{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T17:47:49Z","timestamp":1786470469909,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"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":["The Laryngoscope"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Preoperative systemic corticosteroids are frequently used in chronic rhinosinusitis with nasal polyps (CRSwNP). This meta\u2010analysis aimed to evaluate the effect of preoperative systemic steroids on tissue eosinophil count (TEC) in CRSwNP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>PubMed, EMBASE, and Cochrane Library.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>Systematic searches were conducted through March 2026 for studies assessing TEC following preoperative systemic steroids in adult CRSwNP patients. Eligible designs included randomized controlled trials, cohort studies, and pre\u2010post studies. TEC was reported as cells per high\u2010power field (TEC\/HPF) or as a percentage of eosinophils among inflammatory cells (%TEC). Pooled mean differences (MD) were calculated using random\u2010effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventeen studies (930 participants) were included, of which 13 were eligible for quantitative synthesis. Systemic steroids significantly reduced TEC\/HPF (MD \u221236.57; 95% CI: \u221243.94 to \u221229.20) and %TEC (MD \u221218.14; 95% CI: \u221224.88 to \u221211.39). Reductions were consistent across steroid dose, duration, and concomitant intranasal steroid use. However, low dose (4.2\u201318.6\u2009mg\/day) given in \u2264\u20097\u2010day regimens showed a non\u2010significant reduction (MD \u221217.78; 95% CI: \u221262.62 to 27.05). Adverse events were not statistically different between the steroid and control groups (5.60% vs. 1.12%, odds ratio\u2009=\u20095.22,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.12). No adverse events were reported in studies using low\u2010dose or tapering regimens.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preoperative systemic corticosteroids significantly reduce TEC in CRSwNP, regardless of the quantifying method. This effect may interfere with histologic assessment when biopsy is taken intraoperatively. To avoid misinterpretation, clinicians may consider either withholding preoperative systemic corticosteroids, using a less suppressive regimen, or obtaining a biopsy prior to steroid initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>N\/A.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70600","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T03:44:38Z","timestamp":1777607078000},"page":"3692-3705","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Preoperative Systemic Steroids on Tissue Eosinophils in\n                    <scp>CRSwNP<\/scp>\n                    : Meta\u2010Analysis"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9787-6767","authenticated-orcid":false,"given":"Wirach","family":"Chitsuthipakorn","sequence":"first","affiliation":[{"name":"Center of Excellence in Otolaryngology, Head &amp; Neck Surgery Rajavithi Hospital  Bangkok Thailand"},{"name":"College of Medicine, Rangsit University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4912-5194","authenticated-orcid":false,"given":"Vorachai","family":"Pooldum","sequence":"additional","affiliation":[{"name":"Center of Excellence in Otolaryngology, Head &amp; Neck Surgery Rajavithi Hospital  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8878-2905","authenticated-orcid":false,"given":"Minh P.","family":"Hoang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Medicine and Pharmacy, Hue University  Hue Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2681-2958","authenticated-orcid":false,"given":"Dichapong","family":"Kanjanawasee","sequence":"additional","affiliation":[{"name":"Department of Parasitology Faculty of Medicine, Siriraj Hospital, Mahidol University  Bangkok Thailand"},{"name":"Center of Research Excellence in Allergy &amp; Immunology Faculty of Medicine, Siriraj Hospital, Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0158-7638","authenticated-orcid":false,"given":"Kachorn","family":"Seresirikachorn","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Faculty of Medicine, Chulalongkorn University  Bangkok Thailand"},{"name":"Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7537-4718","authenticated-orcid":false,"given":"Kornkiat","family":"Snidvongs","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Faculty of Medicine, Chulalongkorn University  Bangkok Thailand"},{"name":"Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22214"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.23527"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22194"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.15074"},{"issue":"29","key":"e_1_2_11_6_1","first-page":"1","article-title":"European Position Paper on Rhinosinusitis and Nasal Polyps 2020","volume":"58","author":"Fokkens W. 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