American Journal of Rhinology & Allergy最新文献

{"title":"Outcomes of Immunotherapy Treatment in Sinonasal Mucosal Melanoma.","authors":"Rijul S Kshirsagar, Jacob G Eide, Jacob Harris, Arash Abiri, Daniel M Beswick, Eugene H Chang, Nicholas Fung, Michelle Hong, Brian J Johnson, Michael A Kohanski, Christopher H Le, Jivianne T Lee, Seyed A Nabavizadeh, Isaac P Obermeyer, Vivek C Pandrangi, Carlos D Pinheiro-Neto, Timothy L Smith, Carl H Snyderman, Jeffrey D Suh, Eric W Wang, Marilene B Wang, Garret Choby, Mathew Geltzeiler, Jillian Lazor, Tara C Mitchell, Edward C Kuan, James N Palmer, Nithin D Adappa","doi":"10.1177/19458924241308953","DOIUrl":"10.1177/19458924241308953","url":null,"abstract":"<p><strong>Background: </strong>Sinonasal mucosal melanoma has poor survival despite multimodality treatment. While the impact of immunotherapy (IT) on metastatic cutaneous melanoma is well-defined, there are relatively little data on sinonasal mucosal melanoma.</p><p><strong>Objective: </strong>We sought to define immunotherapy outcomes in patients with sinonasal mucosal melanoma.</p><p><strong>Methods: </strong>A retrospective cohort study evaluated patients treated with IT during their overall treatment strategy for SNMM. Patient demographics, treatment, and survival outcomes were recorded.</p><p><strong>Results: </strong>52 patients had IT treatment for SNMM from 2000 to 2022, with an average age of 69.1 ± 11.9 years. The most common treatment was surgery with radiation and IT (<i>n</i> = 26, 50%). Most regimens consisted of a combination of Nivolumab and Ipilimumab (<i>n</i> = 17, 32.7%) or pembrolizumab (<i>n</i> = 14, 26.9%). 44.2% of patients experienced reported complications. Overall survival at 1-, 2-, and 5 years was 86.9%, 74.1%, and 39.1%, respectively.</p><p><strong>Conclusion: </strong>Approximately half of patients will have a local response following immunotherapy, but it is rare to have improvement at metastatic locations. Further research within our group will assess optimal timing and markers that are predictive of response.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"102-108"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942691","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":"Evaluation of the Patient Global Impression of Symptom Severity (PGISS) Score as a Subjective and Objective Measure of Disease Activity in Chronic Rhinosinusitis.","authors":"Subin Lim, Daniel Trotier, Matvey Karpov, Joseph Han, Kent Lam","doi":"10.1177/19458924241312318","DOIUrl":"10.1177/19458924241312318","url":null,"abstract":"<p><strong>Background: </strong>The Sino-nasal Outcome Test (SNOT-22) is a 22-question survey that is utilized to evaluate health-related quality of life of patients with chronic rhinosinusitis (CRS). The Patient Global Impression Symptom Severity (PGISS) is a similar yet versatile instrument that combines features of both a Likert scale and a visual analog to assess symptom severity in CRS patients. While previous studies have evaluated the validity of SNOT-22 as an instrument to measure CRS patients' symptom severity, no studies have evaluated PGISS scale's ability to evaluate and guide treatment plans for CRS patients.</p><p><strong>Objective: </strong>The primary objective of this study was to analyze the clinical utility of PGISS in assessing subjective symptom severity and objective disease status in CRS patients. We additionally aimed to investigate if PGISS scores could serve as predictors for treatment strategies in CRS patients.</p><p><strong>Methods: </strong>Electronic medical records of CRS patients were retrospectively reviewed between January 2020 and January 2021 from Eastern Virginia Medical School and Sentara Healthcare. Information on demographics, objective disease metrics, treatment, and labs were collected. Statistical analyses were conducted using SAS 9.4 software.