{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:04:15Z","timestamp":1778630655853,"version":"3.51.4"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2016,3,17]],"date-time":"2016-03-17T00:00:00Z","timestamp":1458172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Prognostic implications of mucosal remodeling in chronic rhinosinusitis (CRS) remain unclear. Remodeling of respiratory mucosa in asthma is associated with greater medication use and decreased function. This study investigates the implications of mucosal remodeling on long\u2010term clinical outcomes in patients with CRS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A case\u2010control study of adult patients with CRS undergoing endoscopic sinus surgery (ESS) was performed. Mucosal remodeling was defined by squamous metaplasia, subepithelial fibrosis, and\/or basement membrane thickening. The presence of remodeling changes were assessed relative to clinical and treatment outcomes at a minimum of 12 months postoperatively. Clinical outcomes were assessed at baseline and 12 months using a Nasal Symptom Score (NSS) and 22\u2010item Sino\u2010Nasal Outcome Test (SNOT\u201022). Treatment outcomes were assessed by oral corticosteroid usage (burst\/continuous), topical corticosteroid irrigation frequency, and further surgical intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 110 patients (48.73 \u00b1 14.75 years, 48.2% female) were assessed. Significant improvements where seen for the entire population, in both NSS (2.64 \u00b1 1.06 to 1.34 \u00b1 1.08, <jats:italic>p<\/jats:italic> &lt; 0.001) and SNOT\u201022 (2.05 \u00b1 0.96 to 1.06 \u00b1 0.79, <jats:italic>p<\/jats:italic> &lt; 0.001). Patients with remodeling (n = 88) were younger (47.2 \u00b1 14.8 vs 54.7 \u00b1 13.5 years, <jats:italic>p<\/jats:italic> = 0.03), but had similar symptom scores. Remodeling was seen in CRS with nasal polyposis (CRSwNP) (54.5%) and eosinophilic chronic rhinosinusitis (eCRS) (59.8%). Symptom improvement at 12 months was similar between remodeled and non\u2010remodeled groups (NSS: \u03941.34 \u00b1 1.20 vs \u03941.12 \u00b1 1.31, <jats:italic>p<\/jats:italic> = 0.395; SNOT\u201022: \u03941.05 \u00b1 0.91 vs \u03940.73 \u00b1 0.95, <jats:italic>p<\/jats:italic> = 0.124); however, patients with remodeling had greater corticosteroid irrigation frequency (64.0% vs 31.6% daily use, Kendall's tau\u2010b <jats:italic>p<\/jats:italic> = 0.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Established mucosal remodeling predicts a greater reliance on topical therapies to reach similar clinical endpoints as those without remodeling.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.21754","type":"journal-article","created":{"date-parts":[[2016,3,19]],"date-time":"2016-03-19T02:15:40Z","timestamp":1458353740000},"page":"835-840","source":"Crossref","is-referenced-by-count":35,"title":["Clinical implications of mucosal remodeling from chronic rhinosinusitis"],"prefix":"10.1002","volume":"6","author":[{"given":"Timothy Q.","family":"Do","sequence":"first","affiliation":[{"name":"Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research University of New South Wales  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry P.","family":"Barham","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research University of New South Wales  Sydney Australia"},{"name":"Department of Otolaryngology Head and Neck Surgery Louisiana State University  New Orleans LA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Earls","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology St Vincent's Hospital  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond","family":"Sacks","sequence":"additional","affiliation":[{"name":"Australian School of Advanced Medicine Macquarie University  Sydney Australia"},{"name":"Department of Otolaryngology, Head and Neck Surgery, Concord General Hospital University of Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenna M.","family":"Christensen","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research University of New South Wales  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet","family":"Rimmer","sequence":"additional","affiliation":[{"name":"Department of Thoracic Medicine St Vincent's Hospital  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard J.","family":"Harvey","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research University of New South Wales  Sydney Australia"},{"name":"Australian School of Advanced Medicine Macquarie University  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,3,17]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21410"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21366"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2010.03.001"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.12.048"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21183"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21047"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21496"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21304"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.10.009"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21546"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21032"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajr.2007.21.3096"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22374"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.57.3.247"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1155\/2010\/318029"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2003.1592"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21182"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhino12.000"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2007.01409.x"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-4486.2009.01995.x"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21315"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25147"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2015.29.4111"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2011.06.002"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.04.020"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21172"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2013.27.3880"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin13.217"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21291"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814565606"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.4168\/aair.2010.2.2.87"}],"container-title":["International 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