Rhinology[JOURNAL]
Sun
200 papers
Seasonality in the incidence of acute sinusitis, air pollutant levels, and climate.
Hung SH, Cheng YF, Lin HC … +1 more , Chen CS
Rhinology · 2025 Oct · PMID 40587220 · Publisher ↗
INTRODUCTION: Emerging evidence from epidemiological studies highlights the interaction between air quality metrics and sinusitis occurrence. This study investigates the relationship between acute sinusitis incidence, ai...
INTRODUCTION: Emerging evidence from epidemiological studies highlights the interaction between air quality metrics and sinusitis occurrence. This study investigates the relationship between acute sinusitis incidence, air pollutant levels, and climatic conditions in Taiwan from 2008 to 2017. METHODS: This study extracted outpatient claims data from the Longitudinal Health Insurance Database 2010. We computed seasonal incidence rates of acute sinusitis episodes per 1000 population over 120 months, stratifying the data by gender and three age groups: 20-44, 45-64, and 65 years and older. Addressing the seasonal variability inherent in our dataset, we utilized Auto-Regressive Moving Average (ARMA) models to analyze each variable as a univariate time series influenced by its historical values. RESULTS: The analysis reveals that, except relative humidity, all other climatic factors including CO, NO2, SO2, PM10, O3, ambient temperature and rainfall demonstrated significant crude correlations with the rates of acute sinusitis. The ARIMA test suggested that seasonality plays a significant role in influencing sinusitis episodes across all age groups. Specifically, individuals experience significantly higher incidence rates during winter compared to spring. These findings underscore winter as a period with notably higher incidence rates of acute sinusitis, even after adjusting for meteorological and air pollution variables. CONCLUSIONS: This study provides comprehensive evidence of the significant associations between acute sinusitis incidence, air quality, and climatic factors in Taiwan.
A prospective cohort study comparing the effects of different middle turbinate treatments on olfactory function recovery in CRSwNP patients after FESS.
Jian F, Lao J, Ge R … +2 more , Yang Q, Wu S
Rhinology · 2025 Oct · PMID 40587156 · Publisher ↗
BACKGROUND: The factors affecting postoperative olfactory recovery in chronic rhinosinusitis with nasal polyps (CRSwNP) remain unclear. This study explores postoperative pathological classification and the impact of diff...
BACKGROUND: The factors affecting postoperative olfactory recovery in chronic rhinosinusitis with nasal polyps (CRSwNP) remain unclear. This study explores postoperative pathological classification and the impact of different middle turbinate management strategies on olfactory recovery. METHODOLOGY: Seventy-two CRSwNP patients undergoing functional endoscopic sinus surgery (FESS) with ≥6 months follow-up were classified into eosinophilic (ECRSwNP) and non-eosinophilic (nECRSwNP) groups. Based on middle turbinate management, patients were further divided into resection (partial/complete) and preservation groups. Olfactory scores, clinical characteristics, and nasal endoscopy findings were analyzed, and multifactorial analysis identified factors influencing olfactory recovery. RESULTS: TDI scores in the ECRSwNP group remained lower than those in the nECRSwNP group preoperatively and postoperatively. However, olfactory score improvement and the proportion of significantly improved patients did not differ significantly between the two groups. Middle turbinate management was associated with greater olfactory improvement, particularly in nECRSwNP patients. Although the complete middle turbinate resection group had lower preoperative olfactory scores than the partial resection group, no significant difference was observed in postoperative olfactory improvement between the two approaches.Higher preoperative polyp scores and middle turbinate management predicted olfactory improvement. CONCLUSIONS: FESS significantly improves the olfactory function in CRSwNP patients, and the extent of olfactory improvement is independent of pathological type. Patients with higher preoperative Lildholdt polyp scores and those who underwent middle turbinate management during FESS were more likely to exhibit improved olfactory function at 6 months postoperatively.
Endoscopic surgery versus conservative treatment in nasopharyngeal carcinoma patients with nasopharyngeal necrosis.
