International Rhinologic Society Rhinology 0300-0729 59 6 2021 12 1 34812435 �Whodunnit� in rhinology 489 489 EN S. Reitsma Amsterdam, the Netherlands 2949 10.4193/Rhin21.806

International Rhinologic Society Rhinology 0300-0729 59 6 2021 12 1 34812433 Rhinology in review: from COVID-19 to biologicals 490 500 EN W.J. Fokkens Department of Otorhinolaryngology, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands B.N. Landis Department of Otorhinolaryngology, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland C. Hopkins Department of Otorhinolaryngology, Guy’s Hospital, London, UK S. Reitsma Department of Otorhinolaryngology, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands A.R. Sedaghat Department of Otolaryngology â€" Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA 2950 10.4193/Rhin21.424 We look back at the end of what soon will be seen as an historic year, from COVID-19 to real-world introduction of biologicals influencing the life of our patients. This review describes the important findings in Rhinology over the past year. A large body of evidence now demonstrates loss of sense of smell to be one of the most common symptoms of COVID-19 infection; a meta-analysis of 3563 patients found the mean prevalence of self-reported loss to be 47%. A number of studies have now shown long-term reduced loss of smell and parosmia. Given the high numbers of people affected by COVID-19, even with the best reported recovery rates, a significant number worldwide will be left with severe olfactory dysfunction. The most prevalent causes for olfactory dysfunction, besides COVID-19 and upper respiratory tract infections in general, are trauma and CRSwNP. For these CRSwNP patients a bright future seems to be starting with the development of treatment with biologics. This year the Nobel prize in Medicine 2021 was awarded jointly to David Julius and Ardem Patapoutian for their discoveries of receptors for temperature and touch which has greatly enhanced our understanding of nasal hyperreactivity and understanding of intranasal trigeminal function. Finally, a new definition of chronic rhinitis has been proposed in the last year and we have seen many papers emphasizing the importance of endotyping patients in chronic rhinitis and rhinosinusitis in order to optimise treatment effect.

International Rhinologic Society Rhinology 0300-0729 59 6 2021 12 1 34714895 Omalizumab for the treatment of allergic rhinitis: a systematic review and meta-analysis 501 510 EN S. Tsabouri University of Ioannina, Medical School, Ioannina, Greece G. Ntritsos University of Ioannina, Medical School, Ioannina, Greece F. Koskeridis University of Ioannina, Medical School, Ioannina, Greece E. Evangelou University of Ioannina, Medical School, Ioannina, Greece P. Olsson Novartis AB, Kista, Sweden K. Kostikas University of Ioannina, Medical School, Ioannina, Greece 2939 10.4193/Rhin21.159 Background: Allergic rhinitis (AR), an IgE mediated inflammatory disease, significantly impacts quality of life of a considerable proportion of the general population. Omalizumab, a humanized monoclonal antibody against IgE, has been evaluated for both seasonal and perennial AR. We aimed to assess the efficacy and safety of omalizumab in randomized controlled trials (RCTs) in inadequately controlled AR. Methods: We conducted a systematic literature search of RCTs evaluating the safety and efficacy of omalizumab in AR. We synthesized evidence for clinical improvement of AR symptoms, quality of life, reduction of the use of rescue medication, and adverse events. Results: The systematic search returned 289 articles, of which 12 RCTs were eligible for data extraction and meta-analysis. Omalizumab reduced the Daily Nasal Symptom Severity Score (DNSSS) by a summary standardized mean difference of -0.41 points with large heterogeneity; omalizumab significantly reduced the DNSSS both in the 3 cedar pollen-induced AR trials by -0.97 points and to a lower extent in the remaining five non-cedar trials by -0.19 points. Omalizumab also improved the Daily Ocular Symptom Severity Score (DOSSS) by a summary standardized mean difference of -0.30 points with large heterogeneity; the Rhino-conjunctivitis Quality of Life Questionnaire by a summary standardized mean difference of -0.45 points with no heterogeneity and the mean daily consumption of rescue antihistamines by a summary standardized mean difference of -0.21 with large heterogeneity. No statistically significant difference in the occurrence of adverse events was observed between omalizumab and placebo. Conclusion: Our findings further support the efficacy and safety of omalizumab in the management of patients with allergic rhinitis inadequately controlled with a conventional treatment.

