Rhinology最新文献

{"title":"Blood transcriptomics reveal systemic eosinophilic and neutrophilic inflammation patterns in patients with nasal polyps.","authors":"W Liu, K Wang, H Guan, L Ma, Y Cui, C Liu, J Shi, Y Fan, Y Sun","doi":"10.4193/Rhin24.248","DOIUrl":"10.4193/Rhin24.248","url":null,"abstract":"<p><strong>Background: </strong>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic sinonasal disease characterized by heterogeneous inflammation. However, the presence of systemic inflammation heterogeneity in CRSwNP patients remains unknown. This study aims to profile transcriptomic alterations in the blood of CRSwNP patients and characterize the CRSwNP heterogeneity based on blood transcriptomic biomarkers.</p><p><strong>Methodology: </strong>Patients with CRSwNP were prospectively recruited from three hospitals and chronologically divided into exploratory (n=123) and independent validation (n=46) cohorts. Transcriptomic profiles were generated by whole blood mRNA sequencing and subjected to patient clustering, differential expression, and pathway analysis. Differences in immune pattern and clinicopathologic features between clusters were assessed. A transcriptomic signature was defined and applied to an independent cohort to validate the findings.</p><p><strong>Results: </strong>CRSwNP patients showed diverse blood transcriptomic profiles versus healthy controls, or when stratified by tissue and blood eosinophils and asthma comorbidity. Transcriptome-wide correlation analysis revealed a transcriptional signature associated with blood eosinophil levels, consisting of nine T2-related genes (CLC, SIGLEC8, ALOX15, IL5RA, PTGDR2, CCL23, CCR3, EPX and IL1RL1). Three distinct clusters with differing systemic eosinophilic and neutrophilic inflammation patterns and asthma comorbidity were identified based on transcriptomic profiling of T2 and T1/3-related blood biomarkers. A 36-gene signature was developed by machine learning and accurately predicted the three CRSwNP subtypes. Validation on an independent cohort confirmed the prediction robustness.</p><p><strong>Conclusions: </strong>There is heterogeneous systemic inflammation associated with eosinophilic and neutrophilic patterns in patients with CRSwNP. Endotyping based on blood transcriptomic biomarkers might lead to more personalized treatment strategies for CRSwNP in the future.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":"739-749"},"PeriodicalIF":4.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372756","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":"Correlations of pre- and post-operative symptoms with cytokines in different phenotypes and endotypes of chronic rhinosinusitis.","authors":"S A Han, H Cha, J-A Park, A Jo, D W Kim, H T Ryu, S K Yang, S-N Hong, J Y Kim, S H Oh, D W Kim","doi":"10.4193/Rhin23.215","DOIUrl":"10.4193/Rhin23.215","url":null,"abstract":"<p><strong>Background: </strong>Recognising inflammatory endotypes in chronic rhinosinusitis (CRS) has become more important, especially with the advent of biological treatments. In this study, we investigated the correlations of pre- and post-operative symptoms with cytokine positivity in different endotypes and phenotypes of CRS.</p><p><strong>Methodology: </strong>In total, 102 patients undergoing routine functional endoscopic sinus surgery were enrolled. The endotype classification (type 1, 2, or 3 CRS) was defined based on positivity for interferon-Α, interleukin (IL)-5, or IL-17 respectively, in sinonasal tissue samples. Clinical symptom scores were evaluated pre- and post-operatively using the 22-item Sinonasal Outcome Test and its four symptom subdomains: sleep, nasal, otologic/facial symptoms, and emotional function. Symptoms were compared between endotypes and phenotypes, and exploratory factor analysis (EFA) based on principal component analysis (PCA) was performed. The correlations of cytokine levels with baseline symptoms and changes in symptoms after 1 year were analysed.</p><p><strong>Results: </strong>Symptoms in the otologic/facial pain category were associated with non-type 2 endotypes in PCA and confirmatory analysis. Non-type 2 CRS patients exhibited significantly more improvement in facial symptoms 1 year after surgery. Neutrophil-associated cytokines, such as IL-17, matrix metalloproteinase 9, and myeloperoxidase, were significantly correlated with baseline otologic/facial pain symptoms and changes in those symptoms after surgery.</p><p><strong>Conclusions: </strong>Otologic/facial pain symptoms may be indicative of non-type 2 endotypes. Neutrophil-associated cytokines, such as IL-17, MMP-9, and MPO, were significantly correlated with these symptoms. The establishment of links between specific symptoms and certain cytokines may help use and develop biological therapies for CRS.