Middle ear surgeries are better executed under controlled hypotension. Reverse-Trendelenburg (RTP) position has been used in endoscopic sinus surgeries as a safe and cost-free method to reduce intraoperative bleeding. However, it has not been tried in ear surgery due to surgical field accessibility concerns. The primary aim of this study was to evaluate the effect of two RTP angles (10 and 20 degrees) on quality of surgical field and surgical position accessibility.
Methods
In total, 225 adult patients of both sexes, aged between 18 and 50 years, ASA I–II, scheduled for elective middle ear surgery were enrolled in this randomized, prospective, controlled study. All patients were anesthetized using the same protocol. Patients were randomly and evenly allocated to one of three groups, 75 patients each; group I (control) patients were positioned supine, group II patients were positioned 10̊ RTP position and group III patients were positioned 20̊ RTP position. The surgeons were asked to assess the surgical field using a 5-point scale. The surgeon satisfaction concerning surgical position accessibility was evaluated using a 5-point scale. Total dexmedetomidine consumption, recovery time, surgical time and analgesia time were recorded.
Results
The quality of surgical field was significantly different among the three groups (P-value < 0.001), being best in group III. Surgeon's satisfaction score was found to be statistically insignificant among the three study groups (P-value = 0.251).
Conclusion
This study showed that 10 and 20-degree RTP provided a significantly better surgical field quality without considerably affecting accessibility and decreased intraoperative dexmedetomidine consumption shortening the recovery time.
{"title":"Effect of 10 and 20 degrees reverse Trendelenburg position on surgical field quality during ear surgery. A randomized-controlled trial","authors":"H.S. El-Ozairy , M.R. Naguib , A.M. Abd-Elmaksoud , O.M. Mady","doi":"10.1016/j.anorl.2025.07.004","DOIUrl":"10.1016/j.anorl.2025.07.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Middle ear surgeries are better executed under controlled hypotension. Reverse-Trendelenburg (RTP) position has been used in endoscopic sinus surgeries as a safe and cost-free method to reduce intraoperative bleeding. However, it has not been tried in ear surgery due to surgical field accessibility concerns. The primary aim of this study was to evaluate the effect of two RTP angles (10 and 20 degrees) on quality of surgical field and surgical position accessibility.</div></div><div><h3>Methods</h3><div>In total, 225 adult patients of both sexes, aged between 18 and 50<!--> <!-->years, ASA I–II, scheduled for elective middle ear surgery were enrolled in this randomized, prospective, controlled study. All patients were anesthetized using the same protocol. Patients were randomly and evenly allocated to one of three groups, 75 patients each; group I (control) patients were positioned supine, group II patients were positioned 10̊ RTP position and group III patients were positioned 20̊ RTP position. The surgeons were asked to assess the surgical field using a 5-point scale. The surgeon satisfaction concerning surgical position accessibility was evaluated using a 5-point scale. Total dexmedetomidine consumption, recovery time, surgical time and analgesia time were recorded.</div></div><div><h3>Results</h3><div>The quality of surgical field was significantly different among the three groups (<em>P</em>-value<!--> <!--><<!--> <!-->0.001), being best in group III. Surgeon's satisfaction score was found to be statistically insignificant among the three study groups (<em>P</em>-value<!--> <!-->=<!--> <!-->0.251).</div></div><div><h3>Conclusion</h3><div>This study showed that 10 and 20-degree RTP provided a significantly better surgical field quality without considerably affecting accessibility and decreased intraoperative dexmedetomidine consumption shortening the recovery time.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 1","pages":"Pages 24-29"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.anorl.2025.10.005
F. Simon , M. Mondain , E. Serrano , V. Couloigner , C. Parietti-Winkler , F. Denoyelle
{"title":"Journal white-list versus special issues","authors":"F. Simon , M. Mondain , E. Serrano , V. Couloigner , C. Parietti-Winkler , F. Denoyelle","doi":"10.1016/j.anorl.2025.10.005","DOIUrl":"10.1016/j.anorl.2025.10.005","url":null,"abstract":"","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 1","pages":"Pages 1-3"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.anorl.2025.07.001
P. Rodríguez Lorenzana , Á. Iglesias Castro , F. Vázquez de la Iglesia , A. Fernández Tenreiro
{"title":"Iatrogenic tracheal injury following laser cordotomy via tracheostomy","authors":"P. Rodríguez Lorenzana , Á. Iglesias Castro , F. Vázquez de la Iglesia , A. Fernández Tenreiro","doi":"10.1016/j.anorl.2025.07.001","DOIUrl":"10.1016/j.anorl.2025.07.001","url":null,"abstract":"","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 1","pages":"Pages 72-74"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.anorl.2025.06.007
N. Oishi , C. Rodríguez-Prado , R. Reboll , J.R. Alba , E. Zapater
Introduction
Vestibulectomy prior to Transoral microelectrodes surgery (TOMES) cordectomies improves the tumor exposure, enables precise oncological surgery ensuring minimal invasiveness. The finding of dysplasia in non-oncologic ventricular fold (VF) resections led us to analyze the histopathological results in all the samples.
