Rhinology最新文献

{"title":"The alchemy of precision and innovation: treating chronic airway inflammatory conditions in 2025.","authors":"M B Soyka","doi":"10.4193/Rhin25.902","DOIUrl":"10.4193/Rhin25.902","url":null,"abstract":"<p><p>Chronic inflammatory processes of the upper and lower airways can represent a nightmare for both the treating physician as well as suffering patients. The advent of biologicals and use of personalized medicine has revolutionized its management in many ways, still leaving unresolved gaps that need to be closed with innovative approaches and proof of efficacy in everyday life.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":"129"},"PeriodicalIF":4.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557856","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":"Validity and reliability of the Empty Nose Syndrome Index (ENSI).","authors":"J R Lechien, A Maniaci","doi":"10.4193/Rhin24.394","DOIUrl":"10.4193/Rhin24.394","url":null,"abstract":"<p><strong>Objective: </strong>To validate the French version of the Empty Nose Syndrome Index (Fr-ENSI).</p><p><strong>Methods: </strong>Patients with ENS, chronic rhinitis/rhinosinusitis, and asymptomatic individuals were recruited from April to August 2024. The internal consistency was evaluated with Cronbach-alpha. The test-retest reliability was assessed with the intraclass correlation coefficient (ICC). The external validity was assessed with a correlation study between the Fr-ENSI and the Sinonasal Outcome Tool-22 (Fr-SNOT-22), and Nasal Obstruction Symptom Evaluation (Fr-NOSE). The Fr-ENSI threshold for suspecting the ENS diagnosis was determined with the receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>Ninety-three subjects completed the evaluations. There were 36 ENS patients, 23 patients with chronic rhinosinusitis/rhinitis, and 34 healthy individuals. The mean age was 44.8±14.7 years. Patients with ENS reported significantly higher Fr-ENSI scores compared to others, indicating high internal validity. The Cronbach-alpha of Fr-ENSI was 0.891, which indicates an adequate internal consistency. The test-retest reliability was high. Depression and anxiety scores were associated with sleep disturbances. The Fr-ENSI was significantly correlated with Fr-SNOT-22, which supports a high external validity. The threshold of Fr-ENSI associated with the highest sensitivity and specificity was &gt;23/60.</p><p><strong>Conclusions: </strong>The Fr-ENSI is a valid and reliable questionnaire for documenting 12 prevalent symptoms of ENS. The consideration of sleep disorders in ENSI is important regarding its association with depression and anxiety.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":"200-208"},"PeriodicalIF":4.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903534","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":"Comparison of outcomes for Draf IIB vs Draf III in endoscopic frontal sinus surgery: a comprehensive systematic review and meta-analysis.","authors":"Y Hirayama, M S Shahid, H A Finney, J Muzaffar, M S Haque, R Accorona, H Iftikhar","doi":"10.4193/Rhin24.507","DOIUrl":"https://doi.org/10.4193/Rhin24.507","url":null,"abstract":"<p><strong>Background: </strong>Understanding the factors associated with increased rates of restenosis following Draf procedures is crucial for developing targeted strategies to mitigate complications such as mucocele formation, reduce the need for revision surgeries, and improve long-term patient outcomes.</p><p><strong>Methodology: </strong>A systematic search was conducted using Embase, Medline, CINAHL, AMED, PubMed, and the Cochrane Database on January 17th, 2024. Research articles published in English language were included. Abstracts were independently screened by two reviewers, and data were extracted and assessed for quality in adherence to PRISMA guidelines. Meta- and sub-group analyses were conducted using the REML model and random-effects model to address high heterogeneity and I² values.</p><p><strong>Results: </strong>A total of 96 studies met the inclusion criteria. For the Draf IIB subgroup (15 studies, 239 sinuses), the restenosis rate was 7%, compared to 20% in the Draf III subgroup (40 studies, 1,910 sinuses). Revision surgery rates were 5% for Draf IIB versus 12% for Draf III. Adjuvant interventions, such as steroid-impregnated stents, were associated with improved outcomes, showing an ostium patency OR of 2.20.</p><p><strong>Conclusion: </strong>Draf IIB had superior outcomes compared to Draf III with respect to restenosis and revision surgery. The use of steroid-impregnated stents appears effective in reducing restenosis rates.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586602","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":"Caudal septoplasty, a literature review.","authors":"A Javed, A Alburaiki, A Kamber Zaidi, M U Farooq, J Limbrick, S Anari","doi":"10.4193/Rhin24.415","DOIUrl":"https://doi.org/10.4193/Rhin24.415","url":null,"abstract":"<p><strong>Background: </strong>Caudal septal deviation accounts for around five percent of patients with septal deviations that require surgery. The caudal septum provides support to the nasal tip and the deviations can narrow the nasal airway and lead to marked asymmetry in nostril shape. Over-resection of this area can compromise the structural support leading to tip collapse or saddle nose deformity. This necessitates alternative techniques to submucosal resection for surgical correction of caudal septal deviations.</p><p><strong>Methodology: </strong>This study provides a review of different surgical techniques, including open and closed septoplasty in the literature to address caudal septal deviation. Each technique is described along with a surgical illustration, its advantages, limitations, and examples of case studies with surgical outcomes.</p><p><strong>Results: </strong>The submucosal resection is a commonly used method but can only be used if the septal deviation is not involving the L-strut. Other methods include scoring, swinging door, doorstop, and suturing techniques either as a stand-alone or used combined with cutting techniques. Batten graft can be used alone or in conjunction with the other methods. Extracorporeal septoplasty is used in cases of severe deformity.</p><p><strong>Conclusions: </strong>There is a variety of methods to address caudal septal deviation. Correcting the caudal septal deviation requires proper pre-operative planning and accurate execution of surgical techniques. More research on surgical outcomes is needed to improve the evidence base.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557852","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":"Safety and feasibility of the endoscopic endonasal approach to anterior skull base tumour resections in young children.","authors":"M Castellanos, D K Lerner, S A Hamimi, A D Workman, J E Douglas, M A Kohanski, P B Storm, J N Palmer, N D Adappa","doi":"10.4193/Rhin24.494","DOIUrl":"https://doi.org/10.4193/Rhin24.494","url":null,"abstract":"<p><p>Tumours of the anterior skull base present unique surgical challenges due to critical neurovascular proximity and developing cranial anatomy. While open transcranial approaches (TCAs) have traditionally been used for these tumors, the endoscopic endonasal approach (EEA) is preferred due to reduced morbidity and higher gross total resection (GTR) rates (1). Studies report excellent GTR rates and reconstructive outcomes with EEA in the under-18 paediatric population, with complications including cerebrospinal fluid (CSF) leak, meningitis, and stroke being relatively rare (2-5). However, limitations in anatomy, including restricted sphenoid pneumatization, narrower nasal apertures, and smaller nasoseptal flaps (NSFs), contribute to hesitancy in adopting EEA for younger patients (6,7). Minimal evidence focuses on outcomes in young pediatric patients in particular. This study evaluates outcomes of EEAs for anterior skull base pathologies in young paediatric patients.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557854","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}