Wiley-Online-Library: International Forum of Allergy & Rhinology: Table of Contents

Nationwide Real‐World Prescribing Patterns of Biologics in Chronic Rhinosinusitis With Nasal Polyps and Asthma

Sun A Han, Dae Woo Kim, Seok‐Won Park, Jin Youp Kim — Sat, 13 Jun 2026 20:35:14 -0700

International Forum of Allergy &Rhinology, EarlyView.

Complications and Clinical Outcomes Following Modified Endoscopic Denker's With Pyriform Aperture Preservation: A Prospective Analysis

Fri, 12 Jun 2026 01:58:52 -0700

ABSTRACT

Background

The modified endoscopic Denker's (MED) approach provides access to all maxillary sinus (MS) walls for resection of various MS and retromaxillary pathologies, but the anteromedial maxilla has historically been resected. This study determined complication rates and outcomes following MED with pyriform aperture (PA) preservation (MEDPAP).

Methods

A prospective study was conducted on all adults who underwent MEDPAP for different MS or retromaxillary pathologies over 7.5 years. The following complications were collected at all postoperative visits: epiphora, hypesthesia or complete numbness (teeth, upper lip, lateral nasal sidewall, and cheek), crusting, nasal valve collapse (NVC), and empty nose syndrome 6-item questionnaire (ENS6Q). Complications and disease recurrence rates were determined at a minimum 1 year for most complications and outcomes and 2 years for hypesthesia if hypesthesia had not resolved.

Results

Of 52 MEDPAP patients, median age was 58.5 years; 55.8% were male. Of 34.6% who experienced epiphora postoperatively, 7.7% persisted. When epiphora resolved, it did so by median 63.0 days. Sites of initial postoperative hypesthesia or numbness included teeth (23%–50%), upper lip (42%), nasal (22%), and cheek (30%). Hypesthesia resolved in 88%–100% of subsites by median 89.5–167.0 days. Hypesthesia persisted in 12% of patients (mainly anterior teeth). Crusting resolved in 97.8% by median 91.0 days. No patients developed NVC, and median final ENS6Q = 0.5 (range = 0–8). Non-tumor disease and tumor recurrence rates were 0%.

Conclusions

MEDPAP was 100% successful at managing benign and select malignant MS pathologies during the study period. MEDPAP patients frequently experienced temporary epiphora and dentofacial hypesthesia or numbness that resolved by 2–6 months postoperatively. Epiphora and hypesthesia or numbness persisted in 7.7% and 12% of patients, respectively. No patients developed NVC or ENS.

Evaluating the Potential Infectious Risk Profile of Biologics in Chronic Rhinosinusitis With Nasal Polyposis

Maxime Fieux, Philippe Gevaert, Leigh J. Sowerby — Tue, 09 Jun 2026 08:05:58 -0700

International Forum of Allergy &Rhinology, EarlyView.

Translation and Cross‐Cultural Adaptation of the Chronic Rhinosinusitis Control Test for Global Use

Tue, 09 Jun 2026 08:04:25 -0700

ABSTRACT

Introduction

The Chronic Rhinosinusitis Control Test (CRCT) is a patient-reported outcome measure (PROM) written in English that is psychometrically validated to measure chronic rhinosinusitis control. Because the availability of translated PROMs is a driver of data equity—collection of data that is fair and generally representative—our objective was to create a library of translated, cross-culturally adapted versions of the CRCT that could ultimately be used for patients worldwide.

Methods

A hybrid approach leveraging generative artificial intelligence (genAI) in collaboration with expert human linguists was employed for translation and cross-cultural adaptation of the CRCT. For each target language, forward translations were performed with three large language models (LLMs) (ChatGPT, Copilot, and Perplexity) after which an expert human linguist provided additional revisions that were used to create a consensus final translation. Backward translations were performed using LLMs (Claude, Copilot, and Perplexity). The accuracy and validity of translations at each step were assessed qualitatively and quantitatively.

