{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:38:44Z","timestamp":1791419924440,"version":"4.3.3"},"reference-count":42,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"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":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Endoscopic sinus surgery (ESS) varies substantially in the extent of surgical dissection performed, even when described under the same procedural label. In chronic rhinosinusitis, this heterogeneity may influence postoperative outcomes, revision rates, and response to biologic therapies. This review aimed to identify and characterize available instruments for assessing surgical extent after ESS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Scoping review following PRISMA\u2010ScR guidelines with systematic search of PubMed\/MEDLINE, Scopus, and Web of Science.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010one studies describing 11 instruments were included: spanning computed tomography (CT)\u2010based scores (Amsterdam Classification of Completeness of Endoscopic Sinus Surgery [ACCESS], Completion of Surgery Index [CoSI], Sinus Surgery Completeness Score [SSCS], and Residual Ethmoid Cell [REC] score), intraoperative classifications (Lamella\u2013Ostium\u2013Extent\u2013Mucosa [LOEM], complete vs. targeted, and Japanese Rhinologic Society [JRS]), radiologic\u2013surgical concordance metrics, and study\u2010specific tools. A key conceptual distinction emerged between surgical extent (the procedure performed) and surgical completeness (the anatomical result achieved). CT\u2010based instruments primarily assess completeness, whereas intraoperative classifications capture extent. Because similar procedures may yield different anatomical results, these dimensions are not interchangeable. Among CT\u2010based instruments, CoSI demonstrated the most consistent outcome associations, with incomplete prior surgery predicting greater benefit from revision ESS. ACCESS showed preliminary utility in biologic response prediction. LOEM is the only intraoperative system with reported outcome associations, although evidence is limited to a single group. Overall, evidence across instruments remains limited and predominantly retrospective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CT\u2010based and intraoperative instruments capture different dimensions of prior surgery and should be selected according to the clinical or research question. Notably, structured scoring consistently reveals that many patients meeting guideline criteria for prior surgery have varying anatomical dissection. Given the association between surgical extent, postoperative outcomes, and biologic therapy response, its standardized assessment warrants evaluation for integration into clinical decision making. However, prospective validation is urgently needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alr.70191","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T15:21:33Z","timestamp":1780327293000},"page":"695-715","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessing Surgical Extent in Endoscopic Sinus Surgery: A Scoping Review of Scoring Systems"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9912-9837","authenticated-orcid":false,"given":"Alexander","family":"Lein","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie T.","family":"Ehrgott","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery Medical University of Vienna  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