International Forum of Allergy & Rhinology最新文献

英文中文

Letter to the Editor Regarding “Do Skin Prick Tests Predict Nasal Provocation Test Outcomes in Allergic Rhinitis Patients?” 致编辑关于“皮肤点刺试验能预测变应性鼻炎患者鼻腔激发试验的结果吗？”

IF 6.8 2区医学 Q1 OTORHINOLARYNGOLOGY

International Forum of Allergy & Rhinology

Pub Date : 2025-09-04 DOI: 10.1002/alr.70030

Xu Li, Mingxia Gao, Tingting Gao, Peng Jin, Lili Zhi

引用次数: 0

Response to Li et al.’s Letter to the Editor Regarding “Do Skin Prick Tests Predict Nasal Provocation Test Outcomes in Allergic Rhinitis Patients?” 对Li等人关于“皮肤点刺试验能否预测变应性鼻炎患者鼻腔激发试验的结果？”

IF 6.8 2区医学 Q1 OTORHINOLARYNGOLOGY

International Forum of Allergy & Rhinology

Pub Date : 2025-09-03 DOI: 10.1002/alr.70029

Yunhyung Lee, Marn Joon Park

引用次数: 0

Prevalence of Venous Sinus Stenosis in Spontaneous Cerebrospinal Fluid Leak and the Role for Venous Sinus Stenting: A Systematic Review and Meta-Analysis 自发性脑脊液漏中静脉窦狭窄的发生率及静脉窦支架植入术的作用：一项系统综述和荟萃分析。

IF 6.8 2区医学 Q1 OTORHINOLARYNGOLOGY

International Forum of Allergy & Rhinology

Pub Date : 2025-09-01 DOI: 10.1002/alr.70026

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.

背景：鉴于自发性脑脊液（sCSF）泄漏与特发性颅内高压（IIH）之间的关联，以及IIH与静脉窦狭窄（VSS）之间的关联，我们试图确定自发性脑脊液（sCSF）泄漏中VSS的患病率以及静脉窦支架置入治疗sCSF泄漏的作用。方法：在PROSPERO中注册一个协议[CRD42024568270]。检索四个电子数据库：Medline （Ovid）、Embase、CINAHL、Web of Science和Cochrane CENTRAL。两名审稿人独立筛选引文并提取数据。使用乔安娜布里格斯研究所的关键评估工具评估方法质量。采用随机效应模型汇总数据，计算总体患病率和相对危险度（RR）。结果：15项研究符合最终纳入标准，共有372例患者出现sCSF泄漏。sCSF泄漏患者中VSS的总患病率为0.71 （95% CI: 0.56-0.83, I2 = 74%）。sCSF泄漏患者的VSS是无sCSF泄漏患者的3倍，尽管这没有统计学意义（RR = 3.11; 95% CI: 0.64-15.27, I2 = 87%）。在最后一次随访中，90%的VSS患者接受静脉窦支架置入术作为手术修复sCSF泄漏或医学屈光性IIH的辅助治疗，症状得到缓解，无sCSF泄漏复发。结论：VSS在sCSF泄漏患者中很常见，手术泄漏修复后辅助静脉窦支架置入可能使一部分患者受益。需要进一步的研究来阐明静脉窦支架植入与手术修复泄漏的作用。

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引用次数: 0

Association of Nasal Septal Deviation and Recurrent Epistaxis in Adults 成人鼻中隔偏曲与复发性鼻出血的关系。

IF 6.8 2区医学 Q1 OTORHINOLARYNGOLOGY

International Forum of Allergy & Rhinology

Pub Date : 2025-08-31 DOI: 10.1002/alr.70025

Sairisheel Gabbi Reddy, Ruifeng Cui, Armen Aprahamian, Andrew Seman, Camron Latterner, Hassan H. Ramadan, Chadi A. Makary

引用次数: 0

Comment on “Superior Benefits of Combining Mepolizumab With Sinus Surgery Compared to Mepolizumab Alone: Results From a Randomised 6-Month Trial” 评论“Mepolizumab联合鼻窦手术优于单独Mepolizumab：来自6个月随机试验的结果”。

IF 6.8 2区医学 Q1 OTORHINOLARYNGOLOGY

International Forum of Allergy & Rhinology

Pub Date : 2025-08-28 DOI: 10.1002/alr.70023

Yi Deng, Ping Lv

引用次数: 0

Reply to Letter to the Editor Regarding: “Assessing Adequacy of Surgical Extent in CRSwNP: The Completion of Surgery Index (CoSI)” 回复编辑关于“评估CRSwNP手术程度的充分性：手术指数（CoSI）的完成”的信件。

