American Journal of Rhinology & Allergy最新文献

{"title":"Surgeon Characteristics Associated With Average CPT^® 31237 Utilization per Medicare Beneficiary.","authors":"Max J Hyman, Christopher M Low, Jayant M Pinto, Christopher R Roxbury","doi":"10.1177/19458924261478352","DOIUrl":"https://doi.org/10.1177/19458924261478352","url":null,"abstract":"<p><p>BackgroundA retrospective cohort study of 69,170 patients who underwent endoscopic sinus surgery between 2015 and 2022 found that 38.7% of the variation in the number of postoperative debridements was explained at the surgeon level. The extent to which postoperative debridements patterns after endoscopic sinus surgery depended on the surgeon motivates further research about relevant surgeon characteristics.ObjectiveTo identify surgeon characteristics associated with average Current Procedural Terminology (CPT^®) 31237 utilization per Medicare beneficiary.MethodsWe performed a retrospective cross-sectional study using summary Medicare data from 2023, filtering for CPT 31237 (\"[b]iopsy or removal of nasal polyp or tissue using an endoscope\"). We hypothesized that where surgeons train, whether they complete a fellowship in rhinology, or how much they are reimbursed is associated with average CPT 31237 utilization per beneficiary. We performed multivariable linear regression to analyze surgeon characteristics.ResultsThe sample included 1016 surgeons. Their sex distribution was 86.8% male and 13.2% female, and their mean years of postgraduate experience was 22.6 (SD 10.3). Of the 33.4% of surgeons who completed a fellowship, the majority trained in rhinology (71.4%), followed by facial plastics (14.8%). Approximately 96.5% of surgeons had average CPT 31237 utilization per beneficiary of 3 or less. The median number of beneficiaries per surgeon was 18 (IQR 13-28). Residency or fellowship program did not explain variation in average CPT 31237 utilization per beneficiary. Completing fellowship in rhinology was associated with 0.13 (95% CI 0.01-0.25, <i>P</i> = .027) greater average CPT 31237 utilization per beneficiary. Each additional $100 in the average standardized amount paid for CPT 31237 by Medicare was associated with 0.32 (95% CI 0.20-0.43, <i>P</i> < .001) greater average CPT 31237 utilization per beneficiary.ConclusionAverage CPT 31237 utilization per beneficiary may be associated with the type of fellowship which surgeons complete and the amount which they are reimbursed.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261478352"},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705052","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":"Complicated Acute Rhinosinusitis in Cystic Fibrosis: National Inpatient Pediatric Analysis.","authors":"Emily S Kwon, Saharsh Talwar, Annie Xu, Sudeepti Vedula, Rachel Kaye, Evelyne Kalyoussef, Wayne Daniel Hsueh","doi":"10.1177/19458924261473981","DOIUrl":"https://doi.org/10.1177/19458924261473981","url":null,"abstract":"<p><p>BackgroundNo prior national-level hospital admission analysis has compared acute rhinosinusitis (ARS) outcomes between cystic fibrosis (CF) and non-CF pediatric patients, leaving clinicians without population-level data to contextualize hospitalization burden and complication rates in this group.ObjectiveWe aimed to compare the complication risks and healthcare utilization between patients with CF versus without CF in children hospitalized with ARS.MethodsThe study examined inpatient admissions for pediatric ARS patients with or without CF in 2003-2019 using the Kids' Inpatient Database (KID), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality. Outcomes included orbital complications, intracranial complications, sinus involvement, sinus procedure rates, length of stay, and hospital charges.ResultsOf the weighted 41,148 patients with ARS, 1.5% had CF (n = 632). CF patients had lower odds of orbital complications (aOR 0.09, 95% CI 0.04-0.20, <i>P</i> < .001) but higher odds of sinus procedures (aOR 1.59, 95% CI 1.14-2.20, <i>P</i> = .006) compared to non-CF patients. CF patients also had longer hospital stays (8 vs 3 days, <i>P</i> < .001) and higher hospital charges ($43,918 vs $11,129, <i>P</i> < .001) compared to non-CF patients.ConclusionChildren with concurrent CF and ARS experience greater overall disease burden, reflected in prolonged hospitalization, higher healthcare costs, and higher rates of sinus surgeries. However, CF patients appear less prone to orbital complications.