American Journal of Rhinology & Allergy最新文献

{"title":"Secondary Repair of Iatrogenic CSF Leak During Sinus Surgery in a Tertiary Care Center.","authors":"David K Lerner, Helene Chesnais, Louis-Xavier Barrette, Alan D Workman, Jillian W Lazor, Jennifer E Douglas, Michael A Kohanski, Nithin D Adappa, James N Palmer","doi":"10.1177/19458924251341765","DOIUrl":"10.1177/19458924251341765","url":null,"abstract":"<p><p>BackgroundTertiary care centers often manage patients with iatrogenic CSF leaks from sinus surgeries performed elsewhere. There is little published regarding clinical presentation, patterns of injury, and guidance for management.ObjectiveTo analyze management of patients with iatrogenic skull base injury during sinus surgery managed in a secondary setting and review the literature regarding common management considerations.MethodsThis is a review of patients who underwent endoscopic sinus surgery at an outside facility with iatrogenic CSF leak and secondary repair at our institution between January 2009 and March 2023. The record was reviewed for clinical characteristics, medical interventions, and outcome measures.ResultsNineteen patients were included with an average age of 54.6 years. There was a roughly even split between patients with chronic sinusitis with and without nasal polyps (<i>n</i> = 10, <i>n</i> = 9). Under half (42.1%) of skull base injuries were identified intraoperatively, all injuries occurred to the ethmoid skull base, and there was a predisposition toward right-sided injury. All patients underwent endoscopic repair with a 100% success rate. Two patients (10.5%) were started on acetazolamide postoperatively, both with a body mass index greater than 40.ConclusionsOur findings underscore the importance of maintaining a high degree of suspicion for skull base injury as well as understanding endonasal anatomy and patient-to-patient variations. Our work adds to the literature suggesting a higher-than-suspected rate of missed skull base injury during sinus surgery. We anticipate an impending increase in iatrogenic injuries managed in the secondary setting, reflecting the trend toward sinus procedures being performed in the office setting. We recommend a thoughtful patient-specific approach toward secondary management, including evaluating for intracranial injury for suspected penetrating trauma and tailoring reconstruction to the particular defect.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"345-352"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075501","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":"Long-term Quality of Life After Endoscopic Repair of Choanal Atresia in Children.","authors":"Tal Rozenblat, Roy Hod, Ethan Soudry, Eyal Raveh, Eitan Yaniv, Dror Gilony","doi":"10.1177/19458924251372243","DOIUrl":"https://doi.org/10.1177/19458924251372243","url":null,"abstract":"<p><p>IntroductionChildren with choanal atresia (CA) typically present with nasal obstruction and require surgical intervention to establish a patent airway. Transnasal endoscopic surgery is the preferred treatment approach. However, long-term outcome data are lacking. This study aims to assess the long-term outcomes and quality of life (QoL) after endoscopic repair of CA.MethodsChildren under age 18 years underwent endoscopic repair of CA using mucoperichondrial flaps developed from the nasal septum between 2007 and 2022. Their parents completed two standardized telephonic QoL questionnaires (Hebrew version, Sino-Nasal 5 (SN-5H) and Nasal Obstruction Symptom Evaluation (He-NOSE)).ResultsThe cohort consisted of 40 children, 60% female. Eight had syndromic disease; seven were born prematurely. Mean age at surgery was 25 days for bilateral atresia (65% of patients) and 3.8 years for unilateral atresia. Ten children, most with unilateral CA, needed revision surgery. The mean duration of follow-up was 3.1 years. At the last follow-up, 84.6% of the children had normal choanae, and the remainder had narrowed choanae. Mean time from last follow-up to the parental interview was 5.2 years. SN-5H and He-NOSE scores were similar to those of historical healthy subjects: 1.95 versus 1.76 (<i>P</i> = 0 .4) and 22.3 versus 14.9 (<i>P</i> = 0.08), respectively. Children born prematurely had a higher rate of sinus infections (<i>P</i> = 0 .01) and nasal congestion (<i>P</i> = 0 .05) than children born at term.ConclusionsLong-term follow-up of children who underwent endoscopic repair of CA using mucoperichondrial flaps showed a stable patent nasal passage with normal QoL for both unilateral and bilateral disease.