</p><p><strong>Results: </strong>A total of 150 patients were included in our study. A statistically significant positive correlation was found between PGISS and SNOT-22 scores (r(131) = 0.701, <i>P</i> < .0001). Patients with moderate to severe PGISS scores had significantly higher odds of changing their treatment course (odds ratio [OR] = 6.813, <i>P</i> = .001, and OR = 5.491, <i>P</i> = .018, respectively). Additionally, patients with severe PGISS scores had decreased odds of receiving biological intervention (OR = 0.048, <i>P</i> = .043), but they had considerably higher odds of pursuing surgery (OR = 15.939, <i>P</i> = .046). No significant associations were seen between PGISS scores and receiving topical steroids, systematic steroids, nonsteroidal medical treatment, or imaging interventions (<i>P</i> > .05).</p><p><strong>Conclusion: </strong>Clinicians may consider using the PGISS scale as an alternative method to the SNOT-22 to evaluate subjective symptom severity and guide treatment plans for patients with CRS.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"128-135"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942690","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":"The Association of TSLP and IL-4 with Patient-Reported Outcome Measures in Chronic Rhinosinusitis with Nasal Polyps.","authors":"Sophie E Yu, Tolani F Olonisakin, John A Moore, Simon Chiang, Stella E Lee","doi":"10.1177/19458924241311354","DOIUrl":"10.1177/19458924241311354","url":null,"abstract":"<p><strong>Background: </strong>Thymic stromal lymphopoietin (TSLP) plays an important role in mediating the type-2-inflammatory response. This study examined how TSLP and interleukin (IL)-4 levels in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) correlated with clinical and postoperative outcomes.</p><p><strong>Methods: </strong>Solid-phase sandwich ELISA was used to analyze TSLP and IL-4 levels in mucus (n = 47), plasma (n = 17), polyp (n = 30), inferior (n = 25), and middle (n = 26) turbinate tissue collected during functional endoscopic sinus surgery (FESS) in CRSwNP patients (n = 76) and controls (n = 11). Inclusion criteria includes patients with medical treatment refractory CRSwNP confirmed by endoscopy or maxillofacial CT. Exclusion criteria include history of immunodeficiency, coagulation disorders, fungal sinusitis, or cystic fibrosis. Levels of TSLP and IL-4 were correlated with SNOT-22, UPSIT, and fractional exhaled nitric oxide (FeNO) using MannWhitney U two-tailed test and linear regression with Spearman correlation coefficient test.</p><p><strong>Results: </strong>TSLP is elevated in the inferior turbinates (effect size = 2.695, p = 0.0007) of CRSwNP patients compared to controls. IL-4 is expressed at elevated levels in the inferior (effect size = 3.092, p < 0.0001) and middle turbinates (effect size = 2.041, p = 0.019) compared to controls. Mucus TSLP (r = 0.4013, p = 0.0153) and IL-4 (r = 0.6138, p < 0.0001) positively correlate with preoperative FeNO levels. Lower TSLP in the inferior (r = -0.5179, p = 0.0231) and middle turbinates (r = -0.5075, p = 0.0224) and lower IL-4 in the inferior turbinates (r = -0.5205, p = 0.0223) correlate with a greater improvement in SNOT-22 post-FESS.</p><p><strong>Conclusion: </strong>TSLP and IL-4 are elevated in patients with CRSwNP and correlated with increased preoperative FeNO levels and decreased sinonasal quality of life benefit after FESS. Expression of TSLP and IL-4 may play a role in guiding postoperative expectations in patients with treatment refractory CRSwNP.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"118-127"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942693","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":"Chronic Rhinitis Surgery: Association Between Preoperative Severity and Response Rate.","authors":"Chien-Yu Huang, Jyun-Yi Liao, Bor-Hwang Kang, Yaoh-Shiang Lin, Jun-Wei Hsieh","doi":"10.1177/19458924241308990","DOIUrl":"10.1177/19458924241308990","url":null,"abstract":"<p><strong>Background: </strong>The success rate of chronic rhinitis surgery varies depending on the patients' factor and surgical method. While outcomes for nasal obstruction differ, the association between preoperative severity of other rhinitis symptoms, such as rhinorrhea, sneezing, and nasal itching, measured via the reflective total nasal symptom score (rTNSS) remains unevaluated.