International Rhinologic Society Rhinology 0300-0729 53 3 2015 9 1 Extending borders 193 194 EN W.J. Fokkens Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, the Netherlands 1347 10.4193/RhinRhin.53E3 The last 20 years of the last century, that sounds long ago but was actually the time that many of us already practiced in Rhinology or received their training, was I think the time of endoscopic sinus surgery. We learned all the possibilities of the endoscope, first mainly in limited inflammatory disease but later also because of the development of new technical possibilities like debriders, lens cleaners and probably most important curved drills more extensive surgery.

International Rhinologic Society Rhinology 0300-0729 53 3 2015 9 1 26030035 Hereditary haemorrhagic telangiectasia 195 203 EN J. Rimmer Department of Otolaryngology, Head and Neck Surgery, Monash Health, Melbourne, Victoria, Australia and Department of Surgery, Monash University, Melbourne, Victoria, Australia V.J. Lund Department of Otolaryngology, Royal National Throat Nose and Ear Hospital, London, United Kingdom and Ear Institute, University College London, London, United Kingdom 1303 10.4193/Rhin14.274 BACKGROUND: Hereditary haemorrhagic telangiectasia is an autosomal dominant vascular disease characterized by recurrent epistaxis, mucocutaneous telangiectasia and visceral arteriovenous malformations. METHODOLOGY: The genetic basis and pathophysiology of the disease are discussed. Diagnostic criteria and the clinical course of the condition are considered. The current management options, both medical and surgical, are reviewed. CONCLUSIONS: Hereditary haemorrhagic telangiectasia requires specialist treatment for the problems it causes, and is best ma- naged in specialist centres. Epistaxis is often the major symptom, significantly affecting patients' quality of life. An understanding of the available treatment options is therefore important for the otorhinolaryngologist.

International Rhinologic Society Rhinology 0300-0729 53 3 2015 9 1 Endoscopic surgery for malignant sinonasal tumours: an eighteen year experience 204 211 EN V.J. Lund Royal National Throat Nose and Ear Hospital, London, United Kingdom and University College London, London, United Kingdom W.I. Wei Hong Kong Sanatorium and Hospital, Hong Kong 1316 10.4193/Rhin14.318 INTRODUCTION: Curative resection of malignant tumours of the skull base is increasingly undertaken endoscopically. Hitherto the diverse histology, rarity and long natural history have made it difficult to accrue statistically robust cohorts for comparison with conventional craniofacial resection. It is now possible to make such a comparison in a large personal cohort. METHOD: Data on all cases of sinonasal malignancy undergoing endoscopic resection with curative intent over an eighteen year period were collected prospectively and analysed for survival and prognostic factors. RESULTS: There were 140 cases, 68 men and 72 women, aged 20-92 years (mean 63 yrs). Follow-up ranged from 6-184 months (mean 60 months). Eighteen different histopathologies were represented with olfactory neuroblastoma (36), malignant melanoma (33) and adenocarcinoma (19) being the commonest. Additional radiotherapy was given in 95 cases and chemotherapy in 49. Overall survival is 84% at 5 years and 69% at 10 years. Overall disease-free survival was 77% at 5 years and 56% at ten. Overall and disease-free survival at 5 (and 10) years is, respectively, 97% and 90% for olfactory neuroblastoma, 79% and 68% for adenocarcinoma and 56% and 39% for malignant melanoma. CONCLUSION: These results show that endoscopic resection is an alternative to conventional craniofacial resection in selected cases.