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":"716-725"},"PeriodicalIF":4.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142353027","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":"A phenomenon not to be missed: delayed postoperative cerebrospinal fluid rhinorrhea following no identifiable intraoperative leak in sellar surgery.","authors":"R S Kshirsagar, J G Eide, A Abiri, K P Asmaro, P Filip, D Pangal, J Ruzevick, N D Adappa, P S Batra, M S Bergsneider, J R Craig, J C Fernandez-Miranda, P A Gardner, M S Grady, A A Halderman, F P K Hsu, A Mohyeldin, J N Palmer, P Papagiannopoulos, C H Snyderman, B A Tajudeen, E W Wang, M B Wang, G Zada, G A Zenonos, E C Kuan","doi":"10.4193/Rhin24.175","DOIUrl":"10.4193/Rhin24.175","url":null,"abstract":"","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":"759-762"},"PeriodicalIF":4.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634397","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 value of beta trace protein in CSF-leakage detection confirmed by endoscopic fluorescein evaluation.","authors":"M Habenbacher, D Sebastnik, U Moser, A Andrianakis, P Kiss, M Alsukayt, J Pock, K Walla, E Maitz, P V Tomazic","doi":"10.4193/Rhin24.160","DOIUrl":"10.4193/Rhin24.160","url":null,"abstract":"<p><p>Cerebrospinal fluid (CSF) leaks originating from defects within the anterior and middle cranial fossa typically manifest as unilateral clear watery rhinorrhea. Continuous CSF leakage mandates surgical repair due to the risk of meningitis and brain abscess. It can be categorized based on its underlying etiology into traumatic, iatrogenic and non-traumatic CSF leaks.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":"766-768"},"PeriodicalIF":4.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907612","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":"Differential proteomic expression in non-functional pituitary neuroendocrine tumours and pituitary glands.","authors":"N G Candy, M Ramezanpour, G Bouras, N Chegeni, T Chataway, R J Ormsby, A K Jukes, S Vreugde, P-J Wormald, A J Psaltis","doi":"10.4193/Rhin24.216","DOIUrl":"10.4193/Rhin24.216","url":null,"abstract":"<p><strong>Introduction: </strong>Pituitary neuroendocrine tumours (PitNETs) are common accounting for 10 to 25 % of all intracranial tumours. This project describes the feasibility of developing a novel membrane-based biomarker that could be used for fluorescent guided surgery. The aim was to catalogue the differential expression of membrane proteins between non-functional PitNETs and pituitary glands.</p><p><strong>Methodology: </strong>Ten pituitary gland tissue specimens were obtained from the National Institute of Health (NIH) NeuroBio-Bank and twenty non-functional PitNETs were obtained from the Northwestern University Nervous System Tumour Bank. Mass spectrometry analysis using an Orbitrap Fusion Lumos Tribrid Mass Spectrometer linked to a Dionex Ultimate 3000 UPLC system was undertaken. Data Dependent Acquisition Mass Spectrometry and Data Independent Acquisition Mass Spectrometry was then completed. Pathway enrichment analysis was performed using clusterProfiler v4.6.0. Functional enrichment analysis was conducted using Gene Ontology terms and Reactome pathways.</p><p><strong>Results: </strong>Differential expression analysis between the two groups revealed a total of 2110 significant differently expressed proteins (DEPs), with 1387 of these also having a Log2 fold change either greater than 1, or less than -1. Of the 2110 DEPs, 925 were upregulated in tumours compared to control, while 1185 were downregulated.</p><p><strong>Conclusion: </strong>We have demonstrated a proteomic comparison between non-functional PitNETs and normal pituitary glands. These results demonstrate differences consistent with contemporary literature but shows that NOTCH3 and PTPRJ are up-regulated in non-functional PitNETs compared to pituitary glands.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":"750-758"},"PeriodicalIF":4.