American Journal of Rhinology & Allergy最新文献

{"title":"Evaluation of Disparities in Management of Chronic Rhinosinusitis by Race and Ethnicity: An All of Us Research Program Study.","authors":"Christina Zhu, Wynne Zheng, Emily Clementi, Maeen Arslan, Christopher Guirguis, Daniel Spielman","doi":"10.1177/19458924251383016","DOIUrl":"https://doi.org/10.1177/19458924251383016","url":null,"abstract":"<p><p>ObjectiveTo evaluate disparities in the management of chronic rhinosinusitis (CRS) across racial, ethnic, and gender groups, focusing on treatment patterns and associated comorbidities.MethodsThis cross-sectional study analyzed data from 28,278 adults with CRS in the NIH All of Us Research Program between 2018 and 2022. Multivariable logistic regression was used to assess associations between demographic variables, associated comorbidities, and receipt of treatments including systemic steroids, leukotriene modifiers, antibiotics, biologics, and sinus surgery.ResultsBlack individuals had higher odds of receiving systemic steroids (OR: 1.59, <i>P</i> < .0001) and antibiotics (OR: 1.67, <i>P</i> < .0001), but were less likely to receive biologics (OR: 0.30, <i>P</i> = .051). Non-Hispanic individuals were more likely to receive systemic steroids (OR: 1.54, <i>P</i> < .001) and antibiotics (OR: 1.54, <i>P</i> = .0007), but were less likely to undergo sinus surgery (OR: 0.67, <i>P</i> = .016). Male sex was associated with reduced odds of receiving systemic steroids (OR: 0.86, <i>P</i> < .0001), leukotriene modifiers (OR: 0.81, <i>P</i> < .001), and antibiotics (OR: 0.91, <i>P</i> < .001) but increased odds of undergoing surgery (OR: 1.37, <i>P</i> < .0001). Presence of nasal polyps and comorbid asthma strongly predicted use of biologics (ORs: 4.39 and 13.83, respectively, <i>P</i> < .0001) and surgical intervention (ORs: 13.13 and 1.34, respectively, <i>P</i> < .0001).ConclusionSignificant racial, ethnic, and gender disparities exist in the treatment of CRS, independent of comorbidities. These findings highlight the need for equity-focused strategies to ensure timely access to advanced therapies and to address structural barriers that may influence treatment allocation.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924251383016"},"PeriodicalIF":2.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior Nasal Nerve Neurectomy With Mucosal Flap Coverage of the Sphenopalatine Foramen for Treatment of Allergic Rhinitis: 12-Month Outcomes After Treatment in a Prospective Cohort Study.","authors":"Linlu Wang, Huiyi Deng, Qintai Yang, Shuo Wu","doi":"10.1177/19458924251382757","DOIUrl":"https://doi.org/10.1177/19458924251382757","url":null,"abstract":"<p><p>ObjectivesPosterior nasal nerve (PNN) neurectomy is an effective surgical option for refractory allergic rhinitis (AR), but delayed massive hemorrhage remains a concern. This study aimed to evaluate whether preserving a mucosal flap to cover the sphenopalatine foramen (SPF) affects postoperative efficacy and complications.MethodsThis prospective cohort study included 61 patients with moderate-to-severe AR who underwent PNN neurectomy. Patients were divided into two groups based on whether a mucosal flap was preserved to cover the SPF. Outcomes included mucosal epithelialization time, incidence of delayed bleeding, Visual Analog Scale (VAS), reflective Total Nasal Symptom Score (rTNSS), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), nasal airway resistance (NAR), and inflammatory markers. Follow-up was conducted at 1, 3, 6, and 12 months postoperatively.ResultsNo significant differences were found between groups in baseline characteristics. Both groups showed significant improvements in VAS, rTNSS, RQLQ, and NAR, with sustained benefits up to 12 months. The With Mucosal Flap Preservation group had a significantly shorter epithelialization time (<i>P</i> < .001) and lower incidence of delayed bleeding (<i>P</i> = .046). Mediation analysis indicated that epithelialization time mediated the relationship between the surgical method and delayed bleeding (<i>P</i> = .046), while the direct effect was not significant (<i>P</i> = .748).ConclusionThis study shows that PNN neurectomy with mucosal flap preservation reduces the risk of delayed postoperative bleeding through the key mediating mechanism of accelerated mucosal epithelialization, while achieving comparable improvements in nasal symptom relief and quality of life compared to the procedure without mucosal flap preservation.