International Rhinologic Society Rhinology 0300-0729 59 6 2021 12 1 34726671 Maturation of odour identification ability and related factors in children 511 516 EN E. Mori Department of Otorhinolaryngology, Jikei University School of Medicine, Minato-ku, Tokyo, Japan R. Sekine Department of Otorhinolaryngology, Jikei University School of Medicine, Minato-ku, Tokyo, Japan; Department of Otorhinolaryngology, Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan Y. Tsurumoto Department of Otorhinolaryngology, Jikei University School of Medicine, Minato-ku, Tokyo, Japan R. Sakurai Department of Otorhinolaryngology, Jikei University School of Medicine, Minato-ku, Tokyo, Japan M. Tei Department of Otorhinolaryngology, Jikei University School of Medicine, Minato-ku, Tokyo, Japan H. Kojima Department of Otorhinolaryngology, Jikei University School of Medicine, Minato-ku, Tokyo, Japan N. Otori Department of Otorhinolaryngology, Jikei University School of Medicine, Minato-ku, Tokyo, Japan 2942 10.4193/Rhin21.187 Background: Olfaction plays an important role in our daily and social lives, both as adults and as children. This study assessed whether the ability to identify odours increases with age, as well as the ability in various age groups and the factors involved. Methods: The survey was performed in 2017 on 697 Japanese children (366 girls and 331 boys) aged 6â€"18 years who lived in Tsunan, Niigata Prefecture, Japan by using the â€�Open Essence’, a card-type odour identification test. We collected information regarding age, sex, and physical characteristic. We also inquired whether participants had siblings or if members of the family smoked, and whether they had conversations about odour at home. Statistical analysis was performed to evaluate the factors affecting odour identification abilities. Results: The results showed that the odour identification abilities of children increase with age, and children who have daily conversations about odours at home have better odour identification abilities. Conclusions: Odour identification ability increases with age. In addition, our findings suggest that conversation may positively affect odour identification. Hence, it is important for children to be exposed to an environment where they develop an interest in smells for better growth of their olfactory identification ability.

International Rhinologic Society Rhinology 0300-0729 59 6 2021 12 1 34553706 High prevalence of long-term olfactory, gustatory, and chemesthesis dysfunction in post-COVID-19 patients: a matched case-control study with one-year follow-up using a comprehensive psychophysical evaluation 517 527 EN P. Boscolo-Rizzo Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy T. Hummel Smell and Taste Clinic, Department of Otorhinolaryngology, Technical University of Dresden, Dresden, Germany C. Hopkins Guy’s and St Thomas’ Hospitals, London, United Kingdom M. Dibattista Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari A. Moro, Bari, Italy A. Menini Neurobiology Group, SISSA, Scuola Internazionale Superiore di Studi Avanzati, Trieste, Italy G. Spinato Unit of Otolaryngology, AULSS 2 - Marca Trevigiana, Treviso, Italy; Department of Neurosciences, Section of Otolaryngology, University of Padova, Treviso, Italy; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy C. Fabbris Unit of Otolaryngology, AULSS 2 - Marca Trevigiana, Treviso, Italy E. Emanuelli Unit of Otolaryngology, AULSS 2 - Marca Trevigiana, Treviso, Italy A. D’Alessandro Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy R. Marzolino Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy E. Zanelli Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy E. Cancellieri Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy K. Cargnelutti Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy S. Fadda Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy D. Borsetto Department of ENT, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom L.A. Vaira Department of Medical, Surgical and Experimental Sciences, Maxillofacial Surgery Operative Unit, University of Sassari, Sassari, Italy N. Gardenal Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy J. Polesel Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy G. Tirelli Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy 2928 10.4193/Rhin21.249 Background: Using an age and gender matched-pair case-control study, we aimed to estimate the long-term prevalence of psychophysical olfactory, gustatory , and chemesthesis impairment at least one year after SARS-CoV-2 infection considering the background of chemosensory dysfunction in non-COVID-19 population. Methodology: This case-controlled study included 100 patients who were home-isolated for mildly symptomatic COVID-19 between March and April 2020. One control regularly tested for SARS-CoV-2 infection and always tested negative was matched to each case according to gender and age. Chemosensory function was investigated by a comprehensive psychophysical evaluation including ortho- and retronasal olfaction and an extensive assessment of gustatory function. Differences in chemosensory parameters were evaluated through either Fisher’s exact test or Kruskal-Wallis test. Results: The psychophysical assessment of chemosensory function took place after a median of 401 days from the first SARS-CoV-2 positive swab. The evaluation of orthonasal smell identified 46% and 10% of cases and controls, respectively, having olfactory dysfunction, with 7% of COVID-19 cases being functionally anosmic. Testing of gustatory function revealed a 27% of cases versus 10% of controls showing a gustatory impairment. Nasal trigeminal sensitivity was significantly lower in cases compared to controls. Persistent chemosensory impairment was associated with emotional distress and depression. Conclusion: More than one year after the onset of COVID-19, cases exhibited an excess of olfactory, gustatory , and chemesthesis disturbances compared to matched-pair controls with these symptoms being associated to emotional distress and depression.