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261473981"},"PeriodicalIF":2.8,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148676900","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":"Impact of Medical Treatment on Nasal Discharge in Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis.","authors":"Asher T Ripp, Ethan M Kallenberger, Shaun A Nguyen, Erin E Briggs, Alexander N Duffy, Isabella V Schafer, Zachary M Soler, Jess C Mace, Timothy L Smith, Rodney J Schlosser","doi":"10.1177/19458924261473048","DOIUrl":"https://doi.org/10.1177/19458924261473048","url":null,"abstract":"<p><p>BackgroundOne of the defining symptoms of chronic rhinosinusitis is nasal discharge. There are multiple treatment options, and the relative efficacy of each medication on discharge is unclear.ObjectiveTo characterize the effects of medical treatment on the various forms of nasal discharge in chronic rhinosinusitis.Review MethodsThe literature was searched from inception through 2024 for articles reporting nasal discharge symptom data both at baseline and after treatment with medical therapy. Specific symptoms of interest on the Sino-nasal Outcomes Test 22 (SNOT-22) were \"Need to Blow Nose,\" \"Runny Nose,\" \"Postnasal Discharge,\" and \"Thick Nasal Discharge.\" SNOT-22 scores ranged from 0 to 5 based on severity. Visual Analogue Scale equivalents were recorded when available.ResultsA total of 19 studies (<i>n</i> = 1758) were included. All four nasal discharge questions saw statistically significant improvement, with postnasal drip and thick nasal discharge seeing the largest degree of improvement (both -1.4 [95% CI: -2.3, -0.5). Both patients with polyps (-39.2 [-49.2, -29.2]) and without nasal polyps (-26.0 [-41.9, -10.1]) saw significant improvement in rhinorrhea. Only patients with polyps saw significant improvement in postnasal discharge (PND) (-30.1 [-47.5, -12.7]). Nasal polyp patients treated with biologics saw a mean decrease of 44.1 points [95% CI: 29.9-58.3] in their total SNOT, compared with 15.9 [95% CI: 8.8-22.9] and 14.5 [95% CI: 4.1-25.0] point decreases in standard and alternative medical treatments, respectively. Both biologic and standard medical treatments led to reductions in VAS Rhinorrhea, with biologics leading to a greater reduction (<i>P</i> = .03). Only patients receiving biologics underwent significant improvement in VAS PND scores.ConclusionIn chronic rhinosinusitis, all 4 types of nasal discharge reported on the SNOT-22 saw significant improvement. Both patients with polyps and without polyps see improvement in discharge. Treatment of nasal polyps with biologics results in significantly greater improvement in nasal discharge compared to standard medical therapy and alternative treatments.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261473048"},"PeriodicalIF":2.8,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148676833","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":"Healthcare Utilization After Biologic Initiation for Chronic Rhinosinusitis.","authors":"Beau M Idler, Jananee Muralidharan, Gavin Hui, Noel F Ayoub","doi":"10.1177/19458924261475777","DOIUrl":"https://doi.org/10.1177/19458924261475777","url":null,"abstract":"<p><p>BackgroundBiologic therapies for chronic rhinosinusitis with nasal polyps (CRSwNP) broaden options beyond endoscopic sinus surgery (ESS) and conventional medications. However, the short-term impact of biologic therapy on healthcare utilization relative to ESS is unclear.ObjectiveTo compare 12-month healthcare utilization and costs after biologic initiation versus ESS.MethodsUsing the Atropos Health platform (2019-2024; ∼66 million patients), adults with CRSwNP and ≥12-month follow-up who received treatment with ESS or an approved biologic were identified. After 1:1 propensity-score matching, 12-month outcomes were compared, including medication use, CRSwNP-related visits, subsequent sinus surgery, complications, and Current Procedural Terminology (CPT)-based costs.ResultsOf 7519 ESS and 2084 biologic-treated eligible patients, 998 remained per arm after matching. Biologics and ESS patients had similar office (41.3% vs 38.7%; OR 0.90, 95% CI 0.77-1.07) and ED visit rates (2.0% vs 1.3%; OR 0.65, 95% CI 0.32-1.30). Subsequent sinus surgery was more frequent after biologics (3.6% vs 12.9%; OR 3.97, 95% CI 2.71-5.80). No significant differences were identified in CPT-based costs, complication rates, or steroid use.ConclusionsWithin 1 year, ESS and biologic patients showed similar healthcare utilization, with the exception of subsequent sinus surgery rates, which were higher in biologic patients. These findings may guide shared decision-making and payer policy.