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924251382757"},"PeriodicalIF":2.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Dental Intervention and Disease on Acute Invasive Fungal Rhinosinusitis Severity and Outcomes.","authors":"Jakob L Fischer, Nikitha Kosaraju, Katherine M Lucarelli, Connie M Sears, Jivianne T Lee, Daniel M Beswick, Daniel B Rootman, Marilene B Wang, Jeffrey D Suh","doi":"10.1177/19458924251382514","DOIUrl":"https://doi.org/10.1177/19458924251382514","url":null,"abstract":"<p><p>BackgroundAcute invasive fungal rhinosinusitis (AIFRS) is an aggressive and often fatal disease process that principally impacts immunocompromised patients. Maxillary dental trauma and infections have been associated with the development of maxillary sinus fungal balls, but the role of dental procedures/trauma in the pathogenesis of AIFRS remains poorly defined.ObjectiveThis study seeks to review a single-institutional experience with AIFRS and examine the association between dental events and AIFRS severity and outcomes.MethodsRetrospective review of 95 consecutive patients with biopsy-proven AIFRS treated at a tertiary institution between 2010 and 2024. Demographic information, comorbidities, disease course and outcomes were evaluated. The primary objective was to evaluate the impact of antecedent dental events on AIFRS morbidity and mortality. Secondary objectives included evaluating variability in demographic factors, comorbidities, and extent of disease.ResultsEleven patients with an antecedent dental event within 2 weeks of AIFRS diagnosis were identified for a rate of 11.6%. Dental AIFRS patients were more likely to be African American (<i>P</i> = .003) and more likely to have diabetes mellitus as their underlying immunodeficiency (<i>P</i> = .03) than non-dental AIFRS patients. Patients with dental-related AIFRS were more likely to present with invasion of the orbit (OR 6.0, 95% CI 1.2-29.5) and nasal floor (OR 4.2, 95% CI 1.1-17.1) than non-dental AIFRS patients. There was no difference in mortality between dental and non-dental AIFRS (36.4% vs 52.4%, <i>P</i> = .31).ConclusionMore investigation is necessary to further evaluate the association between dental events and the development of AIFRS. In our cohort, 11.6% of patients experienced AIFRS within 2 weeks of a dental event and these patients tended to present with higher rates of orbital involvement without a resultant increase in mortality.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924251382514"},"PeriodicalIF":2.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Previous Temporary Nasolacrimal Stent Implantation on Endoscopic Dacryocystostomy.","authors":"Linjuan Wu, Xinyu Li, Guangming Zhou, Wencan Wu, Wentao Yan, Bo Yu","doi":"10.1177/19458924251382085","DOIUrl":"https://doi.org/10.1177/19458924251382085","url":null,"abstract":"<p><p>AimsWe compared the outcomes of endoscopic dacryocystorhinostomy (En-DCR) in patients with chronic dacryocystitis (CD), with or without previous temporary nasolacrimal stent implantation (TNLSI), then explored whether previous TNLSI influenced postoperative outcomes.MethodsThis retrospective study included consecutive patients with CD and previous TNLSI who underwent En-DCR (group A) between September 2019 and May 2022, and an age- and sex-matched control group of patients with CD who had not undergone previous implantation (group B). Lacrimal sac parameters were measured by computed tomography-dacryocystography, and surgical findings were recorded during surgeries. The surgical success rates were compared between the two groups at 12 months after surgery.ResultsThere were 53 patients in group A and 106 patients in group B. In group A, the mean horizontal, sagittal, and vertical lengths were 4.94 ± 1.30 mm, 4.88 ± 1.17 mm, and 7.85 ± 2.03 mm; in group B, these three lengths were 6.16 ± 1.25 mm, 5.97 ± 1.20 mm, and 10.00 ± 2.18 mm, respectively. All three parameters were significantly smaller in group A than in group B. Scar formation in the sac was observed in all patients in group A; it was not present in group B. At 12 months after surgery, the anatomical and functional success rates were 75.47% (40/53) and 71.70% (39/53), respectively, in group A; they were 93.40% (99/106) and 91.51% (97/106) in group B. The success rates were significantly higher in group B than in group A.ConclusionPrevious TNLSI may reduce lacrimal sac parameters and cause scar formation, thereby reducing the likelihood of success after En-DCR.