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Background Methods Results Conclusion There is clear evidence that prevalence of primary antibody deficiency (PAD) is higher in children with chronic rhinosinusitis (CRS) than in the general population. The purpose of this multi‐institutional and multidisciplinary evidence‐based review with recommendations (EBRR) is to thoroughly review the literature on rhinosinusitis with PAD, summarize the existing evidence, and provide recommendations on the evaluation and management of rhinosinusitis in children with PAD.The PubMed, Embase, and Cochrane databases were systematically reviewed from inception through December 2023. Studies on the evaluation and management of rhinosinusitis in PAD patients were included. An iterative review process was utilized in accordance with EBRR guidelines. Levels of evidence and recommendations on the evaluation and management principles for PAD were generated.A total of 50 studies were included in this evidence‐based review. These studies were evaluated on the incidence of PAD in rhinosinusitis patients, the incidence of rhinosinusitis in PAD patients, and on the different treatment modalities used and their outcome. The aggregate quality of evidence varied across the reviewed domains.Based on the currently available evidence, the incidence of PAD in children with recalcitrant CRS can be significantly elevated. Despite the presence of multiple studies addressing rhinosinusitis and PAD, the level of evidence supporting different treatment options continues to be lacking. Optimal management requires a multidisciplinary approach through collaboration with clinical immunology. There is need for higher level studies that compare different treatments in children with PAD and rhinosinusitis. [ABSTRACT FROM AUTHOR]

Background Prior studies showed that female patients with chronic rhinosinusitis (CRS) suffer a worse disease-specific quality of life (QoL). Goal The aim of this study is to investigate gender differences in sinonasal QoL outcomes in patients requiring endoscopic endonasal skull base surgeries (EESBS). Methods Cross-sectional analysis of patients presenting to our clinic from August 2020 to December 2022 with skull base tumors, spontaneous cerebrospinal fluid (CSF) rhinorrhea, or Grave's orbitopathy (for orbital decompression) was performed. Baseline and postsurgical QoL were measured using the 22-item Sinonasal Outcome Test (SNOT-22). Patients' demographics and comorbidities were reviewed. Patients with concomitant CRS were excluded. Results Eighty-six patients were included (54 with skull base tumors, 17 Grave's orbitopathy, and 15 spontaneous CSF rhinorrhea). The mean age of the patients was 52 years (range: 12.4–81.5 years), and 51.6% of the patients were females. There was no age difference between female and male patients. Smoking history, asthma, and allergic rhinitis were also similar between the two groups. Female patients had a significantly higher incidence of depression (58.3 vs. 32.4%, p = 0.018) and migraine (50.0 vs. 21.6%, p = 0.007). Female patients had a significantly worse overall SNOT-22 scores at baseline (33.6 vs. 18.2, p = 0.001), at the 3-month follow-up (29.7 vs. 15.5, p = 0.002), and at the 6-month follow-up (33.5 vs. 14.9, p = 0.005). This worse QoL was seen mainly in the ear/facial, sleep, and psychological domains. Linear regression of the SNOT-22 scores and its subdomains adjusting for comorbidities showed that migraine was found to be the most significant determinant of gender differences in the QoL. Conclusion Female patients who undergo EESBS show higher overall SNOT-22 scores secondary to higher incidence of migraine. [ABSTRACT FROM AUTHOR]

The goal of this American Rhinologic Society Expert Practice Statement (EPS) is to provide recommendations and guidance through evidence‐based consensus statements regarding pediatric septoplasty. This EPS was developed following the previously published methodology and approval process. The topics of interest included appropriate indications, safety and efficacy, timing, relevant quality of life instruments, and surgical techniques. Following a modified Delphi approach, six statements were developed, five of which reached consensus and one that did not. These statements and accompanying evidence are summarized along with an assessment of future needs. [ABSTRACT FROM AUTHOR]

