American Journal of Rhinology & Allergy最新文献

{"title":"Postoperative Oral Corticosteroid Use Following Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis.","authors":"Justina Shafik, Kara Sangiuolo, Eden Sheinin, Juan Lin, Meryl B Kravitz, Elizabeth A Borowiec, Christina H Fang","doi":"10.1177/19458924251335075","DOIUrl":"10.1177/19458924251335075","url":null,"abstract":"<p><p>BackgroundPatients with chronic rhinosinusitis (CRS) refractory to medical management often require endoscopic sinus surgery (ESS). Oral corticosteroids (OCSs) are frequently prescribed postoperatively, but the evidence of their efficacy is limited.ObjectiveThe purpose of this study is to evaluate the efficacy of OCS use in patients with CRS following ESS.MethodsA systematic search was performed to identify studies examining the use of OCSs in patients undergoing ESS for CRS. The primary outcomes were sinonasal outcome test (SNOT) and Lund-Kennedy (LK) endoscopic scores. Secondary outcomes were visual analog scale (VAS) scores. Meta-analysis was conducted using a fixed effects model with a heterogeneity test via the I2 statistic.ResultsThe search yielded 1899 articles, and 22 were included in the qualitative analysis, 14 of which were randomized controlled trials with 793 total patients. OCS use differed based on type, dosage, and duration. Studies included in meta-analysis did not show a significant difference in SNOT (Standardized Mean Difference [SMD] -0.03, Confidence Interval [CI] -0.47-0.40, I2 0%), LK (SMD -0.20 CI -0.57-0.17 I2 58%), or VAS (SMD 0.19 CI -0.25-0.63 I2 54%) scores between steroid and non-steroid groups. Two studies that assessed OCSs in the allergic fungal rhinosinusitis (AFRS) subtype of CRS showed significant improvement in outcomes. Two additional studies examined OCS versus itraconazole in AFRS, with both groups showing improvement but neither one with greater significance.ConclusionThis study showed no significant difference in SNOT, LK, or VAS scores in patients with CRS who received OCSs following ESS. Given the limited number of studies in the analysis, further investigations are warranted before making recommendations.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"322-332"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Diabetes Mellitus and Allergic Diseases Sensitized by Different Allergens and the Potential Mechanism of Diabetes Mellitus Affecting Ovalbumin-Induced Allergic Rhinitis.","authors":"Gan Lu, Yan Wang, Huan Huang, Hong-Li Hua, Yang Xi, Shi-Ming Chen, Yong-Gang Kong, Yu Xu, Yu-Qin Deng, Ze-Zhang Tao","doi":"10.1177/19458924251332786","DOIUrl":"10.1177/19458924251332786","url":null,"abstract":"<p><p>ObjectiveTo investigate the association between diabetes mellitus (DM) and allergic diseases caused by different allergens and explore the mechanism of DM in allergic rhinitis (AR) induced by ovalbumin (OVA).MethodsWe established linear regression models to examine the correlation of specific immunoglobulin E (sIgE) and total immunoglobulin E (TIgE) with glycohemoglobin (A1c) and fasting plasma glucose (FPG) in individuals allergic to different allergens by retrospectively analyzing the 2005-2006 National Health and Nutrition Examination Survey database. Participants were classified into Allergy + DM and Allergy groups based on whether they had allergic disease and DM or only allergic disease. An AR mouse model was established using OVA. Mice were randomly assigned to the control, AR, diabetic (db), or db & AR group, with 6 mice in each group. The expression of GATA3, T-bet, and Foxp3 was detected using immunofluorescence and western blotting. Cytokines, FPG, A1c, and immunoglobulin in serum were detected using enzyme-linked immunosorbent assays.ResultsBased on the database, the TIgE and SIgE levels in participants with perennial allergies were lower in the Allergy + DM group than in the Allergy group, whereas those in participants with food allergies were higher in the Allergy + DM group than in the Allergy group. TIgE was negatively correlated with FPG or A1c in participants with perennial allergies and positively correlated with FPG and A1c in participants with egg allergy (among food allergens). In mice, AR symptoms, eosinophilic infiltration, and OVA-induced IgE levels were more serious in the db & AR group than in the AR group. TIgE was positively correlated with FPG, and interleukin-2 (IL-2) was negatively correlated with FPG; this was most pronounced in db & AR mice. The expression of T-bet and Foxp3 in mice was negatively associated with A1c.ConclusionsThe effect of DM on allergic diseases is related to the type of allergen. Decreased IL-2, T-bet, and Foxp3 levels resulting from elevated FPG and A1c levels may be involved in the association between OVA-induced AR and DM.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"271-283"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964179","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":"Serum and Tissue Periostin Expression in Rhinosinusitis With Nasal Polyps.","authors":"Gerasimos Danielides, Spyridon Lygeros, Georgios Kyriakopoulos, Foteini Tsapardoni, Katerina Grafanaki, Constantinos Stathopoulos, Stephanos Naxakis, Vassileios Danielides","doi":"10.1177/19458924251332546","DOIUrl":"10.1177/19458924251332546","url":null,"abstract":"<p><p>BackgroundThere is increasing evidence of the contribution of periostin in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP).ObjectiveThis study aims to investigate the expression of periostin in nasal polyp tissue along with serum periostin and its potential function as a biomarker.MethodsThe study included 36 CRSwNP patients and 12 controls. Nasal polyp tissue from CRSwNP patients and inferior turbinate mucosa samples from controls were intraoperatively collected. <i>POSTN</i> gene mRNA expression from nasal polyp tissue was assessed with polymerase chain reaction and periostin levels on tissue samples were measured with ELISA