American Journal of Rhinology & Allergy最新文献

{"title":"Elevated Body Mass Index Associates With Early Postoperative Recurrence in Pediatric Chronic Rhinosinusitis With Nasal Polyps.","authors":"Yu Chen, Ru Gao, Tiansheng Wang, Jian Liu","doi":"10.1177/19458924261444416","DOIUrl":"https://doi.org/10.1177/19458924261444416","url":null,"abstract":"<p><p>BackgroundPediatric chronic rhinosinusitis with nasal polyps (CRSwNP) is a refractory inflammatory condition characterized by a high recurrence rate, yet reliable predictive biomarkers remain scarce. This study aimed to identify potential markers for early predicting postoperative recurrence in pediatric CRSwNP patients.MethodsA total of 205 pediatric patients with CRSwNP were retrospectively enrolled and followed postoperatively. Clinical variables and disease severity scores were collected. Logistic regression, Kaplan-Meier analysis, and Cox models were applied to identify risk factors associated with postoperative recurrence.ResultsAfter 1 year of follow-up, 114 patients experienced postoperative recurrence, whereas 91 remained recurrence-free. Patients with recurrence exhibited higher body mass index (BMI) and a greater prevalence of allergic rhinitis (AR). Multivariate analyses identified BMI and AR as independent predictors of early recurrence. Kaplan-Meier analysis demonstrated that elevated BMI was associated with shorter relapse-free survival, and stratified analyses confirmed a significantly increased recurrence risk among overweight and obese patients compared with those of normal weight, independent of potential confounders. Notably, among patients with normal baseline BMI, those who became obese within 1 year after surgery had a significantly higher recurrence rate, and postoperative BMI increased significantly only in patients who experienced recurrence.ConclusionElevated BMI was an independent risk factor for early postoperative recurrence in pediatric CRSwNP, with risk increasing alongside BMI levels. Postoperative weight gain further heightened recurrence risk, suggesting BMI as a practical marker for postoperative risk stratification.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261444416"},"PeriodicalIF":2.3,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759989","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":"Nasal Microbiota in Immune Disorders: Bacterial and Fungal Colonization Patterns and Aspergillus Detection Methods.","authors":"Kai-Li Liang, Rong-San Jiang, Yi-Hsing Chen, Pi-Han Wang, Chin-Fu Lin, Ching-Yun Chang","doi":"10.1177/19458924261436615","DOIUrl":"https://doi.org/10.1177/19458924261436615","url":null,"abstract":"<p><p>BackgroundThe human respiratory tract hosts a complex microbial ecosystem. The host immune status plays an important role in regulating the microbial composition at different body sites, including the nasal cavity.ObjectiveThis study investigated the effects of immune disorders on nasal microbial colonization and explored Aspergillus detection methods in immunodeficient hosts.MethodsNasal swabs from healthy volunteers, patients with allergic airway disease, and immunodeficient patients were analyzed using 16S rRNA bacterial and ITS2 fungal microbiome analyses. Aspergillus colonization in immunodeficient individuals was examined using conventional methods (galactomannan testing, quantitative PCR, and fungal culture). The effects of nasal irrigation on fungal colonization were also evaluated.ResultsNo significant differences in the overall microbial composition were found between the healthy, allergic, and immunodeficient groups; however, distinct features were observed within each group. Immunodeficient patients showed higher Aspergillus DNA concentrations and positive culture rates than healthy controls. Nasal irrigation significantly decreased Aspergillus DNA concentration.ConclusionThis study highlights the complex relationship between the immune system and airway microbiota. Although microbiome analysis may not be optimal for analyzing upper respiratory tract microbiology in immunomodulated patients, nasal irrigation could potentially reduce fungal colonization in immunocompromised individuals at risk of developing infections.