Ouyang YF, Lin QL, Li AC … +2 more , Song JY, Xie RL
Rhinology · 2025 Oct · PMID 40587119 · Publisher ↗
BACKGROUND: Nasopharyngeal necrosis is a common sequela after treatment for nasopharyngeal carcinoma (NPC). This study aims to compare the effectiveness of the main interventions, endoscopic surgery and conservative ther...
BACKGROUND: Nasopharyngeal necrosis is a common sequela after treatment for nasopharyngeal carcinoma (NPC). This study aims to compare the effectiveness of the main interventions, endoscopic surgery and conservative therapy, on nasopharyngeal necrosis and identify potential beneficiaries. METHODOLOGY: This retrospective study was conducted on patients with nasopharyngeal necrosis from September 2008 to December 2020 at the Cancer Hospital of Sun Yat-sen University. The overall survival (OS) of patients with nasopharyngeal necrosis and their mucosal healing status were assessed. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used to balance confounding factors between the two groups. RESULTS: A total of 517 patients (124 females; 393 males) with nasopharyngeal necrosis were included in this analysis, among whom 287 received conservative therapy and 230 underwent endoscopic surgical treatment. In the unmatched cohort, the endoscopic surgery group had a higher 3-year OS rate than the conservative therapy group. Patients who underwent surgery had higher cure rates than did those who received conservative therapy. PSM and IPTW analyses yielded similar results. Multivariate analyses of the unmatched, PSM, and IPTW cohorts revealed that nasal endoscopic surgery was an independent protective factor for the OS of patients with nasopharyngeal necrosis. CONCLUSIONS: In this retrospective research, endoscopic surgery demonstrated better efficacy than conservative therapy for nasopharyngeal carcinoma patients with nasopharyngeal necrosis, while conservative therapy may be preferred for patients with superficial mucosal necrosis.
Comment to the article "Comparison of outcomes for Draf IIB vs Draf III in endoscopic frontal sinus surgery: a comprehensive systematic review and meta-analysis".
Kacprzyk A, Glowacki R
Rhinology · 2025 Oct · PMID 40587092 · Publisher ↗
We read with great interest the article by Hirayama et al. (1) and commend the authors on their comprehensive work, which presents an extensive dataset accompanied by robust statistical analyses and a detailed systematic...
We read with great interest the article by Hirayama et al. (1) and commend the authors on their comprehensive work, which presents an extensive dataset accompanied by robust statistical analyses and a detailed systematic review. This study is undoubtedly a significant contribution to the literature on frontal sinus surgery.
The CFTR gene variants in paediatric nasal polyposis: a study in the Italian population.
Santarsiero S, Sitzia E, Majo F … +7 more , Marini G, Sinibaldi L, Cristalli G, Cutrera R, Fiocchi AG, Ciciriello F, Artesani MC
Rhinology · 2025 Aug · PMID 40586793 · Publisher ↗
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a relatively uncommon condition in the paediatric population, with a prevalence estimated at 0.1-0.8%, compared to approximately 4% in adults (1, 2). The early onset o...
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a relatively uncommon condition in the paediatric population, with a prevalence estimated at 0.1-0.8%, compared to approximately 4% in adults (1, 2). The early onset of CRSwNP emphasises the significant role of genetic factors in its pathophysiology (3). Approximately 20% of paediatric patients with CRSwNP are associated with systemic genetic disorders, with cystic fibrosis (CF) being the most prevalent (2). CF is characterised by a dysfunction of the CF transmembrane conductance regulator (CFTR) protein. Over 2,000 distinct CFTR variants have been identified, resulting in varying organ involvement and disease severity. In 2000, the World Health Organization introduced the term "CFTR-related disorders" (CFTR-RDs) to include clinical entities associated with CFTR dysfunction that do not meet the diagnostic criteria for CF (4). CFTR-RDs include congenital bilateral absence of the vas deferens (CBAVD), recurrent pancreatitis (RP), and disseminated bronchiectasis (DB). However, recent studies emphasised a significant prevalence of heterozygous CFTR pathogenic variants in paediatric and adult CRSwNP populations without CF (4-8). We assessed the prevalence of CFTR variants in a paediatric population with CRSwNP.
