Alan D. Workman, Nithin D. Adappa, Pete S. Batra, Nikita Chapurin, Mathew Geltzeiler, Stacey T. Gray, James N. Palmer, Gurston G. Nyquist, Christopher R. Roxbury, Marilene B. Wang, Edward C. Kuan
The goal of this American Rhinologic Society expert practice statement (EPS) is to summarize the best available evidence for surveillance strategies following definitive treatment of sinonasal malignancy. Topics discussed include components of surveillance, including endoscopy and imaging subtypes, frequency and length of surveillance, and highlights of some specific pathologies that warrant special consideration. This EPS was developed following the recommended methodology and approval process as previously outlined. A modified Delphi approach with a working group of practitioners was utilized to develop five statements and one proposed algorithm, and all six items reached consensus after two rounds of discussion and modification. These statements and accompanying evidence are summarized, along with an assessment of gaps in the literature to identify future research needs.
{"title":"American Rhinologic Society Expert Practice Statement: Surveillance Strategies for Sinonasal Malignancy","authors":"Alan D. Workman, Nithin D. Adappa, Pete S. Batra, Nikita Chapurin, Mathew Geltzeiler, Stacey T. Gray, James N. Palmer, Gurston G. Nyquist, Christopher R. Roxbury, Marilene B. Wang, Edward C. Kuan","doi":"10.1002/alr.70028","DOIUrl":"10.1002/alr.70028","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>The goal of this American Rhinologic Society expert practice statement (EPS) is to summarize the best available evidence for surveillance strategies following definitive treatment of sinonasal malignancy. Topics discussed include components of surveillance, including endoscopy and imaging subtypes, frequency and length of surveillance, and highlights of some specific pathologies that warrant special consideration. This EPS was developed following the recommended methodology and approval process as previously outlined. A modified Delphi approach with a working group of practitioners was utilized to develop five statements and one proposed algorithm, and all six items reached consensus after two rounds of discussion and modification. These statements and accompanying evidence are summarized, along with an assessment of gaps in the literature to identify future research needs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"16 1","pages":"23-31"},"PeriodicalIF":6.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kunal R. Shetty, Salman Hasan, Christopher Bankston, Dylan Vance, Elaijah Islam, Gabriella Cruz, Faramarz Ashoori, David Z. Allen, William C. Yao, Martin J. Citardi, Amber U. Luong
<p>Intranasal capsaicin has been described as a novel therapeutic option for nonallergic rhinitis through downregulation and degeneration of the TRPV-1 receptor, which leads to decreased nasal activation by agonists [<span>1, 2</span>]. Prior studies have focused on 0.1 mmol/L administration, although concentrations up to 0.5 mmol/L were found to be tolerable for patients in prior studies [<span>3</span>]. Our study aims are to: (i) evaluate the therapeutic effect of capsaicin on chronic rhinitis symptoms in a larger cohort with higher concentrations of capsaicin administration; and (ii) delineate the relationship between local IgE levels and chronic rhinitis symptomatology and association with response to capsaicin treatment.</p><p>The study protocol was approved by the University of Texas Health Sciences Center at Houston Institutional Review Board, and complete study results are reported in clinicaltrials.gov (NCT05093478). Inclusion criteria for the study included patients with nonallergic rhinitis. Patients with a diagnosis of allergic rhinitis or positive allergy testing were excluded. Patients first completed a screening visit, where they completed skin prick allergy testing using Multi-Test II (Lincoln Diagnostics, Decatur, IL) to six common allergens. Patients who yielded positive results were excluded from study enrollment.