{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T08:32:25Z","timestamp":1769761945705,"version":"3.49.0"},"reference-count":45,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T00:00:00Z","timestamp":1692921600000},"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":["R01DC005805"],"award-info":[{"award-number":["R01DC005805"]}],"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":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>It is unclear whether chronic rhinosinusitis (CRS) endotypes show a differential response to endoscopic sinus surgery (ESS). We explored patient mucous inflammatory cytokine expression and associations with patient\u2010reported and clinically measured post\u2010operative outcome measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with CRS were prospectively recruited between 2016 and 2021 into a national multicenter, observational study. Mucus was collected from the olfactory cleft preoperatively and evaluated for 26 biomarkers using cluster analysis. Patient\u2010reported outcome measures included the 22\u2010item Sino\u2010Nasal Outcome Test (SNOT\u201022) and Questionnaire of Olfactory Dysfunction (QOD). Additional clinical measures of disease severity included threshold, discrimination, and identification (TDI) scores using \u201cSniffin\u2019 Sticks\u201d testing and Lund\u2013Kennedy endoscopic score (LKES).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 115 patients were clustered into type 2 inflammatory, non\u2013type 2 inflammatory, noninflammatory, and two indeterminate clusters based on individual protein levels. Overall, the type 2 inflammatory cluster was found to have the highest mean improvement in both SNOT\u201022 (\u221228.3 [standard deviation,\u00a0\u00b116.2]) and TDI (6.5 [standard deviation,\u00a0\u00b17.9]) scores 6 months after ESS. However, on average, all endotype clusters demonstrated improvement in all outcome measures after ESS without statistically significant between\u2010group differences in SNOT\u201022 (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.738), QOD (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.306), TDI (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.358), or LKES (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.514) measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>All CRS endotype clusters responded favorably to surgery and showed improvements in patient\u2010reported and objective outcome measures. Thus, ESS should be considered a more generalized CRS therapy, and benefits appear to not be limited to specific endotypes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.23255","type":"journal-article","created":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T05:36:31Z","timestamp":1691732191000},"page":"765-774","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["All chronic rhinosinusitis endotype clusters demonstrate improvement in patient\u2010reported and clinical outcome measures after endoscopic sinus surgery"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3744-0451","authenticated-orcid":false,"given":"Nikita","family":"Chapurin","sequence":"first","affiliation":[{"name":"Division of Rhinology and Skull Base Surgery Department of Otolaryngology\u2013Head and Neck Surgery University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodney J.","family":"Schlosser","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Endoscopic Skull Base Surgery Department of Otolaryngology\u2013Head &amp; Neck Surgery Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Endoscopic Skull Base Surgery Department of Otolaryngology\u2013Head &amp; Neck Surgery Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jess C.","family":"Mace","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Sinus\/Skull Base Surgery Department of Otolaryngology\u2013Head and Neck Surgery Oregon Health and Science University  Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"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\u2013Head and Neck Surgery Oregon Health and Science University  Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todd E.","family":"Bodner","sequence":"additional","affiliation":[{"name":"Department of Psychology Portland State University  Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6991-9694","authenticated-orcid":false,"given":"Sofia","family":"Khan","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Endoscopic Skull Base Surgery Department of Otolaryngology\u2013Head &amp; Neck Surgery Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6880-6092","authenticated-orcid":false,"given":"Jennifer K.","family":"Mulligan","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Skull Base Surgery Department of Otolaryngology\u2013Head and Neck Surgery University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8766-1626","authenticated-orcid":false,"given":"Jose L.","family":"Mattos","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Sinus Surgery Department of Otolaryngology\u2013Head and Neck Surgery University of Virginia  Charlottesville Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0560-5028","authenticated-orcid":false,"given":"Jeremiah A.","family":"Alt","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Utah  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2748-0705","authenticated-orcid":false,"given":"Vijay R.","family":"Ramakrishnan","sequence":"additional","affiliation":[{"name":"Division of Rhinology Department of Otolaryngology\u2013Head and Neck Surgery Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary M.","family":"Soler","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Endoscopic Skull Base Surgery Department of Otolaryngology\u2013Head &amp; 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