Topical corticosteroids adherence in chronic rhinosinusitis with nasal polyps patients on dupilumab.
Miotti SM, Brà Hlmann C, Yalamanoglu A … +3 more , Steiner UC, Meerwein CM, Soyka MB
Rhinology · 2025 Aug · PMID 40586754 · Publisher ↗
Biologics like dupilumab have revolutionized the management of patients with severe chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma. However, topical corticosteroids, such as intranasal (INCS) and inhaled (I...
Biologics like dupilumab have revolutionized the management of patients with severe chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma. However, topical corticosteroids, such as intranasal (INCS) and inhaled (ICS) corticosteroids still play a fundamental role in the management of these conditions. To this day, limited data is available on topical corticosteroids medication adherence combined with dupilumab in achieving CRSwNP and asthma symptom control. Considering the generally poor medication-adherence among chronic patients and the remarkable efficacy of dupilumab, we suspected low adherence to INCS and ICS.
Age-related exacerbation in disease-associated olfactory disorders.
Shimmura H, Mori E, Sekine R … +2 more , Tei M, Otori N
Rhinology · 2025 Aug · PMID 40526035 · Publisher ↗
BACKGROUND: Both the physiological degeneration linked to aging and the pathological changes resulting from diseases can impact olfactory function in the patients with olfactory disorder (OD). However, the epidemiologica...
BACKGROUND: Both the physiological degeneration linked to aging and the pathological changes resulting from diseases can impact olfactory function in the patients with olfactory disorder (OD). However, the epidemiological literature addressing the extent of aging's involvement to the diseases which causes OD is limited. Our study aimed to investigate how aging affects olfactory function in major causes of OD by employing psychophysical olfactory sensory testing. METHODOLOGY: Non-eosinophilic chronic rhinosinusitis (NECRS), eosinophilic chronic rhinosinusitis (ECRS), post-infectious OD (PIOD), post-traumatic OD, and idiopathic OD were identified as major contributors to OD. Retrospective data from 1986 patients were collected from our smell clinic. We utilized T&T olfactometer thresholds to assess quantitative olfactory function. Patients were categorized into age groups spanning every 10 years from their 20s to 80s, and we analyzed potential differences between age groups and diseases. Additionally, the odds ratio of severe OD was analyzed with respect to gender and age, categorizing patients into two groups: lower than 60 and over or equal to 60. RESULTS: A significant odds ratio was observed for elevated T&T average threshold with respect to age in the detection and recognition thresholds of patients diagnosed with NECRS, PIOD and idiopathic OD. In contrast, no significant odds ratio was observed in patients with ECRS or post-traumatic OD, regardless of age. CONCLUSION: Analysis of disease-specific OD revealed varying degrees of age-related physiological and disease-pathological across different conditions. These findings underscore the importance for clinicians to consider both age-related physiological changes and the specific disease pathology of the disease when diagnosing and managing OD, particularly in elderly patients.
Rhinology â€" What else?
Landis BN
Rhinology · 2025 Jun · PMID 40517302 · Publisher ↗
Abstract loading — click title to view on PubMed.
Multidimensional benefits of olfactory training for chronic COVID-19-related olfactory dysfunction: a systematic review and meta-analysis.
Chen CH, Shih CF, Hummel T … +1 more , Chao YT
Rhinology · 2025 Aug · PMID 40465208 · Publisher ↗
BACKGROUND: Olfactory dysfunction is commonly observed in patients with COVID-19 infection. Chronic olfactory dysfunction can have a profound effect on one’s quality of life. Olfactory training (OT) is a rehabilitation...
