Type 2 biomarkers in olfactory cleft mucus correlate with SNOT-22 in chronic rhinosinusitis independent of nasal polyp status.

Background: Quantitative mucus cytokine analysis to examine the sinonasal microenvironment may bridge the gap between patient-reported outcome measures (PROMs) and empirical measures of inflammation in patients with chronic rhinosinusitis (CRS).

Objective: Investigate the correlation between mucus cytokine levels and Sino-Nasal Outcome Test (SNOT-22) scores, including individual subdomains.

Methods: Patients with CRS were prospectively recruited between 2016 and 2021 into a multi-institutional observational study.

Fibro-osseous lesions of the sinonasal tract: a contemporary review.

Purpose Of Review: Fibro-osseous lesions (FOL) are benign, slow-growing lesions that are often incidentally discovered in the sinonasal cavity. They may necessitate surgical resection in patients with postobstructive sinusitis, or in cases of cranial nerve and orbital compression. We examine the recent advancements in otolaryngology relating to diagnostic characteristics and treatments for FOL, with emphasis on new technologies to improve outcomes and reduce recurrence.

Olfactory Neuroblastoma With Divergent Differentiation: Contemporary Management of Unusual Pathology and Literature Review.

Olfactory neuroblastoma (ON; Esthesioneuroblastoma) is a malignant tumor that arises from the olfactory neuroepithelium. Very rarely, ON can histologically display a biphenotypic pattern, with only 7 cases reported in the literature to date. We describe a case of this poorly understood entity and review the patient's histology, pathology, and treatment.

Endoscopic Repair of Internal Carotid Artery Injury with a Lateral Tongue Muscle Patch Graft: Novel Technique and Literature Review.

 Iatrogenic injury to the internal carotid artery (ICA) is one of the most catastrophic complications of endoscopic sinus and skull base surgery. Previous research has shown that packing with a crushed muscle graft at the injury site can be an effective management technique to control bleeding and prevent the need for ICA sacrifice. Here, we describe a novel and readily available repair donor site-an autologous lateral tongue muscle patch.

The Inflation Reduction Act: Implications for Medicare spending and access to biologic therapies for chronic rhinosinusitis with nasal polyposis and asthma.

In 2021, Medicare spending on biologics was $926 million in Part B (FFS) and $1.3 billion in Part D (FFS/MA). Between 2017 and 2021, annual Medicare spending on biologics increased by approximately 200%.

Factors Impacting Follow-Up Care in Allergic Fungal Rhinosinusitis.

Objective: The purpose of this study was to analyze barriers to medical care and follow-up in patients with allergic fungal rhinosinusitis (AFRS).

Study Design: Cross-sectional questionnaire-based study with retrospective chart review.

Setting: Tertiary Medical Center.

All chronic rhinosinusitis endotype clusters demonstrate improvement in patient-reported and clinical outcome measures after endoscopic sinus surgery.

Background: It is unclear whether chronic rhinosinusitis (CRS) endotypes show a differential response to endoscopic sinus surgery (ESS). We explored patient mucous inflammatory cytokine expression and associations with patient-reported and clinically measured post-operative outcome measures.

Methods: Patients with CRS were prospectively recruited between 2016 and 2021 into a national multicenter, observational study.

Challenges to medication adherence with intranasal corticosteroid irrigations.

Background: The purpose of this study was to investigate real-world adherence to intranasal corticosteroid irrigations using pharmacy data and assess factors associated with low adherence.

Methods: Patients undergoing treatment with corticosteroid irrigations for any diagnosis during a 2-year period were prospectively recruited. Subjects completed a one-time set of questionnaires including the Barriers to Care Questionnaire (BCQ), 22-item Sino-Nasal Outcome Test (SNOT-22), and a questionnaire assessing their experience with corticosteroid irrigations.

Association between Social Determinants of Health and Allergic Fungal Rhinosinusitis: A Systematic Review and Meta-analysis.

Objective: Some previous studies have shown an increased prevalence of allergic fungal rhinosinusitis (AFRS) among young, black patients with poor access to health care; however, results have been mixed. The purpose of this study was to investigate the relationship between social determinants of health and AFRS.

Data Sources: PubMed, Scopus, CINAHL.

The impact of race on olfaction: A systematic review and meta-analysis.

Background: Many studies have identified a higher degree of Olfactory Dysfunction (OD) in Black patients compared to White patients. This study aims to analyze olfactory outcomes in different races.

Methods: The PubMed, Scopus, and CINAHL databases were searched from inception to September 5, 2022, for English-language articles documenting self-reported and psychophysical OD stratified by race.

Unique Measurements of Intranasal Trigeminal Function: A Pilot Study.