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261475777"},"PeriodicalIF":2.8,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148676856","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":"Revision Endoscopic Sinus Surgery in Cystic Fibrosis With Chronic Rhinosinusitis: Before and After Cystic Fibrosis Transmembrane Conductance Regulator Triple Modulator Therapy.","authors":"Brian P Kinealy, Anthony A Mangino, Jacob D Johnson, Jasarae McKinney, Michael I Anstead, Brett T Comer","doi":"10.1177/19458924261470956","DOIUrl":"https://doi.org/10.1177/19458924261470956","url":null,"abstract":"<p><p>BackgroundThe rate of functional endoscopic sinus surgery (FESS) in cystic fibrosis (CF) with chronic rhinosinusitis (CRS) is greater than 20%, and the rate of revision FESS is higher in CF patients compared to patients without CF. Revision FESS also occurs sooner in CF. Triple modulator therapy has made a positive impact on CRS symptoms and imaging in CF, but little is known regarding its relation to revision FESS.MethodsA retrospective review of CF patients with CRS treated at a single institution identified 53 patients who met inclusion criteria and underwent FESS between 2006 and 2022. There were 32 patients treated with triple modulator therapy, or elexacaftor/tezacaftor/ivacaftor (ETI). We hypothesized that ETI would be associated with a decreased likelihood of revision FESS. Additional cofactors included age, prior modulator treatment, and history of lung transplant.ResultsThere was a decrease in revision FESS in patients treated with ETI, with only one of the 32 patients undergoing surgery since treatment initiation (3.13%). In the years prior to ETI, 18 of these same patients (56.25%) underwent revision FESS. Patients on other modulator therapy had a hazard ratio of 0.85 for revision FESS (not significant).ConclusionThe current study shows a low rate of revision FESS in patients taking ETI, consistent with prior reports on improved quality of life and radiographic measures in these patients.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261470956"},"PeriodicalIF":2.8,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663398","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":"Histopathological Evidence of Persistent Remodeling in Recurrent Acute Rhinosinusitis.","authors":"Hen Chaushu, Ran Bilaus, Narin-Nard Carmel Neiderman, Avraham Abergel, Timur Pestrikov, Yaniv Hadi, Roni Vass, Leonor Leider Trejo, Nidal Muhanna, Liyona Kampel, Forsan Jahshan","doi":"10.1177/19458924261471648","DOIUrl":"https://doi.org/10.1177/19458924261471648","url":null,"abstract":"<p><p>BackgroundRecurrent acute rhinosinusitis (RARS) is traditionally regarded as an episodic infectious disorder with complete mucosal recovery between attacks. However, histopathological evidence supporting this assumption is limited.ObjectiveTo evaluate whether mucosal inflammatory and remodeling changes persist during the asymptomatic interval in patients with RARS compared with nonsinusitis surgical controls.MethodsIn this prospective observational study (January 2023-December 2025), sinonasal mucosal specimens obtained during functional endoscopic sinus surgery were analyzed from adults with RARS and nonsinusitis surgical controls. Patients with chronic rhinosinusitis, active infection, or recent systemic corticosteroid use were excluded. Histopathological outcomes included neovascularization, submucosal fibrosis, inflammatory infiltration, and basement membrane thickness.ResultsTwenty-four patients were included (17 RARS; 7 controls). Compared with controls, RARS specimens demonstrated higher neovascularization scores (median 2.0 vs 1.0; median difference, 1.0; 95% CI, 0.2-1.8; <i>P</i> = .034) and greater submucosal fibrosis (median 2.0 vs 1.0; median difference, 1.0; 95% CI, 0.1-1.9; <i>P</i> = .047). Inflammatory infiltration was numerically higher but did not reach statistical significance (median difference, 0.5; 95% CI, -0.1 to 1.1; <i>P</i> = .053); severe inflammation was observed only in RARS specimens (35% vs 0%). Basement membrane thickness did not differ between groups. Higher symptom burden (SNOT-22 ≥ 57.5) was associated with greater fibrosis (<i>P</i> = .041).ConclusionIn this surgically treated cohort, RARS was associated with persistent mucosal neovascularization and fibrosis despite clinical quiescence. These findings suggest that RARS may involve ongoing interepisode tissue remodeling rather than a purely episodic process.