BACKGROUND: Olfactory dysfunction is commonly observed in patients with COVID-19 infection. Chronic olfactory dysfunction can have a profound effect on one’s quality of life. Olfactory training (OT) is a rehabilitation therapy, which has emerged as a viable treatment for COVID-19-related olfactory dysfunction. Our primary objective was to assess the effectiveness of OT for individuals with chronic COVID-19-related olfactory dysfunction. METHODS: A search was performed on the Cochrane Library, Embase, PubMed, Scopus, and Web of Science databases from their inception through Feb 24, 2024. Eligible studies included those with sufficient information for meta-analysis pertaining to the effectiveness of OT performed for more than 8 weeks in treating chronic (duration > 16 weeks) COVID-19-related olfactory dysfunction. RESULTS: After a systematic review of all relevant articles, 9 studies qualified for inclusion. A total of 179 patients within 7 studies had eligible Sniffin' Sticks test data. The pooled results showed significant post-OT increases in TDI score, threshold, discrimination, and identification. Two studies documented qualified UPSIT scores in 63 patients. Pooled results of all identification tests revealed significant improvement. CONCLUSIONS: OT demonstrates benefits in treating chronic COVID-19-related olfactory dysfunction, as evidenced by multidimensional evaluations. These findings suggest the involvement of both top-down and bottom-up mechanisms in the recovery process.
Risk factors in patients treated with surgical drainage for rhinogenic intracranial complications: a nationwide study.
Morita M, Tarasawa K, Hidaka H … +8 more , Yun Y, Fujimori K, Fushimi K, Hamada S, Asako M, Kawachi R, Yagi M, Iwai H
Rhinology · 2025 Aug · PMID 40445119 · Publisher ↗
BACKGROUND: Data on risk factors for rhinogenic intracranial complications (RICs) including cerebral abscess have been limited. Using a nationwide database, the aim was to identify the factors related to mortality and de...
BACKGROUND: Data on risk factors for rhinogenic intracranial complications (RICs) including cerebral abscess have been limited. Using a nationwide database, the aim was to identify the factors related to mortality and delayed discharge. METHODOLOGY: Data of 326 patients between 2012 and 2022 were extracted from a Japanese inpatient database. The main outcome was survival at discharge. In a subgroup analysis of the 316 surviving patients, the outcome was delayed discharge. RESULTS: The mortality rate was 3.1%. Logistic regression analyses identified intracerebral complications more than one surgical intervention and consciousness level evaluated by the Japan Coma Scale (JCS): JCS I and JCS ≥ II as risk factors for mortality. Concurrent interventions of intracranial and sinonasal drainage was identified as a factor associated with decreased risk. CONCLUSIONS: Although RICs are rare, with decreasing mortality due to progress in imaging and clinical strategies, they remain the most severe complications of rhinosinusitis. Subdural and/or intracerebral abscess, consciousness level at admission, and more than one surgical intervention were found to be risk factors for mortality. Conversely, concurrent interventions, intracranial and sinonasal drainage, contributed to reducing this risk.
Clinical features and outcomes of skull base osteoradionecrosis in nasopharyngeal carcinoma patients: a systematic review and meta-analysis.
Ding S, Liao CXY, Mak WHB … +6 more , Chan HK, Chan CPL, Lai CCF, Chow SMW, Chan JYK, Yeung DCM
Rhinology · 2025 Aug · PMID 40445072 · Publisher ↗
BACKGROUND: Skull base osteoradionecrosis following radiotherapy for nasopharyngeal carcinoma is a potentially life-threatening complication. Assessing severity, prognosis and providing appropriate treatment for the cond...
BACKGROUND: Skull base osteoradionecrosis following radiotherapy for nasopharyngeal carcinoma is a potentially life-threatening complication. Assessing severity, prognosis and providing appropriate treatment for the condition can be clinically challenging. This systematic review evaluates factors associated with patient outcome. METHODOLOGY: A literature search of PubMed, Embase, MEDLINE and Cochrane databases was conducted in August 2024. Data was extracted for patients with skull base osteoradionecrosis caused by nasopharyngeal carcinoma. Results were presented by narrative synthesis or with statistical analysis. RESULTS: 359 patients from 31 papers were included. The clivus and posterior nasopharyngeal wall were the most common subsites for osteoradionecrosis. We categorized subsites into posterior, roof and lateral areas. Subsite was not associated with ICA exposure or infection. Frequent symptoms include headache, foul odour and epistaxis. Foul odour was negatively associated with infection and epistaxis was highly associated with ICA exposure. The most common direct complication was CSF leak (18.2%), whereas the most common post-treatment complication was infection (43.8%). Carotid blowout was the most common cause of mortality (45.9%). CONCLUSIONS: Foul odour and epistaxis may predict cases of skull base osteoradionecrosis complicated by ICA exposure and infection. Further research is necessary to assess the significance of ORN subsite as a prognosticator or guide to treatment.