Results

The translation and cross-cultural adaptation of the CRCT was achieved into 37 languages: Arabic, Bengali, Brazilian Portuguese, Bulgarian, Cantonese Chinese, Czech, Danish, Dutch, European Portuguese, Filipino, Finnish, French, German, Greek, Hebrew, Hindi, Hungarian, Indonesian, Italian, Japanese, Korean, Mandarin Chinese, Norwegian, Persian, Polish, Punjabi, Romanian, Russian, Serbo-Croatian, Spanish, Swahili, Swedish, Thai, Turkish, Ukrainian, Urdu, and Vietnamese. These translated, cross-culturally adapted versions of the CRCT are made available in this article.

Conclusion

Translated, cross-culturally adapted versions of the CRCT developed in this study promote data equity by serving as a basis for psychometric validation of the CRCT for worldwide use.

Region‐Resolved Proteomics Identifies Molecular Features at the Mucosa‐Polyp Interface in Chronic Rhinosinusitis

Mon, 08 Jun 2026 05:45:43 -0700

International Forum of Allergy &Rhinology, EarlyView.

Gaze Mapping and Observational Behavior During Nasal Endoscopy

Fri, 05 Jun 2026 23:58:30 -0700

International Forum of Allergy &Rhinology, EarlyView.

Assessment of MUcociLiary Transport timE in CRSwNP Patients in Treatment With Dupilumab: AMULET Study

Fri, 05 Jun 2026 00:00:00 -0700

International Forum of Allergy &Rhinology, EarlyView.

Stratified Anti‐Biofilm Therapy: Translating Staphylococcal Exoprotein Toxicity Hierarchies Into Clinical Practice

Peiling Li, Tingting Kang — Thu, 04 Jun 2026 01:59:48 -0700

International Forum of Allergy &Rhinology, EarlyView.

Reply to Stratified Anti‐Biofilm Therapy: Translating Staphylococcal Exoprotein Toxicity Hierarchies Into Clinical Practice

Sarah Vreugde, Sintayehu Ambachew, Alkis James Psaltis, Peter‐John Wormald — Thu, 04 Jun 2026 01:57:32 -0700

International Forum of Allergy &Rhinology, EarlyView.

Potential Clinical Impact of Sinonasal Biofilms in CRS: A Structured Evidence Synthesis

Wed, 03 Jun 2026 02:59:43 -0700

International Forum of Allergy &Rhinology, EarlyView.

Issue Information

Tue, 02 Jun 2026 00:00:00 -0700

International Forum of Allergy &Rhinology, Volume 16, Issue 6, Page 537-539, June 2026.

Correction to “Dosing Interval Extension of Dupilumab in CRSwNP: Five‐Year Real World Outcomes”

Tue, 02 Jun 2026 00:00:00 -0700

International Forum of Allergy &Rhinology, Volume 16, Issue 6, Page 654-655, June 2026.

Disease Remission: A Scoping Review With Thematic Analysis of the Scientific Literature With Implications for Chronic Rhinosinusitis

Tue, 02 Jun 2026 00:00:00 -0700

ABSTRACT

Background

Remission, a term used to describe a goal of treatment for some chronic diseases, has recently been proposed for chronic rhinosinusitis (CRS). However, it is unclear what remission means for CRS and why it should serve as a goal in the present-day treatment of CRS.

Methods

Systematic literature search of PubMed, Embase, Scopus, and CINAHL databases for definitions of remission for chronic nonneoplastic diseases derived through consensus studies or society-sponsored position papers. Remission definitions were extracted and common themes identified.

Results

Thirty-nine definitions of remission were identified, the majority (29/39) of which were for inflammatory diseases. Remission uniformly was a term describing a state of completely inactive or minimally active disease, often defined by criteria including patient-reported outcomes, clinician-reported outcomes, and results from physical examination or serological, histologic, imaging findings, or other disease-specific testing. Definitions varied in specifying different categories/levels of remission. However, most definitions stipulated a specific purpose for remission as providing a unique positive prognostic benefit to patients, commonly as cessation of end-organ damage/disease progression. Diseases that also utilized control as an outcome differentiated remission as a state of lesser disease activity.