Material and methods
We present a retrospective study analyzing 64 T1/T2 glottic carcinoma patients treated with TOMES cordectomy and uni/bilateral vestibulectomy. The bleeding rate and presence of dysplasia were evaluated. The procedure using microelectrodes is explained in the video (supplementary material).
Results
Among 64 patients (97% male, mean age 65), 83 non-oncological VF resection were analyzed. Vestibulectomy does not increase the risk of hemorrhage in our series. Total of 37% of dysplasia was found, low-grade dysplasia in 19% and high-grade dysplasia in 18% (high-grade in 6% and carcinoma in situ in 12%).
Conclusion
The vestibulectomy in TOMES cordectomy enhances surgical exposure without increasing bleeding risk or surgery. Dysplastic lesions of the ventricular bands seem to occur quite frequently even when the assessment is normal.
{"title":"Vestibulectomy prior cordectomy in tomes: Advantages and dysplasia findings","authors":"N. Oishi , C. Rodríguez-Prado , R. Reboll , J.R. Alba , E. Zapater","doi":"10.1016/j.anorl.2025.06.007","DOIUrl":"10.1016/j.anorl.2025.06.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Vestibulectomy prior to Transoral microelectrodes surgery (TOMES) cordectomies improves the tumor exposure, enables precise oncological surgery ensuring minimal invasiveness. The finding of dysplasia in non-oncologic ventricular fold (VF) resections led us to analyze the histopathological results in all the samples.</div></div><div><h3>Material and methods</h3><div>We present a retrospective study analyzing 64 T1/T2 glottic carcinoma patients treated with TOMES cordectomy and uni/bilateral vestibulectomy. The bleeding rate and presence of dysplasia were evaluated. The procedure using microelectrodes is explained in the video (supplementary material).</div></div><div><h3>Results</h3><div>Among 64 patients (97% male, mean age 65), 83 non-oncological VF resection were analyzed. Vestibulectomy does not increase the risk of hemorrhage in our series. Total of 37% of dysplasia was found, low-grade dysplasia in 19% and high-grade dysplasia in 18% (high-grade in 6% and carcinoma in situ in 12%).</div></div><div><h3>Conclusion</h3><div>The vestibulectomy in TOMES cordectomy enhances surgical exposure without increasing bleeding risk or surgery. Dysplastic lesions of the ventricular bands seem to occur quite frequently even when the assessment is normal.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 1","pages":"Pages 11-13"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.anorl.2025.08.002
J.-P. Martellosio , L. Deroche , M. Garcia , F. Carsuzaa
Introduction
Nasal infection caused by Mycobacterium avium is rare and is a diagnostic challenge due to the non-specific symptoms and absence of pathognomonic signs.
Case report
We report the case of a 72-year-old patient with chronic rhinitis persisting for 4 years and refractory to conventional treatments. ENT examination revealed irregular nasal mucosa with an inflammatory nasopharyngeal polyp. Histological analysis showed epithelioid granuloma, and Ziehl-Neelsen staining highlighted acid-fast bacilli. Mycobacterial culture confirmed M. avium infection. Treatment with rifampin, azithromycin and ethambutol led to significant clinical improvement, with resolution of local inflammation.
