{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T18:24:10Z","timestamp":1787423050062,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T00:00:00Z","timestamp":1787356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T00:00:00Z","timestamp":1787356800000},"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"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sinus and skull base surgery create areas of demucosalized bone and cartilage in the sinonasal cavity, yet no standardized system exists to describe the progressive healing of these wounds. The goal of this study was to develop the novel Sinonasal Assessment of Reepithelialization (SNARE) and perform parametric testing including inter\u2010rater and intra\u2010rater reliability analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a modified Delphi method, an 11\u2010member expert panel comprising 10 rhinologists and one PhD otolaryngology research scientist developed a four\u2010stage wound healing scale over three iterative rounds, with consensus set at 80%. Consensus scale was as follows: Stage 0: Fully remucosalized; Stage 1: Mostly remucosalized; Stage 2: Extensive healing (granulation) tissue, minimal remucosalization; Stage 3: Minimal healing (granulation) tissue. Fifty\u2010nine postoperative videos of nasoseptal flap (NSF) harvest sites were reviewed by 14 blinded, fellowship\u2010trained rhinologists to assess inter\u2010rater reliability\u201412 of whom repeated the evaluation after 1 month to assess intra\u2010rater reliability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Inter\u2010rater reliability for individual raters was good (intraclass correlation coefficient (ICC)(A,1) = 0.763, Round 1; 0.761, Round 2). Intra\u2010rater ICC(A,1) values ranged from 0.653 to 0.938 (mean = 0.83), indicating moderate reliability for one reviewer and good\u2010to\u2010excellent repeatability for the remainder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The SNARE is a reliable, endoscopically based staging system with good\u2010to\u2010excellent inter\u2010 and intra\u2010rater reliability for describing remucosalization of sinonasal wounds following sinus and skull base surgery. It provides a reliability\u2010tested metric for future studies evaluating the effects of postoperative interventions on sinonasal wound healing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alr.70252","type":"journal-article","created":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T17:51:08Z","timestamp":1787421068000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Reliability Testing of the Sinonasal Assessment of Reepithelialization, a Novel Wound Healing Scale to Assess Postoperative Healing"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5360-5818","authenticated-orcid":false,"given":"Rohan","family":"Bellary","sequence":"first","affiliation":[{"name":"University of Louisville School of Medicine  Louisville Kentucky USA"},{"name":"Snot Force Alliance  St. Matthews Kentucky 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Force Alliance  St. Matthews Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2020-6386","authenticated-orcid":false,"given":"Thomas S.","family":"Higgins","sequence":"additional","affiliation":[{"name":"University of Louisville School of Medicine  Louisville Kentucky USA"},{"name":"Snot Force Alliance  St. Matthews Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor","family":"Carle","sequence":"additional","affiliation":[{"name":"Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8993-6355","authenticated-orcid":false,"given":"Arthur W.","family":"Wu","sequence":"additional","affiliation":[{"name":"Snot Force Alliance  St. Matthews Kentucky USA"},{"name":"Cedars\u2010Sinai Medical Center  Los Angeles California 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