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924251372243"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938635","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 Efficacy of Mupirocin Nasal Irrigations for Treatment of Refractory Chronic Rhinosinusitis After Endoscopic Sinus Surgery.","authors":"Russell A Whitehead, Vidit Talati, Ali M Baird, Grant S Owen, Romney Hansen, Peter Filip, Bobby A Tajudeen, Pete S Batra, Peter Papagiannopoulos","doi":"10.1177/19458924251343389","DOIUrl":"10.1177/19458924251343389","url":null,"abstract":"<p><p>BackgroundChronic rhinosinusitis (CRS) can be difficult to treat medically secondary to crusting and biofilms resistant to oral antibiotics. Treatment with topical antibiotics has grown in popularity due to their ability to administer a high local drug concentration while mitigating systemic effects. Published literature on topical antibiotic efficacy for CRS is mixed and sparse.ObjectiveTo describe the efficacy of postoperative topical mupirocin rinses in reducing objective and subjective markers of CRS disease severity.MethodsPatients with suspected biofilm formation following functional endoscopic sinus surgery who were treated with mupirocin 15 mg or 30 mg rinses twice daily between 2018-2023 were included. These patients' symptoms and endoscopic findings were refractory to high-volume steroid irrigations and oral antibiotics. Data collected involved comorbidities, rinse duration, concurrent therapies, Lund-Kennedy (LK) scores, sino-nasal outcome test-22 (SNOT) scores, and adverse effects. LK and SNOT scores were compared across 3 time points (preoperative, 3-month-postoperative-prerinse, postrinse) using one-way analysis of variance and Wilcoxon rank sum for pairwise comparisons.ResultsThirty patients were included. Average age was 63.3 years, 66.7% of patients were female, and 60% had nasal polyposis. There was a statistically significant decrease in LK scores between the 3-month-postoperative-prerinse period and the postrinse period (-0.92 ± 1.25; <i>P</i>-value = <b>.01</b>) whereas the SNOT-22 score reduction was not significantly different (<i>P</i>-value = .62). One patient reported a \"burning sensation\" and stopped after 4-weeks of treatment; no other adverse events were reported.ConclusionTopical mupirocin rinses may result in improvement of CRS burden on endoscopy without a significant reduction in symptoms. Additional studies are necessary to delineate the safety and appropriate duration and dosing of mupirocin rinses as well as to compare mupirocin to standard saline irrigations for treatment of recalcitrant CRS.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"364-370"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101243","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":"Factors Affecting the Success of Sphenopalatine Artery Ligation in the Management of Intractable Epistaxis-A Single-Centered Retrospective Analysis.","authors":"Joseph Latif, Emma Ho, Jordan Fuzi, Catherine Banks","doi":"10.1177/19458924251372241","DOIUrl":"https://doi.org/10.1177/19458924251372241","url":null,"abstract":"<p><p>BackgroundEndoscopic sphenopalatine artery ligation (ESPAL) is a safe and effective procedure to manage intractable epistaxis. However, in the literature, the peri-operative and patient factors which contribute to surgical success or failure have been poorly defined.ObjectiveThe purpose of this study was to identify the patient, disease and surgical factors which influence the effectiveness of ESPAL in the management of intractable epistaxis.MethodsAll ESPALs performed over a 14-year period at a single tertiary otolaryngology department to manage epistaxis refractory to conservative management were retrospectively analyzed. Recurrence of epistaxis was defined as any patient who presented to an emergency department with epistaxis on the same side as their previous ESPAL at any time post-operatively. Subjects were grouped as either a non-recurrence or recurrence group.Results40 patients underwent ESPAL to treat intractable epistaxis. Anticoagulation, smoking, and active malignancy were associated with higher rates of recurrence after ESPAL (<i>P</i> < .05). The recurrence rate was 20% with an average follow-up period of 5 years. The average time between ESPAL and epistaxis recurrence was 10 days. 50% (n = 4) of patients with recurrence required escalation to endovascular embolization. No patients had recurrence of epistaxis following additional radiological intervention.ConclusionOne in five patients experienced a recurrence in epistaxis following ESPAL within 3 weeks of their surgery. Smokers, patients on anticoagulation and patients with malignancy are more likely to experience recurrence. If re-presenting with epistaxis following ESPAL, patients are likely to require radiological intervention.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924251372241"},"PeriodicalIF":2.