IF 6.8 2区医学 Q1 OTORHINOLARYNGOLOGY

International Forum of Allergy & Rhinology

Pub Date : 2025-08-28 DOI: 10.1002/alr.23601

Alan Workman, James N. Palmer

引用次数: 0

Middle Turbinate Resection May Lead to Nasal Septal Polyp Formation in Allergic Patients 中鼻甲切除术可能导致过敏患者鼻中隔息肉形成。

IF 6.8 2区医学 Q1 OTORHINOLARYNGOLOGY

International Forum of Allergy & Rhinology

Pub Date : 2025-08-26 DOI: 10.1002/alr.70016

John M. DelGaudio

引用次数: 0

Vision-Guided Surgical Navigation Using Computer Vision for Dynamic Intraoperative Imaging Updates 使用计算机视觉进行动态术中影像更新的视觉引导手术导航。

IF 6.8 2区医学 Q1 OTORHINOLARYNGOLOGY

International Forum of Allergy & Rhinology

Pub Date : 2025-08-22 DOI: 10.1002/alr.70000

Jeremy Ruthberg, Nicole Gunderson, Pengcheng Chen, Graham Harris, Hannah Case, Randall Bly, Eric J. Seibel, Waleed M. Abuzeid

Background

Residual disease after endoscopic sinus surgery (ESS) contributes to poor outcomes and revision surgery. Image-guided surgery systems cannot dynamically reflect intraoperative changes. We propose a sensorless, video-based method for intraoperative CT updating using neural radiance fields (NeRF), a deep learning algorithm used to create 3D surgical field reconstructions.

Methods

Bilateral ESS was performed on three 3D-printed models (n = 6 sides). Postoperative endoscopic videos were processed through a custom NeRF pipeline to generate 3D reconstructions, which were co-registered to preoperative CT scans. Digitally updated CT models were created through algorithmic subtraction of resected regions, then volumetrically segmented, and compared to ground-truth postoperative CT. Accuracy was assessed using Hausdorff distance (surface alignment), Dice similarity coefficient (DSC) (volumetric overlap), and Bland‒Altman analysis (BAA) (statistical agreement).

Results

Comparison of the updated CT and the ground-truth postoperative CT indicated an average Hausdorff distance of 0.27 ± 0.076 mm and a 95th percentile Hausdorff distance of 0.82 ± 0.165 mm, indicating sub-millimeter surface alignment. The DSC was 0.93 ± 0.012 with values >0.9 suggestive of excellent spatial overlap. BAA indicated modest underestimation of volume on the updated CT versus ground-truth CT with a mean difference in volumes of 0.40 cm³ with 95% limits of agreement of 0.04‒0.76 cm³ indicating that all samples fell within acceptable bounds of variability.

Conclusions

Computer vision can enable dynamic intraoperative imaging by generating highly accurate CT updates from monocular endoscopic video without external tracking. By directly visualizing resection progress, this software-driven tool has the potential to enhance surgical completeness in ESS for next-generation navigation platforms.

背景：内窥镜鼻窦手术（ESS）后残留疾病导致预后差和翻修手术。图像引导手术系统不能动态反映术中变化。我们提出了一种无传感器、基于视频的术中CT更新方法，该方法使用神经辐射场（NeRF），这是一种用于创建3D手术场重建的深度学习算法。方法：对3个3d打印模型（n = 6侧）进行双侧ESS。术后内窥镜视频通过定制的NeRF管道进行处理，生成3D重建，并与术前CT扫描共同注册。通过算法减去被切除的区域，创建数字更新的CT模型，然后进行体积分割，并与ground-truth术后CT进行比较。采用Hausdorff距离（表面对准）、Dice相似系数（DSC）（体积重叠）和Bland-Altman分析（BAA）（统计一致性）评估准确性。结果：更新后的CT与术后真地CT比较，平均Hausdorff距离为0.27±0.076 mm，第95百分位Hausdorff距离为0.82±0.165 mm，显示亚毫米级的表面对齐。DSC为0.93±0.012,>0.9提示空间重叠良好。BAA表明更新后的CT与基线CT的体积有适度低估，平均体积差异为0.40 cm3, 95%的一致性限为0.04-0.76 cm3，表明所有样本都在可接受的可变性范围内。结论：计算机视觉可以在没有外部跟踪的情况下从单眼内窥镜视频生成高精度的CT更新，从而实现术中动态成像。通过直接可视化切除过程，这种软件驱动的工具有可能提高下一代导航平台的ESS手术完整性。