</p><p>In order to create a standardized capsaicin solution, capsaicin powder (Fisher Scientific, Waltham, MA) was compounded to formulate a 0.1 and 0.5 mmol/L solution. Seven patients were given 0.1 mmol/L capsaicin solution, and 21 patients were given 0.5 mmol/L capsaicin solution. One milliliter of capsaicin formulation was applied to each nasal cavity using a mucosal atomizer device in the clinic. After initial administration, patients were given their corresponding capsaicin solution and instructed to apply it intranasally for four additional treatments at home. The visual analog score (VAS) was employed to quantitatively rate symptom severity [<span>4</span>]. Patients rated severity from 0 to 10, which was summated to create a total symptom score (TSS). Mucosal brush biopsy was utilized for intranasal IgE harvesting in accordance with a standardized technique (Immunovent LLC; New York, NY) [<span>5</span>]. Data collection was performed during three separate intervals: initial recruitment with capsaicin administration, 4-week follow-up, and 12-week follow-up. The statistical significance of mean changes between symptom scores prior to treatment and post-treatment at 4 and 12 weeks was evaluated using the Wilcoxon signed rank test (<i>p</i> < 0.05).</p><p>The initial recruitment phase included a total of 28 patients. Twenty-eight patients reported VAS symptom scores at the 4-week visit, and 24 patients reported their final 12-week VAS symptom scores, with four lost to follow-up. Of these 24 patients who were still enrolled in the study, 19 patients returned to the clinic for the final IgE measurement. The mea
鼻内辣椒素已被描述为一种新的治疗非过敏性鼻炎的选择，它通过下调TRPV-1受体并使其变性，从而导致激动剂对鼻腔的激活降低[1,2]。先前的研究集中于0.1 mmol/L的给药，尽管在先前的研究中发现患者可耐受0.5 mmol/L的浓度[3]。我们的研究目的是：(i)在更大的队列中评估辣椒素对慢性鼻炎症状的治疗效果，并给予更高浓度的辣椒素；（ii）描述局部IgE水平与慢性鼻炎症状之间的关系以及与辣椒素治疗反应的关联。该研究方案已由休斯顿机构审查委员会的德克萨斯大学健康科学中心批准，完整的研究结果已在clinicaltrials.gov （NCT05093478）上报告。该研究的纳入标准包括非过敏性鼻炎患者。诊断为过敏性鼻炎或过敏试验阳性的患者被排除在外。患者首先完成了一次筛查访问，在那里他们使用Multi-Test II（林肯诊断公司，迪凯特，伊利诺伊州）完成了对六种常见过敏原的皮肤点刺过敏测试。获得阳性结果的患者被排除在研究入组之外。为了创造一个标准化的辣椒素溶液，辣椒素粉末（Fisher Scientific, Waltham， MA）被配制成0.1和0.5 mmol/L的溶液。7例患者给予0.1 mmol/L辣椒素溶液，21例患者给予0.5 mmol/L辣椒素溶液。临床使用粘膜雾化装置将1毫升辣椒素制剂应用于每个鼻腔。在初始给药后，患者被给予相应的辣椒素溶液，并被指示在家中鼻内应用它进行四次额外的治疗。采用视觉模拟评分（VAS）对症状严重程度[4]进行定量评分。患者将严重程度从0到10打分，将其相加形成总症状评分（TSS）。按照标准化技术（immunvent LLC; New York， NY）[5]，粘膜刷活检用于鼻内IgE收集。数据收集分三个时间段进行：初始招募时使用辣椒素，4周随访和12周随访。采用Wilcoxon符号秩检验评估治疗前与治疗后4周和12周症状评分平均变化的统计学意义（p < 0.05）。初始招募阶段共包括28名患者。28名患者在随访4周时报告了VAS症状评分，24名患者报告了他们最终的12周VAS症状评分，其中4名患者失去了随访。在这24名仍然参加研究的患者中，19名患者返回诊所进行最终的IgE测量。患者平均年龄63岁（SD±16岁），男女比例为1:1。初始28例患者的平均基线TSS评分为17.0 (SD±7.0)，大多数患者的最严重症状为鼻漏。在4周的随访中，所有患者均报告症状减轻，其中21例患者报告TSS评分较基线下降超过30%（表1）。在12周的随访中，21例（87.5%）患者报告症状改善，14例（14/21,66.7%）患者报告TSS评分较基线下降超过30%。接受0.1和0.5 mmol/L溶液的患者在12周时TSS评分的平均降低分别为5和7.4。基线局部IgE水平与预处理VAS无显著相关性。基线IgE水平与12周治疗后TSS的降低没有关系（r = - 0.15, p = 0.47）（表2）。在研究期间没有发现明显的不良事件。一般来说，患者注意到辣椒素的灼烧感，尽管每个患者都能够在治疗访问时完成五剂量的给药。先前的Cochrane综述以及最近的一项包含9项研究的荟萃分析得出结论，在医生监督下，辣椒素是特发性非过敏性鼻炎患者的合理治疗选择[6,7]。meta分析中包含的四项研究使用的浓度为0.1 mmol/L的溶液。我们的结果表明，0.5 mmol/L的浓度对症状评分有较大的改善（支持信息）。与治疗后4周相比，0.1和0.5 mmol/L浓度的TSS从基线到治疗后12周的降低幅度较小。辣椒素的作用机制先前已被阐明，并被认为引起TRPV1受体的脱敏和变性，导致激动剂的激活降低，从而诱导鼻腔高反应性[8]。 鉴于这些结果，较高浓度的辣椒素可能会使更多的受体脱敏，从而改善治疗效果，但这些受体可能随着时间的推移而恢复或上调，这可以解释临床治疗效果的衰减。在我们的队列中，每位患者在粘膜刷活检中都有临床可检测的局部IgE水平。基线和12周局部IgE水平与从基线到12周VAS上TSS的变化没有相关性。这与之前的一项研究相似，在该研究中，粘膜刷活检在非过敏性鼻炎患者中产生了100%可检测到的鼻内IgE水平，并且鼻内总IgE水平、生活质量评分和季节性症状[5]之间存在不一致。这些发现不允许我们建立辣椒素治疗和鼻黏膜总IgE水平之间的相关关系。潜在的假设是，辣椒素的神经源性作用机制可能完全独立于局部过敏的2型免疫途径。先前的研究发现辣椒素不会干扰鼻上皮细胞形态，也不会诱导肥大细胞或鼻上皮细胞凋亡或坏死，因此可能不会影响鼻微环境[8]。本研究的一个局限性是受试者损耗，特别是对粘膜IgE收集的亲自随访。许多被招募的患者希望避免程序性干预和/或发现每日喷雾剂太有破坏性。因此，存在固有的抽样偏差。在12周的随访中，10名患者亲自要求并接受了辣椒素的重复治疗，这加强了预期的治疗益处超过了治疗带来的痛苦。MC: 3D Matrix、Acclarent、Latica、MicroGenDx和美敦力的顾问。AL: Lyra Therapeutics、Maxwell Bioscience、Stryker ENT、Medtronic、NeurENT、SoundHealth和Sanofi的顾问；阿斯利康、葛兰素史克和赛诺菲的顾问委员会成员；获得Insmed和赛诺菲的支持。王寅：Aerin Medical and Optinose Inc.顾问。
