International Rhinologic Society Rhinology 0300-0729 61 3 2023 6 1 37283455 Global CRSwNP Awareness Day and the European Society meeting in Sofia 193 193 EN W.J. Fokkens Department of Otorhinolaryngology, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands 3084 10.4193/Rhin23-903

International Rhinologic Society Rhinology 0300-0729 61 3 2023 6 1 36999780 EPOS/EUFOREA update on indication and evaluation of Biologics in Chronic Rhinosinusitis with Nasal Polyps 2023 194 202 EN W.J. Fokkens Department of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Personalized Medicine, Asthma and Allergy - IRCCS Humanitas Research Hospital - Rozzano (MI), ItalyPersonalized Medicine, Asthma and Allergy - IRCCS Humanitas Research Hospital - Rozzano (MI), Italy A-S. Viskens Laboratory of Allergy and Clinical Immunology Research Unit, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium V. Backer Department of ENT, head and neck surgery and audiology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark D. Conti The European Forum for Research and Education in Allergy and Airway Diseases Scientific Expert Team Members, Brussels, Belgium E. De Corso The European Forum for Research and Education in Allergy and Airway Diseases Scientific Expert Team Members, Brussels, Belgium P. Gevaert Laboratory of Upper Airways Research, Department of Otorhinolaryngology, University Hospital Ghent, Ghent, Belgium G.K. Scadding Department of Allergy and Rhinology, Royal National ENT Hospital, London, United Kingdom M. Wagemann Department of Otorhinolaryngology, Universitätsklinikum Düsseldorf, Dusseldorf, Germany M. Bernal-Sprekelsen Department of Otorhinolaryngology, University of Barcelona, Barcelona, Spain; Department of Otorhinolaryngology, hospital clinic Barcelona, Spain A. Chaker Dept. of Otorhinolaryngology and Center for Allergy and Environment (ZAUM), TUM School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Germany E. Heffler Personalized Medicine, Asthma and Allergy - IRCCS Humanitas Research Hospital - Rozzano (MI), Italy; Department of Biomedical Sciences - Humanitas University - Pieve Emanuele (MI), Italy J.K. Han Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA E. Van Staeyen The European Forum for Research and Education in Allergy and Airway Diseases Scientific Expert Team Members, Brussels, Belgium C. Hopkins Ear, Nose and Throat Department, Guys and St. Thomas Hospital, London, United Kingdom J. Mullol Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, IDIBAPS, Universitat de Barcelona, CIBERES. Barcelona, Catalonia, Spain A. Peters Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA S. Reitsma Department of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands B.A. Senior Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA P.W. Hellings Department of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Laboratory of Allergy and Clinical Immunology Research Unit, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium; The European Forum for Research and Education in Allergy and Airway Diseases Scientific Expert Team Members, Brussels, Belgium; Laboratory of Upper Airways Research, Department of Otorhinolaryngology, University Hospital Ghent, Ghent, Bel 3069 10.4193/Rhin22.489 Severe chronic rhinosinusitis with nasal polyps (CRSwNP) is a debilitating disease with a significant impact on the quality of life (QoL). It is typically characterized by a type 2 inflammatory reaction and by comorbidities such as asthma, allergies and NSAID-Exacerbated Respiratory Disease (N-ERD). Here, the European Forum for Research and Education in Allergy and Airway diseases discusses practical guidelines for patients on biologic treatment. Criteria for the selection of patients who would benefit from biologics were updated. Guidelines are proposed concerning the monitoring of the drug effects that provide recognition of responders to the therapy and, subsequently, the decision about continuation, switching or discontinuation of a biologic. Furthermore, gaps in the current knowledge and unmet needs were discussed.

