{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T22:47:23Z","timestamp":1781563643209,"version":"3.54.5"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,6,18]],"date-time":"2020-06-18T00:00:00Z","timestamp":1592438400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["R01 DC005805"],"award-info":[{"award-number":["R01 DC005805"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Inflammatory profiles for patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) vary between North American and Asian populations. An elevated ethmoid\u2010to\u2010maxillary (E\/M) opacification ratio on preoperative imaging is associated with certain postoperative outcomes in Asian populations and populations that are non\u2012type 2 dominant. In this study we explore this factor in North American\/type 2\u2012based populations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adult patients (n = 165) from a North American population with CRSwNP who underwent endoscopic sinus surgery (ESS) were prospectively enrolled into an observational, multi\u2010institutional study. The 22\u2010item Sino\u2010Nasal Outcome Test (SNOT\u201022), Brief Smell Identification Test (BSIT), and Lund\u2010Kennedy (LK) endoscopic scores were obtained pre\u2010 and postoperatively. Patients were stratified according to increasing E\/M ratios based on Lund\u2010Mackay (LM) scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>On average, significant within\u2010subject postoperative improvement was found in all patients for SNOT\u201022 total and domain scores, and also BSIT results (<jats:italic>p<\/jats:italic> \u2264 0.019). Preoperatively, elevated E\/M ratio correlated with worse BSIT scores (<jats:italic>r<\/jats:italic> = \u22120.343, <jats:italic>p<\/jats:italic> &lt; 0.001). Postoperatively, elevated E\/M ratio correlated with BSIT improvement (<jats:italic>r<\/jats:italic> = 0.284, <jats:italic>p<\/jats:italic> = 0.002), but did not correlate with SNOT\u201022 improvement or polyp recurrence. An elevated E\/M ratio was associated with greater likelihood of reporting a minimal clinically important difference in BSIT scores (\u03c7<jats:sup>2<\/jats:sup> = 9.96, <jats:italic>p<\/jats:italic> = 0.041).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Elevated E\/M ratios were found to associated with worse baseline olfaction and an increased likelihood of achieving a clinically meaningful postoperative improvement in olfaction in this North American population with CRSwNP. Elevated E\/M ratios did not predict postoperative changes in SNOT\u201022 measures or polyp recurrence. This suggests that prognostic factors may vary according to geography and generalized inflammatory profiles (type 2 vs non\u2012type 2) in patients with CRS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.22625","type":"journal-article","created":{"date-parts":[[2020,6,18]],"date-time":"2020-06-18T19:08:35Z","timestamp":1592507315000},"page":"48-57","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Ethmoid\u2010to\u2010maxillary opacification ratio: a predictor of postoperative olfaction and outcomes in nasal polyposis?"],"prefix":"10.1002","volume":"11","author":[{"given":"Daniel M.","family":"Beswick","sequence":"first","affiliation":[{"name":"Department of Otolaryngology University of Colorado  Aurora CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6424-7083","authenticated-orcid":false,"given":"Timothy L.","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Sinus\/Skull Base Surgery, Department of Otolaryngology\u2012Head and Neck Surgery Oregon Health &amp; Science University  Portland OR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jess C.","family":"Mace","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Sinus\/Skull Base Surgery, Department of Otolaryngology\u2012Head and Neck Surgery Oregon Health &amp; Science University  Portland OR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0560-5028","authenticated-orcid":false,"given":"Jeremiah A.","family":"Alt","sequence":"additional","affiliation":[{"name":"Sinus and Skull Base Surgery Program, Division of Otolaryngology\u2012Head and Neck Surgery, Department of Surgery University of Utah  Salt Lake City UT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nyssa F.","family":"Farrell","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Sinus\/Skull Base Surgery, Department of Otolaryngology\u2012Head and Neck Surgery Oregon Health &amp; Science University  Portland OR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2748-0705","authenticated-orcid":false,"given":"Vijay R.","family":"Ramakrishnan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Colorado  Aurora CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney J.","family":"Schlosser","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2012Head &amp; Neck Surgery Medical University of South Carolina  Charleston SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary M.","family":"Soler","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2012Head &amp; Neck Surgery Medical University of South Carolina  Charleston SC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21695_c"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2017.09.009"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22355"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22221"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27267"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.2332\/allergolint.10-RAI-0231"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21749"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2011.01.007"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000192284.22703.04"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22109"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27473"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22256"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22191"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21903"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22351"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22369"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2007.06.726"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2016.04.013"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-012-0250-y"},{"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":"10.1001\/jamaoto.2014.1045"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22028"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199603000-00021"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21964"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-59989770005-6"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26391"},{"key":"e_1_2_6_28_1","first-page":"183","article-title":"Staging in rhinosinusitus","volume":"31","author":"Lund VJ","year":"1993","journal-title":"Rhinology"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21458"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21800"},{"key":"e_1_2_6_31_1","volume-title":"Overview of Race and Hispanic Origin: 2010 Census Briefs","author":"Humes K","year":"2011"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2012.12.001"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2016.0927"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27112"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22391"},{"key":"e_1_2_6_36_1","unstructured":"Race combinations of two races and not Hispanic or Latino:2010.https:\/\/factfinder.census.gov\/faces\/tableservices\/jsf\/pages\/productview.xhtml?src=bkmk. 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