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261471648"},"PeriodicalIF":2.8,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618012","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":"Microbial Diversity in Odontogenic Sinusitis: Next-Generation Sequencing Versus Culture.","authors":"Abdurrahman Abdurrob, Do-Yeon Cho, Jacob G Eide, Amrita Ray, Jacob S Ancira, Craig Tipton, Zachary Hanna, John Craig","doi":"10.1177/19458924261474104","DOIUrl":"https://doi.org/10.1177/19458924261474104","url":null,"abstract":"<p><p>BackgroundOdontogenic sinusitis (ODS) is a common cause of unilateral infectious maxillary sinusitis but is frequently underdiagnosed due to nonspecific symptoms, subtle dental findings on imaging, and limitations of traditional bacterial cultures-particularly for anaerobic organisms. Next-generation DNA sequencing (NGS) may enhance detection of odontogenic bacteria.ObjectiveThis study compared bacterial detection between standard cultures versus NGS in patients with confirmed ODS.MethodsTwenty consecutive adults with confirmed ODS were enrolled. Maxillary sinus purulence was collected endoscopically and submitted for routine aerobic and anaerobic bacterial cultures and for NGS-based microbial profiling using 16S rRNA gene sequencing. Detected organisms were categorized by aerotolerance and ODS relationship, and likely nasal colonizers were excluded from analyses. Alpha diversity, beta diversity, and compositional differences between methods were analyzed statistically.ResultsNGS detected significantly more bacterial species per specimen than culture (mean 4.9 vs 2.7; <i>P</i> = .0015). Compared to cultures, NGS identified more anaerobic bacteria (4.2 vs 0.9; <i>P</i> = .00004) and more ODS-related species (4.4 vs 1.0; <i>P</i> = .0001), while detection of aerobic species was similar between methods. Cultures also often yielded nonspeciated results, whereas NGS consistently revealed polymicrobial communities dominated by oral anaerobes. Microbial composition differed significantly between detection methods.ConclusionIn confirmed ODS, NGS detected significantly more anaerobic and ODS-related species than culture from the same specimens. These findings suggest that culture alone may underestimate odontogenic contributions to purulent sinusitis. Future studies should explore he utility of NGS as an adjunctive tool to facilitate diagnosis and treatment in the setting of possible ODS.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261474104"},"PeriodicalIF":2.8,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618138","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":"Predictors of Success and Long-Term Outcome in Endoscopic Dacryocystorhinostomy: Single-Center Study.","authors":"Stephen Jacques Alzuphar, Kazumichi Yamamoto, Roland Giger, Jean-Jacques Tritten, Jean Paul Friedrich, Samuel Tschopp, Yves Jaquet","doi":"10.1177/19458924261469353","DOIUrl":"https://doi.org/10.1177/19458924261469353","url":null,"abstract":"<p><p>BackgroundEndoscopic dacryocystorhinostomy (eDCR) is the preferred surgical treatment for nasolacrimal duct obstruction. However, long-term outcome data and reliable predictors of surgical success remain limited.ObjectiveTo assess long-term functional outcomes of eDCR and identify factors associated with recurrence in a large single-center cohort with long-term follow-up.MethodsWe conducted a retrospective cohort study including all patients who underwent primary endonasal eDCR between 1998 and 2022 at a tertiary referral center. Primary outcomes were functional success (absence of epiphora) after first and, if necessary, second surgery, and time to recurrence following primary eDCR. Recurrence-free survival was analyzed using Kaplan-Meier methods and Cox proportional hazards regression. Secondary outcomes included concordance among preoperative diagnostic tests and perioperative complications.ResultsA total of 280 patients underwent 313 primary unilateral eDCR procedures. Functional success after first surgery was achieved in 86.9% of cases, with 41 recurrences (13.1%). After secondary procedures, 95.2% of operated sides were symptom-free. Estimated recurrence-free survival was 93.5% at 1 year, 90.8% at 3 years, and 88.5% at 5 years. On multivariable analysis, concomitant unciformectomy was independently associated with a reduced risk of recurrence (hazard ratio 0.27; 95% CI, 0.13-0.56; <i>P</i> < .001). Agreement among preoperative diagnostic tests was limited, with only fair concordance between fluorescein testing or dacryography and dacryo-CT-scan imaging (Cohen's κ 0.25-0.29). No major surgical complications were observed.ConclusioneDCR provides durable long-term relief of epiphora with high functional success rates. Concomitant unciformectomy appears to reduce the risk of recurrence significantly and may represent an important surgical step in optimizing long-term outcomes. Limited concordance among preoperative diagnostic tests supports the use of a complementary diagnostic approach in clinical practice.