International Rhinologic Society Rhinology 0300-0729 61 3 2023 6 1 36946589 Dupilumab for chronic rhinosinusitis with nasal polyps: real-life retrospective 12-month effectiveness data 203 213 EN R. Böscke Department of Otorhinolaryngology, Head and Neck Surgery, Carl-von-Ossietzky University of Oldenburg, Oldenburg, Germany; Department of Otorhinolaryngology, Head and Neck Surgery, University of Lübeck, Lübeck, Germany M. Heidemann Department of Otorhinolaryngology, Head and Neck Surgery, University of Lübeck, Lübeck, Germany K-L. Bruchhage Department of Otorhinolaryngology, Head and Neck Surgery, University of Lübeck, Lübeck, Germany 3068 10.4193/Rhin22.469 BACKGROUND: Dupilumab, an IL-4/13 receptor inhibitor, is approved for the treatment of uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP). METHODOLOGY: We evaluated the effectiveness and safety of dupilumab for CRSwNP based on retrospective 12-month follow-up data of 41 patients. We analysed nasal endoscopy scores, patient-reported outcome measures (PROMs), 12-item Sniffin’-Sticks odor identification test (SSIT-12), total serum IgE, serum Eosinophilic Cationic Protein (ECP), and total blood eosinophil count (BEC). We performed statistical analysis using non-parametric ANOVA-type models and Spearman’s correlation. RESULTS: At month 1, endoscopy scores, PROMs and SSIT-12 showed meaningful improvements that were maintained until month 12. Initial elevations in both median ECP and BECs returned to near baseline levels by month 12. The percentage of patients withBEC ≥0.6 remained increased at month 12 (42.1%) compared to baseline (19.5%). Total serum IgE levels decreased progressively and correlated with nasal polyp scores at month 12. “Adequate response� was reached in 86.8% of our cohort. CONCLUSIONS: Our data suggest that dupilumab is effective for the treatment of CRSwNP. The potential for short- and long-term BEC elevations in some CRSwNP patients should be carefully monitored.

International Rhinologic Society Rhinology 0300-0729 61 3 2023 6 1 36715355 Chronic rhinitis and stress: the possible culprits of midfacial segment pain 214 220 EN Y-H. Joo Department of Otorhinolaryngology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea; Department of Otorhinolaryngology, Gyeongsang National University College of Medicine, Jinju, Republic of Korea; Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea H-J. Cho Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea; Department of Otorhinolaryngology, Gyeongsang National University Hospital, Jinju, Republic of Korea Y-J. Jeon Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea; Department of Otorhinolaryngology, Gyeongsang National University Hospital, Jinju, Republic of Korea R.B. Kim Regional Cardiocerebrovascular Disease Center, Gyeongsang National University Hospital, Jinju, Republic of Korea S-W. Kim Department of Otorhinolaryngology, Gyeongsang National University College of Medicine, Jinju, Republic of Korea; Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea; Department of Otorhinolaryngology, Gyeongsang National University Hospital, Jinju, Republic of Korea 3054 10.4193/Rhin22.305 BACKGROUND: Bilateral symmetrical pain in the midfacial region without evidence of sinonasal disease is termed midfacial segment pain (MSP), about which little is known. The present study explored the prevalence of facial pain and the risk factors for MSP. METHODS: We analysed cross-sectional data from the Korea National Health and Nutrition Examination Survey (KNHANES). Those who reported facial pain or pressure lasting at least three months with no evidence of a sinonasal disease on nasal endoscopy were considered to have MSP. The participants were categorised according to the presence of facial pain and chronic rhinosinusitis. Basic demographic data and medical conditions, including hypertension, diabetes mellitus, and dyslipidemia, were compared between subject groups. We also evaluated psychological stress, depressive episodes, and suicidal thoughts, as well as physician-diagnosed nasal diseases, including chronic rhinitis and symptomatic nasal septal deviation. Univariate and multivariate logistic regression analyses were performed to determine risk factors for MSP. RESULTS: Of 31,999 participants, the prevalence of facial pain was 0.59%. A total of 58 (0.18%) respondents had MSP, of whom 40 (73.5%) were female. On univariate analysis, female sex, chronic rhinitis, and psychological stress were more prevalent in the subjects with MSP than the control subjects. However, in the multivariate analysis, only chronic rhinitis and psychological stress remained significant, while the female sex exhibited only marginal significance. CONCLUSION: Chronic rhinitis and psychological stress may be significant risk factors for MSP.