International Rhinologic Society Rhinology 0300-0729 59 6 2021 12 1 34636368 The potential cytotoxic effects of urban particle matter on olfaction 528 537 EN B.-Y. Kim Department of Otorhinolaryngology, School of Medicine, Ewha Womans University of Korea, Seoul, South-Korea J.Y. Park Department of clinical laboratory, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu City, Gyeonggi-do, South-Korea K.J. Cho Department of Otorhinolaryngology-Head and Neck Surgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu City, Gyeonggi-do, South-Korea J.H. Bae Department of Otorhinolaryngology, School of Medicine, Ewha Womans University of Korea, Seoul, South-Korea 2934 10.4193/Rhin21.192 Background: Urban particulate matter (UPM) in ambient air is implicated in a variety of human health issues worldwide, however, few studies exist on the effect of UPM on the olfactory system. This study aimed to identify the factors affecting the destruction of the olfactory system in a mouse model following UPM exposure. Methods: Mice were divided into: control and four UPM-exposed groups (200 Â#181;g UPM at 1 and 2 weeks, and 400 Â#181;g UPM at 1 and 2 weeks [standard reference material 1649b; average particle diameter 10.5 μm]). The olfactory neuroepithelium was harvested for histologic examination, gene ontology, quantitative real-time polymerase chain reaction, and western blotting. Results: Compared to the control group, olfactory marker protein, Olfr1507, ADCY3, and GNAL mRNA levels were lower, and S-100, CNPase, NGFRAP1, BDNF, and TACR3 mRNA levels were higher in the olfactory neuroepithelium of the UPM groups. Moderately positive correlation was present between the 1- and 2-week groups. After analyzing the 200 and 400 UPM groups separately, the strength of the association between the 200 UPM 1- and 2-week groups was moderately positive. No differences was present in the neuroepithelial inflammatory marker levels between the UPM and control groups. Conclusions: UPM could have cytotoxic effects on the olfactory epithelium. The exposure time and particular concentration of UPM exposure could affect the degree of destruction of the olfactory neuroepithelium. The olfactory regeneration mechanism could be related to the neurotrophic factors, olfactory ensheathing cell stimulation, and trigeminal nerve support.

International Rhinologic Society Rhinology 0300-0729 59 6 2021 12 1 34432862 Re-evaluating the nasal cycle by long-term rhinoflowmetry: most individuals demonstrate a �mixed� nasal cycle 538 544 EN J. Lindemann Department of Otorhinolaryngology, University Hospital Ulm, Germany C. Weindel Department of Otorhinolaryngology, University Hospital Ulm, Germany T.K. Hoffmann Department of Otorhinolaryngology, University Hospital Ulm, Germany F. Sommer Department of Otorhinolaryngology, University Hospital Ulm, Germany M.O. Scheithauer Department of Otorhinolaryngology, University Hospital Ulm, Germany F. Stupp Department of Otorhinolaryngology, University Hospital Ulm, Germany E.F. Reins Department of Otorhinolaryngology, University Hospital Ulm, Germany 2921 10.4193/Rhin21.101 Background: The nasal cycle seems to be more complex than a strictly alternating swelling of the nasal mucosa. Long-term rhinoflowmetry (LRFM) allows continuous investigation of changes in nasal airflow over 24 hours (24h). We evaluated the various types of nasal cycle with LRFM over 24 hours and investigated the influence of age and gender. Methods: LRFM was continuously performed over 24h in 55 rhinologically healthy subjects (36 female, 19 male). The LRFM flow curves were examined for phases of the �classical�, �in-concert�, �one-sided� and �no-cycle� cycle types. Subjects were divided into 4 age subgroups (19-29; 30-49; 50-69; >70 years). Correlations of age and gender with the individual cycle forms were analyzed. Results: 85.5% of the subjects presented a �mixed� nasal cycle within 24h. The �classical� nasal cycle was seen most often (92.7% vs. �in-concert�; 56.4% vs. �one-sided�; 18.2% vs. �no-cycle�; 5.5%). Older age groups significantly more often presented the "no-cycle" type. A tendency was seen towards a mixed nasal cycle with increasing age. The mixed nasal cycle was significantly more often seen in the female subjects. Conclusions: LRFM is an easy-to-use measurement tool. The �mixed� nasal cycle predominates. However, all 4 different cycle types can be detected, alternating over 24h in each subject. Moreover, the cycle type varies with age.