</p><p><strong>Objective: </strong>To evaluate the association between the response rate to surgical treatment of chronic rhinitis and preoperative severity.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted among adult patients with chronic rhinitis symptoms refractory to medication and nasal spray for over 6 months and received radiofrequency ablation of inferior turbinates with posterior nasal nerve neurolysis. The primary endpoint was the change from baseline in 24-h rTNSS and nasal obstruction symptom evaluation (NOSE) scores. Postoperative surgery response rate, rTNSS score change, and score improvement ratios were also evaluated.</p><p><strong>Results: </strong>A total of 183 patients (110 males, 60.1%) were included in this study. After 3-month follow-up, the preoperative rTNSS was 6.51 ± 2.74 change to 1.70 ± 1.43, and the NOSE score was 56.48 ± 19.90 change to 4.56 ± 7.74. Both scores and all sub-scores showed significant differences when comparing preoperative, 1-month, and 3-month results (<i>P</i> < 0.05-0.001). The response rate by rTNSS for whole cohort was 78.14 ± 41.44% and 93.99 ± 23.83% at 1- and 3-month follow-up. Subgroup analyses were performed according to individual rTNSS scores and 2 in 1 score groups (ie, 1-2, 3-4, etc) and their relationship to the surgery outcomes. Both preoperative individual score and score groups were significantly associated with all post-operation outcomes (<i>P</i> = 0.022 to <0.001) in linear regression analysis.</p><p><strong>Conclusion: </strong>Patients with more severe preoperative rhinitis symptoms are associated with better response rate, post-operation symptom score changes, and score improvement ratio.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"109-117"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920526","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":"Surgical Management of Moderate to Severe Epistaxis in Hereditary Hemorrhagic Telangiectasia: Systematic Review and Meta-Analysis.","authors":"Ezer H Benaim, Ethan M Kallenberger, Yasine Mirmozaffari, Cristine Klatt-Cromwell, Charles S Ebert, Adam J Kimple, Brent A Senior, Raj S Kasthuri, Brian D Thorp","doi":"10.1177/19458924241308952","DOIUrl":"10.1177/19458924241308952","url":null,"abstract":"<p><strong>Background: </strong>Epistaxis is one of the most common and debilitating symptoms of hereditary hemorrhagic telangiectasia (HHT), significantly impacting patients' quality of life. While various medical and surgical interventions exist for managing epistaxis in patients with HHT, patients with moderate to severe epistaxis are high health-care utilizers who frequently need surgical treatment.</p><p><strong>Objective: </strong>To compare the efficacy, complications, and patient-reported outcomes for common surgical interventions utilized in treating epistaxis in patients with HHT.</p><p><strong>Methods: </strong>Studies were identified in PubMed, Embase, Scopus, Redalyc, and LILACS databases and uploaded to Covidence. A systematic review following PRISMA guidelines was conducted on studies evaluating outcomes in adults with HHT with moderate to severe epistaxis who had undergone surgical interventions. We compared the respective outcomes for pre-operative and post-operative epistaxis severity/intensity, need for further interventions or transfusions, estimated blood loss, length of surgery, complications, and patient satisfaction.</p><p><strong>Results: </strong>Twenty studies with a total of 546 patients were included. The most common surgeries studied were nasal closure and laser photocoagulation. Seven studies recorded the change in epistaxis severity score and observed a significant reduction postoperatively (3.91, [95% CI 2.73-5.09]). Eleven studies found a decrease in the number of transfusions and a rise in hemoglobin levels post-operatively. Common complications reported were partial dehiscence of a nasal closure, septal perforation, and continued bleeding requiring re-operation. Most patients report improved quality of life and satisfaction with surgical intervention.</p><p><strong>Conclusion: </strong>Surgery can significantly reduce the severity of epistaxis in patients with HHT and improve quality of life. Further studies should focus on head-to-head comparisons of procedures and standardization of outcome measures.