International Rhinologic Society Rhinology 0300-0729 61 3 2023 6 1 37283512 Ultra-low-dose CBCT: new cornerstone of paranasal sinus imaging 221 230 EN P. Tamminen Department of Otorhinolaryngology â€" Head and Neck Surgery, Tampere University Hospital, Tampere, Finland; Department of Otorhinolaryngology, Satasairaala, Pori, Finland; Department of Internal Medicine, Tampere University Hospital, Tampere, Finland; Allergy Centre, Tampere University Hospital, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland J. Järnstedt Medical Imaging Centre, Department of Radiology Tampere University Hospital, Tampere, Finland J. Numminen Department of Otorhinolaryngology â€" Head and Neck Surgery, Tampere University Hospital, Tampere, Finland A. Lehtinen Medical Imaging Centre, Department of Radiology Tampere University Hospital, Tampere, Finland L. Lehtimäki Allergy Centre, Tampere University Hospital, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland M. Rautiainen Department of Otorhinolaryngology â€" Head and Neck Surgery, Tampere University Hospital, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland I. Kivekäs Department of Otorhinolaryngology â€" Head and Neck Surgery, Tampere University Hospital, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland 3085 10.4193/Rhin22.385 Background: This study evaluates the clinical image quality (IQ) and usability of a sinonasal ultra-low-dose (ULD) cone-beam computed tomography (CBCT) scan. The results are compared to those of a high resolution (HR) CBCT scan to identify the strengths and weaknesses of a ULD CBCT protocol. Methodology: Sixty-six anatomical sites in 33 subjects were imaged twice using two imaging modalities: HR CBCT (Scanora 3Dx scanner; Soredex, Tuusula, Finland) and ULD CBCT (Promax 3D Mid scanner; Plandent, Helsinki, Finland). IQ, opacification and obstruction, structural features and operative usability were assessed. Results: The overall IQ in subjects with “no or minor opacificationâ€� was excellent: 100% (HR CBCT) and 99% (ULD CBCT) of ratings were evaluated as sufficient for every structure. Increased opacification reduced the quality of both imaging modalities, resulting conchtoethmoidectomy, frontal sinusotomy, sphenotomy and posterior ethmoidectomy in cases with greater opacification. Conclusions: IQ of paranasal ULD CBCT is sufficient for clinical diagnostics and should be considered for surgical planning. We recommend it as the primary imaging protocol for all patients who meet imaging criteria due to recurrent or chronic nasal symptoms. Additional or conventional imaging might be needed for patients with extensive chronic rhinosinusitis and/or indications of frontal sinus involvement.

International Rhinologic Society Rhinology 0300-0729 61 3 2023 6 1 36730816 Temporal evolution of quality of life in patients endoscopically treated for sinonasal malignant tumors 231 245 EN G. Maggiore Department of Otorhinolaryngology, Careggi University Hospital, Florence, Italy G. Fancello Department of Otorhinolaryngology, Careggi University Hospital, Florence, Italy A. Gasparini Department of Otorhinolaryngology, Careggi University Hospital, Florence, Italy L.G. Locatello Department of Otorhinolaryngology, Careggi University Hospital, Florence, Italy; Department of Otorhinolaryngology, University Hospital Santa Maria della Misericordia, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy P. Orlando Department of Otorhinolaryngology, Careggi University Hospital, Florence, Italy M. Chieca Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Florence, Italy S. Caini Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Florence, Italy C. Becherini Department of Radiation Oncology, Careggi University Hospital, Florence, Italy P. Bonomo Department of Radiation Oncology, Careggi University Hospital, Florence, Italy O. Gallo Department of Otorhinolaryngology, Careggi University Hospital, Florence, Italy; Department of Clinical and Experimental Medicine, University of Florence, Italy 3058 10.4193/Rhin22.367 BACKGROUND: The aim of our study is to assess which factors may affect the quality of life (QoL) and its fluctuation over time in adult patients who received endonasal endoscopic oncologic sinus surgery (EOSS) for sinonasal malignancies (SNM) in our center. METHODOLOGY: We analyzed EOSS cases for primary SNM from January 2015 to June 2020. For each patient, we have recorded the age at treatment, gender, smoking habits, use of psychotropic drugs for mood disorders, stage, histotype, type of surgical resection, need for skull-base reconstruction, development of postoperative major complications, and the use of adjuvant intensity-modulated radiotherapy (IMRT). We evaluated the patient's performance status pre-treatment using the ECOG scale. Quality of life was measured using three questionnaires (SNOT-22; ASK-9; EORTC QLQ-C30 version 3). RESULTS: Fifty-five patients were enrolled in our study, of whom thirty-two (58.18%) received adjuvant IMRT. Overall, a significant improvement in all QoL outcomes was observed at eighteen months, while, female sex, higher ECOG scores, advanced stage of disease, and adjuvant IMRT were associated with worse QoL. After 18 months the delta in QoL between women and men worsened (in SNOT-22 and EORTC QLQ-GLOBAL) while if only the most fragile patients according to ECOG are considered, this difference was reduced for both tools. CONCLUSION: Our analysis revealed that IMRT is the element that has the greatest impact on patient's quality of life, in association with the female sex, ECOG >2, and advanced stage of the disease.