International Rhinologic Society Rhinology 0300-0729 53 3 2015 9 1 Current management of sinonasal undifferentiated carcinoma 212 220 EN F. Lopez Department of Otorhinolaryngology, Instituto Universitario de Oncologia del Principado de Asturias, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain V. Suarez Department of Otorhinolaryngology, Instituto Universitario de Oncologia del Principado de Asturias, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain B. Vivanco Department of Pathology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain C. Suarez Department of Otorhinolaryngology, Instituto Universitario de Oncologia del Principado de Asturias, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain J.L. Llorente Department of Otorhinolaryngology, Instituto Universitario de Oncologia del Principado de Asturias, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain 1313 10.4193/Rhin14.054 BACKGROUND: The management of sinonasal undifferentiated carcinoma (SNUC) remains unclear. Low incidence and poor outcomes make treatment standardization difficult. The objective of this study was to review the used treatment and our outcomes. METHODS: From 2001 to 2013, 17 cases of SNUC were treated at our department. Charts were reviewed for standard demographic, tumour size and extension, histological features, treatment strategies, surgical approach, adjuvant therapies, outcomes and complications. RESULTS: All patients presented with extensive local disease and 2 patients also had neck metastases. All patients were treated using a multimodality approach: 10 patients underwent surgery and postoperative chemoradiation, 1 patient was treated with surgery and adjuvant radiotherapy, 3 patients were treated with neoadjuvant chemotherapy, surgery and postoperative chemoradiation and the remaining 3 patients were treated with chemoradiotherapy. After median follow-up of 39 months 6 patients developed recurrences. The 3-year local control rate was 76% and the 5-year rate of overall survival was 58%. CONCLUSIONS: Management and outcomes of SNUC have improved due to advances in surgery and radiotherapy. Gross tumour resection followed by postoperative radiotherapy should be the standard of care in patients with SNUC. High-precision high-dose radiotherapy should be implemented to try to improve the outcomes.

International Rhinologic Society Rhinology 0300-0729 53 3 2015 9 1 Exposure to odours improves olfactory function in healthy children 221 226 EN E. Mori Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Germany W. Petters Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Germany V.A. Schriever Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Germany C. Valder Frey and Lau, Henstedt-Ulzburg, Germany T. Hummel Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Germany 1312 10.4193/Rhin14.192 BACKGROUND: Short-term exposure to odours, also called "olfactory training" has been shown to improve olfactory function in healthy people but also in people with olfactory loss. Aim of this single center, prospective, controlled study was to investigate the change of olfactory function following twice-daily, short-term exposure to 4 odours over a period of approximately 12 weeks. MATERIAL AND METHODS: We compared odour identification abilities and odour thresholds between an olfactory training group (TR group) and a group that did not perform such training (noTR group). Participants exposed themselves twice daily to 4 odours ("rose", "eucalyptus", "lemon", "clove"). Olfactory testing was performed before and after the training period using the "Sniffin' Sticks" test kit (odour identification plus odour thresholds). RESULTS: At baseline the two groups were not significantly different in terms of age and measures of olfactory sensitivity. The TR group performed significantly better for odour thresholds for all 4 odours compared to the noTR group after 12 weeks of olfactory training. Also, with regard to odour identification the TR group outperformed the noTR group. No significant differences were found for diary-based intensity ratings. CONCLUSION: Repeated exposure to odours seems to improve general olfactory sensitivity in children.

International Rhinologic Society Rhinology 0300-0729 53 3 2015 9 1 Post-operative budesonide irrigations for patients with polyposis: a blinded, randomized controlled trial 227 234 EN R.B. Rawal Department of Otolaryngology- Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA A.M. Deal Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA C.S. Ebert, Jr Department of Otolaryngology- Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA V.H. Dhandha Department of Otolaryngology- Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA C.A. Mitchell Department of Otolaryngology- Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA A.X. Hang Department of Otolaryngology- Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA M.R. Gore Department of Otolaryngology- Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA B.A. Senior Department of Otolaryngology- Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA A.M. Zanation Department of Otolaryngology- Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 1318 10.4193/Rhin14.196 OBJECTIVE: To compare normal saline (NS) vs. NS + budesonide irrigations in post- functional endoscopic sinus surgery (FESS) patients with chronic rhinosinusitis with polyposis (CRSwNP). Currently, no evidence exists for NS + budesonide irrigation over NS irrigation alone. STUDY DESIGN: Prospective, single-blind, randomized controlled trial. METHODS: Subjects were prospectively enrolled to NS or NS + budesonide arms. Patients were evaluated at pre-operative and three post-operative visits (POV): POV1 (1-2 weeks post-op), POV2 (3-8 weeks post-op), and POV3 (3-6 months post-op). Patients were evaluated by three quality of life (QOL) questionnaires (SNOT-22, RSOM-31, and RSDI) and two olfaction scores (UPSIT and the PEA test). RESULTS: Fifty patients were randomized, with 25 patients in the NS arm and 25 patients in the NS + budesonide arm. Two patients had unexpected pathology and were excluded from the study. By POV2 and POV3, patients experienced a significant improvement in all three QOL surveys, although the degree of improvement between arms was not significant up through POV3. Neither arm experienced significant olfactory improvement up through POV3. CONCLUSIONS: While both NS and NS + budesonide treatments improve QOL for post-FESS patients, neither intervention significantly increases QOL as compared to the other. Olfaction was not significantly improved in either treatment group.