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":"39 2","pages":"159-168"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dupilumab Treatment for Aspirin-Exacerbated Respiratory Disease in a Real-World Setting: Impact on Quality of Life and Healthcare Utilization.","authors":"Jyotsna Mullur, Rie Maurer, Tessa Ryan, Alanna McGill, Jillian C Bensko, Tanya M Laidlaw, Kathleen M Buchheit","doi":"10.1177/19458924241298817","DOIUrl":"10.1177/19458924241298817","url":null,"abstract":"<p><strong>Background: </strong>Patients with aspirin-exacerbated respiratory disease (AERD) have difficult-to-treat asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) and often require treatment with biologic therapy for asthma or CRSwNP. Healthcare utilization in patients with AERD has not been well described since the advent of respiratory biologics.</p><p><strong>Objective: </strong>To determine real-world healthcare utilization and quality of life among patients with AERD and to understand the impact of dupilumab, a monoclonal antibody targeting the interleukin 4 receptor, on patient-reported health outcomes and healthcare utilization.</p><p><strong>Methods: </strong>We conducted a longitudinal survey study of 98 patients with AERD recruited from the Brigham and Women's Hospital AERD registry. Patients completed online questionnaires describing their medication history, healthcare utilization, and quality of life every 3 months for 2 years.</p><p><strong>Results: </strong>At the end of 24 months, participants who were on dupilumab at the start of the study and those who started dupilumab had a significant reduction in the number of reported poor health days in the preceding month compared to patients not on dupilumab (<i>P</i> < .001 and <i>P</i> < .01, respectively). Participants on dupilumab and those who started dupilumab also had significantly lower overall sinonasal outcome test-22 and asthma control test scores compared to those not on dupilumab over 24 months (<i>P</i> < .05 for both groups).</p><p><strong>Conclusion: </strong>Dupilumab therapy significantly improves health-related quality of life in patients with AERD, specifically as it pertains to patient assessment of days of overall poor health and quality of life related to sinonasal and asthma symptoms.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"90-97"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142685780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Common Cold Coronavirus 229E Induces Higher Interferon Stimulating Gene Responses in Human Nasal Epithelial Cells from Patients with Chronic Rhinosinusitis with Polyposis.","authors":"Elizabeth A Sell, Li Hui Tan, David M Renner, Jennifer Douglas, Robert J Lee, Michael A Kohanski, John V Bosso, David W Kennedy, James N Palmer, Nithin D Adappa, Susan R Weiss, Noam A Cohen","doi":"10.1177/19458924241276274","DOIUrl":"10.1177/19458924241276274","url":null,"abstract":"<p><strong>Background: </strong>Viral infections have long been implicated in the development of chronic rhinosinusitis with nasal polyps (CRSwNP). Given widespread exposure to the common cold coronavirus 229E (HCoV229E), we sought to investigate how HCoV-229E is cleared and stimulates interferon pathways in air-liquid interface (ALI) cultures from patients with CRSwNP.</p><p><strong>Objective: </strong>The objective of this study was to identify whether viral clearance and ISG expression is different in ALI cultures from donors with CRSwNP compared with controls.</p><p><strong>Methods: </strong>Plaque assays were used to quantify infectious virus released by infected air-liquid interface (ALI) cultures derived from patients with CRSwNP compared to patients without CRS (controls). Additionally, mock and induced levels of Interferon Stimulated Genes (ISGs) mRNA following HCoV-229E infection were quantified by RT-qPCR.</p><p><strong>Results: </strong>Quantification of infectious virus by plaque assay reveals that CRSwNP ALI cultures were equally susceptible to HCoV-229E infection, and surprisingly viral titers dropped significantly faster than in the control ALI cultures. We further demonstrate that this accelerated viral clearance correlates with increased mRNA expression of at least 4 ISGs following viral infection in the CRSwNP ALIs compared to the control ALIs.