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924251382085"},"PeriodicalIF":2.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Long-Term Revision Rates and Health Care Utilization Between Standalone Balloon Sinus Dilation and Endoscopic Sinus Surgery in Chronic Rhinosinusitis Patients Without Nasal Polyps: Is the Balloon Value Proposition Overinflated?","authors":"David Hoying, Matthew J Kabalan, David C Kaelber, Raj Sindwani","doi":"10.1177/19458924251377259","DOIUrl":"https://doi.org/10.1177/19458924251377259","url":null,"abstract":"<p><p>BackgroundPrevious research has reported inconsistent results when evaluating long-term revision rates of patients undergoing balloon sinus dilation (BSD) compared to primary endoscopic sinus surgery (ESS).ObjectiveWe aimed to compare outcomes and long-term rates of revision surgery in patients with chronic rhinosinusitis without nasal polyps (CRSsP) who underwent primary standalone BSD versus primary ESS. We also wanted to better understand the post-procedure utilization of major healthcare resources between these groups.MethodsRetrospective cohort study using the TriNetX platform to identify patients with CRSsP undergoing standalone BSD versus primary ESS. 1:1 propensity score matching was performed to balance age and gender in each cohort. The primary outcome was revision ESS rates at 1 and 10 years. Secondary outcomes were rates of healthcare utilization and complications, including orbital, cerebrospinal fluid (CSF) leak, and epistaxis within 90 days.ResultsAfter matching, each cohort had 2112 patients. At 1 year, the revision ESS rate was 3.5% in the balloon cohort and 3.5% in the ESS cohort (OR = 0.97, 95% CI: 0.70-1.35). Extending follow-up to 10 years, revision rates were also not statistically different: 5.8% in the balloon cohort and 6.3% in the ESS cohort (OR = 0.92, 95% CI: 0.72-1.19). Patients in the balloon cohort had a lower 90-day risk of inpatient encounters (OR = 0.29, 95% CI: 0.23-0.38), CRS-related patient visits (OR = 0.63, 95% CI: 0.55-0.71), diagnostic nasal endoscopies (OR = 0.57, 95% CI: 0.50-0.65), antibiotic prescriptions (OR = 0.53, 95% CI: 0.43-0.66), and corticosteroid prescriptions (OR = 0.62, 95% CI: 0.53-0.71).ConclusionNo significant difference was observed in revision ESS rates in CRSsP patients who underwent primary BSD versus ESS after 10 years in this large database study. Findings suggest that in appropriately selected patients, BSD offers a durable response and a favorable value proposition in the management of patients with CRSsP.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924251377259"},"PeriodicalIF":2.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Sinus Surgery in Older Patients With Chronic Rhinosinusitis: Meta-Analysis of Surgical Outcomes.","authors":"Ahmad A Mirza, Maha A Alzahrani, Khalid M Alkhalifah, Sadeem J Almoajil, Reema S AlShugaig, Reem A Alghamdi, Jazmin A Alghamdi, Osama A Marglani","doi":"10.1177/19458924251339100","DOIUrl":"10.1177/19458924251339100","url":null,"abstract":"<p><p>BackgroundChronic rhinosinusitis (CRS) is a common condition that significantly impacts quality of life. While endoscopic sinus surgery (ESS) has proven effective in the general adult population, its specific effectiveness in older patients remains understudied.ObjectiveThis meta-analysis assessed the therapeutic effect and safety of ESS in patients aged 55 years and older with CRS.MethodsFive electronic databases were queried: PubMed, Embase, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials. Therapeutic effectiveness of ESS was quantitatively assessed using random-effects meta-analysis, in which mean changes of pre- versus postoperative scores of the Sino-Nasal Outcome Test-22 (SNOT-22) were pooled. Meta-regression was conducted to predict the variability in SNOT-22 changes. Comparative meta-analyses evaluating surgical complications between older and younger adult patients were conducted.ResultsA total of 12 