International Rhinologic Society Rhinology 0300-0729 61 3 2023 6 1 36715464 Stent pretreatment for internal carotid artery exposed to necrotic lesions in nasopharyngeal carcinoma 246 254 EN W-B. Wu Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, P.R. China X-B. Zhang Department of Neurosurgery, The third affiliated hospital of Southern Medical University, Guangzhou, P. R. China Y-P. Liu Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, P.R. China X. Zou Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, P.R. China R. You Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, P.R. China Y-L. Xie Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, P.R. China X-T Duan Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, P.R. China H-F. Li Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, P.R. China K. Wen Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, P.R. China L. Peng Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, P.R. China Y-J. Hua Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, P.R. China P-Y. Huang Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, P.R. China R. Sun Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, P.R. China J-H. Chen Department of Neurosurgery, The third affiliated hospital of Southern Medical University, Guangzhou, P. R. China M-Y. Chen Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, P.R. China 3056 10.4193/Rhin22.451 BACKGROUND: Post radiation nasopharyngeal necrosis (PRNN) invading the internal carotid artery (ICA) contributes to the death of 69.2â€"72.7% of PRNN patients. ICA occlusion is an effective treatment to avoid fatal bleeding, while some patients are intolerant. We present a novel method that allows for these patients without interrupting blood flow through the ICA. METHODOLOGY: This study enrolled patients with PRNN-invaded ICA who were not suitable for ICA occlusion from April 2020 to November 2022. ICA stent pretreatment was performed in the 36 patients and followed the endoscopic nasopharyngectomy (ENPG) or conservative treatment for PRNN. We report the survival outcome and incidence of complications after stent implantation and compare the survival outcomes of ENPG and conservative treatment for PRNN followed by stent implantation. RESULTS: ICA stent pretreatment was performed in the 36 enrolled patients, among which 14 underwent ENPG, and 22 received conservative treatment. 27.8% patients died after a median follow-up of 15 months. The Kaplan-Meier estimates of overall survival were higher in the ENPG group than in the conservative treatment group. Karnofsky performance status (KPS) was significantly higher in the ENPG group than in the non-ENPG group. CONCLUSIONS: The innovative application of ICA stents is a promising treatment to improve outcomes in patients with PRNN invading the ICA who are unsuitable for ICA embolization, especially when followed by endoscopic surgery. However, methods to avoid postoperative cerebral ischemia and nasopharyngeal hemorrhage still require further study.