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261436615"},"PeriodicalIF":2.3,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759973","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":"Clinical and Molecular Presentation of Respiratory Epithelial Adenomatoid Hamartoma: A Systematic Review.","authors":"Frederick Lam, Alvin Po-Ngai Chu, Fergus Kai-Chuen Wong, Jason Ying-Kuen Chan, Eddy Wai-Yeung Wong, Yuk-Fai Lau","doi":"10.1177/19458924261440421","DOIUrl":"https://doi.org/10.1177/19458924261440421","url":null,"abstract":"<p><p>BackgroundRespiratory epithelial adenomatoid hamartoma (REAH) is a benign tumor-like lesion that appears in the sinonasal tract. Due to the lack of well-defined distinctive features of REAH, specifically clinical and molecular characteristics, this lesion is often misdiagnosed as an inflammatory nasal polyp or sinonasal malignancy.ObjectiveThis study aimed to systematically review the existing literature to determine the distinguishing attributes of REAH.MethodsIn accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a Medline, EMBASE and Web-of-Science literature review was undertaken to evaluate studies published till July 1, 2024. Forest and funnel plots were used to present prevalence and potential small-study effects, respectively. The estimates were calculated using random-effects methodology. The <i>I</i>² value was determined to assess the interstudy heterogeneity. The quality of the included studies was evaluated using National Heart, Lung, and Blood Institute Study Quality Assessment Tools.ResultsA total of 39 studies were included, of which 10 investigated molecular characteristics. Several studies have shown the involvement of inflammatory processes in REAH. In addition, 37 studies with 1127 patients met the inclusion criteria for the meta-analysis. The findings of these studies showed that REAH was most commonly identified in the olfactory cleft (66.7% [49.8%-83.7%]), often bilaterally (66.4% [54.0%-78.7%]). Furthermore, REAH was associated with enlarged olfactory cleft widths on computed tomography scans, with an estimated width of 10.58 mm [9.41-11.75 mm].ConclusionOur study showed that inflammatory responses likely play a role in REAH. Notably, the symptoms of REAH are often indistinguishable from those of chronic rhinosinusitis with nasal polyposis. Thus, a high index of suspicion is required to diagnose REAH, typically when patients present with bilateral olfactory cleft masses with an enlarged olfactory cleft width on a computed tomography head scan.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261440421"},"PeriodicalIF":2.3,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759983","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":"Effects of Olfactory Training on Olfactory Bulb Volume Among Patients With Non-Sinonasal-Related Olfactory Dysfunction: A Systematic Review and Meta-Analysis.","authors":"Xiangxian Liu, Xincen Jiang, Yankun Li, Xinyi Ge, Dawei Wu","doi":"10.1177/19458924261442892","DOIUrl":"https://doi.org/10.1177/19458924261442892","url":null,"abstract":"<p><p>ObjectiveOlfactory training (OT) is being used increasingly among patients with olfactory dysfunction (OD). Evidence suggests that OT could significantly improve olfactory function among patients with non-sinonasal-related OD. Neuroplasticity of olfactory bulb (OB) is associated with the input of olfactory receptor neurons, and exposure to a wide variety of odors facilitates neuroplasticity of OB. This study aimed to perform a meta-analysis to evaluate the effect of OT on olfactory bulb volume (OBV) among patients with non-sinonasal-related OD.MethodsWe performed a systematic review and meta-analysis of studies sourced from PubMed, Google Scholar, Web of Science, and Embase, covering the period from their inception to May 2025. The included studies provided magnetic resonance imaging measurements of OBV in individuals with non-sinonasal-related OD or normosmia individuals. These participants either underwent OT or were part of a non-intervention control group.ResultsSeven studies with 310 participants were analyzed to assess changes in OBV before and after OT. The training significantly improved overall unilateral OBV by 2.14 mm³ [<i>Z</i> = 5.27; 95% confidence interval (CI) = 1.34-2.93; <i>P</i> < .001], with the OBV of patients with non-sinonasal OD increasing by 1.91 mm³ (<i>Z</i> = 4.47; 95%CI, 1.07-2.75; <i>P</i> < .001) and OBV of healthy individuals by 4.22 mm³ (<i>Z</i> = 3.26; 95%CI, 1.68-6.75; <i>P</i> = .001). Among patients with non-sinonasal-related OD, OT resulted in an increase of 1.52 mm³ in the left OBV (<i>Z</i> = 2.66; 95%CI, 0.40-2.64; <i>P</i> = .008) and an increase of 2.40 mm³ in the right OBV (<i>Z</i> = 3.74; 95%CI, 1.14-3.66; <i>P</i> < .001). There were no significant differences in OBV changes between the left and right sides (<i>P</i> = .30). In contrast, patients with non-sinonasal-related OD who did not receive OT did not show significant changes in OBV after OT (<i>Z</i> = 0.74, <i>P</i> = .46).ConclusionsThis meta-analysis provided evidence that OT was associated with a small but statistically significant increase in OBV among patients with non-sinonasal-related OD. The increase in OBV was comparable between the left and right OB of patients with non-sinonasal-related OD.