International Rhinologic Society Rhinology 0300-0729 53 3 2015 9 1 25923031 Pedicled lateral nasal wall flap for the reconstruction of the nasal septum perforation. A radio-anatomical study 235 241 EN I. Alobid Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic, Universitat de Barcelona, Spain E. Mason Center for Cranial Base Surgery, Department of Otolaryngology, Georgia Regents University, Augusta, GA, USA C.A. Solares Center for Cranial Base Surgery, Department of Otolaryngology, Georgia Regents University, Augusta, GA, USA J. Ensenat Department of Neurosurgery, Hospital Clinic, Universitat de Barcelona, Spain M. De Notaris Laboratory of Surgical Neuroanatomy (LSNA), Hospital Clinic, Universitat de Barcelona, Spain A. Prats-Galino Laboratory of Surgical Neuroanatomy (LSNA), Hospital Clinic, Universitat de Barcelona, Spain M. Bernal- Sprekelsen Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic, Universitat de Barcelona, Spain R. Carrau Comprehensive Skull Base Surgery Centre, Department of Otorhinolaryngology, The Ohio State University Medical Center, Columbus, OH, USA 1315 10.4193/Rhin14.042 INTRODUCTION: The aim of this radio-anatomical study is to ensure that the potential donor area of the pedicled lateral nasal wall flap (PLNW) is adequate to reconstruct nasal perforation. MATERIAL AND METHODS: Analysis was conducted on 40 de-identified CT angiographies. The area and length of the PLNW, the septum, and the nasal floor were measured. In a cadaver study, 20 hemi-cranial sagittal sections were also analyzed. The anterior-posterior length of the PLNW flap and the distance between the sphenopalatine foramen and piriform aperture were measured. A clinical study with endoscopic closure of a large perforation was conducted in three patients. RESULTS: The CT angiographies demonstrated an average PLNW area of 10.80 ± 1.13 cm2 and a nasal floor area of 3.78 ± 0.58 cm2. The septal area (22.54 ± 21.32 cm2) was significantly larger than the total PLNW flap area (14.59 ± 1.21 cm2). The average length of the flap was 5.58 ± 0.39 cm, while the septum was 6.66 ± 0.42 cm; therefore the PLNW flap is insufficient to reconstruct the entire septum. The cadaver study showed that the length of the PLNW flap was 5.28 ± 0.40 cm. These results demonstrate that measurements obtained from CT scans are reliable data and similar to those found in the radiological study. Complete closure was achieved in all three patients. CONCLUSION: The PLNW flap does not render enough tissue to reconstruct a total septal perforation; however, up to 84% of the septum could be repaired with a PLNW. The potential donor area obtained by CT scan and clinical practice support the approachability of PLNW to repair large septal perforation.

