American Journal of Rhinology & Allergy最新文献

{"title":"Orbital Decompression for Thyroid Eye Disease: Outcomes by Preoperative Severity and Technique.","authors":"Lazaro R Peraza, Forrest W Fearington, Gabriel A Hernandez-Herrerra, Andrew S Awadallah, Lilly H Wagner, Andrea A Tooley, Elizabeth A Bradley, Marius N Stan, Janalee K Stokken","doi":"10.1177/19458924251330947","DOIUrl":"10.1177/19458924251330947","url":null,"abstract":"<p><p>BackgroundOrbital decompression is an essential tool for reducing proptosis in thyroid eye disease (TED), yet the impact of surgical approach and preoperative factors on outcomes remains uncertain.ObjectiveTo compare proptosis reduction following different orbital decompression techniques, identify additional risk factors that may play a role in surgical orbital decompression outcomes, and develop clinical decision-making recommendations based on these results.MethodsA retrospective analysis was performed on TED patients who underwent endoscopic medial wall, orbital floor, and/or open lateral wall decompression. We evaluated the influence of preoperative comorbidities, anatomic and laboratory values, and surgical approach on postdecompression Hertel exophthalmometry outcomes.ResultsAnalysis encompassed 130 orbits from 80 patients, 83% female, 48 with preoperative diplopia, and mean age of 54.4 years. Preoperative Hertel measurement was predictive of extent of proptosis reduction (<i>P</i> < .0001), indicating that higher initial Hertel measurement predicts greater absolute reduction following surgical intervention. Surgical technique correlated with outcome on univariate analysis (<i>P</i> = .04), but not multivariate (<i>P</i> = .13) analyses. When categorized into preoperative Hertel ranges, combined endoscopic medial and open lateral wall decompression resulted in mean proptosis reduction of 3.13 mm for range 20.01 to 24 mm and 3.85 mm for range 24.01 to 28 mm. Three-wall decompression resulted in mean proptosis reduction of 2.49 mm for and 3.84 mm for these ranges, respectively. Variables such as smoking, body mass index, orbital wall height, and TRAb level, did not affect outcomes. Nine patients had new onset diplopia.ConclusionsPreoperative Hertel exophthalmometry is the strongest predictor of proptosis reduction following orbital decompression in TED. Surgical technique appears to be less impactful on outcome than expected. Surgical decision making should be individualized based on patient goals; these findings can be used to achieve proptosis reduction and limit the risk of new onset diplopia.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"284-292"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966897","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":"Using Machine Learning Models to Diagnose Chronic Rhinosinusitis: Analysis of Pre-Treatment Patient-Generated Health Data to Predict Cardinal Symptoms and Sinonasal Inflammation.","authors":"Arun M Raghavan, Mohamed A Aboueisha, Ion Prohnitchi, David J Cvancara, Ian M Humphreys, Aria Jafari, Waleed M Abuzeid","doi":"10.1177/19458924251322081","DOIUrl":"10.1177/19458924251322081","url":null,"abstract":"<p><p>BackgroundThe diagnosis of chronic rhinosinusitis (CRS) relies upon patient-reported symptoms and objective nasal endoscopy and/or computed tomography (CT) findings. Many patients, at the time of evaluation by an otolaryngologist or rhinologist, lack objective findings confirming CRS and do not have this disease.ObjectiveWe hypothesized that a machine learning model (MLM) could predict probable CRS using patient-reported data acquired prior to rhinologist-directed treatment. We leveraged patient-generated health data using a machine learning approach to predict: (1) the primary endpoint of sinonasal inflammation on CT evidenced by a Lund-Mackay score (LMS) ≥ 5 and (2) the secondary endpoint of LMS ≥ 5 and ≥2 cardinal symptoms of CRS.Methods543 patients were evaluated at a tertiary care rhinology clinic and subsequently underwent CT imaging with LMS. Patient-reported outcome measures and additional patient data were collected via an electronic platform prior to in-person evaluation. Three MLMs, a random forest classifier, a deep neural network, and an extreme gradient Boost (XGBoost) algorithm, were trained on predictors drawn from patient-generated health data and tested on a naïve test set (90:10 training:test set split). Cross-validation was executed, and model performance compared between algorithms and with linear regression techniques.Results57 predictors were extracted from the patient-generated health data. The best model (XGBoost) achieved an area-under-the-curve (AUC) of 71.3% (accuracy 74.5%, sensitivity 38.9%, specificity 91.9%) in predicting the primary endpoint, and an AUC of 79.8% (accuracy 85.5%, sensitivity 36.4%, specificity 97.7%) in predicting the secondary endpoint. This exceeded the performance of a linear regression model.ConclusionA MLM using patient-generated health data accurately predicted patients with probable CRS (≥2 cardinal symptoms and LMS ≥ 5). With further validation on a larger cohort, such a tool could potentially be used by otolaryngologists to inform clinical utility of diagnostic imaging and for screening prior to subspecialty Rhinology referral.