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261442892"},"PeriodicalIF":2.3,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759969","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":"Histopathologic Analysis of Chronic Rhinosinusitis in Immunosuppressed Transplant Patients.","authors":"Abdulkader Yassin-Kassab, Ali M Baird, Sushanth Neerumalla, Saif Salih, Peter Filip, Pete S Batra, Bobby A Tajudeen, Peter Papagiannopoulos","doi":"10.1177/19458924261420314","DOIUrl":"https://doi.org/10.1177/19458924261420314","url":null,"abstract":"<p><p>BackgroundImmunosuppressed organ transplant recipients experience higher rates of medically refractory chronic rhinosinusitis (CRS) requiring endoscopic sinus surgery (ESS).ObjectiveTo better understand the pathogenesis of CRS in immunosuppressed organ transplant recipients to aid in developing effective treatment protocols.MethodsStructured histopathology (SHP) reports of sinonasal mucosa were obtained for 27 transplant and 505 nontransplant patients with CRS undergoing ESS. SHP reports were compared to identify differences in the inflammatory environment between the 2 groups.ResultsSHP analysis revealed significantly higher rates of neutrophil infiltrate (48.1% vs 10.7%, <i>P</i> < .001), basement membrane thickening (74.1% vs 30.9%, <i>P</i> < .001), subepithelial edema (85.2% vs 25.7%, <i>P</i> < .001), and fibrosis (37.0% vs 16.8%, <i>P</i> = .008) in the sinus tissue of transplant patients compared to nontransplant patients, respectively.ConclusionCRS patients with a history of organ transplant overall displayed higher tissue neutrophilia and extensive tissue modeling on SHP. This patient population could potentially benefit from treatment modalities that are comparable to those used in patients with non-type 2 CRS.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261420314"},"PeriodicalIF":2.3,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147626860","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":"Clinical Characteristics of Patients with Non-Type 2 Chronic Rhinosinusitis with Nasal Polyps.","authors":"Pei-Wen Wu, Cheng-Hsun Chiu, Cheng-Chi Lee, Po-Hung Chang, Chi-Che Huang, Ta-Jen Lee, Yu-Hsi Fan, Chien-Chia Huang","doi":"10.1177/19458924261436871","DOIUrl":"https://doi.org/10.1177/19458924261436871","url":null,"abstract":"<p><p>BackgroundEndotype identification based on clinical characteristics is crucial for the selection and prediction of the efficacy of various therapeutic modalities in patients with chronic rhinosinusitis with nasal polyps (CRSwNP).ObjectiveThis study aimed to evaluate the clinical characteristics of patients with non-type 2 (non-T2) CRSwNP.MethodsClinical and laboratory data, as well as nasal tissues, were collected from adult patients who underwent endoscopic sinus surgery (ESS) for primary diffuse CRSwNP. Non-T2 CRSwNP was defined as a tissue eosinophil count <10/high power field. The levels of interleukin (IL)-5 and IL-13 in nasal polyps were measured using real-time polymerase chain reaction.ResultsA total of 199 patients with bilateral CRSwNP were recruited. Sixty-five (32.7%) exhibited non-T2 CRSwNP. Regression analysis revealed that male sex, absence of asthma, low ethmoid/maxillary (E/M) ratio, high blood neutrophil, low lymphocyte, and low eosinophil percentages were significantly associated with non-T2 inflammation in patients with CRSwNP. Age and nasal polyp score were significant predictors of postoperative residual sinus inflammation-defined as a modified Lund-Kennedy endoscopy score of ≥5 at 3 months after surgery-in patients with non-T2 CRSwNP.ConclusionMale sex, absence of asthma, E/M ratio, and the percentages of neutrophils, lymphocytes, and eosinophils were significantly associated with non-T2 CRSwNP. Age and polyp score were predictors of postoperative residual sinus inflammation in patients with non-T2 CRSwNP. These findings may help clinicians better evaluate patients with non-T2 CRSwNP and provide optimal therapeutic strategies.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261436871"},"PeriodicalIF":2.3,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621642","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":"High Response Rates and Predictors in Patients with CRSwNP Treated With Mepolizumab and Dupilumab: Results From a Prospective, Multicenter Cohort Study.","authors":"Mireia Golet, Paula Cruz Toro, Albert Llansana Ríos, Carlota González Lluch, Laura Pardo-Muñoz, Ignacio Clemente, Aina Brunet, Xavier Gonzalez-Compta","doi":"10.1177/19458924261431418","DOIUrl":"https://doi.org/10.1177/19458924261431418","url":null,"abstract":"<p><p>BackgroundDupilumab and mepolizumab are effective add-on therapies for severe chronic