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938607","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":"Occult Nodal Involvement in Sinonasal Squamous Cell Carcinoma.","authors":"Samer T Elsamna, Aman M Patel, Ibraheem Shaikh, Lucy Revercomb, Vraj P Shah, Prayag Patel, Christina H Fang, Soly Baredes, Jean Anderson Eloy","doi":"10.1177/19458924251371257","DOIUrl":"https://doi.org/10.1177/19458924251371257","url":null,"abstract":"<p><p>BackgroundSinonasal squamous cell carcinoma (SNSCC) is an aggressive subtype of sinonasal cancer. While elective neck dissection (END) is not typically recommended for SNSCC, occult nodal involvement (ONI) may be present. We therefore sought to evaluate the incidence, associated factors, and survival impact of ONI in SNSCC.MethodsThe National Cancer Database was queried for patients with SNSCC from 2004 to 2016. Data regarding patient demographics, clinicopathology, and treatment were obtained. Univariate and multivariate logistic regression and Kaplan-Meier analyses were conducted to identify predictors of ONI with odds ratios (ORs) and overall survival.ResultsIn total, 522 patients satisfied inclusion criteria. Most patients were elderly (>60 years old, 55.0%), male (67.2%), White (86.4%), and insured with Medicare (44.1%). Cases of SNSCC most frequently involved the paranasal sinuses (69.7%), were T-stage 4 (50.6%), moderately differentiated (52.5%), underwent treatment at academic centers (76.4%), and lacked lymphovascular invasion (LVI, 84.4%). ONI was observed in 10.9% of patients. Following propensity score matching, ONI significantly negatively impacted survival: 3 year survival was 65% for patients without ONI and 35% for patients with ONI (log-rank <i>P</i> < .001). The highest rate of ONI was observed in patients with LVI (31.4%). On multivariate analysis, LVI was the sole predictor of ONI (OR: 6.75, 95% confidence interval: 3.09-14.73, <i>P</i> < .001).ConclusionsONI was identified in 10.9% of patients with SNSCC and was found to be a negative prognostic factor for survival. Patients with identified LVI may benefit from END.<b>Level of Evidence:</b> 4.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924251371257"},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938618","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 Inferior Turbinate Radiofrequency Procedure on Nasal Flora: A Prospective Study.","authors":"Fatma G I Bayraktar, Ragıp Ç Çelik, Güler Berkiten, Çiğdem Arabaci, Kenan Ak, Tuğçe Gültepe Zorlu, Yavuz Uyar","doi":"10.1177/19458924251370502","DOIUrl":"https://doi.org/10.1177/19458924251370502","url":null,"abstract":"<p><p>BackgroundInferior turbinate hypertrophy is a common cause of chronic nasal obstruction, and radiofrequency treatment has become an effective minimally invasive option for management. However, the impact of this procedure on nasal bacterial flora and the need for postoperative antibiotics remains unclear.ObjectiveTo investigate the effect of inferior turbinate radiofrequency treatment on the nasal cavity bacterial flora and the need for postoperative antibiotics.MethodsForty-five voluntary patients aged 18 to 65, who were referred to the Otorhinolaryngology clinic between 11/2023 and 02/2024 due to chronic nasal obstruction, were included in the study. The patients had noninfective inferior turbinate hypertrophy, were recommended for inferior turbinate radiofrequency treatment, and agreed to undergo the procedure. Before and one month after the procedure, nasal swabs were taken from the patients and sent to the Clinical Microbiology Department for culture. The microorganisms isolated from both swabs were compared. The statistical analysis of the study data was conducted using SPSS 26.0 software.ResultsNo significant difference was observed in the total bacterial colonization count after the radiofrequency procedure compared to before the procedure (<i>p</i> = .44). There was no significant difference in the total count of normal flora elements and potentially pathogenic bacteria between the pre and post procedure (<i>p</i> = .10, <i>p</i> = .23). Among the isolated normal flora microorganisms, no significant difference was observed in the bacterial colonization count for all species except coagulase-negative staphylococci, in which a significant decrease was detected (<i>p</i> > .05, <i>p</i> = .004).ConclusionThe data from this study suggest that inferior turbinate radiofrequency treatment does not significantly affect nasal flora bacterial colonization and does not cause a significant increase in the number and variety of pathogenic bacteria, thereby indicating that postoperative antibiotic therapy is not necessary. However, further studies with a larger sample size are required.