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"229-236"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603537","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 Significance of Fractional Exhaled Nitric Oxide, Fractional Nasal Exhaled Nitric Oxide and Lung Function Tests in Children with Moderate-to-Severe Allergic Rhinitis.","authors":"Wanying Li, Wanyu Jia, Xiaowen Yi, Peng Li, Chunlan Song","doi":"10.1177/19458924251313495","DOIUrl":"10.1177/19458924251313495","url":null,"abstract":"<p><p>PurposeFractional nasal exhaled NO (FnNO), fractional exhaled NO (FeNO) and lung function tests were performed in children with moderate-to-severe persistent allergic rhinitis (AR) to investigate the significance of the above indices in the assessment and diagnosis of children with AR.MethodsA total of 135 children with persistent AR were selected and divided into moderate-to-severe and mild groups; serum total immunoglobulin E (IgE), peripheral blood eosinophil counts (EOS), FnNO, FeNO, and lung function tests were performed.ResultsChildren in the moderate-to-severe group had increased levels of FnNO and FeNO and decreased levels of forced expiratory flow at 75% of forced vital capacity as a percentage of the predicted value (FEF75%) and maximum mid-term expiratory flow as a percentage of the predicted value (MMEF%) . IgE in children with AR was positively correlated with FeNO and FnNO and negatively correlated with FEF75% . EOS was positively correlated with FnNO. FeNO was negatively correlated with FEF75% and forced expiratory flow at 50% of forced vital capacity as a percentage of the predicted value (FEF50%). FnNO was negatively correlated with FEF75%, FEF50%, and MMEF%.ConclusionFnNO, FeNO, and pulmonary function tests may help assess disease severity and level of disease control in children with persistent AR.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"181-186"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998683","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":"Double-Blinded Randomised Controlled Trial Evaluating the Efficacy of Chitogel Versus PureRegen Gel on Postoperative Outcomes from Endoscopic Sinus Surgery.","authors":"Marina N Cavada, Michael Fook-Ho Lee, Arjuna Ananda, Raymond Sacks, Yuresh S Naidoo","doi":"10.1177/19458924251321142","DOIUrl":"10.1177/19458924251321142","url":null,"abstract":"<p><p>ObjectivesThis study aims to compare Chitogel^® with topical corticosteroid versus PureRegen^® gel on wound healing and postoperative outcomes in the treatment of chronic rhinosinusitis.MethodsA double-blinded randomized controlled trial was performed with patients undergoing functional endoscopic sinus surgery who were prospectively recruited and randomized to receive Chitogel with triamcinolone to one side of the sinuses and PureRegen to the contralateral sinuses. The patients underwent endoscopic follow-up at 2, 6, and 12 weeks postoperatively. Patient factors including age, gender, smoking status, comorbidities (reflux, allergy, and asthma), and disease specific factor (chronic rhinosinusitis phenotype) were collected. Sinus ostial measurements, adhesions, mucopurulent discharge, edema, crusting, and granulation were assessed. A visual analogue scale questionnaire on quality of life was assessed in each follow-up appointment.ResultsA total of 40 patients were randomized. At 12 weeks, Chitogel had a 10.7 mm² reduction in frontal sinus ostium area compared to 15 mm² in the PureRegen group; Chitogel had a 2.2 mm² increase in maxillary ostium area compared to 0.1 mm² in the PureRegen group; Chitogel had a 27.6 mm² reduction in area of the sinus ostium compared to 28.7 mm² in the PureRegen group. However, these differences were not statistically significant. The difference between the two groups when analysing adhesion, mucopurulent discharge, mucosal oedema, crusting, granulation, and phenotype was not statistically significant. Patient self-directed grading on quality of life was not statistically significant.ConclusionBoth Chitogel with triamcinolone and PureRegen have demonstrated to be great options to prevent adhesion, stenosis, and optimize healing. There were no clinical and statistical differences between both products in wound healing and postoperative outcomes in the treatment of chronic rhinosinusitis.