International Rhinologic Society Rhinology 0300-0729 53 3 2015 9 1 The effect of Pyriform Turbinoplasty on nasal airflow using a virtual model 242 248 EN D. Simmen Centre for Otorhinolaryngology and Plastic, Hospital of Hirslanden, Zurich, Switzerland F. Sommer University Hospital Ulm, Department of Otorhinolaryngology, Head and Neck Surgery, Germany H.R. Briner Centre for Otorhinolaryngology and Plastic, Hospital of Hirslanden, Zurich, Switzerland N. Jones Department of Otorhinolaryngology, Head and Neck Surgery, Universtity Hospital, Queens Medical Centre, Nottingham, United Kingdom R. Kröger ANSYS Germany, Darmstadt, Germany T.K. Hoffmann University Hospital Ulm, Department of Otorhinolaryngology, Head and Neck Surgery, Germany J. Lindemann University Hospital Ulm, Department of Otorhinolaryngology, Head and Neck Surgery, Germany 1320 10.4193/Rhin14.259 BACKGROUND: A new procedure, pyriform turbinoplasty, is described and nasal airflow is measured before and after this procedure in a virtual model. METHODOLOGY: Pyriform turbinoplasty is the submucosal reduction of the bone of the frontal process of the maxilla and the lacrimal bone. It opens part of the lateral margin of the nasal valve area with minimal damage to nasal mucosa. The resection of bone in this area can be extended by "nasal wall lateralization" when the lacrimal bone that joins the uncinate process behind the lacrimal duct as well as the base of the inferior turbinate and the edge of the maxilla at the rim of the pyriform aperture are removed. Nasal airflow was simulated using computational fluid dynamics and ANSYS Fluent solver. RESULTS: Analysis using fluid dynamics showed that these procedures help ventilation in the main airflow areas without substantially altering the normal pattern of airflow. CONCLUSIONS: The changes after performing a pyriform turbinoplasty seem to be an improvement when compared to the changes after inferior turbinate surgery that can misdirect the airflow largely through the inferior meatus.

International Rhinologic Society Rhinology 0300-0729 53 3 2015 9 1 Reduced effect of intravenous antibiotic treatment on sinonasal markers in pulmonary inflammation 249 259 EN F. Doht CF-Center, Pediatrics, Jena University Hospital, Germany J. Hentschel CF-Center, Pediatrics, Jena University Hospital, Germany N. Fischer CF-Center, Pediatrics, Jena University Hospital, Germany T. Lehmann Institute of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, Germany U.R. Markert Department of Obstetrics, Placenta Laboratory, Jena University Hospital, Germany K. Boer Institute for Clinical Chemistry and Laboratory Diagnostics, Jena University Hospital, Germany W. Pfister Institute of Medical Microbiology, University of Jena, Germany M.W. Pletz Center for Infectious Diseases and Infection Control, Jena University Hospital, Germany O. Guntinas- Lichius Department of Otorhinolaryngology, Jena University Hospital, Germany J.G. Mainz CF-Center, Pediatrics, Jena University Hospital, Germany 1314 10.4193/Rhin14.300 BACKGROUND: Chronic bacterial rhinosinusitis is a common feature in Cystic fibrosis (CF) as mucociliary clearance in the sinonasal compartment is impaired. Aim of the present prospective study was to compare dynamics of inflammatory markers in the upper and lower airways (UAW/LAW) during systemic antibiotic therapy. METHODS: Nasal lavage and sputum of 16 CF-patients receiving an IV-antibiotic treatment against Pseudomonas aeruginosa and/ or Staphylococcus aureus were collected before and during treatment (median after 7.5 days). Cytological changes, DNA concentration, and inflammatory markers interleukin (IL)-4, IL-8, IL-13 and Myeloperoxidase (MPO) were assessed in samples from both airway compartments. RESULTS: Total cell count declined significantly in LAW-samples but not in UAW. Although MPO and IL-8 decreased significantly in both airway compartments, this was considerably more pronounced for LAW (median decrease MPO: LAW = 9.8-fold vs UAW = 1.75-fold, respectively; IL-8: LAW = 3-fold vs UAW = 1.9-fold, respectively). DISCUSSION: This is the first publication demonstrating substantially lower effects of IV-antibiotic treatment on sinonasal than on pulmonary inflammatory markers. Consequently, our findings highlight limitations of systemic antibiotic treatment to control infection in the sinonasal compartment. Primarily, we attribute this to the paranasal sinus ́ structure: these hollow organs, which in bacterial sinusitis are frequently filled with pus, mucoeceles and polyps, are not reached effectively by systemic antibiotic treatment.