</p><p><strong>Conclusion: </strong>This study paradoxically demonstrates that ALI cultures from patients with CRSwNP are more efficient at clearing the common cold HCoV-229E virus compared to controls. We also demonstrate significantly increased ISG mRNA expression following HCoV-229E infection in CRSwNP. These findings call for further investigation into the effect of unimpaired interferon signaling on the type 2 inflammatory environment in patients with CRSwNP.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"13-20"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cribriform Plate Foramina Count in Patients With Acquired and Congenital Anosmia.","authors":"Jerry Hadi Juratli, Brigit High, Akshita Joshi, Eren Yilmaz, Duzgun Yildirim, Aytug Altundag, Thomas Hummel","doi":"10.1177/19458924241288664","DOIUrl":"10.1177/19458924241288664","url":null,"abstract":"<p><strong>Background: </strong>Cribriform foramina provide the openings for olfactory nerve fibers to cross from the nasal cavity to the olfactory bulb. Disruption of the olfactory nerve fibers is known to affect olfactory function, but little is known about the potential effects on the number of cribriform foramina in congenital anosmia.</p><p><strong>Objective: </strong>This pilot study aimed to investigate whether there was a reduction in foramina in patients with acquired and congenital anosmia (including both Kallmann syndrome and isolated congenital anosmia) compared to controls with normal olfactory function.</p><p><strong>Methods: </strong>Paranasal CT image stacks were analyzed from 20 patients with congenital anosmia (<i>n</i> = 6), acquired anosmia (<i>n</i> = 6), or normal olfactory function (<i>n</i> = 8). Cribriform foramina were counted by three observers from the slice revealing the crista galli and the ethmoidal slits. The two closest values for each subject were analyzed in comparison across the three groups using one-way analysis of variance.</p><p><strong>Results: </strong>Patients with congenital, but not acquired, anosmia had significantly fewer cribriform foramina (x̄ ± SE = 10.17 ± 1.23) compared to healthy, normosmic controls (x̄ ± SE = 19.88 ± 2.01). There was no significant difference in foramina count between congenital and acquired anosmics (x̄ ± SE = 15.83 ± 3.47).</p><p><strong>Conclusion: </strong>In this pilot study, a reduced number of cribriform foramina was found in individuals with congenital anosmia. Examination of cribriform foramina could be helpful in counseling patients with olfactory loss. Further investigation in larger studies with additional cohorts is warranted.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"58-62"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455959","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":"Implementation of an Optimized Preoperative Checklist for Endoscopic Sinus Surgery Within a Multiinstitutional Resident Education Curriculum.","authors":"Stephen Leong, Thomas Scharfenberger, Nathan Yang, Amrita Ray, Nadeem Akbar, Patrick M Colley, Anthony Del Signore, Jean Anderson Eloy, Satish Govindaraj, David Gudis, Samuel Helman, Wayne Hsueh, Alfred-Marc Iloreta, Ashutosh Kacker, Seth M Lieberman, Aaron N Pearlman, Madeleine R Schaberg, Abtin A Tabaee, Jonathan B Overdevest","doi":"10.1177/19458924241291289","DOIUrl":"10.1177/19458924241291289","url":null,"abstract":"<p><strong>Background: </strong>Preoperative review of computed tomography (CT) imaging assists with endoscopic sinus surgery (ESS) planning, where trainees may benefit from a systematic approach. We have previously developed an optimized preoperative checklist for sinus CT imaging using an iterative modified Delphi method.</p><p><strong>Objective: </strong>In this study, we assess the utility of an optimized preoperative checklist for residents performing ESS.