and Western Blot. ELISA was performed to evaluate serum periostin on blood samples collected from patients undergoing functional endoscopic sinus surgery for CRSwNP (<i>n</i> = 36) and results were compared with assays performed on control subjects (<i>n</i> = 12).ResultsTissue periostin gene expression in terms of mRNA levels was significantly elevated in patients with CRSwNP than in healthy control subjects (<i>P</i>-value <.05). Τissue periostin values in CRSwNP patients were also significantly higher in CRSwNP compared to controls. A positive correlation between periostin levels and the presence of asthma and smoking was observed in the patient group. Serum periostin did not present a statistically significant difference between the 2 groups.ConclusionsOur data suggest that periostin expression is upregulated in nasal polyps and might determine a crucial role in the occurrence and evolution of the disease. Periostin appears to be a promising therapeutic target candidate in CRSwNP.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"259-265"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970247","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 Improvement in Symptoms After Sublingual Immunotherapy for Japanese Cedar Pollinosis Coincided With the Reduction in Nasal Metachromatic and Eosinophilic Cells.","authors":"Otsuka Hirokuni, Matsune Shoji, Okubo Kimihiro, Otsuka Kuninori","doi":"10.1177/19458924251332768","DOIUrl":"10.1177/19458924251332768","url":null,"abstract":"<p><p>Background and objectivePreviously, it was reported that droplet SLIT in Japanese cedar pollinosis reduced metachromatic cell and eosinophil counts in nasal swabs along with symptom improvement. In this study, it was confirmed that SLIT using tablets also reduces the number of these cells along with symptom improvement, and examined the time course of these effects.MethodsOne hundred twenty-one visits of 57 subjects treated with SLIT occurred in our clinic between January 16 and April 8, 2023 (Jc pollen season). The 57 patients had been receiving SLIT for 0.16 to 7.8 yr, and symptoms were assessed using a self-reported questionnaire. Nasal swab cytology was used to compare the reduction in Mc, eosinophil and neutrophil numbers with that of non-SLIT 110 subjects. We then investigated the timelines of the decrease in Mc and eosinophils and their relationship to symptoms.ResultsC Subjects who received SLIT had significantly reduced moderate to most severe symptoms compared to non-SLIT subjects over the Jc pollen season. There was symptom improvement for subjects with ≤2 yr SLIT treatment, but more improvement after >2 yr of SLIT treatment. Mc and eosinophil numbers in nasal swabs of SLIT subjects were significantly lower than in non-SLIT subjects. Moreover, levels of eosinophilia decreased within 2 yr of SLIT treatment, but further decreased with >2 yr of SLIT. Mc numbers in subjects with >2 years of SLIT were significantly lower than in non-SLIT subjects. There was no significant difference in neutrophil numbers in nasal swabs between non-SLIT and SLIT subjects.ConclusionSLIT administered by tablet was effective in improving symptoms within 2 yr, and further improved after 2 yr. The eosinophil counts also decreased within 2 yr, and further decreased over 2 yr. The Mc count significantly decreased only after 2 yr of SLIT treatment.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"300-308"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970568","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":"Two Decades at 21%: Unchanging Gender Disparities in Rhinology Fellowships.","authors":"Taylor J Stack, Morgan N McCain, Samuel P O'Rourke, Nina Westcott, Theresa Dickerson, Cristine Klatt-Cromwell, Brian D Thorp, Brent A Senior, Charles S Ebert, Adam J Kimple","doi":"10.1177/19458924251324238","DOIUrl":"10.1177/19458924251324238","url":null,"abstract":"<p><p>BackgroundThe representation of women in otolaryngology has increased significantly over recent decades, yet discrepancies remain in certain subspecialties, including rhinology. Despite overall improvements in gender equity within otolaryngology, the specific demographic trends and scholarly productivity of fellowship-trained rhinologists have not been thoroughly examined.ObjectiveWe aimed to address this gap by examining demographic trends and academic productivity among rhinology fellowship graduates.MethodsThis cross-sectional study examined publicly available data to analyze fellowship-trained rhinologists in the United States, focusing on gender, career stage, practice setting, h-index, and academic rank. Statistical analyses included Fischer's exact test, Wilcoxon rank sum test, ANOVA, and <i>η</i>².ResultsWe included 477 fellowship-trained rhinologists who trained at 31 fellowships. No gender differences in career stage or practice type were found. Despite an absolute increase in women per year (0 to 9, <i>η</i>² = 0.65), the percentage of women in rhinology fellowships has plateaued since 2002 (<i>η</i>² = 0.001), averaging 21.1% (SD = 10.8%). Most fellowship-trained rhinologists were mid-career, with a median of 7 practice years; 55% worked in academics, mainly as assistant professors. Overall, women rhinologists had a slightly lower h-index than men (7 vs 9; <i>P</i> = .01), but when stratified by academic rank, there was no difference in h-index between men and women.ConclusionThe percentage of women fellowship-trained rhinologists has not increased since 2002 (<i>η</i>² = 0.001), remaining at a mean of 21.1%. Contrasting with other subspecialties, women and men rhinologists have similar h-indices by academic rank. However, there are still fewer women in rhinology overall than men.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"266-270"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603536","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":"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}