{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T17:30:06Z","timestamp":1777570206390,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,2,13]],"date-time":"2018-02-13T00:00:00Z","timestamp":1518480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011542","name":"Center for Clinical and Translational Science, Mayo Clinic","doi-asserted-by":"publisher","award":["UL1 TR000135"],"award-info":[{"award-number":["UL1 TR000135"]}],"id":[{"id":"10.13039\/100011542","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Endotypic and prognosticating features of chronic rhinosinusitis without nasal polyposis (CRSsNP) are poorly understood. Our objectives were to use an unbiased symptom\u2010based approach to: (1) study symptoms, clinical and endotypic features; and (2) identify features predicating outcomes from endoscopic sinus surgery (ESS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical, computed tomography (CT), histopathology, and 22\u2010item Sino\u2010Nasal Outcome Test (SNOT\u201022) data was collected on 146 adult CRSsNP patients who underwent ESS. Unsupervised network modeling of presurgical SNOT\u201022 scores was performed to classify symptom\u2010based clusters. Subject characteristics and post\u2010ESS SNOT\u201022 scores were compared between clusters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline characteristics of the subject population were as follows: females, 56.2%; revision ESS status in 35%; asthma prevalence, 32.6%; median Lund\u2010Mackay CT score, 8; and median SNOT\u201022 total score, 43. Network mapping and unsupervised clustering of preoperative SNOT\u201022 scores revealed 4 clusters: (A) severely burdened with high scores in all 4 subdomains; (B) moderately burdened with high scores in the rhinologic subdomain; (C) moderately burdened with high scores in psychological\u2010sleep subdomains; and (D) mildly burdened. The number of previous ESS and asthma prevalence differed significantly between clusters; CT scores were similar. Asthma burden and tissue eosinophilia were greatest in cluster A (<jats:italic>p<\/jats:italic> = 0.03). All groups showed significant improvement at 3 months post\u2010ESS (<jats:italic>p<\/jats:italic> &lt; 0.0001). At 6 months, patients in cluster C tended to worsen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>SNOT\u201022\u2013based network modeling of CRSsNP patients yielded 4 clusters with distinct features. Asthma prevalence and tissue eosinophilia were highest in the cluster with highest SNOT\u201022 scores. All patients showed significant improvement from ESS at 3 months; those with high sleep\u2010psychosocial symptoms tended to show worsening at 6 months.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.22101","type":"journal-article","created":{"date-parts":[[2018,2,13]],"date-time":"2018-02-13T16:18:23Z","timestamp":1518538703000},"page":"797-805","source":"Crossref","is-referenced-by-count":37,"title":["SNOT\u201022\u2013based clusters in chronic rhinosinusitis without nasal polyposis exhibit distinct endotypic and prognostic differences"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7593-2385","authenticated-orcid":false,"given":"Devyani","family":"Lal","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Mayo Clinic in Arizona  Phoenix AZ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Hopkins","sequence":"additional","affiliation":[{"name":"Guy's and St. Thomas\u2019 Hospitals  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohit D.","family":"Divekar","sequence":"additional","affiliation":[{"name":"Division of Allergic Diseases Mayo Clinic in Rochester  Rochester MN"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,2,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2007.06.726"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21695_c"},{"issue":"20","key":"e_1_2_6_4_1","first-page":"1","volume":"2007","author":"Fokkens W","year":"2007","journal-title":"Rhinol Suppl"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815572097"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2013.02.036"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2015.12.1324"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21904"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26741"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2017.0752"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2007.06.726"},{"issue":"2","key":"e_1_2_6_12_1","first-page":"S1","article-title":"Clinical Practice Guideline (Update): Adult Sinusitis","volume":"152","author":"Rosenfeld RM","year":"2015","journal-title":"Otolaryngol Head Neck Surg"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-015-0064-8"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201308-1500ED"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814522419"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21773"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21667"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2015.08.037"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2011.05.022"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-59989770005-6"},{"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.21032"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0098679"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2015.06.018"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21502"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000147917.43615.c0"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2013.06.033"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25318"}],"container-title":["International Forum of Allergy &amp; 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