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引用次数: 0

External Validation of a Multivariable Diagnostic Prediction Model for Acute Invasive Fungal Rhinosinusitis in Tertiary Care Settings 三级医疗机构急性侵袭性真菌性鼻窦炎多变量诊断预测模型的外部验证。

IF 6.8 2区医学 Q1 OTORHINOLARYNGOLOGY

International Forum of Allergy & Rhinology

Pub Date : 2025-08-22 DOI: 10.1002/alr.70024

Aviv Spillinger, Johanna Ellefson, Qiuyu Yang, Linda X. Yin, Janalee K. Stokken, Thomas Pasic, Ian J. Koszewski, Sandra Y. Lin

Background

Prompt detection and intervention are crucial for improving outcomes in acute invasive fungal rhinosinusitis (AIFS). Diagnostic prediction models assist in risk-stratification, but their accuracy requires testing through external validation. This study aims to validate a previously published diagnostic prediction model for AIFS in an independent cohort.

Methods

A retrospective chart review was conducted at a tertiary care center (2008–2023) to identify patients with an otolaryngology consult for suspected AIFS. Of 65 patients identified, 11 (16.9%) were diagnosed with AIFS based on histopathology. Risk was calculated using Yin et al.’s predictive model. Predictive performance was assessed by calibration and discrimination.

Results

Patients had significantly higher rates of diabetes (46.2% vs. 26.1%, p = 0.002), long-term steroid use (60% vs. 28.2%, p < 0.0001), and solid organ transplantation (38.5% vs. 8.5%, p < 0.001), compared with the development cohort, with conversely lower rates of hematologic malignancy (29.2% vs. 58.7, p < 0.001) and neutropenia (19.4% vs. 41%, p = 0.001). Despite these differences, both the three-variable (C-index: 0.844; 95% CI, 0.736–0.952) and four-variable models (C-index: 0.963; 95% CI, 0.919–1) showed adequate discrimination. Both models exhibited slight overprediction of risk, with a calibration-in-the-large predicted risk of 24.1% (95% CI, 13.68–34.46) for the three-variable model and 24.2% (95% CI, 13.76–34.57) for the four-variable model. Calibration plots confirmed overprediction.

Conclusion

The AIFS diagnostic model demonstrates acceptable discrimination and calibration on external validation, with generalizability to patients with different comorbidities. Larger studies are recommended to further test the model's predictive performance and clinical applicability.

背景：及时发现和干预是改善急性侵袭性真菌性鼻窦炎（AIFS）预后的关键。诊断预测模型有助于风险分层，但其准确性需要通过外部验证进行测试。本研究的目的是在一个独立的队列中验证先前发表的AIFS诊断预测模型。方法：回顾性分析2008-2023年在某三级保健中心就诊的疑似AIFS患者的耳鼻喉科就诊情况。在确诊的65例患者中，11例（16.9%）经组织病理学诊断为AIFS。使用Yin等人的预测模型计算风险。通过校准和判别来评估预测性能。结果：与发展队列相比，患者的糖尿病（46.2% vs. 26.1%, p = 0.002）、长期类固醇使用（60% vs. 28.2%, p < 0.0001）和实体器官移植（38.5% vs. 8.5%, p < 0.001）的发生率显著高于发展队列，相反，血液恶性肿瘤（29.2% vs. 58.7%, p < 0.001）和中性粒细胞减少（19.4% vs. 41%, p = 0.001）的发生率较低。尽管存在这些差异，但三变量模型（C-index: 0.844; 95% CI, 0.736-0.952）和四变量模型（C-index: 0.963; 95% CI, 0.919-1）都显示出足够的区别。两种模型都表现出轻微的过度预测风险，三变量模型的校准大预测风险为24.1% (95% CI, 13.68-34.46)，四变量模型的校准大预测风险为24.2% （95% CI, 13.76-34.57）。校正图证实了高估。结论：AIFS诊断模型经外部验证具有良好的辨别性和定标性，对不同合并症患者具有通用性。建议进行更大规模的研究，以进一步测试该模型的预测性能和临床适用性。

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引用次数: 0

Central Compartment Atopic Disease: Analysis of Current Literature and Proposal of Diagnostic Criteria 中央室特应性疾病：当前文献分析及诊断标准建议。

IF 6.8 2区医学 Q1 OTORHINOLARYNGOLOGY

International Forum of Allergy & Rhinology

Pub Date : 2025-08-22 DOI: 10.1002/alr.70012

Emily M. Barrow, Sarah K. Wise, Anthony Botros, Richard J. Harvey, Thomas S. Edwards, John DelGaudio

Background

Central compartment atopic disease (CCAD) is a nasal inflammatory condition associated with allergy and categorized as type 2 dominant chronic rhinosinusitis with nasal polyps (CRSwNP). Sinus opacification in this condition is secondary to obstruction from central tissue remodeling. Although the literature supports a unique phenotype of CCAD, controversy persists due to variations in published studies. Standardized diagnostic criteria for CCAD are lacking. The current literature was systematically evaluated to propose a set of diagnostic criteria for CCAD.