Concomitant cystic fibrosis and NSAID-exacerbated respiratory disease.
Le Bon SD, Plojoux J, Coattrenec Y … +1 more , Landis BN
Rhinology · 2025 Aug · PMID 40407713 · Publisher ↗
Chronic rhinosinusitis (CRS) with nasal polyps occurs in 6-57% of individuals with cystic fibrosis (CF). According to the EPOS 2020 guidelines, CF-related CRS is classified as secondary diffuse, non-type-2 CRS. In contra...
Chronic rhinosinusitis (CRS) with nasal polyps occurs in 6-57% of individuals with cystic fibrosis (CF). According to the EPOS 2020 guidelines, CF-related CRS is classified as secondary diffuse, non-type-2 CRS. In contrast, most nasal polyposis in the general population is associated with primary, type-2 CRS. This educationally-oriented classification system facilitates the categorization of CRS in distinct groups. However, it may suggest that each type of CRS is caused by a single underlying mechanism, potentially leading clinicians to overlook that, in reality, multiple factors can drive CRS development. The incidence of CRS stemming from multiple etiologies remains currently underexplored. We report an illustrative case of a CF patient with concomitant NSAID-Exacerbated Respiratory Disease (NERD), necessitating two distinct targeted therapies to achieve effective symptomatic relief.
The extra cost of biologics as first-line treatment in uncontrolled chronic rhinosinusitis with nasal polyps with no previous sinus surgery is overwhelming: a budget impact analysis.
Fieux M, Margier J, Bartier S … +7 more , Chang M, Carsuzaa F, Hwang PH, Patel ZM, Tringali S, Favier V, Savary T
Rhinology · 2025 Aug · PMID 40407262 · Publisher ↗
BACKGROUND: Both surgery and biologics offer comparable control rates for patients with uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) but differ in terms of cost and complications. The aim was to assess...
BACKGROUND: Both surgery and biologics offer comparable control rates for patients with uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) but differ in terms of cost and complications. The aim was to assess the mean total direct cost per patient of biologics or surgery as first-line treatment in uncontrolled CRSwNP and to perform a budget impact analysis (BIA). METHODS: An economic model was build based on pricing of March 2024, and on the theoretical French population to simulate both the 5-year mean direct cost per patient and the BIA. For the BIA, two scenarios were evaluated: in scenario 1 (the normal one), 18% of patients received biologics as first-line (vs 82% surgery) and in scenario 2 (the less likely one), 90% of patients received biologics as first-line (vs 10% surgery). Within both scenarios, two approaches were considered, the surgical one (when patients received surgery as first-line) and the biological one (when patients received biologics as first-line, no previous sinus surgery). RESULTS: Over 5 years, the estimated mean direct cost per patient per year was significantly lower in the surgical approach compared to the biological one (60,026 EUR). The BIA found that the estimated net overall incremental budget impact was 91,287,924 EUR in scenario 1 and 1,024,768,639 EUR in scenario 2. In both scenarios, the biological approach was the most expensive (+184% and +1048%, respectively). CONCLUSION: At current costs, if biologics were used as a first-line treatment (no previous sinus surgery) in patients with uncontrolled CRSwNP, the extra direct cost would be overwhelming.
Chronic rhinosinusitis in nasopharyngeal carcinoma patients post- IMRT: a meta-analysis.
Chua NYM, Lau WK, Chui AL … +2 more , Ng CL, Wang DY
Rhinology · 2025 Aug · PMID 40406956 · Publisher ↗
BACKGROUND: Intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC) can cause chronic rhinosinusitis (CRS), an underexplored side effect. This review aimed to determine the incidence and severity of CR...
