ICAR: endoscopic skull‐base surgery

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International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Assessing the correlations between subjective symptom scores and turbinoseptal relationships in pretreatment adults with chronic rhinosinusitis

Abstract Background This study was undertaken to assess the correlations between subjective symptom score in patients with chronic rhinosinusitis and endoscopic turbinoseptal relationship (TSR). Aim To assess the pattern of TSR and their correlations with symptom score in patients with chronic rhinosinusitis. Settings and design This was an observational study in a tertiary/teaching hospital setting Patients and Methods Consecutive pretreatment adults with chronic rhinosinusitis completed the sinonasal outcome test 22 (SNOT22) and had nasal endoscopy. At endoscopy, the TSR was determined, as well as the presence of nasal polyps. Statistical analysis Mean SNOT22 score was calculated and TSR types were grouped and their distribution documented with types 3 and 4 taken as unfavorable types. χ2-Tests were used to determine the correlations between turbinoseptal types, presence of nasal polys, and SNOT22 scores with the level of significance set at P value up to 0.05. Results A total of 53 [23 (43.4%) men and 30 (56.6%) women] patients with a mean age of 42.5±18.6, completed the study. Median symptom duration was 36 weeks (13–112 weeks). Mean SNOT22 score was 29.7±2.8. Unfavorable TSR types were found in 42.5% of nostrils, more on the right (χ2=13.2; P≤0.01). There is no significant correlation between the presence of unfavorable TSR and worsening total SNOT22 scores [R (K-S=0.13 P=0.95) L (K-S=0.34, P=0.07)]. Conclusion Unfavorable TSR is common in patients with chronic rhinosinusitis. However, there is no correlation between the presence of abnormal TSR and symptom scores