Objective: To investigate novel methods of measuring intranasal trigeminal function and correlate to validated measures of trigeminal function.

Study Design: Prospective cohort study.

Setting: Tertiary medical center.

Economics of Medical and Surgical Management of Chronic Rhinosinusitis with Nasal Polyps: A Contemporary Review.

Background: Chronic rhinosinusitis (CRS) with nasal polyposis (CRSwNP) is a chronic inflammatory condition with significant patient morbidity and associated healthcare costs. While the economic burden of CRS overall has been previously described, the economic impact of CRSwNP has received less attention. Patients with CRSwNP have higher disease burden and healthcare resource utilization than those with CRS without nasal polyposis.

Prognosis and persistence of smell and taste dysfunction in patients with covid-19: meta-analysis with parametric cure modelling of recovery curves.

Objective: To clarify in patients with covid-19 the recovery rate of smell and taste, proportion with persistent dysfunction of smell and taste, and prognostic factors associated with recovery of smell and taste.

Design: Systematic review and meta-analysis.

Data Sources: PubMed, Embase, Scopus, Cochrane Library, and medRxiv from inception to 3 October 2021.

Association of cytokine profile with prior treatment failure and revision surgery in chronic rhinosinusitis.

Background: Inflammatory patterns in chronic rhinosinusitis (CRS) may predict disease severity, need for multiple sinus surgeries, and treatment response. This study analyzes nasal mucus inflammatory cytokine patterns in patients with (CRSwNP) and without (CRSsNP) nasal polyposis and their association with revision sinus surgery.

Methods: A total of 319 CRS patients who underwent sinus surgery were included.

Current insight into treatment of chronic rhinosinusitis: Phenotypes, endotypes, and implications for targeted therapeutics.

Chronic rhinosinusitis is characterized by persistent locoregional mucosal inflammation of the paranasal sinuses and upper airway that has substantial associated health care costs. Personalized approaches to care that incorporate use of molecular biomarkers, phenotypes, and inflammatory endotypes is a major focus of research at this time, and the concurrent rise of targeted therapeutics and biologic therapies has the potential to rapidly advance care and improve outcomes. Recent findings suggest that improved understanding of chronic rhinosinusitis phenotypic and endotypic heterogeneity, and incorporation of these characteristics into clinical care pathways, may facilitate more effective selection of surgical and/or therapeutic interventions.

Neuroendocrine carcinomas of the head and neck: A small case series.

Introduction: Neuroendocrine tumors of the head and neck are rare and arise either from epithelial or neuronal origin. Debate continues over the classification systems and appropriate management of these pathologies.

Objective: By investigating a small set of cases of high grade epithelial-derived neuroendocrine tumors of the head and neck (neuroendocrine carcinomas or NEC) from one institution, we compare survival rates of NEC of the head and neck to pulmonary NEC.

Sinonasal Small Cell Carcinoma-Case Series of a Rare Malignancy.

Sinonasal small cell neuroendocrine carcinoma (SNEC) is an extremely rare and aggressive neoplasm that can arise in the sinonasal region. These tumors are associated with high morbidity and mortality, are difficult to diagnose, and are hard to treat. We describe 2 cases of this poorly understood malignancy and review imaging, pathology, and treatment decisions.

Treatment of Sinonasal Teratocarcinosarcoma: A Systematic Review and Survival Analysis.

Background: Sinonasal teratocarcinosarcoma (SNTCS) is a rare malignancy of the anterior skull base with only 127 cases described in the English literature. Given the rarity of this tumor, new cases and analysis of published reports may assist in future management of SNTCS.

Objectives: 1) Describe findings from a systematic review of all available literature for malignant SNTCS including the clinical presentation, treatment modalities and outcomes.

Elevated mucus interleukin-17A levels are associated with increased prior sinus surgery for chronic rhinosinusitis.

Background: Recent advances in molecular biology have enabled the identification of potential inflammatory endotypes of chronic rhinosinusitis (CRS), with prior work suggesting differential short-term surgical outcome trajectories based on cytokine signatures. However, there is a paucity of data assessing long-term treatment failure and need for revision surgery based on inflammatory biomarkers.

Methods: Retrospective analysis of prospectively collected cross-sectional data from 231 patients electing surgical therapy for CRS.

The Role of Postoperative Imaging after Orbital Floor Fracture Repair.

Obtaining postoperative images of maxillofacial fractures does not affect the clinical management of asymptomatic patients; however, few studies have evaluated the role of postoperative imaging in the context of orbital floor fractures. In this study, we evaluate current practice techniques and the role of postoperative imaging in the management of orbital floor fractures in isolation and with concomitant facial fractures. Retrospective review of patients who underwent open reduction and internal fixation of orbital floor fractures between 2005 and 2015 at a single medical institution.