Joshua M. Levy

Prevalence of polyp recurrence after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis

Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a disease process that is driven, in part, by intrinsic mucosal inflammation. Surgery plus continued medical therapy is commonly elected by medically recalcitrant, symptomatic patients. The objective was to evaluate the prevalence of nasal polyp recurrence up to 18 months after endoscopic sinus surgery (ESS) with congruent continuing medical management.

International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis

Critical examination of the quality and validity of available allergic rhinitis (AR) literature is necessary to improve understanding and to appropriately translate this knowledge to clinical care of the AR patient. To evaluate the existing AR literature, international multidisciplinary experts with an interest in AR have produced the International Consensus statement on Allergy and Rhinology: Allergic Rhinitis (ICAR:AR).

Longitudinal improvement and stability of olfactory function in the evaluation of surgical management for chronic rhinosinusitis

Abnormal olfaction is common with chronic rhinosinusitis (CRS) and associates with various measures of sinonasal inflammation. The Brief Smell Identification Test (BSIT) has demonstrated improvements in abnormal olfactory detection following endoscopic sinus surgery (ESS), but olfaction remains understudied using this instrument. Discerning longitudinal, postoperative durability in olfaction is critical for patient counseling.

Low 22-item sinonasal outcome test scores in chronic rhinosinusitis: Why do patients seek treatment?

Patients with chronic rhinosinusitis (CRS) who experience minimal reductions in quality of life (QoL) may present for treatment despite QoL scores comparable to controls without CRS. This study seeks to identify cofactors influencing patients with CRS and low 22‐item Sinonasal Outcome Test (SNOT‐22) scores to seek care.

Improvements in psychological dysfunction after endoscopic sinus surgery for patients with chronic rhinosinusitis

Psychological dysfunction is highly prevalent among patients with chronic rhinosinusitis (CRS). Previous study has identified various measures of anxiety and depression as predictors of quality‐of‐life outcomes following endoscopic sinus surgery (ESS). Psychological dysfunction scores, as measured by the 22‐item Sino‐Nasal Outcome Test (SNOT‐22), have been found to influence treatment decision making in CRS. This study aims to further elucidate improvement in discrete psychological symptoms following ESS for CRS.

Contemporary management of chronic rhinosinusitis with nasal polyposis in aspirin-exacerbated respiratory disease: An evidence-based review with recommendations

Chronic rhinosinusitis (CRS) in aspirin‐exacerbated respiratory disease (AERD) represents a recalcitrant form of sinonasal inflammation for which a multidisciplinary consensus on patient management has not been reached. Several medical interventions have been investigated, but a formal comprehensive evaluation of the evidence has never been performed. The purpose of this article is to provide an evidence‐based approach for the multidisciplinary management of CRS in AERD.

Investigating the Minimal Clinically Important Difference for SNOT-22 Symptom Domains in Surgically Managed Chronic Rhinosinusitis

Prior work has described 5 domains within the 22‐item Sino‐Nasal Outcomes Test (SNOT‐22) that allow for stratification of symptoms into similar clusters and that can be used to direct therapy. Although the outcomes of various interventions on these symptom domains have been reported, minimal clinically important difference (MCID) values have not been investigated, which has limited clinical interpretation of these results.

Defining the Minimal Clinically Important Difference for Olfactory Outcomes in the Surgical Treatment of Chronic Rhinosinusitis

Olfactory dysfunction is a common and defining symptom of chronic rhinosinusitis (CRS). Many measures of olfactory dysfunction in CRS are limited by scoring criteria defined within general populations with interpretations of statistical significance to infer clinically meaningful improvement. In this investigation we define a minimal clinically important difference (MCID) for the Brief Smell Identification Test (BSIT) in CRS patients electing endoscopic sinus surgery (ESS).

Is aspirin desensitization indicated for the treatment recalcitrant chronic rhinosinusitis with nasal polyposis in aspirin‐exacerbated respiratory disease?

BACKGROUND Chronic rhinosinusitis with nasal polyposis (CRSwNP) in aspirin-exacerbated respiratory disease (AERD) represents a severe chronic rhinosinusitis (CRS) phenotype with increased sinonasal inflammation and worse health-related quality-of-life (HRQoL) compared to CRSwNP without aspirin sensitivity. Conventional treatment strategies frequently fail to control this recalcitrant form of airway inflammation, with 37% of patients requiring revision endoscopic sinus surgery (ESS) within 5 years of their first procedure. Aspirin desensitization represents a treatment option for patients with AERD, with associated benefits extending beyond those seen with strict acetylsalicylic acid avoidance. However, broad utilization remains limited due to heterogeneous outcome studies, availability, and concerns of adverse reactions associated with long-term therapeutic daily aspirin therapy.

Influence of interpersonal traits on patient outcomes in the treatment of chronic rhinosinusitis

Patient‐reported outcome measures (PROMs) measure health states in chronic rhinosinusitis (CRS) and have become the dominant metrics of treatment outcomes. Interpersonal traits (IPTs) are patient‐specific factors that include personality type, perceived social support, and trust in physicians. The association of IPTs on treatment outcomes among patients with CRS has not been described previously, and IPTs may represent major clinical factors influencing treatment outcomes.