{"title":"Prevalence of Local IgE Elevation and Its Effect on Intranasal Capsaicin Therapy in the Nonallergic Rhinitis Population","authors":"Kunal R. Shetty, Salman Hasan, Christopher Bankston, Dylan Vance, Elaijah Islam, Gabriella Cruz, Faramarz Ashoori, David Z. Allen, William C. Yao, Martin J. Citardi, Amber U. Luong","doi":"10.1002/alr.70020","DOIUrl":"10.1002/alr.70020","url":null,"abstract":"<p>Intranasal capsaicin has been described as a novel therapeutic option for nonallergic rhinitis through downregulation and degeneration of the TRPV-1 receptor, which leads to decreased nasal activation by agonists [<span>1, 2</span>]. Prior studies have focused on 0.1 mmol/L administration, although concentrations up to 0.5 mmol/L were found to be tolerable for patients in prior studies [<span>3</span>]. Our study aims are to: (i) evaluate the therapeutic effect of capsaicin on chronic rhinitis symptoms in a larger cohort with higher concentrations of capsaicin administration; and (ii) delineate the relationship between local IgE levels and chronic rhinitis symptomatology and association with response to capsaicin treatment.</p><p>The study protocol was approved by the University of Texas Health Sciences Center at Houston Institutional Review Board, and complete study results are reported in clinicaltrials.gov (NCT05093478). Inclusion criteria for the study included patients with nonallergic rhinitis. Patients with a diagnosis of allergic rhinitis or positive allergy testing were excluded. Patients first completed a screening visit, where they completed skin prick allergy testing using Multi-Test II (Lincoln Diagnostics, Decatur, IL) to six common allergens. Patients who yielded positive results were excluded from study enrollment.</p><p>In order to create a standardized capsaicin solution, capsaicin powder (Fisher Scientific, Waltham, MA) was compounded to formulate a 0.1 and 0.5 mmol/L solution. Seven patients were given 0.1 mmol/L capsaicin solution, and 21 patients were given 0.5 mmol/L capsaicin solution. One milliliter of capsaicin formulation was applied to each nasal cavity using a mucosal atomizer device in the clinic. After initial administration, patients were given their corresponding capsaicin solution and instructed to apply it intranasally for four additional treatments at home. The visual analog score (VAS) was employed to quantitatively rate symptom severity [<span>4</span>]. Patients rated severity from 0 to 10, which was summated to create a total symptom score (TSS). Mucosal brush biopsy was utilized for intranasal IgE harvesting in accordance with a standardized technique (Immunovent LLC; New York, NY) [<span>5</span>]. Data collection was performed during three separate intervals: initial recruitment with capsaicin administration, 4-week follow-up, and 12-week follow-up. The statistical significance of mean changes between symptom scores prior to treatment and post-treatment at 4 and 12 weeks was evaluated using the Wilcoxon signed rank test (<i>p</i> < 0.05).</p><p>The initial recruitment phase included a total of 28 patients. Twenty-eight patients reported VAS symptom scores at the 4-week visit, and 24 patients reported their final 12-week VAS symptom scores, with four lost to follow-up. Of these 24 patients who were still enrolled in the study, 19 patients returned to the clinic for the final IgE measurement. The mea","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 11","pages":"1300-1302"},"PeriodicalIF":6.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alr.70020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Arshbir Aulakh, Pradumn Choudhary, Gurwinder Sidhu, Deanna Gigliotti, Jane Jun, Andrew Thamboo
