Craig, S Delaney, D Hanci, Y J Jang, Y Rusetsky, A Alqahtani, S Alsaleh, J D Bedoya, C Callejas, J C Ceballos, A Cordero, S Gode, R Gohil, F Mariño-Sánchez, A Obando, P Pegoraro, A J Psaltis, M Tepedino, R Harvey, C Hopkins","doi":"10.4193/Rhin26.027","DOIUrl":"https://doi.org/10.4193/Rhin26.027","url":null,"abstract":"<p><strong>Background: </strong>Nasal septal perforation (NSP) is a multifactorial condition characterised by a full-thickness defect in the nasal septum, with clinical presentation ranging from asymptomatic cases to significant nasal obstruction, crusting, epistaxis, and impaired quality of life. A major challenge in NSP management is the absence of standardised diagnostic and therapeutic protocols, contributing to inconsistent outcomes. This study aimed to develop an international consensus on the assessment, classification, and management of NSP to standardise linical decision-making and improve patient care.</p><p><strong>Methodology: </strong>A modified Delphi process was conducted over three iterative rounds involving 25 panellists from 15 countries across four continents. Structured questionnaires addressing NSP diagnosis and management were developed, distributed, and refined. Statements covered eight categories: assessment; physiopathology and causes; position; dimensions; non-surgical treatment; surgical treatment, follow-up and results; and quality of life. Consensus was defined as ≥70% agreement, with no more than 10% disagreement.</p><p><strong>Results: </strong>Consensus was reached for 98.2% of the proposed statements. Fifty-six agreements included validated symptom assessment tools, imaging protocols, classification systems based on size and location, preferred medical and surgical treatments, perioperative care standards, and outcome evaluation methods. Areas without full consensus included the clinical relevance of superior-inferior perforation location, prognostic significance of mucosal oedema, the optimal abstinence period from intranasal drug use, and the necessity of early postoperative debridement.</p><p><strong>Conclusions: </strong>These expert consensus statements emphasise validated assessment tools, structured classification systems, and treatment approaches, providing a comprehensive framework to unify NSP management, guide future research, and improve patient outcomes.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866755","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 KnowsWatch: concept and prototype for a wearable chemosensory sensing device.","authors":"S Weise, W Jedryczka, V Gonzalez, A Bernal, J Lozano, T Hummel","doi":"10.4193/Rhin25.513","DOIUrl":"https://doi.org/10.4193/Rhin25.513","url":null,"abstract":"<p><strong>Background: </strong>Olfactory dysfunction (OD) leads to significant consequences in daily life, including increased risk of exposure to toxic substances such as gas or spoiled food, concerns about personal hygiene, increased risk of depression about many other thinks.</p><p><strong>Methodology: </strong>This study examined patient needs for an electronic olfactory sensor and tested one potential application of a prototype device. Twenty-three Participants with OD completed a questionnaire identifying situations impaired by OD and their expectations regarding a sensor device. The prototype KnowsWatch, a smartwatch integrating an electronic nose, was trained in a laboratory setting to distinguish spoiled meat and fish from fresh samples.</p><p><strong>Results: </strong>Around half of the participants (44%) expressed interest in using KnowsWatch in their daily lives. Most prevalent mentions of desired functions were detection of smoke and gas (91%), recognition of spoiled food (74%), and personal hygiene (57%). KnowsWatch was trained to recognize spoiled and fresh meat and fish and achieved very good accuracy (100% each) in the laboratory environment.</p><p><strong>Conclusions: </strong>Patients with OD identify critical needs for wearable olfactory sensors, particularly for safety and hygiene applications. The KnowsWatch prototype demonstrates promising laboratory performance to distinguish fresh and spoiled food. Further real-world studies are needed to assess the practical utility.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813972","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 occupational formaldehyde exposure on objective olfactory thresholds and olfaction-related quality of life.","authors":"Melih Alpay, Fuat Bulut, Betül Ağırgöl, Hande Özgen, Ahmet Emre Kaymaz, Hakkı Caner İnan","doi":"10.4193/Rhin26.076","DOIUrl":"https://doi.org/10.4193/Rhin26.076","url":null,"abstract":"<p><strong>Background: </strong>Formaldehyde (FA) is essential for tissue fixation, but its chronic effects on the olfactory system are concerning. This study investigated the impact of occupational FA exposure on objective olfactory function, nasal patency, and smell-related quality of life in pathology laboratory workers.</p><p><strong>Methods: </strong>This cross-sectional case-control study included 68 participants (33 pathology workers, 35 controls). Assessments included otorhinolaryngological examination, Peak Nasal Inspiratory Flow (PNIF), and the Nasal Obstruction Symptom Evaluation (NOSE) scale. Objective olfactory function was evaluated using n-butanol threshold,identification tests, and the Connecticut Chemosensory Clinical Research Center (CCCRC) battery. Quality of life was measured using the Associated Factors in Olfaction-Related Quality of Life (ASOF) questionnaire.</p><p><strong>Results: </strong>Only 27.3% of pathology workers were normosmic, compared to 97.1% of controls. Total occupational FA exposure duration (months) correlated negatively with nbutanol thresholds and CCCRC scores, but not with identification. Weekly FA exposure correlated inversely with Olfaction-Related Quality of Life (ORQ) and positively with Subjective Olfactory Capability (SOC). No significant intergroup differences were found in NOSE or PNIF values.</p><p><strong>Conclusion: </strong>Occupational FA exposure significantly impairs objective olfactory thresholds and adversely affects smell-related quality of life. The discrepancy between objective loss and subjective capability highlights the need for regular chemosensory screening and improved air quality standards in laboratories.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759881","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}