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976525","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":"Characterization of the ciliary beating efficiency in primary diffuse chronic rhinosinusitis.","authors":"M Renaud, A Venkatasamy, E Escudier, R Mitri-Frangieh, M Filoche, V Fournier, J-F Papon, A Coste, B Louis, E Bequignon","doi":"10.4193/Rhin24.101","DOIUrl":"10.4193/Rhin24.101","url":null,"abstract":"<p><p>Ciliary dysfunction may result in chronic airway inflammation and infection causing injury and structural changes to the airway epithelium, leading to a variety of diseases, like bronchiectasis and primary diffuse chronic rhinosinusitis (CRS). Currently, ciliary beating analysis has mainly been studied through the measure of the ciliary beating frequency (CBF) by high-speed digital video microscopy (HSDV). However, a normal CBF has been described in different forms of primary and acquired ciliary dyskinesia.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":"763-765"},"PeriodicalIF":4.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907611","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":"Adherence to olfactory training improves orthonasal and retronasal olfaction in post-COVID-19 olfactory loss.","authors":"P Boscolo-Rizzo, T Hummel, A Menini, A Maniaci, F Uderzo, L Bigolin, G Tirelli","doi":"10.4193/Rhin24.233","DOIUrl":"10.4193/Rhin24.233","url":null,"abstract":"<p><strong>Background: </strong>Olfactory loss (OL) has emerged as one of the most prevalent and debilitating symptoms of SARS-CoV-2 infection and long-COVID-19. The present prospective observational study aimed to evaluate the efficacy of olfactory training (OT) on orthonasal and retronasal olfactory function in a cohort of individuals with persistent post-COVID-19 OL.</p><p><strong>Methodology: </strong>Participants with post-COVID-19 olfactory impairment underwent 4 months of OT, self-assessing their smell perception and undergoing comprehensive psychophysical evaluation of orthonasal and retronasal olfaction at baseline and after training. Orthonasal olfactory function was assessed using the extended Sniffin' Sticks test battery. Retronasal olfactory function was tested with powdered aromas.</p><p><strong>Results: </strong>Among 114 participants with post-COVID-19 olfactory loss, adherence to OT was 60%. In adherents, the average increase in composite TDI score was 6.0 points compared to 2.6 points in non-adherents. Fifty-seven percent of adherent participants achieved a clinically significant improvement in TDI score (≥ 5.5 points), compared to 22% of non-adherents. In retronasal olfactoryidentification, 56% of adherents achieved a clinically significant improvement (≥ 4 points), compared to 16% of non-adherents.</p><p><strong>Conclusion: </strong>Adherence to a 4-month OT regimen can yield clinically meaningful improvements in both orthonasal and retronasal olfactory function among individuals with persistent post-COVID-19 olfactory dysfunction.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":"681-688"},"PeriodicalIF":4.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000668","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":"Sphenopalatine ganglion block for pain control after septoplasty: a systematic review and meta-analysis with trial sequential analysis.","authors":"E Albazee, B AlRajhi, A Alfadhli, A M Alharran, M Al-Qudah","doi":"10.4193/Rhin24.225","DOIUrl":"10.4193/Rhin24.225","url":null,"abstract":"<p><strong>Introduction: </strong>Septoplasty corrects a deviated nasal septum (DNS) and improves nasal obstruction. Sphenopalatine ganglion block (SPGB) effectively reduces postoperative pain after septoplasty, but conclusive evidence is still lacking. This systematic review and meta-analysis aim to comprehensively evaluate the analgesic efficacy of SPGB in septoplasty patients.</p><p><strong>Methods: </strong>We systematically searched PubMed/Medline, Scopus, Web of Science, Embase, and CENTRAL from inception to April 10th, 2024. Randomized controlled trials (RCTs) were assessed using the RoB-2 tool. The primary outcomes were postoperative pain scores, analgesic consumption, surgery duration, postoperative nausea and vomiting (PONV), and patient satisfaction. Continuous data were pooled as mean difference (MD), and dichotomous data as risk ratio (RR) with a 95% confidence interval (CI) using STATA software. Additionally, trial sequential analysis (TSA) was conducted.</p><p><strong>Results: </strong>Three RCTs with 180 patients were included. Two RCTs had a 'low risk' of bias, while one RCT had 'some concerns'. The SPGB group had significantly lower postoperative pain within 24 hours compared to controls, particularly after particularly after 1-2 hours (MD = -1.85), 4-6 hours (MD = -2.02), 12 hours (MD = -2.14), and 24 hours (MD = -2.36) TSA confirmed the conclusive evidence. Analgesic use was significantly reduced in the SPGB group. No significant differences were observed in surgery duration or PONV rates between groups. Patient satisfaction was significantly higher in the SPGB group.