Conclusions

Commonalities from previously described remission definitions can be applied to define CRS remission as a state of minimal-to-no disease activity characterized by criteria reflecting the CRS disease process, the achievement of which would provide specific prognostic, future benefit to the patient. However, evidence is still lacking to support the utility or an exact definition of a remission construct for CRS.

Evaluation of the Quality of Life in Adults With Acute Rhinosinusitis

Tue, 02 Jun 2026 00:00:00 -0700

International Forum of Allergy &Rhinology, Volume 16, Issue 6, Page 633-635, June 2026.

Air Quality Index Association With Cytokine Inflammatory Markers in Chronic Rhinosinusitis

Tue, 02 Jun 2026 00:00:00 -0700

International Forum of Allergy &Rhinology, Volume 16, Issue 6, Page 630-632, June 2026.

Wearable Activity Data Demonstrate an Association Between Sinus Surgery and Improved Real‐World Activity

Tue, 02 Jun 2026 00:00:00 -0700

International Forum of Allergy &Rhinology, Volume 16, Issue 6, Page 643-645, June 2026.

Exploring Sleep Quality and Chronic Rhinosinusitis Risk Using Wearable Technology

Tue, 02 Jun 2026 00:00:00 -0700

International Forum of Allergy &Rhinology, Volume 16, Issue 6, Page 636-639, June 2026.

Fascia‐Fat‐Fascia “Sandwich Graft” Decreases Postoperative Cerebrospinal Fluid Leak Rate for High‐Flow Skull Base Defects

Tue, 02 Jun 2026 00:00:00 -0700

International Forum of Allergy &Rhinology, Volume 16, Issue 6, Page 646-649, June 2026.

Deep Learning‐Based Cribriform Segmentation and Automated Olfactory Fossa Depth Estimation on Sinus CT

Tue, 02 Jun 2026 00:00:00 -0700

International Forum of Allergy &Rhinology, Volume 16, Issue 6, Page 650-653, June 2026.

Effect of Platelet‐Rich Plasma and Hyaluronic Acid Olfactory Cleft Injection on Traumatic Olfactory Dysfunction: A Prospective Randomized Clinical Trial

Conclusions

CT-based and intraoperative instruments capture different dimensions of prior surgery and should be selected according to the clinical or research question. Notably, structured scoring consistently reveals that many patients meeting guideline criteria for prior surgery have varying anatomical dissection. Given the association between surgical extent, postoperative outcomes, and biologic therapy response, its standardized assessment warrants evaluation for integration into clinical decision making. However, prospective validation is urgently needed.

AI‐Based Quantitative Nasal Cytology for Predicting Eosinophilic Chronic Rhinosinusitis With Nasal Polyps: A Pilot Study

Mon, 01 Jun 2026 08:20:46 -0700

International Forum of Allergy &Rhinology, EarlyView.

Impact of Genetic and Molecular Alterations on Clinical Outcomes in Sinonasal Squamous Cell Carcinoma: A Systematic Review and Meta‐Analysis

Mon, 01 Jun 2026 08:19:36 -0700

ABSTRACT

Background

Sinonasal squamous cell carcinoma (SNSCC) is a rare malignancy with variable outcomes, and the prognostic impact of molecular alterations remains incompletely defined. This meta-analysis aims to clarify the associations of genetic alterations and protein expression with clinical outcomes in SNSCC.

Methods

PubMed, Embase, Web of Science, and ScienceDirect were searched from inception through February 2026. Eligible studies reported prognostic outcomes in SNSCC according to EGFR mutation, TP53 mutation, EGFR copy number gain, EGFR-associated progression from inverted papilloma to SNSCC, DEK::AFF2 alteration, or expression of EGFR, p53, Foxp3, SOX2, KMT2D, PD-L1, and Bax. Random-effects models were used to pool survival or recurrence rates and hazard ratios (HRs) with 95% confidence intervals.