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924251370502"},"PeriodicalIF":2.3,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938620","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 Platelet-Rich Plasma Injection in Patients With Atrophic Rhinitis: A Systematic Review.","authors":"Ali Jaber Asiry, Musleh Hussain Mubarki, Ramzi Mohammed Dighriri, Ibrahem H Erwe, Fadi Abdu Munhish, Ahmed Ali Daghriri, Radeif Essa Shamakhi","doi":"10.1177/19458924251369316","DOIUrl":"https://doi.org/10.1177/19458924251369316","url":null,"abstract":"<p><p>BackgroundAtrophic rhinitis (AR) is a chronic condition characterized by mucosal atrophy, crusting, and impaired mucociliary clearance. Current treatments are palliative and do not focus on tissue regeneration. Although platelet-rich plasma (PRP) has gained attention for its regenerative properties, evidence supporting its effectiveness in AR remains limited.ObjectiveTo systematically evaluate the effectiveness and safety of PRP in the treatment of AR, focusing on nasal symptom relief, mucociliary clearance, and tissue repair biomarkers.MethodsA systematic literature search was conducted in PubMed and the Cochrane Library from database inception to September 2024 for randomized clinical trials, prospective trials, and case series evaluating PRP for AR. Study quality was assessed using the Cochrane Risk of Bias tool and Newcastle-Ottawa Scale.ResultsPRP treatment resulted in significant improvements in nasal symptoms, with sino-nasal outcome test scores decreasing from 22.4 to 12.7. Four studies demonstrate enhanced mucociliary clearance, including a reduction in saccharin transit time from 420 s to 220 s in 1 study. Biochemical analyses revealed elevated levels of nitric oxide synthase and arginase, suggesting tissue regeneration. Improvements in anosmia and nasal obstruction symptom scores were also reported. No severe adverse effects were observed.ConclusionWhile PRP shows promise for AR, current evidence is compromised by diagnostic uncertainty, methodological inconsistencies, and potential commercial bias. Significant demographic variations suggest different patient populations were evaluated. Rigorous, independently funded trials with standardized protocols are essential before clinical recommendations.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924251369316"},"PeriodicalIF":2.3,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870905","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":"Biologics and Surgery in Chronic Rhinosinusitis With Nasal Polyps: A Comparative Outcomes Analysis.","authors":"Nirushan Narendran, Shireen Samargandy, Sophia Volpe, James Patterson, Barite Gutama, Eugene Chang","doi":"10.1177/19458924251366569","DOIUrl":"https://doi.org/10.1177/19458924251366569","url":null,"abstract":"<p><p><b>Objective:</b> Chronic rhinosinusitis with nasal polyps (CRSwNP) presents with nasal obstruction, facial pressure, smell alterations, and post-nasal drainage. Endoscopic sinus surgery (ESS) is indicated when medical treatments fail, however some patients' nasal polyps can recur. Biologic therapies targeting type-2 inflammation have been shown to improve sinonasal symptoms in CRSwNP. Few studies compare ESS to biologic outcomes longitudinally. To review and compare the efficacy of ESS to biologics in managing CRSwNP using standardized outcome measures longitudinally. <b>Data Sources:</b> We searched electronic databases, including MEDLINE, EMBASE, Cochrane Library, Web of Science, and ClinicalTrials.gov from inception through August 2024. <b>Review Methods:</b> Primary outcome included changes in symptom scores (SNOT-22). Secondary analyses included change in nasal polyp score (NPS) and olfactory function scores. The mean differences and 95% CI were synthesized using a random-effects meta-analysis with heterogeneity assessed using I² statistics. <b>Results:</b> Although there was significant heterogeneity between and within groups, we performed a meta-analysis of SNOT-22 outcomes from both biologic and ESS studies (n = 27). SNOT-22 significantly improved at 6/12 months in biologic and ESS studies with no differences between groups. Secondary analysis of NPS and olfactory function were limited by the small number of studies. Both treatments improved outcomes from baseline, with biologics showing improved olfaction at 6 months compared to ESS. <b>Conclusion:</b> Significant heterogeneity in patient selection, testing methods, and longitudinal data collection was identified. Future comparative studies should incorporate individual complete data with consistent follow-up to reduce heterogeneity and synthesize the best evidence comparing biologic to ESS outcomes in CRSwNP.