Methods

A comprehensive literature review on CCAD was performed. Using current knowledge as the foundation, diagnostic criteria for CCAD are proposed.

Results

Tissue remodeling of the central part of the nasal and sinus cavity in a patient with features of an IgE mediated allergic process is the cornerstone of CCAD. It is a type 2 dominant endotype with an eosinophilic inflammatory profile. While CCAD is represented by unique phenotypic and endotypic features, there are likely geographic variations in CCAD presentation, especially when comparing CCAD to other subtypes of CRS. Previous lack of clear diagnostic criteria for CCAD has likely contributed to conflicting findings in the published literature on CCAD.

Conclusion

Endoscopic confirmation of polypoid changes of central compartment structures (middle/superior turbinate, and/or posterosuperior nasal septum) is critical to the diagnosis of CCAD. Allergic history strongly supports CCAD diagnosis. While CCAD may display some unique radiologic features, radiology alone is insufficient to diagnose CCAD.

背景：中央室特应性疾病（CCAD）是一种与过敏相关的鼻腔炎症，被归类为2型显性慢性鼻窦炎伴鼻息肉（CRSwNP）。这种情况下的鼻窦混浊是继发于中央组织重塑引起的阻塞。尽管文献支持CCAD的独特表型，但由于发表的研究存在差异，争议仍然存在。CCAD缺乏标准化的诊断标准。对现有文献进行系统评价，提出一套CCAD的诊断标准。方法：对CCAD的相关文献进行综述。在现有知识的基础上，提出了CCAD的诊断标准。结果：在具有IgE介导的过敏过程特征的患者中，鼻窦中心部分的组织重塑是CCAD的基础。它是2型显性内型，具有嗜酸性炎症特征。虽然CCAD具有独特的表型和内型特征，但CCAD的表现可能存在地理差异，特别是在将CCAD与其他CRS亚型进行比较时。此前CCAD缺乏明确的诊断标准，这可能导致CCAD已发表文献中相互矛盾的发现。结论：内镜下确认中央腔室结构（中/上鼻甲和/或后上鼻中隔）息肉样改变对CCAD的诊断至关重要。过敏史有力地支持CCAD的诊断。虽然CCAD可能表现出一些独特的放射学特征，但仅靠放射学不足以诊断CCAD。

{"title":"Central Compartment Atopic Disease: Analysis of Current Literature and Proposal of Diagnostic Criteria","authors":"Emily M. Barrow, Sarah K. Wise, Anthony Botros, Richard J. Harvey, Thomas S. Edwards, John DelGaudio","doi":"10.1002/alr.70012","DOIUrl":"10.1002/alr.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Central compartment atopic disease (CCAD) is a nasal inflammatory condition associated with allergy and categorized as type 2 dominant chronic rhinosinusitis with nasal polyps (CRSwNP). Sinus opacification in this condition is secondary to obstruction from central tissue remodeling. Although the literature supports a unique phenotype of CCAD, controversy persists due to variations in published studies. Standardized diagnostic criteria for CCAD are lacking. The current literature was systematically evaluated to propose a set of diagnostic criteria for CCAD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive literature review on CCAD was performed. Using current knowledge as the foundation, diagnostic criteria for CCAD are proposed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Tissue remodeling of the central part of the nasal and sinus cavity in a patient with features of an IgE mediated allergic process is the cornerstone of CCAD. It is a type 2 dominant endotype with an eosinophilic inflammatory profile. While CCAD is represented by unique phenotypic and endotypic features, there are likely geographic variations in CCAD presentation, especially when comparing CCAD to other subtypes of CRS. Previous lack of clear diagnostic criteria for CCAD has likely contributed to conflicting findings in the published literature on CCAD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Endoscopic confirmation of polypoid changes of central compartment structures (middle/superior turbinate, and/or posterosuperior nasal septum) is critical to the diagnosis of CCAD. Allergic history strongly supports CCAD diagnosis. While CCAD may display some unique radiologic features, radiology alone is insufficient to diagnose CCAD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 10","pages":"1113-1135"},"PeriodicalIF":6.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952883","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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