Objectives: Prior studies evaluating the role of sinonasal anatomic variants with recurrent acute rhinosinusitis (RARS) are limited by inconsistent results. The goal of this study is to evaluate the association between sinonasal anatomic variants and RARS. Methods: A 1:2 retrospective case–control study was conducted using patients presenting to the rhinology clinic from August 2020 to January 2023. A total of 60 patients with RARS were compared to 120 control patients. RARS was diagnosed based on the International Consensus Statement on Allergy and Rhinology criteria of four or more independent episodes of acute rhinosinusitis per year with at least one episode documented by objective findings, with complete resolution of the infection in‐between episodes. Sinonasal anatomic variants included nasal septal deviation (NSD), concha bullosa (CB), infraorbital (Haller) cells, nasal septal spur in the middle meatus, and frontal sinus cells (supra‐agger, supra‐agger frontal, and suprabullar frontal cells). Results: Age was similar in RARS and control patients (47.4 ± 16.5 vs. 49.3 ± 14.5, p = 0.432). Both the RARS group and control group were more likely to be female (78.3% vs. 77.5%, p = 0.899). There was no significant association between NSD and RARS compared to the control group (OR = 0.97, p = 0.916), and no significant association between any of the anatomic variants and RARS [infraorbital cells (OR = 0.64, p = 0.167), CB (OR = 0.84, p = 0.596), spur in the middle meatus (OR = 1.28, p = 0.514), supra‐agger (OR = 0.88, p = 0.708), supra‐agger frontal cells (OR = 0.97, p = 0.939), or suprabullar frontal cells (OR = 1.13, p = 0.766)]. Conclusion: Our findings suggest no association between nasal septal deviation or any of the anatomic variants studied and RARS. Level of Evidence: 3 Laryngoscope, 134:3489–3492, 2024 [ABSTRACT FROM AUTHOR]

This article, published in the Journal of Neurological Surgery, explores the use of AI chatbots in generating novel research questions in skull base surgery (SBS). The study compared the efficacy of ChatGPT-4 and Google Bard in producing systematic review ideas for different subspecialties within SBS. The results showed that both chatbots were successful in generating novel, unpublished systematic review topics in skull-base surgery. ChatGPT-4 had an overall rate of 30% for producing novel ideas, compared to Bard's rate of 15%. The study concludes that AI chatbots can be valuable tools in discovering new research questions in SBS. [Extracted from the article]

Objectives: To identify the differences in the impact of chronic rhinosinusitis (CRS) between female and male adolescent patients at presentation. Study Design: Cross sectional study. Methods: Adolescent patients, age 12 to 18 years old, presenting to our Otolaryngology clinic between August 2020 and April 2023 for CRS were asked to fill both the SNOT-22 and the SN5 forms. Female and male cohorts were compared regarding their demographics, comorbidities, subjective and objective disease measurements, and choice of treatment. Results: Sixty-six patients were included, 30 female and 36 male patients. There were no differences in age, allergic rhinitis, asthma, obstructive sleep apnea, presence of nasal septal deviation, and objective disease severity (P >.05 for all). At presentation, mean overall SNOT-22, ear/facial, sleep, and psychological domains were all higher in female patients (43vs 30.9, P =.02; 9.1vs 6, P =.03; 11.8vs 8.3, P =.07; 14.1vs 8.8, P =.02 respectively). SN5 scores and overall QoL visual analog scale were similar in females and males. Conclusion: Female patients with CRS show higher subjective disease burden. Incorporating data on gender-specific differences may be important to personalize treatment decision making. [ABSTRACT FROM AUTHOR]

The article describes the case of nasopharyngeal choristoma with features consistent with hairy cell polyp and compound odontoma arising from the skull base in a premature newborn. Topics discussed include prenatal diagnosis of a cleft palate, complication of the pregnancy, and finding on surgical pathology.

