{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T13:17:30Z","timestamp":1784726250730,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T00:00:00Z","timestamp":1759536000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T00:00:00Z","timestamp":1759536000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>More extensive endoscopic sinus surgery (ESS) has been shown to correlate with better disease control for chronic rhinosinusitis with nasal polyps (CRSwNP). The Completion of Surgery Index (CoSI) is a recently developed radiologic scoring system that assesses the extent of surgery, where CoSI &lt;70 (previous incomplete surgery) correlated with greater sino\u2010nasal outcome test (SNOT\u201022) improvement after revision surgery. However, the benefit of complete surgery on asthma outcomes has not been defined. Here, we evaluated the impact of CoSI on SNOT\u201022 and Asthma Control Test (ACT) improvements after surgery in CRSwNP with asthma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>CRSwNP patients with asthma who underwent ESS between January 2018 and December 2023 were identified. Subjects were placed into two groups based on the preoperative CT scans: CoSI &lt;70 (previous incomplete surgery) and CoSI 70 or greater (previous complete surgery). SNOT\u201022 and ACT data were collected at baseline and over 2 years postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventy CRSwNP patients with comorbid asthma underwent revision surgery, of which 49 (70.0%) patients had a preoperative CoSI &lt;70. The CoSI &lt;70 group had a greater average SNOT\u201022 improvement than the CoSI 70 or greater group from baseline to 2 years postoperatively (30.8\u00a0\u00b1\u00a020.5 vs. 20.4\u00a0\u00b1\u00a014.9,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.042). In uncontrolled asthma, the average ACT improvement was significantly greater for the CoSI &lt;70 group than the CoSI 70 or greater group (3.9\u00a0\u00b1\u00a02.2 vs. 0.88\u00a0\u00b1\u00a01.4,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.029).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preoperative CoSI &lt;70 was associated with significantly greater long\u2010term improvements in SNOT\u201022 and ACT after revision surgery than CoSI 70 or greater group, supporting the need for complete surgery in CRSwNP with asthma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alr.70043","type":"journal-article","created":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T14:34:22Z","timestamp":1759588462000},"page":"132-137","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Completeness of Surgery Index Predicts Success in CRSwNP With Asthma by SNOT\u201022 and Asthma Control Test"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1244-9193","authenticated-orcid":false,"given":"Alison J.","family":"Yu","sequence":"first","affiliation":[{"name":"Division of Rhinology Department of Otorhinolaryngology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chau","family":"Phung","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krithika","family":"Kuppusamy","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexa M.","family":"Finuoli","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria C.","family":"Espinosa","sequence":"additional","affiliation":[{"name":"Division of Rhinology Department of Otorhinolaryngology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3634-2067","authenticated-orcid":false,"given":"Jennifer E.","family":"Douglas","sequence":"additional","affiliation":[{"name":"Division of Rhinology Department of Otorhinolaryngology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Kohanski","sequence":"additional","affiliation":[{"name":"Division of Rhinology Department of Otorhinolaryngology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nithin D.","family":"Adappa","sequence":"additional","affiliation":[{"name":"Division of Rhinology Department of Otorhinolaryngology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noam A.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Division of Rhinology Department of Otorhinolaryngology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John V.","family":"Bosso","sequence":"additional","affiliation":[{"name":"Division of Rhinology Department of Otorhinolaryngology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James N.","family":"Palmer","sequence":"additional","affiliation":[{"name":"Division of Rhinology Department of Otorhinolaryngology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan D.","family":"Workman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Massachusetts Eye and Ear\/Harvard Medical School  Boston Massachusetts 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