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924251366569"},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844018","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":"Three-Year Outcomes After Temperature-Controlled Radiofrequency Ablation of the Posterior Nasal Nerve for Chronic Rhinitis.","authors":"Jivianne T Lee, Gregory M Abbas, Daniel D Charous, Mandy Cuevas, Önder Göktas, Patricia A Loftus, Nathan E Nachlas, Elina M Toskala, Jeremy P Watkins, Detlef Brehmer","doi":"10.1177/19458924251360889","DOIUrl":"10.1177/19458924251360889","url":null,"abstract":"<p><p>BackgroundChronic rhinitis (CR) is characterized by refractory symptoms such as rhinorrhea, sneezing, nasal congestion, postnasal drip (PND), and cough. Most patients do not achieve lasting symptom relief with medical management.ObjectiveTo evaluate the long-term efficacy and safety of temperature-controlled radiofrequency treatment targeting posterior nasal nerves (PNNs) for CR.MethodsThis prospective, single-arm, open-label, multicenter study included patients aged 18-85 years across 19 centers in the United States and Germany. Outcome measures included reflective Total Nasal Symptom Score (rTNSS), PND and cough scores, and the Mini Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ). Outcomes, including adverse events, were reported through 3 years post-procedure.SettingAll procedures were performed in an outpatient office-based setting.ResultsOne hundred twenty-nine patients received treatment; 101 completed 3-year follow-up. The adjusted mean rTNSS Score improved from 7.8 (95% confidence interval [CI]: 7.5-8.1) at baseline to 3.2 (95% CI: 2.8-3.7) at 3 years (mean change: -4.5 [95% CI: -5.1 to -4.0]; <i>P</i> < .001). Rhinorrhea symptom scores improved from 2.6 to 1.2 (55.8% reduction). Compared to baseline, at 3 years, adjusted mean cough and PND scores declined from 1.3 to 0.4 (mean change: -0.9; <i>P</i> < .001, 69% reduction) and from 2.4 to 1.2 (mean change: -1.2; <i>P</i> < .001, 50% reduction), respectively. MiniRQLQ scores were significantly reduced from an adjusted mean of 3.0 (95% CI: 2.8-3.2) at baseline to 1.2 (95% CI: 1.0-1. 4) at 3-year follow-up; <i>P</i> < .001. No serious device- or procedure-related adverse events were reported.ConclusionA single temperature-controlled radiofrequency treatment of the PNN safely and effectively reduced CR symptoms, including cough and PND, improved quality of life, and decreased medication burden through a period of 3 years with no serious adverse events.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924251360889"},"PeriodicalIF":2.3,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12480620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783246","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":"Vericiguat Enhances Olfactory Function in Post-Infectious Anosmia: A Randomized Pilot Double-Blind Placebo-Controlled Trial.","authors":"Adnan Alharbi, Mohamed H Abdelazim, Abdullah S Alshammari, Majed A Algarni, Abdulaziz Ibrahim Alzarea, Fahad H Baali, Abdullah H Altemani, Ahmed H Abdelazim","doi":"10.1177/19458924251364571","DOIUrl":"https://doi.org/10.1177/19458924251364571","url":null,"abstract":"<p><p>BackgroundOlfactory dysfunction affects approximately 29% of the population and has a profound impact on quality of life. It frequently follows upper respiratory tract infections and lacks effective pharmacological treatments. Vericiguat, a soluble guanylate cyclase stimulator that increases intracellular cyclic guanosine monophosphate, is approved for heart failure and has potential neuro-modulatory effects relevant to olfactory processing.ObjectiveThis pilot study investigates the efficacy of oral vericiguat in improving olfactory function in patients with persistent anosmia following upper respiratory tract infections.MethodsIn a double-blind, randomized controlled trial, 88 participants with post-infectious anosmia were assigned to receive either placebo (n = 44) or vericiguat (4 mg, twice daily; n = 44) for 12 months. Olfactory function was assessed monthly using the Sniffin' Sticks test, measuring Threshold (T), Discrimination (D), and Identification (I) scores. Data were analyzed using repeated-measures ANOVA and post-hoc Bonferroni corrections.ResultsAt baseline, all olfactory scores were similar between groups. In the vericiguat group, T scores increased from 3.84 ± 0.19 to 4.65 ± 0.20 (P = 0.003), D scores from 8.25 ± 0.65 to 9.20 ± 0.86 (P = 0.008), and I scores from 7.34 ± 0.72 to 8.62 ± 0.79 (P = 0.008). No significant changes were observed in the placebo group. Between-group differences became statistically significant for D at month 4 (P < 0.05), T at month 6 (P < 0.05), and I at month 7 (P < 0.05). However, the mean total TDI improvement in the vericiguat group (+ 3.19) did not reach the clinical threshold of 5.5 points.ConclusionVericiguat significantly improved olfactory threshold, discrimination, and identification scores compared to placebo. These findings highlight its potential as a pharmacological option for olfactory dysfunction, although the clinical magnitude of benefit remains below the established threshold. Further studies should explore mechanisms and broader clinical applications.Trial registrationDFM-IRB00012367-23-07-008.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924251364571"},"PeriodicalIF":2.3,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783247","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}