Objective: To study the long-term outcomes of pediatric chronic rhinosinusitis (CRS) after surgical treatment. Methods: Cross-sectional survey of patients who were treated surgically for CRS as children more than 10 years ago. Survey included SNOT-22 questionnaire, additional functional endoscopic sinus surgery (FESS) since last treatment, status of allergic rhinitis and asthma, and availability of any CT scan sinus/face for review. Results: About 332 patients were contacted by phone or email. Seventy-three patients filled the survey (22.5% response rate). Current age was 26 years (±+/−4.7, 15.3-37.8 years). Age at initial treatment was 6.8 years (+/−3.1, 1.7-14.7 years). Fifty-two patients (71.2%) had FESS and adenoidectomy, and 21 patients (28.8%) had adenoidectomy only. Follow-up since surgical treatment was 19.3 years (+/−4.1). SNOT-22 score was 34.5 (+/−22.2). None of the patients had any additional FESS for the duration of the follow-up, and only 3 patients had septoplasty and inferior turbinoplasty as adults. Twenty-four patients had CT scan sinuses/face available for review. Scans were obtained at an average of 14 years after surgical intervention (+/−5.2). CT LM score was 0.9 (+/−1.9), compared to 9.3 at time of their surgery (+/−5.9) (P <.0001). Currently 45.8% and 36.9% of patients have asthma and AR, compared to 35.6% and 40.6% respectively as kids (P =.897 and P =.167). Conclusion: Children who had surgery for CRS do not seem to have CRS as adults. However, patients continue to have active allergic rhinitis that may affect their quality of life. [ABSTRACT FROM AUTHOR]

Objectives: Endovascular embolization has emerged as an effective treatment for intractable epistaxis. This systematic review and meta-analysis aimed to calculate the rates of success, rebleeds, and complications and to identify the etiologies and complications of patients who undergo endovascular embolization. Methods: This systematic review and meta-analysis was conducted per the guidelines set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles were extracted from Scopus, PubMed, Web of Science, and Cochrane Central and were filtered by a systematic review process using Rayyan software. A random-effects model was used to quantify the rates success, rebleeds, and complications. Results: Forty-two studies were included, totaling 1660 patients. The pooled success rate was 89% (95% confidence interval [CI] 86%-92%) and the pooled rebleed rate was 19% (95% CI 16%-22%). The pooled minor complication rate was 18% (95% CI 11%-27%). The most common major complication was soft tissue necrosis followed by stroke. The most common minor complication was facial pain. No minor complications were reported to be permanent. Of the patients who failed initial embolization, 42% underwent repeat embolization and 34% underwent surgical arterial ligation. Conclusions: Endovascular embolization is an effective treatment for intractable epistaxis. The decision to perform embolization should be carefully weighed given the rare but significant major complications. [ABSTRACT FROM AUTHOR]

Objectives: To validate each of the sino‐nasal outcome test (SNOT‐22) and the sinus and nasal quality of life (SN5) surveys for the adolescent population defined as 12 to 18 years old, and to determine if they correlate in regard to reports of sinonasal symptoms and quality of life. Study Design: Cross‐sectional study. Methods: Adolescent patients, age 12 to 18 years old, presenting to our otolaryngology clinic between August 2020 and June 2021 were asked to fill both the SNOT‐22 and the SN5 forms. Demographics and comorbidities were reviewed. Patients recruited were then divided into a sinonasal cohort (those with chronic sinonasal symptoms) and a control cohort (those who did not have any sinonasal disorders at time of visit). Results: One hundred fifteen patients completed both surveys, 80 patients in the sinonasal cohort and 35 patients in the control cohort. Average age was 14.9 years, and 49.6% were female. Mean SNOT‐22 and SN5 scores were significantly higher in the sinonasal cohort as compared with the control cohort which confirmed validity of both surveys for the adolescents. Good test–retest reliability for both surveys was obtained (r = 0.76 for SNOT‐22, and r = 0.64 for SN5). SNOT‐22 and SN5 scores correlated well in both the sinonasal cohort (r = 0.63, p < 0.0001) and the control cohort (r = 0.61, p = 0.0003). Both surveys strongly predicted chronic sinonasal disorders with an odds ratio of 2.5 for SNOT‐22 and 2.2 for SN5. Conclusion: Both instruments can be used to study the outcome of treatment for sinonasal disorders in adolescent patients. Level of Evidence: 4 Laryngoscope, 133:1052–1058, 2023 [ABSTRACT FROM AUTHOR]