studies were synthesized. Both short- and long-term follow-up data demonstrated significant improvement by reference to baseline. Our analysis demonstrated statistically significant mean reduction in the SNOT-22 score by 21.4 points (95% confidence interval [CI], -26.9 to -15.9) at an average follow-up of approximately 9 months. This improvement exceeds the minimal clinically important difference for SNOT-22. The presence of nasal polyposis was a favorable prognostic indicator of SNOT-22 improvement (β = -0.21; <i>P</i> = .002). The rates of surgical adverse events among older patients were 4.2% for significant bleeding, 0.6% for orbital injury, and 0.2% for skull base injury. A significant difference between the two age groups was observed only in skull base injury (odds ratio = 2.98; 95% CI, 1.53-5.80; <i>P</i> < .001).ConclusionESS offers clinically significant benefits for older individuals, particularly those with nasal polyposis. It is a safe treatment option for CRS in the older patients, with outcomes largely comparable to those in younger adults, though certain risks, such as skull base injury, may be slightly higher in older populations.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"379-391"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upfront Draf III Strategy Often Less Costly for Severe CRS Requiring Surgery.","authors":"David K Lerner, Saawan Patel, Chau Phung, Alan D Workman, Glenn Pennington, Robert Stetson, Jennifer E Douglas, Michael A Kohanski, Nithin D Adappa, James N Palmer","doi":"10.1177/19458924251337788","DOIUrl":"10.1177/19458924251337788","url":null,"abstract":"<p><p>BackgroundDraf III procedures are considered to be time- and supply-intensive compared to standard functional endoscopic sinus surgery (FESS).ObjectiveTo quantify the cost of a Draf III compared to standard FESS and examine time- and supply-related cost factors.MethodsWe performed a retrospective analysis of inflammatory sinus surgeries at a tertiary care medical center from July 2021 to July 2023. The medical record was reviewed for patient factors and cost variables, and multivariable analysis was performed.ResultsThree hundred and fifty patients were included with a mean age of 50.6 years. One hundred and twenty-nine patients underwent a Draf III, 99 of whom (76.7%) underwent a Draf III as part of a full FESS whereas 30 (23.3%) underwent a targeted revision Draf III. Among all Draf III procedures, operating room and supply costs represented 63.1% ($6231.67) and 16.6% ($1638.46) of total costs, respectively, compared to 54.8% ($4912.46) and 14.5% ($1296.06) for standard FESS (both p < .001). The average total cost for a full FESS with Draf III was $10118.60, compared to $9414.29 for a targeted Draf III, and $8960.31 for standard FESS (n = 221). Using these values, we calculated that the approach of performing an upfront Draf III would be less costly relative to the approach of performing standard FESS with Draf II and then revision Draf III as needed when the expected revision rate exceeds 12.3%.ConclusionsSurgical costs associated with a FESS with Draf III are driven primarily by operating room time costs, to a greater degree even than for standard FESS. The cost of performing a full FESS with Draf III is not considerably higher than a standard FESS or a targeted Draf III revision, suggesting that an upfront Draf III may represent a relatively less costly treatment approach for patients at high risk of recurrent frontal disease.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"338-344"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLUT1 Promotes Squamous Metaplasia in Eosinophilic Chronic Rhinosinusitis with Nasal Polyps.","authors":"Shouming Cao, Yan Niu, Wenrong Lou, Nannan Wen, Rui Chen, Haosu Huang, Yuchao Su, Haiying Wu","doi":"10.1177/19458924251342999","DOIUrl":"10.1177/19458924251342999","url":null,"abstract":"<p><p>BackgroundSquamous metaplasia is commonly observed in eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP). However, its underlying mechanisms remain unclear. This study aimed to evaluate the role of glucose transporter 1 (GLUT1) in the development of squamous metaplasia in eCRSwNP.MethodsTissue proteomics was employed to identify disease-specific proteins in eCRSwNP. Immunofluorescence, western blotting, and RT-qPCR were