rhinosinusitis with nasal polyps (CRSwNP). However, predictors of response and guidance on biologic selection remain limited. The aims were to identify baseline parameters associated with favorable response to dupilumab or mepolizumab at 6 and 12 months in severe CRSwNP and compare outcomes among treatments.MethodsWe conducted a multicenter, prospective, non-randomized, real-world cohort study across three tertiary hospitals in Spain. Patients with severe CRSwNP initiating dupilumab or mepolizumab were enrolled and followed at 6 and 12 months. Response was defined using EPOS/EUFOREA 2023 criteria, incorporating nasal polyp score (NPS), sinonasal outcome test (SNOT-22), total symptom score (TSS), olfaction (Sniffin' Sticks Smell Test), systemic corticosteroid need, and asthma control test. Patients were classified as excellent, good, poor, or non-responders based on criteria fulfilled.ResultsSixty-nine patients were included: 35 received dupilumab and 34 mepolizumab. Asthma was present in 86.8%, and 42.6% had aspirin-exacerbated respiratory disease. Both biologics improved SNOT-22, TSS and NPS at 6 and 12 months (<i>P</i> < .05), with comparable efficacy for most outcomes. Dupilumab showed superior improvement in olfaction (coefficient <i>B</i> [95% CI] mepolizumab vs dupilumab: -6.30 [-9.42; -3.19]). Overall, 84.2% of patients achieved a good/excellent response at 6 months and 89.6% at 12 months. Factors associated with better response included comorbid asthma and shorter time since last surgery.ConclusionsDupilumab and mepolizumab improved clinical outcomes in severe CRSwNP, with dupilumab offering greater benefit in olfaction. Asthma and surgical history may help predict response.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261431418"},"PeriodicalIF":2.3,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621640","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":"Sinus Surgery Improves Maxillary Sinus Deformation in Cystic Fibrosis Detected by Magnetic Resonance Imaging.","authors":"Miray-Su Yılmaz Topçuoğlu, Ingo Baumann, Veronika Kolb, Hans-Ulrich Kauczor, Olaf Sommerburg, Mirjam Stahl, Marcus A Mall, Monika Eichinger, Lena Wucherpfennig, Mark O Wielpütz","doi":"10.1177/19458924261435339","DOIUrl":"https://doi.org/10.1177/19458924261435339","url":null,"abstract":"<p><p>BackgroundChronic rhinosinusitis (CRS) contributes to morbidity in cystic fibrosis (CF), and sinus surgery serves as second-line treatment. Magnetic resonance imaging (MRI) was recently shown to differentiate CF-related CRS (CF-CRS) manifestations, and to monitor therapy response, but has not been used to investigate the effects of sinus surgery on CF-CRS.ObjectiveThe aim of this study was to systematically study the effects of sinus surgery on CF-CRS.MethodsTwenty controls with CF (median age 15 years, range 9-33 years) who had not undergone sinus surgery with annual MRI examinations were age-matched to the surgery group. The surgery group comprised 10 individuals with CF (median age 15 years, range 8-32 years) who underwent endoscopic sinus surgery between 2010 and 2018 and underwent MRI in median 2.5 months before (MRI1) and at least one (MRI2) or two (MRI3) annual MRIs after surgery. The median time difference between sinus surgery and MRI2 was 14 months, and between MRI2 and MRI3 it was 13 months. All patients were modulator-naïve. The established CRS-MRI score was used including sinus dimension measurement.ResultsIn controls, the median maxillary sinus width was stable from MRI1 through MRI3 (range 23.0-24.5 mm; <i>P</i> > .999). In the surgery group, the median maxillary sinus width decreased from MRI1 to MRI2 (-5.5 mm, <i>P</i> < .01), and remained stable from MRI2 to MRI3 (+3.0 mm; <i>P</i> = .544). The prevalence of maxillary sinus deformation decreased from MRI1 to MRI2 (-35%; <i>P</i> < .05) and was stable from MRI2 to MRI3 (+19%; <i>P</i> = .295). The CRS-MRI sum score was stable from MRI1 through MRI3 in controls (median 28, 23 and 34 at MRI1-2-3), and in the surgery group (36, 35 and 39, respectively) (<i>P</i> = .743-.999).ConclusionSinus surgery improves maxillary sinus width and deformation. The CRS-MRI score could not detect further benefits of surgery on CF-CRS. MRI supports the evaluation of sinus surgery in the era of modulator treatment strategies as some patients still suffer from CF-CRS despite optimized modulator treatment and there is a need to identify patients that still might profit from sinus surgery.