International Rhinologic Society Rhinology 0300-0729 59 6 2021 12 1 34762075 Patient-reported chronic rhinosinusitis disease control is a valid measure of disease burden 545 551 EN K.M. Phillips Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA F.A. Houssein Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA K. Singerman Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA L.M. Boeckermann Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA A.R. Sedaghat Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA 2947 10.4193/Rhin21.282 Background: Disease control is an important treatment goal for chronic uncurable conditions such as chronic rhinosinusitis (CRS). The objective of this study was to determine whether patient-reported CRS disease control is a valid reflection of disease burden. Methods: Prospective longitudinal study of 300 CRS patients (35% CRS with nasal polyps, 65% CRS without nasal polyps). At enrollment and at a subsequent follow-up timepoint, all participants were asked to rate their CRS disease control as �not at all,� �a little,� �somewhat,� �very,� or �completely�, as well as to complete a 22-item Sinonasal Outcome Test (SNOT-22) and the 5-dimension EuroQol general health questionnaire from which the visual analogue scale (EQ-5D VAS) was used. Results: At enrollment and follow-up timepoints, patient-reported CRS disease control was significantly correlated with SNOT-22 and EQ-5D VAS scores. The change in patient-reported CRS disease control was significantly correlated with change in SNOT-22 and change in EQ-5D VAS scores. There was significant cross-sectional and longitudinal correlation between patient-reported control and all SNOT-22 subdomain scores. A SNOT-22 score of � 25 points or lower, or an EQ-5D VAS score of �77 was predictive of having well - (i.e. �very� or �completely�) controlled CRS. Conclusions: Patient-reported CRS disease control is a valid measure of CRS disease burden and general QOL. A patient-reported assessment of CRS disease control could be considered as a component of a more comprehensive measure of CRS disease control.

International Rhinologic Society Rhinology 0300-0729 59 6 2021 12 1 34708838 Multi-institutional minimal clinically important difference of the 22-item Sinonasal Outcome Test in medically managed chronic rhinosinusitis 552 559 EN K.M. Phillips Department of Otolaryngology â€" Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA F.A. Houssein Department of Otolaryngology â€" Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA L.M. Boeckermann Department of Otolaryngology â€" Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA K.W. Singerman Department of Otolaryngology â€" Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA D.T. Liu Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria A.R. Sedaghat Department of Otolaryngology â€" Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA 2936 10.4193/Rhin21.253 Background: With a rapid proliferation of clinical trials to study novel medical treatments for CRS, the objective of this study was to study the minimal clinically important difference (MCID) of the 22-item Sinonasal Outcome Test (SNOT-22) in medically-managed CRS patients. Methods: A total of 183 medically-treated CRS patients were recruited. All patients completed a SNOT-22 at enrollment and subsequent follow up visit. Distribution and anchor-based methods were used for MCID calculation. These data were combined with data from a previously published study on SNOT-22 MCID in 247 medically managed CRS patients to determine a final recommended MCID value using the combined cohort of 430 patients. Results: In our cohort, distribution- and anchor-based methodsâ€"using both sinus-specific and general health anchorsâ€"provided greatest support for a 12-point SNOT-22 MCID, which had approximately 55% sensitivity but 81% specificity for detecting patients explicitly reporting improvement in their sinus symptoms and general health. In the combined cohort of 430 patients, we also found greatest support for a 12-point SNOT-22 MCID, which had approximately 57% sensitivity and 81% specificity for detecting patients explicitly reporting improvement in their sinus symptoms and general health. We also find evidence that the MCID value may be higher in CRS patients without nasal polyps compared to those with nasal polyps. Conclusions: Our results - which include data from patients from two different institutions and regions - confirm a SNOT-22 MCID of 12 in medically managed CRS patients. The SNOT-22 MCID was specific but not sensitive for identifying CRS patients experiencing improvement in symptoms or general health.