BACKGROUND: Intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC) can cause chronic rhinosinusitis (CRS), an underexplored side effect. This review aimed to determine the incidence and severity of CRS in NPC patients post-IMRT. METHODS: Electronic databases (PubMed, CINAHL, Embase, Cochrane Library, Web of Science) were searched for studies published from 2000 onwards. Eligible studies assessed CRS in NPC patients post-IMRT, using validated methods per EPOS 2020 (Lund-Mackay (LM) CT scoring, Lund-Kennedy (LK) endoscopic scoring, SNOT questionnaire). Meta-analysis was conducted using SPSS and R to quantify pooled CRS incidence and severity. RESULTS: Nine studies (n=1,478) were included, revealing distinct patterns in CRS development and severity. Patients without prior sinusitis showed significantly increased likelihood of developing CRS post-IMRT, while those with prior sinusitis had reduced odds due to a ceiling effect, as CRS was already present in 100% of these patients before IMRT. Both groups showed significant increases in CRS severity pre- and post-IMRT, with the LK and LM scoring methods showing the most substantial changes. CONCLUSIONS: This review underscores the significant increases in both the incidence and severity of CRS in NPC patients post- IMRT. Clinicians should recognise the risk of CRS post-IMRT and recommend options to reduce the likelihood of CRS development.
Effectiveness of Artificial Intelligence in detecting sinonasal pathology using clinical imaging modalities: a systematic review.
Petsiou DP, Spinos D, Martinos A … +3 more , Muzaffar J, Garas G, Georgalas C
Rhinology · 2025 Aug · PMID 40388840 · Publisher ↗
BACKGROUND: Sinonasal pathology can be complex and requires a systematic and meticulous approach. Artificial Intelligence (AI) has the potential to improve diagnostic accuracy and efficiency in sinonasal imaging, but its...
BACKGROUND: Sinonasal pathology can be complex and requires a systematic and meticulous approach. Artificial Intelligence (AI) has the potential to improve diagnostic accuracy and efficiency in sinonasal imaging, but its clinical applicability remains an area of ongoing research. This systematic review evaluates the methodologies and clinical relevance of AI in detecting sinonasal pathology through radiological imaging. METHODOLOGY: Key search terms included "artificial intelligence", "deep learning", "machine learning", "neural network" and "paranasal sinuses". Abstract and full-text screening was conducted using predefined inclusion and exclusion criteria. Data were extracted on study design, AI architectures used (e.g., Convolutional Neural Networks (CNN), Machine Learning classifiers), and clinical characteristics, such as imaging modality (e.g., Computed Tomography (CT), Magnetic Resonance Imaging (MRI)). RESULTS: A total of 53 studies were analyzed, with 85% retrospective, 68% single-center, and 92.5% using internal databases. CT was the most common imaging modality (60.4%), and chronic rhinosinusitis without nasal polyposis (CRSsNP) was the most studied condition (34.0%). Forty-one studies employed neural networks, with classification as the most frequent AI task (35.8%). Key performance metrics included Area Under the Curve (AUC), accuracy, sensitivity, specificity, precision, and F1-score. Quality assessment based on CONSORT-AI yielded a mean score of 16.0 +- 2. CONCLUSIONS: AI shows promise in improving sinonasal imaging interpretation. However, as existing research is predominantly retrospective and single-center, further studies are needed to evaluate AI’s generalizability and applicability. More research is also required to explore AI's role in treatment planning and post-treatment prediction for clinical integration.
Eosinophilic complications during dupilumab therapy for type 2 diseases: a systematic review.
Lazzeroni M, Kemp P, Fokkens WJ … +1 more , Reitsma S
Rhinology · 2025 Aug · PMID 40305840 · Publisher ↗
BACKGROUND: Dupilumab shows promising results in the management of several type 2 disorders. However, it often leads to transient, early increases in blood eosinophil count (BEC). This has led to awareness of possibly as...