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261435339"},"PeriodicalIF":2.3,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621635","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":"Efficacy and Safety of Simultaneous Bilateral Nasal Cauterization in Pediatric Recurrent Anterior Epistaxis: A Prospective Randomized Controlled Trial.","authors":"Zhengcai Lou, Hailing Yang, Chaowei Zhao, Kanfeng Jin, Junzhi Sun, Mengyun Liu, Tian Lv, Weiwei Li","doi":"10.1177/19458924261437216","DOIUrl":"https://doi.org/10.1177/19458924261437216","url":null,"abstract":"<p><p>ObjectiveWe compared the efficacy and safety of simultaneous bilateral silver nitrate cautery (SNC), bipolar electrocautery (BEC), and radiofrequency coagulation (RFC) for the treatment of pediatric bilateral recurrent anterior epistaxis (RAE).Materials and MethodsChildren with bilateral RAE were prospectively randomized to receive SNC (<i>n</i> = 40), BEC (<i>n</i> = 40), or RFC (<i>n</i> = 40). The primary outcome measures were successful hemostasis and re-bleeding at 4 weeks, 6 months, and 12 months. Secondary outcomes included the requirement for postoperative analgesia, visual analog scale (VAS) pain scores, and procedure-related complications.ResultsIn total, 212 nostrils of 106 patients were analyzed. The rates of successful hemostasis were 73.4%, 85.9%, and 97.1% in the SNC, BEC, and RFC groups, respectively (<i>P</i> < .01). At 4 weeks, the re-bleeding rates were 45.3%, 19.2%, and 2.9% in the SNC, BEC, and RFC groups, respectively (<i>P</i> < .01). At 6 months, re-bleeding occurred in 59.4% of SNC patients, 11.5% of BEC patients, and 0% of RFC patients (<i>P</i> < .001). At 12 months, the re-bleeding rates were 70.3%, 5.1%, and 0.0% in the SNC, BEC, and RFC groups, respectively (<i>P</i> < .001). Significant differences were observed in VAS scores for nasal crusting across the three groups at all follow-up points; however, no significant difference was detected between SNC and RFC. In contrast, septal perforation was observed in 5.1% of BEC patients, with mucosal necrosis in 6.4% of treated nostrils. In the RFC group, septal perforation developed in 2.9% of patients.ConclusionRFC demonstrated higher hemostatic success and lower recurrence of epistaxis compared with SNC and BEC in the treatment of bilateral RAE, while bilateral cross-cauterization with RFC should still be used with caution given the incidence of septal perforation. Additionally, stepwise cauterization with BEC (treating each side after healing of the opposite side) should be considered when managing pediatric bilateral RAE.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261437216"},"PeriodicalIF":2.3,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621589","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":"Steroid-Eluting Stents for Maintaining Frontal Sinus Patency After Endoscopic Sinus Surgery: A Systematic Review and Meta-Analysis.","authors":"Meshal S Alsaedi, Hassan H Alshurafa, Amal M Sunyur, Ethar A Alahmadi, Hatim N Alsaedi, Renad A Alhusayni, Nisreen Albouq, Nayef S Alkhazi","doi":"10.1177/19458924261429546","DOIUrl":"https://doi.org/10.1177/19458924261429546","url":null,"abstract":"<p><p>BackgroundSteroid-eluting stents (SES) are used alongside functional endoscopic sinus surgery (FESS) to maintain sinus ostium patency and reduce Scar tissue formation and inflammation. Their effectiveness in minimizing oral steroid use and revision surgeries is debated. This review assesses the efficacy and safety of SES in maintaining patency of the frontal sinus ostium (FSO) and improving postoperative outcomes after endoscopic sinus surgery (ESS).MethodsThis review followed PRISMA guidelines and searched multiple databases, including PubMed and Web of Science, for studies published up to 2024. It included 6 studies: 4 randomized controlled trials and 2 non-randomized studies. A meta-analysis was conducted using OpenMetaAnalyst to evaluate postoperative outcomes.ResultsSix studies involving 412 patients from the U.S. and China found that the use of SES was linked to a non-significant trend in reducing the need for postoperative oral steroids (odds ratio: 0.58, 95% CI: 0.25 to 1.32). The pooled proportion of patients needing additional surgery was 6.9% (95% CI: -0.1% to 13.8%, <i>P</i> = .052). The rate of FSO occlusion/restenosis was 15.6% (95% CI: 10.5% to 20.8%, <i>P</i> < .001). SES showed benefit in studies with control groups receiving surgery alone, but no benefit when compared to those receiving large-volume steroid irrigations.ConclusionSES effectively reduce inflammation and restenosis after surgery compared with surgery alone. However, their benefits may be limited to selected patients. Further studies on patient selection and cost-effectiveness will be required to guide future clinical practice.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261429546"},"PeriodicalIF":2.3,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147525333","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}