International Rhinologic Society Rhinology 0300-0729 59 6 2021 12 1 34608896 Endoscopic sinus surgery improves Eustachian tube function in patients with chronic rhinosinusitis: a multicenter prospective study 560 566 EN X. Chen Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, Guangdong, China H. Dang Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China Q. Chen Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China Z. Chen Dazhu County People’s Hospital, Dazhou, Sichuan, China Y. Ma Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China X. Liu Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China P. Lin Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China H. Zou Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China H. Xiong Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China 2 Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, Guangdong, China 2931 10.4193/Rhin21.209 Background: Patients with chronic rhinosinusitis (CRS) often have Eustachian tube dysfunction (ETD) symptoms. This study aimed to prospectively investigate the effect of endoscopic sinus surgery (ESS) on improvement of Eustachian tube function in CRS patients with ETD from a Chinese population and determine factors associated with improvement. Methods: A prospective study was performed in CRS patients with ETD who underwent ESS from 3 tertiary medical centers in south China. The Eustachian tube Dysfunction Questionnaire 7 (ETDQ-7), Sinonasal Outcome Test 22 (SNOT-22), tympanograms, endoscopic findings and Valsalva maneuver were recorded and analyzed preoperatively and postoperatively at 8-12 weeks. Results: A total of 70 CRS patients with ETD were included in this study. The ETDQ-7 score and the ability of positive Valsalva maneuver in CRS patients were significantly improved postoperatively at 8-12 weeks. The number of patients with type A tympanogram was increased postoperatively. Reduced Eustachian tube mucosal inflammation was also observed postoperatively. In addition, ESS appeared to reverse slight tympanic membrane atelectasis after 8-12 weeks. Moreover, improvement in tympanogram was presented in more than half of CRS patients with concomitant otitis media with effusion postoperatively at 8-12 weeks. Univariate and multivariate analysis revealed failure of normalization of ETDQ-7 postoperatively was associated with concomitant allergic rhinitis and higher preoperative SNOT-22 score. Conclusions: This study confirms Eustachian tube function is often improved after ESS in CRS patients with ETD. Concomitant allergic rhinitis and higher preoperative SNOT-22 score are associated with failure of normalization of ETD symptoms.