Discussion
Nasal infection by M. avium is exceptional, with only a few cases reported in the literature. Diagnosis relies on histological examination and mycobacterial culture. Treatment combines surgical resection of the polypoid tumor and prolonged antibiotic therapy.
Conclusion
M. avium infection should be considered in cases of atypical chronic rhinitis resistant to treatment. Thorough microbiological evaluation is essential for accurate diagnosis and appropriate management.
{"title":"Chronic rhinitis associated with Mycobacterium avium infection: A CARE case report","authors":"J.-P. Martellosio , L. Deroche , M. Garcia , F. Carsuzaa","doi":"10.1016/j.anorl.2025.08.002","DOIUrl":"10.1016/j.anorl.2025.08.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Nasal infection caused by <em>Mycobacterium avium</em> is rare and is a diagnostic challenge due to the non-specific symptoms and absence of pathognomonic signs.</div></div><div><h3>Case report</h3><div>We report the case of a 72-year-old patient with chronic rhinitis persisting for 4<!--> <!-->years and refractory to conventional treatments. ENT examination revealed irregular nasal mucosa with an inflammatory nasopharyngeal polyp. Histological analysis showed epithelioid granuloma, and Ziehl-Neelsen staining highlighted acid-fast bacilli. Mycobacterial culture confirmed <em>M. avium</em> infection. Treatment with rifampin, azithromycin and ethambutol led to significant clinical improvement, with resolution of local inflammation.</div></div><div><h3>Discussion</h3><div>Nasal infection by <em>M. avium</em> is exceptional, with only a few cases reported in the literature. Diagnosis relies on histological examination and mycobacterial culture. Treatment combines surgical resection of the polypoid tumor and prolonged antibiotic therapy.</div></div><div><h3>Conclusion</h3><div><em>M. avium</em> infection should be considered in cases of atypical chronic rhinitis resistant to treatment. Thorough microbiological evaluation is essential for accurate diagnosis and appropriate management.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 1","pages":"Pages 58-60"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.anorl.2025.08.004
M.Y. Lin , C.C. Wang
This case report details the innovative use of transoral robotic surgery (TORS) for cricopharyngeal (CP) myectomy, a procedure that has never been documented for this condition. Our patient, who was previously treated for tongue cancer by total glossectomy, experienced persistent dysphagia and received gastric tube feeding despite multiple rehabilitations. After botulinum toxin injection confirmed CP muscle spasm, a TORS CP myectomy was performed using the da Vinci Si robotic system. The procedure involved a minimally invasive transoral approach, providing high-magnified 3D panoramic visualization, precise resection of a CP muscle segment and re-approximation of the post-hypopharyngeal mucosa. Postoperatively, the patient showed significant improvement in swallowing function, evidenced by successful removal of the feeding tube and improved videofluoroscopy results. This case report explains why we think TORS CP myectomy could be a feasible alternative to other existing methods.
{"title":"Transoral robotic cricopharyngeal myectomy for cricopharyngeal muscle spasm","authors":"M.Y. Lin , C.C. Wang","doi":"10.1016/j.anorl.2025.08.004","DOIUrl":"10.1016/j.anorl.2025.08.004","url":null,"abstract":"<div><div>This case report details the innovative use of transoral robotic surgery (TORS) for cricopharyngeal (CP) myectomy, a procedure that has never been documented for this condition. Our patient, who was previously treated for tongue cancer by total glossectomy, experienced persistent dysphagia and received gastric tube feeding despite multiple rehabilitations. After botulinum toxin injection confirmed CP muscle spasm, a TORS CP myectomy was performed using the da Vinci Si robotic system. The procedure involved a minimally invasive transoral approach, providing high-magnified 3D panoramic visualization, precise resection of a CP muscle segment and re-approximation of the post-hypopharyngeal mucosa. Postoperatively, the patient showed significant improvement in swallowing function, evidenced by successful removal of the feeding tube and improved videofluoroscopy results. This case report explains why we think TORS CP myectomy could be a feasible alternative to other existing methods.</div></div>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 1","pages":"Pages 61-64"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.anorl.2025.10.010
C.-A. Righini
{"title":"Is being a surgeon bad for your health?","authors":"C.-A. Righini","doi":"10.1016/j.anorl.2025.10.010","DOIUrl":"10.1016/j.anorl.2025.10.010","url":null,"abstract":"","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":"143 1","pages":"Pages 4-6"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145453926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.anorl.2025.10.012
T Bocquillon, I Mosnier, M Marx, G Petit, E Truy, G Lina-Granade, P Reynard, R Hermann
Introduction: Cochlear implantation (CI) is an option for severe to profound hearing loss when hearing aids are ineffective. This study aimed to evaluate its relevance in individuals over 80 by assessing long-term CI use and audiological outcomes.