used for validation. Human nasal epithelial cells were utilized to assess GLUT1 expression and its regulatory mechanisms. A chronic rhinosinusitis with nasal polyps (CRSwNP) mouse model was used to examine the effect of GLUT1 inhibition on squamous metaplasia and nasal inflammation.ResultsProteomic analysis revealed a disease-specific protein expression profile in eCRSwNP polyps. Cohort validation demonstrated that GLUT1 and keratin 13 (KRT13) expression levels were significantly higher in the eCRSwNP group, with expression primarily localized in the epithelial regions. GLUT1 expression was positively correlated with the incidence of squamous metaplasia as well as KRT13 and involucrin (IVL) expression. In vitro experiments confirmed that combined Interleukin (IL)-4/IL-13 treatment upregulated GLUT1, KRT13, and IVL expression in human nasal epithelial cells in a dose-dependent manner, whereas GLUT1 inhibition reduced KRT13 and IVL expression, possibly through suppression of the PI3K-AKT signaling pathway. Animal experiments demonstrated that GLUT1 inhibition alleviated squamous metaplasia and inflammation in the nasal mucosa of mice.ConclusionElevated GLUT1 expression plays a key role in driving squamous metaplasia in eCRSwNP. GLUT1 inhibition attenuates nasal epithelial squamous metaplasia and inflammation in CRSwNP.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"353-363"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Past, Present, and Future: Innovation is at Our Core.","authors":"Christopher Ito","doi":"10.1177/19458924251358032","DOIUrl":"https://doi.org/10.1177/19458924251358032","url":null,"abstract":"","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":"39 5","pages":"336-337"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topical Glutamate Diacetate: A Promising Therapy for Post-Coronavirus Disease 2019 Olfactory Dysfunction Through Calcium Modulation.","authors":"Majed A Algarni, Mohammed S Alharthi, Fahad H Baali, Abdulaziz I Alzarea, Adnan Alharbi, Wadia S Alruqayb, Ahmed H Abdelazim, Mohamed H Abdelazim","doi":"10.1177/19458924251347727","DOIUrl":"10.1177/19458924251347727","url":null,"abstract":"<p><p>BackgroundOlfactory dysfunction is a frequent symptom experienced by individuals recovering from coronavirus disease 2019 (COVID-19) and significantly impacts daily life activities. Recent studies suggest that reducing nasal calcium levels may help restore olfactory function. Glutamate diacetate (GLD) is a natural sequestering agent that binds calcium ions and may offer therapeutic benefits in managing post-COVID olfactory dysfunction.ObjectiveThis study aimed to evaluate the effectiveness of topical GLD treatment in reducing nasal calcium levels and improving olfactory function in individuals with chronic olfactory dysfunction following COVID-19.MethodsA double-blind, placebo-controlled trial was conducted with 66 participants who were randomized into two groups: GLD (1% solution) and saline placebo (0.9% solution). Participants received nasal treatment three times daily for six months. Olfactory function was assessed using the Sniffin' Sticks test, measuring threshold (T), discrimination (D), and identification (I) scores. Nasal calcium levels were also measured. Statistical analysis included independent <i>t</i>-tests and change-from-baseline comparisons.ResultsSignificant improvements were observed in the GLD group across olfactory assessments. By month 6, threshold scores increased by 0.78 ± 0.15, discrimination scores by 0.72 ± 0.15, and identification scores by 1.80 ± 0.15, all exceeding gains in the saline group. Nasal calcium levels decreased significantly in the GLD group (7.36 ± 1.21 mM vs 2.49 ± 0.51 mM in saline), suggesting a contribution mechanism in olfactory improvement.ConclusionGLD treatment resulted in statistically significant improvements in olfactory function and a reduction in nasal calcium levels in individuals with post-COVID olfactory dysfunction. However, the observed changes did not reach the threshold for clinical significance. These findings suggest a potential role for GLD in olfactory recovery, but further studies are needed to evaluate its long-term efficacy and clinical relevance.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"371-378"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}