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"211-219"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655574","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":"Complication Rates Following Endoscopic Sinus Surgery for Chronic Sinusitis.","authors":"Ravi Dhamija, Nikita Das, Peng Ding","doi":"10.1177/19458924251315434","DOIUrl":"10.1177/19458924251315434","url":null,"abstract":"<p><p>BackgroundEndoscopic sinus surgery (ESS) is a minimally invasive procedure indicated for medically refractory chronic sinusitis (CRS). As with any surgical procedure, there are potential risks and complications.ObjectiveThe purpose of this study is to report skull base, orbital, and hemorrhagic-associated complication rates following ESS.MethodsA retrospective query on the TriNetX platform identified patients diagnosed with CRS who subsequently underwent ESS in the last 20 years. Outcomes analyses were performed to determine the incidence of skull base (cerebrospinal fluid rhinorrhea, bacterial meningitis, dural tear), orbital (diplopia, optic nerve injury, blindness, epiphora, orbital hemorrhage, canthotomy/canthoplasty), and hemorrhagic (epistaxis, carotid artery injury, blood transfusion) complications within 30 days postoperatively. Kaplan-Meier Analysis estimated survival probability from each complication type. Outcome rates were also compared between female and male patients.ResultsA total of 116 669 patients from 55 healthcare organizations fit the study criteria. The average age at surgery was 47.9 ± 17.9 years. The gender distribution of the cohort was 50% female and 48% male. The risk of skull base, orbital, and hemorrhagic complications within 30 days of the surgery was found to be 0.212%, 0.741%, and 3.00%, respectively. Kaplan-Meier Analysis revealed that survival probability from each complication type was 99.783%, 99.260%, and 96.903%, respectively. Comparison of outcome risks stratified by gender revealed no major differences for skull base and orbital complications; however, males exhibited a significantly higher risk of hemorrhagic complications (3.2% vs 2.8%, <i>P</i> < .0001).ConclusionsThe study supports ESS as a safe procedure for the management of CRS. Though rare, hemorrhagic complications are more common than orbital and skull base complications. Hemorrhagic complications are also more common in men than women. These findings provide insights for counseling patients about ESS risks and benefits.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"197-204"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063156","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":"Therapeutic Potential of Chitosan Nasal Gel in Addressing Olfactory Dysfunction: A Clinical Trial and Mechanistic Study.","authors":"Majed A Algarni, Mohamed H Abdelazim, Fahad T Alsulami, Abdulaziz Ibrahim Alzarea, Adnan Alharbi, Abdullah H Altemani, Abdullah S Alshammari, Faisal Alsenani, Ahmed H Abdelazim","doi":"10.1177/19458924251322058","DOIUrl":"10.1177/19458924251322058","url":null,"abstract":"<p><p>BackgroundOlfactory dysfunction significantly impacts daily life, affecting safety, appetite, and sensory enjoyment. Olfactory receptor neurons (ORNs) are essential for odor detection, but environmental exposure can lead to dysfunction. Regeneration of these neurons is crucial for maintaining olfactory function, and elevated calcium levels in nasal mucus are linked to this dysfunction.ObjectiveThe study evaluated chitosan nasal gel for persistent olfactory dysfunction lasting over 6 months, focusing on ORNs regeneration and reduced calcium levels in nasal mucus.MethodsA randomized, double-blind trial included 215 participants with persistent olfactory dysfunction lasting over 6 months. Participants were divided into two groups: 116 received nasal chitosan gel, and 99 received a control sodium chloride gel. Over 3 months, 11 participants in the chitosan group and 9 in the control group were lost to follow-up. Olfactory function was assessed with the Sniffin' Sticks test, and calcium levels were measured before and after treatment.ResultsPatients treated with chitosan nasal gel showed an increased composite threshold, discrimination, identification (TDI) score, indicating improved olfactory function. Discrimination and identification scores improved, while threshold scores showed no significant change. Notably, while the total TDI score improved by 4.55 points, it did not reach the threshold for clinical significance (5.5 points). Furthermore, chitosan nasal gel significantly reduced calcium levels in nasal secretions compared to the control group. No improvement was observed in the placebo group, likely due to the strict inclusion criteria targeting individuals with treatment-resistant olfactory dysfunction persisting over 6 months.ConclusionThis small-scale pilot study highlights the potential of chitosan nasal gel to improve specific domains of olfactory dysfunction and reduce nasal calcium levels. However, further studies with larger sample sizes, diverse populations, and longer follow-up periods are required to confirm these preliminary findings.