International Rhinologic Society Rhinology 0300-0729 59 6 2021 12 1 34608897 miRNA-205-5p can be related to T2-polarity in Chronic Rhinosinusitis with Nasal Polyps 567 576 EN M.L.C. Silveira Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirao Preto Medical School, University of Sao Paulo, Brazil E. Tamashiro Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirao Preto Medical School, University of Sao Paulo, Brazil A.R.D. Santos Genomics Medical Center, Clinics Hospital at Ribeirao Preto Medical School, University of Sao Paulo, Brazil R.B. Martins Department of Cell and Molecular Biology and Pathogenic Bioagents, Virology Research Center, Ribeirao Preto Medical School, University of Sao Paulo, Brazil F.M. Faria Department of Pathology and Legal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Brazil L.E.C.M. Silva Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirao Preto Medical School, University of Sao Paulo, Brazil R. Torrieri Genomics Medical Center, Clinics Hospital at Ribeirao Preto Medical School, University of Sao Paulo, Brazil P. de C Ruy Genomics Medical Center, Clinics Hospital at Ribeirao Preto Medical School, University of Sao Paulo, Brazil W.A. Silva Jr Genomics Medical Center, Clinics Hospital at Ribeirao Preto Medical School, University of Sao Paulo, Brazil; Department of Genetics, Ribeirao Preto Medical School, University of Sao Paulo, Brazil E. Arruda Department of Cell and Molecular Biology and Pathogenic Bioagents, Virology Research Center, Ribeirao Preto Medical School, University of Sao Paulo, Brazil W.T. Anselmo-Lima Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirao Preto Medical School, University of Sao Paulo, Brazil F.C.P. Valera Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirao Preto Medical School, University of Sao Paulo, Brazil 2932 10.4193/Rhin21.109 Background: microRNAs (miRNAs) are directly associated with inflammatory response, but their direct role in CRSwNP (chronic rhinosinusitis with nasal polyps) remains evasive. This study aimed to compare the expression of several miRNAs in tissue samples obtained from patients with CRSwNP and controls and to evaluate if miRNAs correlate to a specific inflammatory pattern (T1, T2, T17, and Treg) or intensity of symptoms in CRSwNP. Methods: nasal polyps (from patients with CRSwNP â€" n=36) and middle turbinate mucosa (from control patients â€" n=41) were collected. Microarray determined human mature miRNA expression, and the results obtained were validated by qPCR. miRNAs that were differentially expressed were then correlated to cytokine proteins (by Luminex), tissue eosinophilia, and SNOT-22. Results: After microarray and qPCR analyses, six microRNAs were up-regulated in CRSwNP samples when compared with controls: miR-205-5p, miR-221-3p, miR-222-3p, miR-378a-3p, miR-449a and miR-449b-5p. All these miRNAs are directly implicated with cell cycle regulation and apoptosis, and to a minor extent, with inflammation. Importantly, miR-205-5p showed a significantly positive correlation with IL-5 concentration and eosinophil count at the tissue and with the worst SNOT-22 score. Conclusions: miRNA 205-5p was increased in CRSwNP compared to controls, and it was especially expressed in CRSwNP patients with higher T2 inflammation (measured by both IL-5 levels and local eosinophilia) and worst clinical presentation. This miRNA may be an interesting target to be explored in patients with CRSwNP.

International Rhinologic Society Rhinology 0300-0729 59 6 2021 12 1 34726201 Epidemiological, clinical and endoscopic features of epistaxis severity and quality of life in Hereditary haemorrhagic telangiectasia: a cross-sectional study 577 584 EN F. Pagella Department of Otorhinolaryngology, University of Pavia, Pavia, Italy; Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy E. Maiorano Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy S. Ugolini Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy R. Lizzio Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy F. Sovardi Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy R. Mirabella Department of Otorhinolaryngology, University of Pavia, Pavia, Italy; Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy L. Nanfit� Department of Otorhinolaryngology, University of Pavia, Pavia, Italy; Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy C. Tinelli Clinical Epidemiology and Biometry Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy A. De Silvestri Clinical Epidemiology and Biometry Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy C. Olivieri Molecular Medicine Department, General Biology and Medical Genetics Unit, University of Pavia, Italy G. Spinozzi Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy E. Matti Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy 2941 10.4193/Rhin21.286 Background: Epistaxis is the main complaint in patients with Hereditary haemorrhagic telangiectasia (HHT). Even though the role of epistaxis in affecting the quality of life (QoL) is well-known, little is known about epidemiological and clinical factors contributing to epistaxis severity and QoL. Methodology: This is a cross-sectional study, including adult patients with HHT with epistaxis. All patients underwent an otolaryngological evaluation with nasal endoscopy. Epistaxis severity was graded using the FID score, and QoL was evaluated with the Short-Form Health Survey (SF-36). Descriptive statistics were produced for demographic characteristics; the Shapiro-Wilk test was used to test the normal distribution of quantitative variables. Correlation between the quantitative variables was evaluated with Pearson’s correlation coefficient. Both univariate and multivariate linear regression models were fitted to find associations between demographic or clinical factors and the FID score or SF-36. Results: A total of 234 patients with HHT were included in the study. The univariate analysis highlighted the association between high blood pressure, septal perforation, nocturnal epistaxis, surgery, blood transfusion, hormonal therapy and both FID score and QoL. Sex, allergic rhinitis and nasal polyposis were neither related to epistaxis severity nor perceived health. Conclusions: Epistaxis severity and QoL in patients with HHT are influenced by several clinical factors both dependent and independent from HHT. Some of the results are consistent with those already published, but for the first time, we extended the analysis to different clinical parameters, such as endoscopic findings, never assessed before.