International Rhinologic Society Rhinology 0300-0729 53 3 2015 9 1 The influence of European legislation on the use of diagnostic test allergens for nasal allergen provocation in routine care of patients with allergic rhinitis 260 269 EN L. Klimek Center for Rhinology and Allergology, An den Quellen 10, D-65183 Wiesbaden, Germany A.S. Hammerbacher Regulatory Sciences Manager Bristol-Myers Squibb, Regulatory Sciences Germany, Arnulfstrasse 29, D-80636 Munchen, Germany P.W. Hellings Department of Otorhinolaryngology, University Hospitals Leuven, Kapucijnenvoer 33, B-3000 Leuven, Belgium and Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands W.J. Fokkens Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands H.J. Hoffmann Chairman, Interest Group Allergy Diagnosis, EAACI, Department Respiratory Disease and Allergy, Institute of Clinical Medicine, University of Aarhus, Aarhus C, Denmark A. Muraro Secretary General of the European Academy of Allergy and Clinical Immunology (EAACI); Head Food Allergy Referral Centre Veneto Region, Department of Women and Child Health Padua General University Hospital, Padua, Italy N. Papadopoulos President European Academy of Allergy and Clinical Immunology (EAACI), Centre for Paediatrics and Child Health, Institute of Human Development, University of Manchester, Royal Manchester Childrens Hospital, Manchester, United Kingdom 1317 10.4193/Rhin14.316 In patients with allergic rhinitis (AR), the nasal provocation test (NPT) is the standard procedure to evaluate the clinical response of the nasal mucosa to allergens with a high specificity and sensitivity. In AR, it is the only test that really measures the response of the diseased mucosa to allergens while skin prick test and serum IgE confirm the clinical suspicion of sensitization. Moreover, it is of special relevance in the detection of patients with Local Allergic Rhinitis (LAR), where general sensitization cannot be measured. For the evaluation of therapeutic interventions, NPT has been used for the clinical monitoring of antiallergic drugs and allergen specific immunotherapy. Legislation within the European Union (EU) defines allergens used for diagnostic tests like NPT to be medicinal products according to Directive 2001/83 EC, but national law is considering these products to be medicinal devices in a number of EU countries. Thus, NPT products are governed by different legislations and therefore standards throughout the EU. In consequence, allergens used for diagnostic purposes need different registrations and Marketing Authorization by national authorities. After a transition period, regulations of EU Directives are to be implemented in national law by all member states. At the moment, most EU countries have not fully implemented these Directives, however, it can be expected that most countries will implement it and enforce their rules within the next years. This development has a tremendous impact on the availability of diagnostic allergens for NPT in Europe and will make make nasal provocation testing very difficult if not impossible. We describe the current situation of diagnostic allergens under the special legislative conditions in the EU with special focus on allergen products used for NPT and the consequences for the diagnosis of AR and LAR.

International Rhinologic Society Rhinology 0300-0729 53 3 2015 9 1 Autophagy is deficient and inversely correlated with COX-2 expression in nasal polyps: a novel insight into the inflammation mechanism 270 276 EN L.F. Wang Department of Otolaryngology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan C.Y. Chien Department of Otolaryngology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan Y.H. Yang School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan T.C. Hour Department of Biochemistry, Kaohsiung Medical University, Kaohsiung, Taiwan S.F. Yang Department of Pathology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan H.R. Chen Department of Life Science and Institute of Molecular Biology, National Chung Cheng University, Chia-Yi, Taiwan K.L. Tsai Department of Physiology, Kaohsiung Medical University, Kaohsiung, Taiwan J.Y. Ko Department of Otolaryngology, National Taiwan University, College of Medicine, Taipei, Taiwan J.Y.F. Chen Department of Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan 1305 10.4193/Rhin14.232 BACKGROUND: Nasal polyposis is characterised by persistent inflammation of the upper airways. Autophagy has been implicated in many chronic inflammatory diseases. Whether autophagy plays a role in nasal polyp (NP) inflammation is completely unknown and deserves investigation. METHODS: LC3 and COX-2 expression, the common autophagy and inflammation indicators, respectively, was analysed by immunoblotting in fresh tissues of NP and control nasal mucosa (NM). Primary cultures of NP-derived fibroblasts (NPDFs) and NMDFs were established for in vitro studies. Autophagy was induced by amino acid starvation and LC3 ectopic overexpression or inhibited by 3-methyladenine in the fibroblasts. Inflammation was induced by IL1-β and TNF-α. LC3 and COX-2 expression was confirmed in NP specimens by immunohistochemistry. RESULTS: LC3 expression was decreased while COX-2 expression was significantly increased in fresh NP tissues compared with the NM control. In NMDFs and NPDFs, autophagy induction by starvation and LC3 overexpression downregulated COX-2 expression. Conversely, autophagy inhibition by 3-methyladenine enhanced COX-2 expression. However, IL1-β and TNF-α had no effect on autophagy. Immunohistochemical studies on the NP specimens showed that most displayed low LC3 expression, whereas COX-2 was highly expressed in >50% of the specimens. Examination of two consecutive NP sections from the same tissue blocks revealed a negative correlation between LC3 and COX-2 expression. CONCLUSION: Autophagy is deficient in NP tissues and COX-2 is negatively regulated by autophagy in NP-derived fibroblasts. Since COX-2 is essential for the production of pro-inflammatory mediators, this study might help interpret persistent mucosal inflammation in NP. Attenuation of inflammation by restoring autophagy might be a therapeutic strategy for treating NP.