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"237-244"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497491","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 a Medical Robot for Non-Face-to-Face Nasopharyngeal Swab Specimen Collection: Nonclinical and Clinical Trial Findings for COVID-19 Testing.","authors":"Jae-Min Shin, Munsoo Han, Dabin Lee, Joonho Seo, Jeoung-Min Lee, Yeongjun Chang, Tae Hoon Kim","doi":"10.1177/19458924251323363","DOIUrl":"10.1177/19458924251323363","url":null,"abstract":"<p><p>ObjectivesTo meet the high demand for polymerase chain reaction (PCR) tests to diagnose COVID-19 and rapidly control the outbreak, an efficient and safe molecular diagnostic protocol is necessary. In this study, we evaluated the efficacy and safety of the medical robot developed for non-face-to-face nasopharyngeal swab specimen collection.MethodsIn a nonclinical study, an otorhinolaryngologist collected swab specimens manually and using a medical robot. In a single-institution, randomized, open-label, prospective, exploratory clinical trial, nasopharyngeal swab specimens were collected from the enrolled participants both manually and by using the medical robot.ResultsEvaluation of the efficacy and safety of nasopharyngeal swab collection using a medical robot was assessed. After the operation of the robot, subjective discomfort experienced by the participants and any side effects or abnormalities in the nose were also monitored. Preliminary nonclinical data revealed comparable results between robotic and manual methods in terms of RNA metrics and cytokeratin-8 expression. Minor initial damage to A549 cells by the robot improved with subsequent use. In the clinical setting, the robot-assisted technique yielded a 92.31% detection rate for human RNase P, while the manual method achieved 100%. Post-swabbing discomfort reported by participants was similar for both methods and resolved within 48 h.ConclusionsThe medical robot system could efficiently, safely, and accurately collect nasopharyngeal swab samples in a non-face-to-face manner. Its installation in respiratory clinics, airports, or ports could minimize the infection risk between individuals and healthcare workers, thereby contributing to an efficient distribution of medical resources.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"220-228"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536565","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":"Trends in Dupilumab-Related Payments to Physicians Across Five Specialties.","authors":"Zoe Hsiao, Sina J Torabi, Edward C Kuan","doi":"10.1177/19458924251316686","DOIUrl":"10.1177/19458924251316686","url":null,"abstract":"<p><p>BackgroundDupilumab was first approved by the United States Food and Drug Administration in 2017 for atopic dermatitis and has since been approved for many other indications. The use of dupilumab has grown, but industry payments to physicians have yet to be explored.ObjectiveThe study objective is to characterize the change in payments by pharmaceutical companies to physicians for dupilumab-related promotional activities.MethodsData from 2017 to 2023 was extracted from the Open Payments website and filtered to determine the number of dupilumab-related payments to physicians, the amounts of these payments, the number of unique physicians that were paid, and the amount of money going towards different payment purposes.ResultsIn 2017, pharmaceutical companies paid a total of $6.1 million to allergists/immunologists, dermatologists, gastroenterologists, otolaryngologists, and pulmonologists for dupilumab-related activities. This amount grew to a total of $22.6 million in 2023. These specialties all experienced an increase in the number of unique physicians paid; the number of allergists/immunologists paid increased by 1.8-fold, dermatologists by 1.4-fold, gastroenterologists by 640-fold, otolaryngologists by 95-fold, and pulmonologists by 118-fold. Across all five specialties, pharmaceutical companies paid the most money for the purpose of non-consulting, non-continuing education speaker fees.ConclusionFrom 2017 to 2023, pharmaceutical companies have paid increasing numbers of payments to increasing numbers of unique allergists/immunologists, dermatologists, gastroenterologists, otolaryngologists, and pulmonologists for dupilumab-related promotional events.