Methods: We conducted a retrospective, single-center study including 29 patients over 80years old who received their first CI between January 2012 and December 2021 with data recorded until December 2024. Annual rates of users and non-users, audiometric test results, and pre- and postoperative complications were recorded.
Results: The mean age at implantation was 82.8, and the mean duration of CI usage was 4.9years. The percentage of patients still using their implant was 100%, 93%, 83%%, 76% and 75% at 1, 2, 3, 4 and 5years respectively. This number dropped to 33% 8years after the surgery. The main reasons for discontinuation were loss of autonomy and lack of benefit. Audiometric results showed improvement in mean pure-tone audiometry thresholds and free-field speech audiometry. Minor complications occurred in 24% of cases, while severe complications occurred in 13%.
Conclusion: CI is a viable option for patients over 80years old with severe to profound hearing loss. However, given the progressive decline of usage after implantation in this age group, a detailed cost-benefit analysis could provide valuable insight into its indication for this population.
{"title":"Cochlear implantation in the very elderly: Longitudinal assessment of device use and outcomes.","authors":"T Bocquillon, I Mosnier, M Marx, G Petit, E Truy, G Lina-Granade, P Reynard, R Hermann","doi":"10.1016/j.anorl.2025.10.012","DOIUrl":"https://doi.org/10.1016/j.anorl.2025.10.012","url":null,"abstract":"<p><strong>Introduction: </strong>Cochlear implantation (CI) is an option for severe to profound hearing loss when hearing aids are ineffective. This study aimed to evaluate its relevance in individuals over 80 by assessing long-term CI use and audiological outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective, single-center study including 29 patients over 80years old who received their first CI between January 2012 and December 2021 with data recorded until December 2024. Annual rates of users and non-users, audiometric test results, and pre- and postoperative complications were recorded.</p><p><strong>Results: </strong>The mean age at implantation was 82.8, and the mean duration of CI usage was 4.9years. The percentage of patients still using their implant was 100%, 93%, 83%%, 76% and 75% at 1, 2, 3, 4 and 5years respectively. This number dropped to 33% 8years after the surgery. The main reasons for discontinuation were loss of autonomy and lack of benefit. Audiometric results showed improvement in mean pure-tone audiometry thresholds and free-field speech audiometry. Minor complications occurred in 24% of cases, while severe complications occurred in 13%.</p><p><strong>Conclusion: </strong>CI is a viable option for patients over 80years old with severe to profound hearing loss. However, given the progressive decline of usage after implantation in this age group, a detailed cost-benefit analysis could provide valuable insight into its indication for this population.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-11DOI: 10.1016/j.anorl.2025.11.006
X Pan, Y Li, Z Liu, S Xu, D Wu
Objectives: This study aimed to measure and compare nasal mucus cystatin SN levels in patients with controlled and uncontrolled chronic rhinosinusitis, and to evaluate its diagnostic performance in distinguishing between these disease states.