Results

Of 689 records, 25 retrospective cohort studies including at least 1194 patients with SNSCC were analyzed. Median age was 63.8 years, 69.7% were male, and median follow-up was 33 months. EGFR mutation was associated with worse overall survival (OS) at 2, 3, 5, and 10 years (HRs 1.57, 1.49, 1.41, and 1.32, respectively) and worse disease-free survival (DFS) at 1 and 3 years (HRs 3.70 and 1.51). TP53 mutation was associated with worse OS at 2, 3, and 5 years (HRs 3.54, 3.33, and 2.70). EGFR copy number gain was associated with worse 5-year OS (HR 1.59), EGFR overexpression with higher regional recurrence (HR 2.69), and PD-L1 expression with worse 3-year OS (HR 1.43). In contrast, Foxp3 expression was associated with improved 2-, 3-, and 5-year OS (HRs 0.42, 0.51, and 0.53) and DFS (HRs 0.48, 0.48, and 0.50). Other biomarkers, such as SOX2, Bax, p53 overexpression, and KMT2D expression, were not significantly associated with prognosis.

Conclusion

Molecular profiling has prognostic value in SNSCC. EGFR and TP53 alterations were associated with poorer outcomes, whereas Foxp3 expression was associated with more favorable survival, supporting further biomarker-integrated risk stratification in SNSCC.

Wearable Real‐Time Translation in Rhinology: A Comparative Study of Accuracy and Efficiency

Thu, 28 May 2026 06:09:42 -0700

International Forum of Allergy &Rhinology, EarlyView.

Effects of Sinonasal Mucus Debridement on Nasal Nitric Oxide in Primary Ciliary Dyskinesia

Thu, 28 May 2026 06:04:31 -0700

International Forum of Allergy &Rhinology, EarlyView.

In Response to the Letter to the Editor: “Methodological Considerations in Interpreting Quality‐of‐Life Recovery in C19OD”

Tiana M. Saak, Jonathan B. Overdevest — Wed, 27 May 2026 01:13:08 -0700

International Forum of Allergy &Rhinology, EarlyView.

Lower Airway Conditions Contribute to the Prediction of Polyp Recurrence in Chronic Rhinosinusitis With Nasal Polyps and Comorbid Asthma

Wed, 27 May 2026 01:13:07 -0700

Key Points

Duration of asthma, ratio of peak expiratory flow to predicted value, and ratio of maximal expiratory flow at 25% of the vital capacity to predicted value are independent risk factors for polyp recurrence in patients with CRSwNP+AS. A lower+upper model created with the ethmoid sinus score and the three lower airway factors shows good predictive value for polyp recurrence in patients with CRSwNP+AS.

Site‐Specific Olfactory Cleft Opacification Predicts Olfactory Function and Olfactory Training Outcome in Persistent Postinfection Olfactory Dysfunction

Wed, 27 May 2026 01:11:54 -0700

ABSTRACT

Background

Persistent postinfectious olfactory dysfunction (PIOD) is a prevalent and often refractory condition, with low recovery rates following olfactory training (OT), primarily due to sustained localized inflammation and opacification within the olfactory cleft (OC). However, conventional radiological assessments of OC opacification overlook the vertical distribution of olfactory neuroepithelium, limiting prognostic accuracy. This study introduces a modified subregion computed tomography (CT) scoring system integrated with computational fluid dynamics (CFD) to evaluate OC opacification's role in baseline olfaction and OT efficacy.

Methods

In this prospective study, 58 adults with persistent PIOD of more than 3 months’ duration were enrolled and completed CT imaging, psychophysical olfactory testing (Sniffin’ Sticks TDI score), and questionnaire assessments. Using a modified scoring system, the OC was segmented on coronal sections into upper (superior one-third) and lower (inferior two-thirds) portions, with three coronal sections assessed in both the anterior and posterior OC. Each section was scored dichotomously (0 for no opacification, 1 for opacification), and bilateral scores were recorded. Unsupervised K-means clustering identified phenotypes, random forest modeling predicted functional anosmia, and CFD analyzed airflow dynamics. Thirty-one patients completed 3-month OT with follow-up assessments.