International Rhinologic Society Rhinology 0300-0729 61 3 2023 6 1 36912244 Peak nasal inspiratory flow in chronic obstructive pulmonary disease 255 262 EN W. M. Thorstensen Department of Otolaryngology, Head and Neck Surgery, St. Olavs University hospital, Trondheim, Norway; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway M. Rystad Øie Department of Otolaryngology, Head and Neck Surgery, St. Olavs University hospital, Trondheim, Norway; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway M. Sue-Chu Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway; Department of Thoracic Medicine, St. Olavs University hospital, Trondheim, Norway S. Karmhus Steinsvåg Department of Otolaryngology, Head and Neck Surgery, Sørlandet Hospital, Kristiansand, Norway; Haukeland University Hospital, Bergen, Norway A-S. Helvik Department of Otolaryngology, Head and Neck Surgery, St. Olavs University hospital, Trondheim, Norway; Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway 3063 10.4193/Rhin22.316 BACKGROUND: The nasal airflow in chronic obstructive pulmonary disease (COPD) is poorly characterized. Peak nasal inspiratory flow (PNIF) is a valuable instrument for assessing nasal airflow and the effect of pulmonary pathology such as COPD on PNIF remains unknown. To test the hypothesis that nasal airflow is reduced in COPD, we assessed airflow using PNIF in COPD and a control group. We also explored whether there is an association between COPD, chronic rhinosinusitis without nasal polyps (CRSsNP), and other predefined covariates with PNIF. METHODOLOGY: Ninety patients with COPD and 67 controls underwent PNIF and spirometry. The associations between PNIF and COPD and pre-bronchodilator forced expiratory volume in the first second (FEV1) (% predicted) were assessed by multivariable linear regression in two separate models. RESULTS: PNIF was significantly lower in the COPD group than in the control group. Multivariable linear regression showed that COPD and pre-bronchodilator FEV1 (% predicted) were significantly associated with lower PNIF after adjustment for age, sex, CRSsNP, weight and height. CRSsNP was not associated with PNIF in either of the adjusted regression analyses. CONCLUSIONS: PNIF is lower in COPD than in a control group. The finding of a low PNIF in the absence of disease in the upper airways may be due to obstructive lower airways diseases and special care should be taken when interpreting PNIF values in patients with COPD or reduced FEV1

International Rhinologic Society Rhinology 0300-0729 61 3 2023 6 1 36891983 TRIM27 expression is associated with poor prognosis in sinonasal mucosal melanoma 263 271 EN S. Kimura Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan M. Suzuki Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan Y. Nakamaru Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan S. Kano Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan M. Watanabe Department of Biochemistry, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan A. Honma Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan A. Nakazono Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan N. Tsushima Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan S. Hatakeyama Department of Biochemistry, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan A. Homma Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan 3062 10.4193/Rhin22.405 BACKGROUND: Tripartite motif-containing 27 (TRIM27) has been implicated in the progression of various cancers. However, the role of TRIM27 in sinonasal mucosal melanoma (SNMM) remains poorly understood. MATERIALS & METHODS: We retrospectively examined 28 patients with SNMM treated with between 2003 and 2021. We undertook immunohistochemical analysis of TRIM27, Ki-67, and p-Akt1 expression in SNMM tissues. We also investigated the relationship between TRIM27 expression and clinical characteristics, prognosis, Ki-67 as a tumor growth potential marker, and p-Akt1 as one of the prognostic factors in mucosal melanoma. RESULTS: TRIM27 expression was significantly higher in T4 disease than in T3 disease and was higher in stage IV than in stage III. Patients with high-TRIM27 SNMM had a significantly poorer prognosis in terms of overall survival (OS) and disease-free survival.There was also a significantly higher rate of distant metastasis. Univariate analysis for OS revealed that TRIM27 and T classification were significant poor prognostic factors. In addition, the Ki-67 positive score and the p-Akt1 total staining score were significantly higher in the high-TRIM27 group than in the low-TRIM27 group. CONCLUSIONS: High TRIM27 expression in SNMM was associated with advanced T classification, poor prognosis and distant metastasis. We suggest that TRIM27 has potential as a novel biomarker for prognosis in SNMM.

