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Kuan EC, Wang EW, Adappa ND, Beswick DM, London NR, Su SY, Wang MB, Abuzeid WM, Alexiev B, Alt JA, Antognoni P, Alonso-Basanta M, Batra PS, Bhayani M, Bell D, Bernal-Sprekelsen M, Betz CS, Blay JY, Bleier BS, Bonilla-Velez J, Callejas C, Carrau RL, Casiano RR, Castelnuovo P, Chandra RK, Chatzinakis V, Chen SB, Chiu AG, Choby G, Chowdhury NI, Citardi MJ, Cohen MA, Dagan R, Dalfino G, Dallan I, Dassi CS, de Almeida J, Dei Tos AP, DelGaudio JM, Ebert CS, El-Sayed IH, Eloy JA, Evans JJ, Fang CH, Farrell NF, Ferrari M, Fischbein N, Folbe A, Fokkens WJ, Fox MG, Lund VJ, Gallia GL, Gardner PA, Geltzeiler M, Georgalas C, Getz AE, Govindaraj S, Gray ST, Grayson JW, Gross BA, Grube JG, Guo R, Ha PK, Halderman AA, Hanna EY, Harvey RJ, Hernandez SC, Holtzman AL, Hopkins C, Huang Z, Huang Z, Humphreys IM, Hwang PH, Iloreta AM, Ishii M, Ivan ME, Jafari A, Kennedy DW, Khan M, Kimple AJ, Kingdom TT, Knisely A, Kuo YJ, Lal D, Lamarre ED, Lan MY, Le H, Lechner M, Lee NY, Lee JK, Lee VH, Levine CG, Lin JC, Lin DT, Lobo BC, Locke T, Luong AU, Magliocca KR, Markovic SN, Matnjani G, McKean EL, Meço C, Mendenhall WM, Michel L, Na'ara S, Nicolai P, Nuss DW, Nyquist GG, Oakley GM, Omura K, Orlandi RR, Otori N, Papagiannopoulos P, Patel ZM, Pfister DG, Phan J, Psaltis AJ, Rabinowitz MR, Ramanathan M, Rimmer R, Rosen MR, Sanusi O, Sargi ZB, Schafhausen P, Schlosser RJ, Sedaghat AR, Senior BA, Shrivastava R, Sindwani R, Smith TL, Smith KA, Snyderman CH, Solares CA, Sreenath SB, Stamm A, Stölzel K, Sumer B, Surda P, Tajudeen BA, Thompson LDR, Thorp BD, Tong CCL, Tsang RK, Turner JH, Turri-Zanoni M, Udager AM, van Zele T, VanKoevering K, Welch KC, Wise SK, Witterick IJ, Won TB, Wong SN, Woodworth BA, Wormald PJ, Yao WC, Yeh CF, Zhou B, Palmer JN. International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors. Int Forum Allergy Rhinol 2024;14:149-608. [PMID: 37658764 DOI: 10.1002/alr.23262] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 09/05/2023]

Abstract

BACKGROUND

Sinonasal neoplasms, whether benign and malignant, pose a significant challenge to clinicians and represent a model area for multidisciplinary collaboration in order to optimize patient care. The International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors (ICSNT) aims to summarize the best available evidence and presents 48 thematic and histopathology-based topics spanning the field.

METHODS

In accordance with prior International Consensus Statement on Allergy and Rhinology documents, ICSNT assigned each topic as an Evidence-Based Review with Recommendations, Evidence-Based Review, and Literature Review based on the level of evidence. An international group of multidisciplinary author teams were assembled for the topic reviews using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses format, and completed sections underwent a thorough and iterative consensus-building process. The final document underwent rigorous synthesis and review prior to publication.

RESULTS

The ICSNT document consists of four major sections: general principles, benign neoplasms and lesions, malignant neoplasms, and quality of life and surveillance. It covers 48 conceptual and/or histopathology-based topics relevant to sinonasal neoplasms and masses. Topics with a high level of evidence provided specific recommendations, while other areas summarized the current state of evidence. A final section highlights research opportunities and future directions, contributing to advancing knowledge and community intervention.

CONCLUSION

As an embodiment of the multidisciplinary and collaborative model of care in sinonasal neoplasms and masses, ICSNT was designed as a comprehensive, international, and multidisciplinary collaborative endeavor. Its primary objective is to summarize the existing evidence in the field of sinonasal neoplasms and masses.