Results

OC opacification was present in 69.0% of persistent PIOD patients, with opacification in the upper posterior OC notably serving as the primary determinant of baseline olfactory function. Random forest analysis further confirmed that upper OC opacification ranked as the top predictor for functional anosmia, with the combined model achieving an area under the curve of 0.920. Cluster analysis revealed three distinct phenotypes, among which the diffuse severe opacification cluster involving upper OC regions was associated with the poorest olfactory function. Although posterior OC opacification was positively correlated with increased airflow velocity ratios (r = 0.570, p < 0.01) and these ratios were negatively correlated with olfactory scores, OC airflow itself did not significantly mediate the relationship between structure and olfactory function. Only 25.8% of patients achieved clinically meaningful olfactory improvement. Significant improvements were observed in TDI (p = 0.001), olfactory threshold (p = 0.010), olfactory discrimination (p = 0.028), and olfactory VAS scores (p < 0.001) after OT. Baseline opacification in posterior-middle section of OC significantly predicted non-response.

Conclusions

The modified subregion OC opacification scoring system provides a more refined assessment of site‑specific OC obstruction for patients with persistent PIOD, underscoring the critical role of OC opacification in mediating olfactory impairment and resistance to OT.

Clinical Implication

For patients with persistent PIOD, this modified olfactory cleft opacification scoring system allows for olfactory assessment and prognosis by identifying specific opacification patterns associated with olfactory training outcomes.

Endoscopically Confirmed False‐Positive β2‐Transferrin in the Postoperative Setting

Wed, 27 May 2026 01:10:55 -0700

International Forum of Allergy &Rhinology, EarlyView.

Letter to the Editor Regarding “Recovery of Parosmia Preferentially Influences Longitudinal Improvement of Quality of Life in C19OD”

Results

Increased serum leptin and galectin-10 levels were associated with Type 2 inflammatory markers and correlated with CRSwNP severity. RNA sequencing revealed upregulation of chemokine ligands in eosinophilic cell lines. Leptin induced plasminogen activator inhibitor 1 (PAI-1) expression in eosinophils but not in basophils or neutrophils. Leptin pretreatment substantially enhanced migration toward both C–C motif chemokine ligand (CCL) 11 and CCL26 in eosinophilic cell lines. The leptin-primed eosinophilic cell line promoted angiogenesis, as demonstrated in co-culture with HUVECs.

Conclusion

Leptin promotes eosinophil migration and angiogenesis, potentially via chemokine ligands and PAI-1 induction, and may promote CRSwNP progression under a Type 2 inflammatory milieu.

Temperature‐Controlled Radiofrequency for Severe Nasal Airway Obstruction: A Non‐Inferiority Comparison With Surgical Intervention

Tue, 14 Apr 2026 00:00:00 -0700

ABSTRACT

Introduction

ABSTRACT

Background

Central compartment atopic disease (CCAD) has recently been recognized as a distinct phenotype within the spectrum of type 2–dominant chronic rhinosinusitis (CRS). Although international guidelines highlight polypoid changes in the central nasal cavity, standardized diagnostic and classification criteria are still lacking. This study aims to develop and internally validate a consensus-based classification system through expert agreement.

Methods

A two-round modified Delphi study was conducted with 10 international rhinology experts. Participants evaluated the need for a specific grading framework, the relative diagnostic value of nasal endoscopy versus radiology, and the clarity and applicability of the proposed criteria (Grades 0–IV). Six representative endoscopic and radiologic cases were used in each round to assess interpretive accuracy and interobserver agreement. Consensus was predefined as ≥ 80% of ratings in the top two categories (4–5) on a 5-point Likert scale.

Results

Eighty percent of experts identified nasal endoscopy as the primary diagnostic tool in the first Delphi round. The interpretive accuracy of the preliminary grading system was high, with all panelists correctly recognizing the proposed distinctions. Interobserver agreement was substantial (κ = 0.72). In the second round, refined definitions improved overall consensus and reproducibility. Endoscopy was reaffirmed as the cornerstone of diagnosis, while radiology played a complementary role. Diagnostic clarity and agreement increased, reaching κ = 0.80.

Conclusion

The consensus process confirmed nasal endoscopy as the key diagnostic method for CCAD, supported by substantial interobserver reproducibility. The refined definitions improved clarity and agreement, facilitating differentiation from other CRS phenotypes and establishing a reliable framework for future research.