Background
Emerging evidence suggests a possible link between rhinosinusitis and systemic rheumatic diseases; however, no meta-analysis has comprehensively examined this association to date. We aimed to investigate if patients with rhinosinusitis have a predisposition to unmasking rheumatic diseases compared to individuals without rhinosinusitis.
Methods
A comprehensive search in MEDLINE, Embase, Cochrane Library, and Web of Science was conducted until February 2025 for studies characterizing rheumatic disease incidence, prevalence, and risk in cohorts of rhinosinusitis patients. The search was limited to records authored in English and involved combining both rhinitis and sinusitis Medical Subject Headings (MeSH) terms. Relative risk and prevalence data were pooled using random-effects models.
Results
Nine studies with 86,081 rhinosinusitis patients were included. Chronic rhinosinusitis (CRS) was significantly associated with increased risk of rheumatoid arthritis (RA) (odds ratio [OR]: 1.70; 95% CI: 1.44–2.00; p < 0.00001), systemic lupus erythematosus (OR: 1.61; 95% CI: 1.25–2.08; p = 0.0002), and ankylosing spondylitis (OR: 1.48; 95% CI: 1.26–1.72; p < 0.00001). Acute rhinosinusitis (ARS) showed weaker associations, notably with seronegative RA. Rheumatic disease prevalence in rhinosinusitis patients was highest for RA (10%, 95% CI: 8.2–13).
Conclusion
Rhinosinusitis, particularly CRS, is associated with several rheumatic diseases. Mechanisms of mucosal immune dysregulation associated with rhinosinusitis may contribute to, or act in parallel with, the pathogenesis of systemic autoimmunity. Management of CRS (surgical or immunomodulatory) may lead to the sentinel presentation and subsequent identification of previously undiagnosed systemic autoimmune conditions. Clinicians should maintain a high index of suspicion for early autoimmune symptoms in rhinosinusitis patients.
背景：新出现的证据表明鼻窦炎与系统性风湿病之间可能存在联系；然而，到目前为止，还没有荟萃分析全面地研究了这种关联。我们的目的是调查与没有鼻窦炎的个体相比，患有鼻窦炎的患者是否有暴露风湿性疾病的倾向。方法：在MEDLINE、Embase、Cochrane图书馆和Web of Science中进行综合检索，直到2025年2月，以确定鼻窦炎患者队列中风湿性疾病的发病率、患病率和风险。搜索仅限于用英文撰写的记录，并涉及鼻炎和鼻窦炎医学主题标题（MeSH）术语。使用随机效应模型汇总相对风险和患病率数据。结果：纳入9项研究，共纳入86081例鼻窦炎患者。慢性鼻窦炎（CRS）与类风湿关节炎（RA）风险增加显著相关（优势比[OR]: 1.70; 95% CI: 1.44-2.00; p）结论：鼻窦炎，特别是CRS，与几种风湿性疾病相关。与鼻窦炎相关的粘膜免疫失调的机制可能有助于或与全身性自身免疫的发病机制并行。CRS的管理（手术或免疫调节）可能导致前哨表现和随后未确诊的全身自身免疫性疾病的识别。临床医生应该对鼻窦炎患者的早期自身免疫症状保持高度的怀疑。
{"title":"The Risk of Rheumatic Disorders Among Patients With Rhinosinusitis: A Systematic Review and Meta-Analysis","authors":"Arshbir Aulakh, Pradumn Choudhary, Gurwinder Sidhu, Deanna Gigliotti, Jane Jun, Andrew Thamboo","doi":"10.1002/alr.70032","DOIUrl":"10.1002/alr.70032","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Emerging evidence suggests a possible link between rhinosinusitis and systemic rheumatic diseases; however, no meta-analysis has comprehensively examined this association to date. We aimed to investigate if patients with rhinosinusitis have a predisposition to unmasking rheumatic diseases compared to individuals without rhinosinusitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive search in MEDLINE, Embase, Cochrane Library, and Web of Science was conducted until February 2025 for studies characterizing rheumatic disease incidence, prevalence, and risk in cohorts of rhinosinusitis patients. The search was limited to records authored in English and involved combining both rhinitis and sinusitis Medical Subject Headings (MeSH) terms. Relative risk and