International Rhinologic Society Rhinology 0300-0729 61 3 2023 6 1 36946425 The association between allergic rhinitis and airway dysfunction and nasal endothelial damage and oxidative stress 272 282 EN Z.G. Koksal Department of Pediatric Allergy and Immunology, Aydin Adnan Menderes University Faculty of Medicine, Aydin, Türkiye P. Uysal Department of Pediatric Allergy and Immunology, Aydin Adnan Menderes University Faculty of Medicine, Aydin, Türkiye O. Erdogan Department of Basic Science, Medical Biochemistry, Aydin Adnan Menderes University Faculty of Medicine, Aydin, Türkiye O. Cevik Department of Basic Science, Medical Biochemistry, Aydin Adnan Menderes University Faculty of Medicine, Aydin, Türkiye 3065 10.4193/Rhin22.484 BACKGROUND: Although lower airway hyperresponsiveness is present in approximately one in three patients with allergic rhinitis (AR), the underlying mechanism remains unclear. To evaluate nasal patency and pulmonary functions in AR independently of the presence of asthma and to investigate the relationships between these and nasal oxidative stress parameters and endothelial damage. METHODOLOGY: Seventy adolescents with AR (AR group - 27 with asthma and 43 without asthma) and 30 healthy controls (HC group) were included in this prospective, cross-sectional study. Endocan and oxidative biomarkers [total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI)] in nasal lavage fluid specimens; peak nasal inspiratory flow (PNIF); fractional exhaled nitric oxide (FeNO), and impulse oscillometry (zR5, zR20, and R5-20 for resistance and zX5 and zX20 for reactance) were investigated. RESULTS: Nasal endocan, TOS, and OSI values were higher in the AR group and TAS in the HC group. There was no difference between AR groups with and without asthma in terms of nasal endocan and oxidative biomarkers. FeNO levels and airway resistance (zR5, zR20, and R5-20) were higher in the AR group than in the HC group. However, there was no difference between the groups in PNIF. X5 was higher among the AR without asthma than in the other groups. Correlation between OSI and R5-20 was observed in the AR group. In the linear regression model, (logged) OSI was significantly predicted (logged) R5-20. CONCLUSIONS: The airways of adolescents with AR without asthma were as much affected as those of the AR with asthma, and this effect was associated with nasal endothelial damage and an increase in oxidative stress.

International Rhinologic Society Rhinology 0300-0729 61 3 2023 6 1 36946510 Biologicals in severe chronic rhinosinusitis with nasal polyps: translation to clinical practice while waiting for head-to-head studies 283 286 EN J.L. Boechat Clinical Immunology Service, Internal Medicine Department, Faculty of Medicine, Universidade Federal Fluminense, Niterói/RJ, Brazil; Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal; Center for Health Technology and Services Research (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal B. Sousa-Pinto Center for Health Technology and Services Research (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal; MEDCIDS â€" Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal L. Delgado Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal; Center for Health Technology and Services Research (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal;Serviço de Imunoalergologia, Centro Hospitalar de São João, E.P.E., Porto, Portugal D. Silva Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal; Serviço de Imunoalergologia, Centro Hospitalar de São João, E.P.E., Porto, Portugal; EPIUnit - Institute of Public Health, University of Porto, Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal 3066 10.4193/Rhin22.436 Chronic rhinosinusitis with nasal polyps (CRSwNP) affects 1.0-2.6% of the population (1) and results in relevant direct and indirect costs. Recently, several randomized controlled trials (RCTs) with Type 2-targeting biologicals (anti-IL4Rα, anti-IL5R, anti-IL5 and anti-IgE) opened a new treatment field for patients refractory to first-line treatments (2,3).

International Rhinologic Society Rhinology 0300-0729 61 3 2023 6 1 36912435 Local allergic rhinitis in children 287 288 EN A. Bożek Clinical Department of Internal Diseases, Dermatology and Allergology, Medical University of Silesia, Katowice, Poland B. Ignasiak Allergy Outaptient Clinic, Katowice, Poland M. Krupka Clinical Department of Internal Diseases, Dermatology and Allergology, Medical University of Silesia, Katowice, Poland M. Miodonska Clinical Department of Internal Diseases, Dermatology and Allergology, Medical University of Silesia, Katowice, Poland 3064 10.4193/Rhin22.474 Local allergic rhinitis (LAR) is one of the endotypes of rhinitis. Despite much data about epidemiology diagnosis and treatment in adult patients with LAR, there is little information on children. Many studies indicate the need for such an assessment of the phenomenon in children, which results in one meta-analysis based on young patients selected from cohorts of patients of different ages.