2018 Section 5 - Rhinology and Allergic Disorders

Rivero A, Liang J. Anti-IgE and anti-IL5 biologic therapy in the treatment of nasal polyposis: a systematic review and meta-analysis. Ann Otol Rhinol Laryngol . 2017; 126(11):739-747. EBM level 1...............199-207

Summary : Rivero and Liang conducted a systematic review and meta-analysis of anti-IgE and anti-IL5 biologic therapy in the treatment of nasal polyposis. The authors searched PubMed, OVID MEDLINE, and Cochrane Central from 2000 to 2015 and found seven eligible studies (four randomized control trials, one case-control, and two case series). Meta-analysis was performed on five studies. The authors present their results in terms of improvement in nasal polyp score, sinus symptoms, and sinus CT improvement. Office-Based Procedures A. Sinus i. Balloon dilation Chandra RK, Kern RC, Cutler JL, et al. REMODEL larger cohort with long-term outcomes and meta- analysis of standalone balloon dilation studies. Laryngoscope . 2016; 126(1):44-50. EBM level 1...................................................................................................................................................208-214 Summary : This is a prospective, randomized study comparing balloon catheter dilation versus endoscopic sinus surgery. The study also includes a meta-analysis on stand-alone balloon trials with 24-month follow up. Overall statistical improvement in SNOT-20, sick days, acute infections, and antibiotic usage was noted with balloon dilation, though no statistically significant difference was noted when compared to ESS. Levy JM, Marino MJ, McCoul ED. Paranasal sinus balloon catheter dilation for treatment of chronic rhinosinusitis: a systematic review and meta-analysis. Otolaryngol Head Neck Surg . 2016; 154(1):33-40. EBM level 2.........................................................................................................................................215-222 Summary : This paper presents a well-performed and well-written systematic review and meta-analysis on balloon catheter dilation studies to date. A variety of study methodologies was noted. Multiple studies reported improved SNOT-20 outcomes and CT findings. Stents Forwith KD, Han JK, Stolovitzky JP, et al. RESOLVE: bioabsorbable steroid-eluting sinus implants for in-office treatment of recurrent sinonasal polyposis after sinus surgery: 6-month outcomes from a randomized, controlled, blinded study. Int Forum Allergy Rhinol . 2016; 6(6):573-581. EBM level 1...................................................................................................................................................223-231 Summary : This article presents a randomized, controlled, blinded study evaluating steroid-eluting stent versus sham procedure in a cohort of CRS with nasal polyp patients and a prior history of sinus surgery. The 6-month follow-up data presented a statistically improved NOSE score, endoscopy scores, and less need for surgery. The study was industry sponsored. Lavigne F, Miller SK, Gould AR, et al. Steroid-eluting sinus implant for in-office treatment of recurrent nasal polyposis: a prospective, multicenter study. Int Forum Allergy Rhinol . 2014; 4(5):381-389. EBM level 4...................................................................................................................................................232-240 Summary : This is a prospective, multicenter study reporting SNOT-22 and endoscopy grading for 12 patients with a prior history of endoscopic sinus surgery and CRSwNP treated with a steroid-dissolving implant placed in the office setting. Improved symptoms and endoscopy findings were noted. ii.

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