International Rhinologic Society Rhinology 0300-0729 53 3 2015 9 1 Manifestation of eosinophilic granulomatosis with polyangiitis in head and neck 277 285 EN H. Petersen Department of Otorhinolaryngology, Head and Neck Surgery, University of Kiel, Kiel, Germany P. Gőtz Department of Otorhinolaryngology, Head and Neck Surgery, University of Kiel, Kiel, Germany M. Both Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany M. Hey Department of Otorhinolaryngology, Head and Neck Surgery, University of Kiel, Kiel, Germany P. Ambrosch Department of Otorhinolaryngology, Head and Neck Surgery, University of Kiel, Kiel, Germany J.P. Bremer Klinikum Bad Bramstedt, Department of Rheumatology and University Hospital Schleswig-Holstein, Bad Bramstedt, Germany J. Holle Klinikum Bad Bramstedt, Department of Rheumatology and University Hospital Schleswig-Holstein, Bad Bramstedt, Germany F. Moosig Klinikum Bad Bramstedt, Department of Rheumatology and University Hospital Schleswig-Holstein, Bad Bramstedt, Germany M. Laudien Department of Otorhinolaryngology, Head and Neck Surgery, University of Kiel, Kiel, Germany 1319 10.4193/Rhin14.074 INTRODUCTION: Besides an obvious clinical involvement of the ear, nose and throat (ENT)-region in Eosinophilic Granulomatosis with Polyangiitis (EGPA), systematic data is sparse. Only a few case series and case reports are available that particularly describe rhinological, otological or other manifestations of EGPA in the ENT-region. Therefore, the objective of this study is to systematically describe data on ENT-region involvement in a large series of EGPA patients. METHOD: EGPA patients examined in the Department of Otorhinolaryngology of the Christian-Albrechts-University of Kiel between 1990 and 2010 were included in the study. Criteria for ENT-manifestation were assigned to five subgroups (history, ENT examination, audiological and rhinological diagnostic findings and cranial MRI) and documented cumulatively. EGPA patients were examined in a standardized way based on the validated Ear Nose and Throat Activity Score (ENTAS) or its precursor, including audiological and rhinological diagnostic findings. MRI scans were analysed to further evaluate ENT involvement. RESULTS: A total of 95 EGPA patients were included in the study. In approximately 80% of them, ENT-involvement was documented and the assumption of a frequent rhinological manifestation in patients with EGPA was confirmed. Moreover, the data reveals remarkable evidence for an otological manifestation. A missing correlation between the rhinological and the otological manifestation indicates an independent autoimmune-inflammatory process for this manifestation. CONCLUSION: The data of the largest monocentric study presented here confirms the hypothesis of a frequent ENT involvement in EGPA patients, in whom rhinological and otological manifestations are most common. Therefore, treatment should include long term follow-up and should be managed interdisciplinary.