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Affiliation(s)

Edward C Kuan Departments of Otolaryngology-Head and Neck Surgery and Neurological Surgery, University of California, Irvine, Orange, California, USA
Eric W Wang Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
Nithin D Adappa Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Daniel M Beswick Department of Otolaryngology-Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA
Nyall R London Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Sinonasal and Skull Base Tumor Program, Surgical Oncology Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
Shirley Y Su Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Marilene B Wang Department of Otolaryngology-Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA
Waleed M Abuzeid Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA
Borislav Alexiev Department of Pathology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, Chicago, Illinois, USA
Jeremiah A Alt Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA
Paolo Antognoni Division of Radiation Oncology, University of Insubria, ASST Sette Laghi Hospital, Varese, Italy
Michelle Alonso-Basanta Department of Radiation Oncology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
Pete S Batra Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
Mihir Bhayani Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
Diana Bell Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, California, USA
Manuel Bernal-Sprekelsen Otorhinolaryngology Department, Surgery and Medical-Surgical Specialties Department, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
Christian S Betz Department of Otorhinolaryngology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Jean-Yves Blay Department of Medical Oncology, Centre Léon Bérard, UNICANCER, Université Claude Bernard Lyon I, Lyon, France
Benjamin S Bleier Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
Juliana Bonilla-Velez Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA
Claudio Callejas Department of Otolaryngology, Pontificia Universidad Católica de Chile, Santiago, Chile Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA
Ricardo L Carrau Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA
Roy R Casiano Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
Paolo Castelnuovo Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi Hospital, Varese, Italy
Rakesh K Chandra Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
Vasileios Chatzinakis Department of Head, Neck and Skull Base Surgery, Hygeia Hospital, Athens, Greece
Simon B Chen Department of Pathology, Stanford University, Stanford, California, USA
Alexander G Chiu Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
Garret Choby Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
Naweed I Chowdhury Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
Martin J Citardi Department of Otorhinolaryngology-Head & Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
Marc A Cohen Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Roi Dagan Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, Florida, USA
Gianluca Dalfino Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi Hospital, Varese, Italy
Iacopo Dallan Department of Otolaryngology-Head and Neck Surgery, Pisa University Hospital, Pisa, Italy
Camila Soares Dassi São Paulo ENT Center (COF), Edmundo Vasconcelos Complex, São Paulo, Brazil
John de Almeida Department of Otolaryngology-Head and Neck Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
Angelo P Dei Tos Section of Pathology, Department of Medicine, University of Padua, Padua, Italy
John M DelGaudio Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
Charles S Ebert Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Ivan H El-Sayed Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA
Jean Anderson Eloy Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
James J Evans Department of Neurological Surgery and Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Christina H Fang Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine, Bronx, New York, USA
Nyssa F Farrell Department of Otolaryngology-Head and Neck Surgery, Washington University in St. Louis, St. Louis, Missouri, USA
Marco Ferrari Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
Nancy Fischbein Department of Radiology, Stanford University, Stanford, California, USA
Adam Folbe Department of Otolaryngology-Head and Neck Surgery, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, USA
Wytske J Fokkens Department of Otorhinolaryngology, Amsterdam UMC, Amsterdam, The Netherlands
Meha G Fox Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
Valerie J Lund Ear Institute, University College London, London, UK
Gary L Gallia Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Paul A Gardner Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
Mathew Geltzeiler Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA
Christos Georgalas Department of Otorhinolaryngology-Head and Neck Surgery, University of Nicosia Medical School, Nicosia, Cyprus
Anne E Getz Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA
Satish Govindaraj Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
Stacey T Gray Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
Jessica W Grayson Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
Bradley A Gross Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
Jordon G Grube Department of Otolaryngology-Head and Neck Surgery, Albany Medical Center, Albany, New York, USA
Ruifeng Guo Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
Patrick K Ha Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA
Ashleigh A Halderman Department of Otolaryngology-Head and Neck Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
Ehab Y Hanna Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Richard J Harvey Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of South Wales, Sydney, New South Wales, Australia
Stephen C Hernandez Department of Otolaryngology-Head and Neck Surgery, LSU Health Sciences Center, New Orleans, Louisiana, USA
Adam L Holtzman Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, Florida, USA
Claire Hopkins Department of Otolaryngology-Head and Neck Surgery, Guys and St Thomas' Hospital, London, UK
Zhigang Huang Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology-Head and Neck Surgery, Ministry of Education, Beijing, China
Zhenxiao Huang Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology-Head and Neck Surgery, Ministry of Education, Beijing, China
Ian M Humphreys Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA
Peter H Hwang Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA
Alfred M Iloreta Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
Masaru Ishii Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Michael E Ivan Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
Aria Jafari Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA