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"205-210"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063229","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":"A Predictive Model for Diagnosis of Acute Invasive Fungal Rhinosinusitis Among High-Risk Patients.","authors":"Danunuch Pasupat, Songklot Aeumjaturapat, Kornkiat Snidvongs, Supinda Chusakul, Kachorn Seresirikachorn, Jesada Kanjanaumporn","doi":"10.1177/19458924251322949","DOIUrl":"10.1177/19458924251322949","url":null,"abstract":"<p><p>BackgroundAcute invasive fungal rhinosinusitis (AIFR) is a life-threatening disease mainly affecting immunocompromised patients. Early detection is therefore key to improving patient survival. To date, there are still no standard clinical criteria for AIFR diagnosis.ObjectiveThis study develops a predictive model that utilizes clinical presentation and computed tomography (CT) findings to diagnose AIFR.MethodsA retrospective cohort study was conducted on patients with high risk for AIFR at King Chulalongkorn Memorial Hospital over the past 15 years (2008-2022). We constructed several multivariate logistic regression models for AIFR diagnosis based on different subsets of variables from 3 categories: signs/symptoms, endoscopy, and CT imaging.ResultsThere were 67 AIFR-positive patients and 68 AIFR-negative patients. Combining variables from 3 categories, a 6-variable model (fever, visual loss, mucosal discoloration, crusting, mucosal loss of contrast, retroantral fat stranding) achieved the highest area under the receiver operating characteristic curve of 0.8900 (74.63% sensitivity, 89.71% specificity).ConclusionsWe proposed predictive models for AIFR diagnosis in high-risk patients using clinical variables. The models can be used to guide the decision for further management such as biopsy or surgical intervention.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"245-252"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498014","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":"Deep Learning-Derived Quantitative Scores for Chronic Rhinosinusitis Assessment: Correlation With Quality of Life Outcomes.","authors":"Zhefan Shen, Ying Wei, Kexin Liu, Zhiqi Ma, Zhiliang Zhang, Xuechun Wang, Yong Li, Feng Shi, Zhongxiang Ding","doi":"10.1177/19458924251313845","DOIUrl":"10.1177/19458924251313845","url":null,"abstract":"<p><p>BackgroundComputed tomography (CT) plays a crucial role in assessing chronic rhinosinusitis, but lacks objective quantifiable indicators.ObjectiveThis study aimed to use deep learning for automated sinus segmentation to generate distinct quantitative scores and explore their correlations with disease-specific quality of life.MethodsFrom July 2021 to August 2022, 445 CT data were collected from 2 medical centers. A deep learning model based on nnU-Net was trained for automatic sinus segmentation and internally validated using 300 cases. The remaining 145 cases were split into an external testing set (74 cases) and an independent testing set (71 cases). Two quantitative scores, the quantitative Lund-MacKay score and the quantitative opacification score (QOS), were derived from the segmentation results. The quantitative scores' efficacy was assessed by comparing them with the Lund-MacKay score (LMS), the 22-item Sinonasal Outcome Test score (SNOT-22), and other clinical variables through correlation analyses. Furthermore, the relationship between quantitative scores and postoperative quality of life improvement was explored using single-factor logistic regression.ResultThe segmentation model achieved average Dice similarity coefficients of 0.993, 0.978, 0.958, and 0.871 for the training, validation, external testing, and independent testing sets, respectively. Both quantitative scores significantly correlated with the LMS (<i>rho </i>= 0.87 and <i>rho </i>= 0.70, <i>P </i>< .001). Neither score correlated with the total SNOT-22 score, although the modified QOS showed significant correlations with the nasal and sleep subdomains (<i>rho </i>= 0.26 and <i>rho </i>= 0.27, <i>P </i><<i> </i>.05). No significant association was found between quantitative score and postoperative improvement in quality of life.ConclusionDeep learning enables the automated segmentation of sinuses on CT scans, producing quantitative scores of sinus opacification. These automatic quantitative scores may serve as tools for chronic rhinosinusitis assessment.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"187-196"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998676","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}