Material and methods: A total of 98 CRS patients were prospectively enrolled and evaluated for disease control based on the EPOS criteria. Specimens of nasal mucus and tissue from patients with CRS and 15 healthy controls undergoing surgery for the deviated septum were obtained to measure cystatin SN levels. Disease severity was evaluated using the 22-item Sinonasal Outcome Test (SNOT-22), Questionnaire of Olfactory Disorders Negative Statements (QOD-NS) score, Lund-Kennedy score, Lund-Mackay score, olfactory cleft endoscopy scale (OCES), and olfactory cleft computed tomography (CT) score. Multivariable logistic regression analysis was used to determine the risk factors associated with uncontrolled CRS.
Results: Among the patients with CRS, 42.86% were uncontrolled. Cystatin SN expression in the nasal epithelium was significantly increased among patients with uncontrolled CRS compared to those with controlled CRS and healthy controls (both P<0.001). Furthermore, the uncontrolled CRS exhibited significantly higher blood eosinophil counts (BEC) (P=0.001), SNOT-22 score (P=0.001), QOD-NS score (P=0.004), Lund-Mackay score (P=0.022), OCES (P=0.004), and olfactory cleft CT score (P=0.012) than controlled CRS. Additionally, mucus cystatin SN levels showed a positive correlation with BEC (R=0.126, P=0.012) in patients with CRS. Multivariable logistic regression analysis showed that nasal mucus cystatin SN was identified as an independent predictor of uncontrolled CRS (OR=1.011, P=0.028). Mucus cystatin SN levels with a cutoff point greater than 106.050pg/mL had a superior predictive value for uncontrolled CRS compared to BEC (area under the curve, 0.886 vs. 0.782, P<0.001).
Conclusion: Mucus cystatin SN levels were highly associated with disease severity in patients with uncontrolled CRS.
{"title":"Association of nasal mucus cystatin SN levels with disease severity in patients with uncontrolled chronic rhinosinusitis.","authors":"X Pan, Y Li, Z Liu, S Xu, D Wu","doi":"10.1016/j.anorl.2025.11.006","DOIUrl":"https://doi.org/10.1016/j.anorl.2025.11.006","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to measure and compare nasal mucus cystatin SN levels in patients with controlled and uncontrolled chronic rhinosinusitis, and to evaluate its diagnostic performance in distinguishing between these disease states.</p><p><strong>Material and methods: </strong>A total of 98 CRS patients were prospectively enrolled and evaluated for disease control based on the EPOS criteria. Specimens of nasal mucus and tissue from patients with CRS and 15 healthy controls undergoing surgery for the deviated septum were obtained to measure cystatin SN levels. Disease severity was evaluated using the 22-item Sinonasal Outcome Test (SNOT-22), Questionnaire of Olfactory Disorders Negative Statements (QOD-NS) score, Lund-Kennedy score, Lund-Mackay score, olfactory cleft endoscopy scale (OCES), and olfactory cleft computed tomography (CT) score. Multivariable logistic regression analysis was used to determine the risk factors associated with uncontrolled CRS.</p><p><strong>Results: </strong>Among the patients with CRS, 42.86% were uncontrolled. Cystatin SN expression in the nasal epithelium was significantly increased among patients with uncontrolled CRS compared to those with controlled CRS and healthy controls (both P<0.001). Furthermore, the uncontrolled CRS exhibited significantly higher blood eosinophil counts (BEC) (P=0.001), SNOT-22 score (P=0.001), QOD-NS score (P=0.004), Lund-Mackay score (P=0.022), OCES (P=0.004), and olfactory cleft CT score (P=0.012) than controlled CRS. Additionally, mucus cystatin SN levels showed a positive correlation with BEC (R=0.126, P=0.012) in patients with CRS. Multivariable logistic regression analysis showed that nasal mucus cystatin SN was identified as an independent predictor of uncontrolled CRS (OR=1.011, P=0.028). Mucus cystatin SN levels with a cutoff point greater than 106.050pg/mL had a superior predictive value for uncontrolled CRS compared to BEC (area under the curve, 0.886 vs. 0.782, P<0.001).</p><p><strong>Conclusion: </strong>Mucus cystatin SN levels were highly associated with disease severity in patients with uncontrolled CRS.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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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