David W Kennedy Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Mohemmed Khan Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
Adam J Kimple Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Todd T Kingdom Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA
Anna Knisely Department of Otolaryngology, Head and Neck Surgery, Swedish Medical Center, Seattle, Washington, USA
Ying-Ju Kuo Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan
Devyani Lal Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
Eric D Lamarre Head and Neck Institute, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, Ohio, USA
Ming-Ying Lan Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
Hien Le Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
Matt Lechner UCL Division of Surgery and Interventional Science and UCL Cancer Institute, University College London, London, UK
Nancy Y Lee Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Jivianne K Lee Department of Head and Neck Surgery, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, California, USA
Victor H Lee Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
Corinna G Levine Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
Jin-Ching Lin Department of Radiation Oncology, Changhua Christian Hospital, Changhua, Taiwan
Derrick T Lin Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
Brian C Lobo Department of Otolaryngology-Head and Neck Surgery, University of Florida, Gainesville, Florida, USA
Tran Locke Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
Amber U Luong Department of Otorhinolaryngology-Head & Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
Kelly R Magliocca Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
Svetomir N Markovic Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, Minnesota, USA
Gesa Matnjani Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Erin L McKean Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
Cem Meço Department of Otorhinolaryngology, Head and Neck Surgery, Ankara University Medical School, Ankara, Turkey Department of Otorhinolaryngology Head and Neck Surgery, Salzburg Paracelsus Medical University, Salzburg, Austria
William M Mendenhall Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, Florida, USA
Loren Michel Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Shorook Na'ara Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA
Piero Nicolai Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
Daniel W Nuss Department of Otolaryngology-Head and Neck Surgery, LSU Health Sciences Center, New Orleans, Louisiana, USA
Gurston G Nyquist Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Gretchen M Oakley Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA
Kazuhiro Omura Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
Richard R Orlandi Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA
Nobuyoshi Otori Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
Peter Papagiannopoulos Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
Zara M Patel Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA
David G Pfister Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Jack Phan Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Alkis J Psaltis Department of Otolaryngology-Head and Neck Surgery, Queen Elizabeth Hospital, Adelaide, South Australia, Australia
Mindy R Rabinowitz Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Murugappan Ramanathan Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Ryan Rimmer Department of Otolaryngology-Head and Neck Surgery, Yale University, New Haven, Connecticut, USA
Marc R Rosen Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Olabisi Sanusi Department of Neurosurgery, Oregon Health and Science University, Portland, Oregon, USA
Zoukaa B Sargi Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
Philippe Schafhausen Department of Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Rodney J Schlosser Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
Ahmad R Sedaghat Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
Brent A Senior Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Raj Shrivastava Department of Neurosurgery and Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
Raj Sindwani Head and Neck Institute, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, Ohio, USA
Timothy L Smith Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA
Kristine A Smith Department of Otolaryngology-Head and Neck Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
Carl H Snyderman Departments of Otolaryngology-Head and Neck Surgery and Neurological Surgery, University of California, Irvine, Orange, California, USA
C Arturo Solares Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
Satyan B Sreenath Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, Indiana, USA
Aldo Stamm São Paulo ENT Center (COF), Edmundo Vasconcelos Complex, São Paulo, Brazil
Katharina Stölzel Department of Otorhinolaryngology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Baran Sumer Department of Otolaryngology-Head and Neck Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
Pavol Surda Department of Otolaryngology-Head and Neck Surgery, Guys and St Thomas' Hospital, London, UK
Bobby A Tajudeen Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
Lester D R Thompson Head and Neck Pathology Consultations, Woodland Hills, California, USA
Brian D Thorp Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Charles C L Tong Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Raymond K Tsang Department of Otolaryngology-Head and Neck Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Justin H Turner Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
Mario Turri-Zanoni Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi Hospital, Varese, Italy
Aaron M Udager Department of Pathology, Michigan Center for Translational Pathology, Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
Thibaut van Zele Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
Kyle VanKoevering Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA
Kevin C Welch Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
Sarah K Wise Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
Ian J Witterick Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
Tae-Bin Won Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
Stephanie N Wong Division of Otorhinolaryngology, Department of Surgery, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
Bradford A Woodworth Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
Peter-John Wormald Department of Otolaryngology-Head and Neck Surgery, Queen Elizabeth Hospital, Adelaide, South Australia, Australia
William C Yao Department of Otorhinolaryngology-Head & Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
Chien-Fu Yeh Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
Bing Zhou Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology-Head and Neck Surgery, Ministry of Education, Beijing, China
James N Palmer Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA

