{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:45:04Z","timestamp":1785775504168,"version":"3.56.0"},"reference-count":53,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"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":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic rhinosinusitis (CRS) is a prevalent, heterogeneous inflammatory disease associated with significant morbidity. Systemic corticosteroids (SCS) are commonly prescribed for their anti\u2010inflammatory effects, but cumulative exposure carries risks, including metabolic, cardiovascular, and skeletal complications. Despite widespread use, evidence\u2010based guidance on optimal indications, timing, and duration of SCS in CRS remains inconsistent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology\/Principal<\/jats:title>\n                    <jats:p>An evidence\u2010based review was performed using MEDLINE, EMBASE, and Cochrane databases (2013\u20132023). Studies were screened and categorized into two primary groups: CRS with (CRSwNP) or without (CRSsNP) nasal polyps. Within CRSwNP, evidence was subcategorized by indication, including (1) polyp size reduction, (2) olfactory dysfunction, (3) comorbid disease, and (4) perioperative use, encompassing pre\u2010 and postoperative SCS administration. The CRSsNP category included studies evaluating SCS in non\u2010polypoid disease, with or without comorbidities. Recommendations were graded according to evidence quality and the balance of benefit versus harm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Short courses of SCS provide consistent, short\u2010term improvements in nasal polyp size, nasal congestion, and olfactory function in CRSwNP, but benefits wane within weeks unless followed by intranasal corticosteroids. Preoperative SCS improves intraoperative visualization, though comparable nonsteroidal techniques exist. Routine postoperative SCS are not supported, showing no meaningful advantage over topical therapy. No additional benefit was seen in comorbid subgroups. Evidence in CRSsNP is limited, with possible benefit only in early disease or select medically managed cases. Repeated use contributes to cumulative toxicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SCS have a narrow, time\u2010limited role in CRS. Stewardship should emphasize optimized topical therapy, appropriate sinus surgery, and biologics to minimize systemic steroid exposure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alr.70211","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T06:27:46Z","timestamp":1783405666000},"page":"852-879","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Systemic Corticosteroids in the Management of Sinonasal Disease: An Evidence\u2010Based Expert Review"],"prefix":"10.1002","volume":"16","author":[{"given":"Andrew","family":"Thamboo","sequence":"first","affiliation":[{"name":"Otolaryngology\u2013Head &amp; Neck Surgery University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deanna","family":"Gigliotti","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head &amp; Neck Surgery University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5761-7018","authenticated-orcid":false,"given":"Eugenio","family":"De Corso","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology\u2013Department of Medicine and Surgery University of Perugia  Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stella","family":"Lee","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head and Neck Surgery Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin S.","family":"Bleier","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head and Neck Surgery Massachusetts Eye and Ear Infirmary Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"Chin","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head &amp; Neck Surgery Dalhousie University  Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie\u2010Noelle","family":"Corriveau","sequence":"additional","affiliation":[{"name":"Oto\u2010rhino\u2010laryngologie Chirurgie Cervico\u2010faciale CHU De Qu\u00e9bec Universit\u00e9 Laval  Quebec City Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Hox","sequence":"additional","affiliation":[{"name":"Service D'otorhinolaryngologie Head and Neck Surgery Cliniques Universitaires Saint\u2010Luc  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3993-1569","authenticated-orcid":false,"given":"Claire","family":"Hopkins","sequence":"additional","affiliation":[{"name":"ENT Department Guy's and St Thomas\u2019 NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0786-4675","authenticated-orcid":false,"given":"Peter H.","family":"Hwang","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head and Neck Surgery Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arif","family":"Janjua","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head &amp; Neck Surgery University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludger","family":"Klimek","sequence":"additional","affiliation":[{"name":"Center for Rhinology and Allergology  Wiesbaden Hessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4057-2858","authenticated-orcid":false,"given":"Daniel","family":"Lee","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head &amp; Neck Surgery Division of Rhinology University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Lee","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head &amp; Neck Surgery Division of Rhinology University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6078-8010","authenticated-orcid":false,"given":"Amber","family":"Luong","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head and Neck Surgery McGovern Medical School University of Texas Health Science Center at Houston  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey","family":"Mortuaire","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology\u2013Head and Neck Department Huriez Hospital, CHU Lille  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaquim","family":"Mullol","sequence":"additional","affiliation":[{"name":"Rhinology Unit and Smell Clinic Otorhinolaryngology Department Hospital Clinic Barcelona, IDIBAPS, Universitat de Barcelona, CIBERES  Barcelona Catalonia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2072-982X","authenticated-orcid":false,"given":"Zara M.","family":"Patel","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head and Neck Surgery Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Scott","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head &amp; Neck Surgery Dalhousie