BACKGROUND: Dupilumab shows promising results in the management of several type 2 disorders. However, it often leads to transient, early increases in blood eosinophil count (BEC). This has led to awareness of possibly associated eosinophilic complications, such as eosinophilic granulomatosis with polyangiitis (EGPA) and hypereosinophilic syndrome (HES). Aim of the current work was to collect all eosinophilic complications reported in literature. METHODOLOGY: PubMed, Embase, Scopus, and Web of Science were systematically searched for papers reporting on eosinophilic complications of dupilumab therapy for type 2 disorders. RESULTS: While around one million patients are treated with dupilumab globally, we identified a total of 35 reports on 53 patients. The most common complications were EGPA: 24 patients, eosinophilic pneumonia: 15, and HES: 6. Complications developed after a median of 9 (range: 0-71) weeks and the median eosinophilic count at the moment of diagnosis was 6.38x109 cells/L (IQR 3.13- 9.08). Most complications were treated with systemic corticosteroids. Of all patients, 89% discontinued dupilumab therapy and no deceased patients were reported. CONCLUSIONS: Reported eosinophilic complications during dupilumab therapy are extremely rare and mostly develop during the first months of treatment, challenging the need for (prolonged) BEC monitoring during dupilumab therapy. No patient patterns or predictors were identified.
Olfactory disorder after COVID-19 vaccination.
Kawabata M, Mori E, Yanagi N … +2 more , Tei M, Otori N
Rhinology · 2025 Aug · PMID 40305821 · Publisher ↗
This systematic review examines 16 reported cases of olfactory disorders occurring after COVID-19 vaccination. Symptoms such as anosmia, parosmia, hyposmia, ageusia, and dysgeusia appeared within one week of vaccination....
This systematic review examines 16 reported cases of olfactory disorders occurring after COVID-19 vaccination. Symptoms such as anosmia, parosmia, hyposmia, ageusia, and dysgeusia appeared within one week of vaccination. Among the 16 patients (12 women, 4 men; mean age 38 years), 9 received the Pfizer mRNA vaccine, 6 received the AstraZeneca viral vector vaccine, and 1 received the Moderna mRNA vaccine. Symptoms persisted from 4 days to 18 months, with varying degrees of severity. Diagnoses were made using Sniffin’ Sticks tests and T&T olfactometry, mosty revealing mild hyposmia. Treatment included vitamin B12, multivitamins, olfactory training, Kampo formula, and, in some cases, corticosteroids. The hypothesized mechanism involves inflammatory responses triggered by spike protein interaction with the α7 nicotinic acetylcholine receptor on macrophages. Given the lack of definitive diagnostic methods, careful clinical evaluation is essential to rule out other causes such as subclinical COVID-19 infection. While olfactory disorders have been reported after vaccination, no direct causal relationship has been established.Further research is needed to clarify underlying mechanisms and contributing factors.
The 4 item Concise Aging adults Smell Test (4CAST) to screen for olfactory-related comorbidities.
Schlosser RJ, Gregoski MJ, Eckert MA … +2 more , Benitez A, Soler ZM
Rhinology · 2025 Aug · PMID 40305767 · Full text
BACKGROUND: Olfactory dysfunction (OD) is associated with numerous comorbidities, including cognitive decline and depression. Age-related OD is one of the most common causes of smell loss, but it is often underrecognized...
BACKGROUND: Olfactory dysfunction (OD) is associated with numerous comorbidities, including cognitive decline and depression. Age-related OD is one of the most common causes of smell loss, but it is often underrecognized. In previous research the 4 item Concise Aging adults Smell Test (4CAST) accurately predicted psychophysical olfactory function in over 80% of older adults. This study examined the relationship of 4CAST to olfactory-related comorbidities. METHODS: A community-based cohort of adults over 50 years of age completed the 4CAST. Its association with olfactory-related comorbidities was assessed using: 1) National Institutes of Health Toolbox -Cognition Battery; 2) Questionnaire for Olfactory Disorders-Negative Statements (QOD-NS); 3) Patient Health Questionnaire 9 (PHQ9); 4) DeJong Giervald (DJG) social isolation scale; and 5) Mini-Nutritional Assessment (MNA). RESULTS: Participants who failed the 4CAST had worse median scores for all measures of fluid cognition, QOD-NS, and PHQ9. Of participants who failed the 4CAST, 24-39% had cognition scores suggestive of possible cognitive impairment. Participant’s 4CAST results did not differ in crystallized cognition (Picture Vocabulary Test), total DJG and MNA scores. CONCLUSION: The 4CAST is a quick screening instrument that may indicate psychophysical OD in older adults and identify olfactory-related comorbidities (i.e. cognitive decline, depression) that may merit further in-depth assessments.