prevalence data were pooled using random-effects models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine studies with 86,081 rhinosinusitis patients were included. Chronic rhinosinusitis (CRS) was significantly associated with increased risk of rheumatoid arthritis (RA) (odds ratio [OR]: 1.70; 95% CI: 1.44–2.00; <i>p</i> < 0.00001), systemic lupus erythematosus (OR: 1.61; 95% CI: 1.25–2.08; <i>p</i> = 0.0002), and ankylosing spondylitis (OR: 1.48; 95% CI: 1.26–1.72; <i>p</i> < 0.00001). Acute rhinosinusitis (ARS) showed weaker associations, notably with seronegative RA. Rheumatic disease prevalence in rhinosinusitis patients was highest for RA (10%, 95% CI: 8.2–13).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Rhinosinusitis, particularly CRS, is associated with several rheumatic diseases. Mechanisms of mucosal immune dysregulation associated with rhinosinusitis may contribute to, or act in parallel with, the pathogenesis of systemic autoimmunity. Management of CRS (surgical or immunomodulatory) may lead to the sentinel presentation and subsequent identification of previously undiagnosed systemic autoimmune conditions. Clinicians should maintain a high index of suspicion for early autoimmune symptoms in rhinosinusitis patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 11","pages":"1279-1292"},"PeriodicalIF":6.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alr.70032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter to the Editor Regarding “Do Skin Prick Tests Predict Nasal Provocation Test Outcomes in Allergic Rhinitis Patients?”","authors":"Xu Li, Mingxia Gao, Tingting Gao, Peng Jin, Lili Zhi","doi":"10.1002/alr.70030","DOIUrl":"10.1002/alr.70030","url":null,"abstract":"","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 11","pages":"1323-1324"},"PeriodicalIF":6.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Response to Li et al.’s Letter to the Editor Regarding “Do Skin Prick Tests Predict Nasal Provocation Test Outcomes in Allergic Rhinitis Patients?”","authors":"Yunhyung Lee, Marn Joon Park","doi":"10.1002/alr.70029","DOIUrl":"10.1002/alr.70029","url":null,"abstract":"","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 11","pages":"1334-1335"},"PeriodicalIF":6.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jenny B. Xiao, Carlos Khalil, Helen Hsiao, Janiss Skulsampaopol, Daniel J. Lee, Michael D. Cusimano, John M. Lee
Background
Given the association between spontaneous cerebrospinal fluid (sCSF) leak and idiopathic intracranial hypertension (IIH), and the association of IIH and venous sinus stenosis (VSS), we sought to determine the prevalence of VSS in sCSF leak and the role of venous sinus stenting for sCSF leak.
Methods
A protocol was registered in PROSPERO [CRD42024568270]. A search was conducted in four electronic databases: Medline (Ovid), Embase, CINAHL, Web of Science, and Cochrane CENTRAL. Two reviewers independently screened citations and extracted data. Methodological quality was assessed using the Joanna Briggs Institute's critical appraisal tool. Data were pooled using a random effects model to calculate overall prevalence and relative risk (RR).
Results
Fifteen studies met the final inclusion criteria, with a total of 372 patients presenting with sCSF leak. The pooled prevalence of VSS in patients with sCSF leak was 0.71 (95% CI: 0.56–0.83, I2 = 74%). VSS was three-fold greater in patients with sCSF leak compared to those without, although this was not statistically significant (RR = 3.11; 95% CI: 0.64–15.27, I2 = 87%). Ninety percent of patients with VSS who underwent venous sinus stenting as adjunctive therapy to surgical repair of sCSF leak or for medically refractive IIH demonstrated resolution of symptoms without sCSF leak recurrence at last follow-up.