University  Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doron","family":"Sommer","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head and Neck Surgery Department of Surgery McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5825-2759","authenticated-orcid":false,"given":"Leigh","family":"Sowerby","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head and Neck Surgery Schulich School of Medicine &amp; Dentistry University of Western Ontario  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Tewfik","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head and Neck Surgery McGill University Health Centre  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Voizard","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head and Neck Surgery Universit\u00e9 De Montr\u00e9al  Montr\u00e9al Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9734-0241","authenticated-orcid":false,"given":"Martin","family":"Wagenmannm","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology D\u00fcsseldorf University Hospital (UKD)  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah K.","family":"Wise","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head and Neck Surgery Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Yip","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head &amp; Neck Surgery Department of Surgery Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7150-9906","authenticated-orcid":false,"given":"Quirina","family":"Thompson","sequence":"additional","affiliation":[{"name":"University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3774-2959","authenticated-orcid":false,"given":"Martin","family":"Desrosiers","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head and Neck Surgery Universit\u00e9 De Montr\u00e9al  Montr\u00e9al Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Chan","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head &amp; Neck Surgery St. Michael's Hospital, University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1710\u20101492\u20109\u201030"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.2500\/aap.2025.46.250050"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25180"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.2147\/JAA.S176026"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.03054\u20102021"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13601\u2010019\u20100303\u20106"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.20095"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011991.pub2"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin22.328"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/1744666X.2023.2209724"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12111935"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.14744\/SEMB.2018.40316"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.waojou.2020.100131"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010017\u20104809\u2010z"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2025.128"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22863"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24330"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin20.600"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24937"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anorl.2020.06.028"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.29271\/jcpsp.2021.06.699"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28233"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin23.452"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100042\u20101743275"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28347"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.55519\/JAMC\u201003\u201013602"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25352"},{"issue":"2","key":"e_1_2_8_29_1","first-page":"123","article-title":"Oral Steroids and Intraoperative Bleeding During Endoscopic Sinus Surgery","volume":"11","author":"G\u00fcnel C.","year":"2015","journal-title":"B\u2010ENT"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2014.55.6.1683"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otoeng.2013.04.008"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000004833"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e318157f764"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2014.28.4023"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21376"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010024\u201009005\u20100"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.23203"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2021.102874"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1177\/01455613221086027"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215122002481"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30586"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin19.325"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2018.09.005"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016489.2015.1063784"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814521373"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2021.0011"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29495"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1186\/1710\u20101492\u20107\u20102"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2017.31.4396"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011992.pub2"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102222.2007.02889.x"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin20.415"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2023.08.015"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2414482"}],"container-title":["International Forum of Allergy &amp; Rhinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alr.70211","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/alr.70211","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alr.70211","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:53:11Z","timestamp":1785772391000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/alr.70211"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,6]]},"references-count":53,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/alr.70211"],"URL":"https:\/\/doi.org\/10.1002\/alr.70211","archive":["Portico"],"relation":{},"ISSN":["2042-6976","2042-6984"],"issn-type":[{"value":"2042-6976","type":"print"},{"value":"2042-6984","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,6]]},"assertion":[{"value":"2026-01-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}