</p><p><strong>Methods: </strong>Resident sinus CT scan education consisted of a preintervention questionnaire, an 18-min video outlining the optimized preoperative checklist, and a delayed postintervention questionnaire; these were distributed via Qualtrics to otolaryngology residents across 5 training programs in the NY metro area. The preintervention questionnaire contained 25 survey questions and a 225-point quiz on sinus CT anatomy; the delayed postintervention questionnaire contained the same 25 survey questions and a second, distinct 225-point quiz.</p><p><strong>Results: </strong>In total, 74 residents completed the preintervention questionnaire, 47 completed the postintervention questionnaire, and 36 completed both. Among residents completing both questionnaires, the average preintervention quiz score was 136.8 ± 24.0 and the average postintervention quiz score was 156.0 ± 23.5 (<i>P</i> < .001). Resident habitual utilization of a systematic preoperative CT imaging checklist increased significantly from 21.6% to 72.9% as a result of the curriculum intervention.</p><p><strong>Conclusion: </strong>We find that an educational program centered on an iteratively optimized preoperative checklist for ESS improves the ability of trainees to identify critical sinus CT structures. Further integration of checklists and educational curricula may enhance rhinology education efforts and improve surgical anatomy competency.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"76-83"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543049","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":"Association Between Smell Loss, Disease Burden, and Dupilumab Efficacy in Chronic Rhinosinusitis with Nasal Polyps.","authors":"Zachary M Soler, Zara M Patel, Joaquim Mullol, Jose Mattos, Scott Nash, Changming Xia, Zhixiao Wang, Kinga Borsos, Mark Corbett, Juby A Jacob-Nara, Harry Sacks, Paul Rowe, Yamo Deniz, Andrew P Lane","doi":"10.1177/19458924241274501","DOIUrl":"10.1177/19458924241274501","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between smell loss and other aspects of disease, and evaluate dupilumab efficacy in patients with severe chronic rhinosinusitis with nasal polyps (CRSwNP) and moderate or severe smell loss.</p><p><strong>Methods: </strong>This post-hoc analysis of the SINUS-24/52 studies (NCT02912468/NCT02898454) analyzed nasal polyp score (NPS, 0-8), nasal congestion/obstruction (NC, 0-3), Lund-Mackay CT-scan score (LMK-CT, 0-24), rhinosinusitis severity visual analog scale (RS-VAS, 0-10), and 22-item Sinonasal Outcome Test (SNOT-22, 0-110) according to baseline monthly average patient-reported loss of smell scores (LoS, 0-3) of >1 to 2 (moderate) or >2 to 3 (severe) in patients randomized to dupilumab 300 mg or placebo every 2 weeks.</p><p><strong>Results: </strong>Of 724 patients randomized, baseline LoS was severe in 601 (83%) and moderate in 106 (15%). At baseline, severe versus moderate LoS was associated with 1-point greater severity of NC (odds ratio [OR] 6.01 [95% confidence interval, (CI) 3.95, 9.15]), 5-point greater severity of LMK-CT (OR 2.19 [1.69, 2.85]), and 8.9-point greater severity of SNOT-22 (OR 1.35 [1.20, 1.49]). At Week 24, least squares mean differences (95% CI) dupilumab versus placebo in change from baseline were: NPS -1.90 (-2.56, -1.25) and -1.95 (-2.20, -1.70) in the moderate and severe baseline LoS subgroups, respectively; NC -.35 (-.64, -.06) and -1.00 (-1.13, -.87); LMK-CT -6.30 (-7.88, -4.72) and -6.22 (-6.82, -5.63); RS-VAS -1.18 (-2.20, -.16) and -3.47 (-3.90, -3.03); and SNOT-22 -7.52 (-14.55, -.48) and -21.72 (-24.63, -18.82); all nominal <i>P </i>< .05 versus placebo. Improvements with dupilumab in NC, RS-VAS, and SNOT-22 were statistically greater in patients with severe versus moderate baseline LoS.</p><p><strong>Conclusion: </strong>Significant smell impairment in severe CRSwNP is associated with significant disease (NC, RS-VAS, LMK), health-related quality of life impairment (SNOT-22), asthma, and non-steroidal anti-inflammatory drug-exacerbated respiratory disease. Dupilumab significantly improved NPS, NC, LMK-CT, RS-VAS, and SNOT-22 in subjects with moderate and severe baseline smell loss.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"6-12"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}