Conclusion
VSS is common in patients with sCSF leak, and adjunctive venous sinus stenting after surgical leak repair may benefit a subset of patients. Further studies are needed to clarify the role of venous sinus stenting in conjunction with surgical repair of leaks.
{"title":"Prevalence of Venous Sinus Stenosis in Spontaneous Cerebrospinal Fluid Leak and the Role for Venous Sinus Stenting: A Systematic Review and Meta-Analysis","authors":"Jenny B. Xiao, Carlos Khalil, Helen Hsiao, Janiss Skulsampaopol, Daniel J. Lee, Michael D. Cusimano, John M. Lee","doi":"10.1002/alr.70026","DOIUrl":"10.1002/alr.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Given the association between spontaneous cerebrospinal fluid (sCSF) leak and idiopathic intracranial hypertension (IIH), and the association of IIH and venous sinus stenosis (VSS), we sought to determine the prevalence of VSS in sCSF leak and the role of venous sinus stenting for sCSF leak.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A protocol was registered in PROSPERO [CRD42024568270]. A search was conducted in four electronic databases: Medline (Ovid), Embase, CINAHL, Web of Science, and Cochrane CENTRAL. Two reviewers independently screened citations and extracted data. Methodological quality was assessed using the Joanna Briggs Institute's critical appraisal tool. Data were pooled using a random effects model to calculate overall prevalence and relative risk (RR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen studies met the final inclusion criteria, with a total of 372 patients presenting with sCSF leak. The pooled prevalence of VSS in patients with sCSF leak was 0.71 (95% CI: 0.56–0.83, <i>I</i><sup>2</sup> = 74%). VSS was three-fold greater in patients with sCSF leak compared to those without, although this was not statistically significant (RR = 3.11; 95% CI: 0.64–15.27, <i>I</i><sup>2</sup> = 87%). Ninety percent of patients with VSS who underwent venous sinus stenting as adjunctive therapy to surgical repair of sCSF leak or for medically refractive IIH demonstrated resolution of symptoms without sCSF leak recurrence at last follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>VSS is common in patients with sCSF leak, and adjunctive venous sinus stenting after surgical leak repair may benefit a subset of patients. Further studies are needed to clarify the role of venous sinus stenting in conjunction with surgical repair of leaks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 10","pages":"1136-1151"},"PeriodicalIF":6.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alr.70026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sairisheel Gabbi Reddy, Ruifeng Cui, Armen Aprahamian, Andrew Seman, Camron Latterner, Hassan H. Ramadan, Chadi A. Makary
{"title":"Association of Nasal Septal Deviation and Recurrent Epistaxis in Adults","authors":"Sairisheel Gabbi Reddy, Ruifeng Cui, Armen Aprahamian, Andrew Seman, Camron Latterner, Hassan H. Ramadan, Chadi A. Makary","doi":"10.1002/alr.70025","DOIUrl":"10.1002/alr.70025","url":null,"abstract":"","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 11","pages":"1303-1305"},"PeriodicalIF":6.8,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comment on “Superior Benefits of Combining Mepolizumab With Sinus Surgery Compared to Mepolizumab Alone: Results From a Randomised 6-Month Trial”","authors":"Yi Deng, Ping Lv","doi":"10.1002/alr.70023","DOIUrl":"10.1002/alr.70023","url":null,"abstract":"","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 11","pages":"1321-1322"},"PeriodicalIF":6.8,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reply to Letter to the Editor Regarding: “Assessing Adequacy of Surgical Extent in CRSwNP: The Completion of Surgery Index (CoSI)”","authors":"Alan Workman, James N. Palmer","doi":"10.1002/alr.23601","DOIUrl":"10.1002/alr.23601","url":null,"abstract":"","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 11","pages":""},"PeriodicalIF":6.8,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Middle Turbinate Resection May Lead to Nasal Septal Polyp Formation in Allergic Patients","authors":"John M. DelGaudio","doi":"10.1002/alr.70016","DOIUrl":"10.1002/alr.70016","url":null,"abstract":"","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 10","pages":"1178-1180"},"PeriodicalIF":6.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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