Olfactory training using nasal inserts is more effective due to increased adherence.
Winter AL, Henecke S, Thunell E … +4 more , Swartz M, Martinsen J, Sahlstrand Johnson P, Lundstrom JN
Rhinology · 2025 Aug · PMID 40278843 · Publisher ↗
BACKGROUND: The recommended treatment for hyposmia (a clinically reduced sense of smell) is olfactory training using odor containers that the patients smell twice a day for several weeks. Adherence to the olfactory train...
BACKGROUND: The recommended treatment for hyposmia (a clinically reduced sense of smell) is olfactory training using odor containers that the patients smell twice a day for several weeks. Adherence to the olfactory training regimen is, however, generally low. We aimed to investigate if a new form of odor delivery, using scented nasal inserts, could enhance adherence to olfactory training by allowing participants to be mobile during the training and thereby lower the perceived intrusion on everyday life. METHODS: Using a randomized controlled parallel-group design, individuals (N = 116) with hyposmia underwent 8 weeks of olfactory training. One group was assigned olfactory training using scented nasal inserts (nasal devices that retain nasal patency) while the other group was assigned the standard care regimen currently recommended by the Swedish healthcare system. We assessed objective and subjective olfactory ability before and after olfactory training as well as adherence to training. RESULTS: Both groups significantly improved both their objective and subjective olfactory abilities, and training with nasal inserts produced similar improvement as standard care in overall treatment outcome. However, there was a significantly greater increase in discrimination performance and lower dropout rate (6.7%) in the nasal insert compared to the standard care group (23.2%). Critically, after exclusion of the drop-out participants, the nasal insert group still showed significantly higher adherence to the training regimen. CONCLUSIONS: Olfactory training with nasal inserts could serve as a more effective form of treatment for hyposmia due to patients' improved adherence to protocol and increased tendency to finish their treatment regimen.
Prevalence and recovery rate of persistent olfactory dysfunction in COVID-19: the COVORTS study.
van Dijk B, Postma EM, Boek WM … +2 more , Kamalski DMA, Boesveldt S
Rhinology · 2025 Jun · PMID 40257240 · Publisher ↗
BACKGROUND: Olfactory dysfunction is a well-recognized symptom of COVID-19 infection. However, prevalence and recovery rate of these persistent symptoms differ across reports. Here, we report prevalence and recovery rate...
BACKGROUND: Olfactory dysfunction is a well-recognized symptom of COVID-19 infection. However, prevalence and recovery rate of these persistent symptoms differ across reports. Here, we report prevalence and recovery rate of psychophysically measured quantitative olfactory dysfunction, qualitative complaints, and subjective olfactory functioning up to 15 months after infection. METHODOLOGY: The COVORTS cohort included 76 patients between 18-60 years with recent (1 month) olfactory dysfunction. The (extended) Sniffin’ Sticks test was performed at baseline (T1), and 3 months, 6 months, 9 months, and 12 months later (T13). Monthly online questionnaires were completed on self-reported overall olfactory functioning and qualitative complaints. RESULTS: Prevalence of quantitative olfactory dysfunction was 89.5% at baseline, and 69.1% at T13. Clinically relevant recovery was achieved by 29.4% of patients at T13. Prevalence of parosmia remained around 50%, while phantosmia slowly decreased from 43.4% to 23.5%. Subjective olfactory functioning slowly improved over time before levelling out at around half of pre-illness ability. At T13, 37.9% of patients reported an improvement of at least 80% of pre-COVID function. Fluctuations were observed within individuals for all three measurements. CONCLUSIONS: Irrespective of measurement method, prevalence of olfactory dysfunction remains high up to 15 months after infection, and recovery rate is low. Individual fluctuations were observed between timepoints, indicating that recovery is not stable. Acknowledgement of symptoms, knowledge of fluctuations, and longer follow-up to evaluate further recovery are crucial to improve patient management.
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