</p><p><strong>Conclusion: </strong>SPGB demonstrates efficacy and safety in managing postoperative pain in patients undergoing septoplasty for DNS.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":"642-651"},"PeriodicalIF":4.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142353029","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":"Technical skills of endoscopic sinus surgery for performance assessment using the Delphi methodology.","authors":"M J Guldager, S A Wuyts Andersen, J Melchiors, E Prokopakis, C Hopkins, C von Buchwald","doi":"10.4193/Rhin23.371","DOIUrl":"10.4193/Rhin23.371","url":null,"abstract":"<p><strong>Background: </strong>In surgical residency, competence has traditionally been defined by a specified number of surgical procedures. Modern advances in medical education and surgical fellowships have challenged this approach. It is widely accepted that a definition of a skill set, enabling a systematic, competency-based assessment is mandatory in surgical education.</p><p><strong>Methodology: </strong>We conducted an international Delphi study with panelists from the European Rhinologic Society, representing 27 countries. Through four rounds, the panel reached consensus on the phrasing of an assessment tool-, for the technical skills of endoscopic sinus surgery (ESS).</p><p><strong>Results: </strong>Thirty panelists participated throughout the study. The median age of the panelists was 54 years (range 31-66 years) with a median experience of 25 years (range 6-40 years). All were experts in the field of endoscopic sinus surgery. Consensus was reached. The final assessment tool consists of 21 items with descriptive anchors.</p><p><strong>Conclusion: </strong>The assessment tool, European Endoscopic Sinus Surgery â€\" Technical Skills Assessment (EE-TSA), enables a competency-based approach to acquiring and maintaining essential elements of endoscopic sinus surgery. The international Delphi panel makes the tool internationally applicable. Further research should gather validity evidence for EE-TSA, enhancing the assessment of ESS by setting a pass/fail-standard ultimately improving surgical outcomes and patient safety.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":"710-715"},"PeriodicalIF":4.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142353030","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 patients with type 2 diabetes mellitus.","authors":"A Cardella, A Ferrulli, S Vujosevic, A Preti, F Ambrogi, I Terruzzi, A Cecamore, A Yakirevitch, A Schindler, L Luzi, F Mozzanica","doi":"10.4193/Rhin23.451","DOIUrl":"10.4193/Rhin23.451","url":null,"abstract":"<p><strong>Background: </strong>diabetic complications and olfactory dysfunction (OD) in patients with type 2 diabetes mellitus (T2DM) seem related. This study aims to evaluate the prevalence of OD in T2DM patients and to analyze its relationship with diabetic complications.</p><p><strong>Methods: </strong>130 T2DM patients and 100 comparable controls were enrolled. Olfaction was evaluated using the Extended Smell Test (TDI) and the Italian brief Questionnaire of Olfactory Disorders â€\" Brief-IT-QOD. T2DM patients were divided into: \"Group 1\" patients with no complications, and \"Group 2\" patients with at least one diabetic complication. Non-parametric tests were used. Machine learning algorithms were applied to explore which variables were most important in predicting the presence of OD in T2DM.</p><p><strong>Results: </strong>The prevalence of OD was significantly higher in Group 2 than in controls (71.4% vs 30%) and in Group 1 (71.4% vs 43.3%). However, when comparing the TDI scores between Group 1 and 2 the only significant difference was found for the discrimination scale and not for the identification and threshold scales. Brief-IT-QOD scores were significantly higher in Group 2 than in controls. The Random Forest and variable importance algorithms highlighted the relevance of LDL, glycated hemoglobin, type of complication (macrovascular) and age in determining OD in T2DM. The last three variables were included in a nomogram for the prediction of OD risk in T2DM.</p><p><strong>Conclusions: </strong>T2DM patients with diabetic complications are more frequently affected by OD. Poor glycemic control, LDL values, age and presence of macrovascular complications are the more important factors in determining OD in T2DM patients.</p>","PeriodicalId":21361,"journal":{"name":"Rhinology","volume":" ","pages":"537-547"},"PeriodicalIF":4.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477313","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}