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261469353"},"PeriodicalIF":2.8,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148496964","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":"Sex Steroid Hormones and Olfactory Dysfunction in US Adults.","authors":"Chubo Xie, Pinning Feng, Zhiqing He, Shaobing Xiong, Miaofang Wu, Yunyun Liu, Yuewu Wang, Qianhui Qiu","doi":"10.1177/19458924261469381","DOIUrl":"https://doi.org/10.1177/19458924261469381","url":null,"abstract":"<p><p>BackgroundOlfactory dysfunction is a common disorder linked to adverse health outcomes and is more prevalent in men than in women. Sex steroid hormones have been proposed to underlie these sex differences, but population-based evidence remains limited.ObjectiveTo examine the associations of serum free testosterone and estradiol with olfactory dysfunction in US adults and to explore sex and age differences.MethodsWe analyzed data from 2750 participants (1373 men and 1377 women) aged ≥40 years in the 2013-2014 National Health and Nutrition Examination Survey. Olfactory function was assessed using the 8-item Pocket Smell Test. Dysfunction was defined as a score ≤5. Serum sex hormones were measured by mass spectrometry, and free testosterone was calculated from total testosterone, sex hormone-binding globulin, and albumin. Survey-weighted multivariable logistic and linear regression models evaluated associations between hormone quartiles and olfactory dysfunction or test scores, adjusting for sociodemographic factors, lifestyle, comorbidities, and olfaction-related medical history.ResultsThe weighted prevalence of olfactory dysfunction was 16.49% in men and 10.58% in women. Among men, higher free testosterone was associated with lower odds of olfactory dysfunction (adjusted odds ratio for highest vs lowest quartile, 0.47; 95% CI, 0.26-0.83; <i>P</i> for trend = .004), particularly in those older than 50 years. No significant associations were observed for free testosterone or estradiol in women.ConclusionHigher free testosterone levels are associated with a lower prevalence of olfactory dysfunction in men, whereas no clear hormone-olfaction associations were detected in women. Circulating testosterone may contribute to sex differences in olfactory performance.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261469381"},"PeriodicalIF":2.8,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148496924","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":"Angular Variations of the Lateral Nasal Wall as Independent Predictors of Primary Acquired Nasolacrimal Duct Obstruction: A Computed Tomography Study.","authors":"Oğuzhan Dikici, Ismail Alkan, Osman Durgut, Fevzi Solmaz, Malik Afifoğlu","doi":"10.1177/19458924261469364","DOIUrl":"https://doi.org/10.1177/19458924261469364","url":null,"abstract":"<p><p>BackgroundThe aim of this study was to investigate the relationship between specific sinonasal anatomical parameters and primary acquired nasolacrimal duct obstruction (PANDO) using paranasal sinus computed tomography (PSCT).MethodsThis retrospective case-control study included 42 patients with PANDO and 42 controls. Axial and coronal PSCT images were analyzed to measure the anterior medial lacrimal crest-uncinate process angle (AMLC-UP), nasal bone-lacrimal crest angle (NB-LC), and orbital-maxillary wall distance (OMD). Independent samples <i>t</i>-tests and Mann-Whitney U tests were applied based on data distribution. Variables were entered into stepwise binary logistic regression to identify independent predictors of PANDO.ResultsAMLC-UP angle was significantly higher in the PANDO group compared with controls (mean difference 4.04°, 95% CI: 0.34-7.74, <i>P</i> = .033), while NB-LC angle and OMD did not differ significantly. Multivariate analysis identified both AMLC-UP (OR = 0.916, <i>P</i> = .007) and NB-LC (OR = 1.061, <i>P</i> = .030 (Control:1, PANDO:0)) angles as independent predictors of PANDO. An increasing AMLC-UP angle and a decreasing NB-LC angle were independently associated with higher odds of PANDO. OMD was not retained in the final model. The logistic regression explained 14.6% of variance (Nagelkerke <i>R</i>²) with an overall classification accuracy of 61.9%.ConclusionSubtle angular variations between the lacrimal crest, uncinate process, and nasal bone are independently associated with PANDO, suggesting that lateral nasal wall anatomy contributes to nasolacrimal duct patency. These findings may inform preoperative planning for endoscopic dacryocystorhinostomy.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"19458924261469364"},"PeriodicalIF":2.8,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429716","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}