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Alsharif S, Jonstam K, van Zele T, Gevaert P, Holtappels G, Bachert C. Endoscopic Sinus Surgery for Type‐2 CRS wNP: An Endotype‐Based Retrospective Study. Laryngoscope 2019;129:1286-1292. [DOI: 10.1002/lary.27815] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2018] [Indexed: 11/07/2022]

Garcia-Larsen V, Thawer N, Charles D, Cassidy A, van Zele T, Thilsing T, Ahlström M, Haahtela T, Keil T, Matricardi PM, Brożek G, Kowalski ML, Makowska J, Niżankowska-Mogilnicka E, Rymarczyk B, Loureiro C, Todo Bom A, Bachert C, Forsberg B, Janson C, Torén K, Potts JF, Burney PG. Dietary Intake of Flavonoids and Ventilatory Function in European Adults: A GA²LEN Study. Nutrients 2018;10:nu10010095. [PMID: 29342980 PMCID: PMC5793323 DOI: 10.3390/nu10010095] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 01/05/2018] [Accepted: 01/08/2018] [Indexed: 11/16/2022] Open

Abstract

BACKGROUND

Flavonoids exert anti-inflammatory properties and modulate oxidative stress in vitro, suggesting a protective effect on lung function, but epidemiological studies examining this association are scarce.

METHODS

A stratified random sample was drawn from the GA²LEN screening survey, in which 55,000 adults aged 15 to 75 answered a questionnaire on respiratory symptoms. Post-bronchodilator spirometry was obtained from 2850 subjects. Forced vital capacity (FVC), the ratio between the forced exhaled volume in 1 second (FEV₁) and FVC (FEV₁/FVC), FVC below lower limit of normal (FVC < LLN), and FEV₁/FVC < LLN were calculated. Intake of the six main subclasses of flavonoids was estimated using the GA²LEN Food Frequency Questionnaire. Adjusted associations between outcomes and each subclass of flavonoids were examined with multivariate regressions. Simes' procedure was used to test for multiple comparisons.

RESULTS

A total of 2599 subjects had valid lung function and dietary data. A lower prevalence of FVC < LLN (airway restriction) was observed in those with higher total flavonoid (adjusted odds ratio (aOR), higher vs. lowest quintile intake 0.58; 95% Confidence Interval (CI) 0.36, 0.94), and pro-anthocyanidin intakes (aOR 0.47; 95% CI 0.27, 0.81). A higher FEV₁/FVC was associated with higher intakes of total flavonoids and pro-anthocyanidins (adjusted correlation coefficient (a β-coeff 0.33; 0.10, 0.57 and a β-coeff 0.44; 95% CI 0.19, 0.69, respectively). After Simes' procedure, the statistical significance of each of these associations was attenuated but remained below 0.05, with the exception of total flavonoids and airway restriction.

CONCLUSIONS

This population-based study in European adults provides cross-sectional evidence of a positive association of total flavonoid intake and pro-anthocyanidins and ventilatory function, and a negative association with spirometric restriction in European adults.

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Affiliation(s)

Vanessa Garcia-Larsen Program in Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
Narjis Thawer Respiratory Epidemiology and Public Health Group, National Heart and Lung Institute, Imperial College London, London SW7 1BU, UK.
David Charles Respiratory Epidemiology and Public Health Group, National Heart and Lung Institute, Imperial College London, London SW7 1BU, UK. Barts and the London School of Medicine, Queen Mary University of London, London E1 1BZ, UK.
Aedin Cassidy Department of Nutrition, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK.
Thibaut van Zele Upper Airway Research Laboratory, Ghent University, 9000 Ghent, Belgium.
Trine Thilsing Research Unit of General Practice, Department of Public Health, University of Southern Denmark, 5230 Odense M; Denmark.
Matti Ahlström Skin and Allergy Hospital, Helsinki University Hospital, 00029 HUS Helsinki, Finland.
Tari Haahtela Skin and Allergy Hospital, Helsinki University Hospital, 00029 HUS Helsinki, Finland.
Thomas Keil Deptartment of Pediatrics, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany. Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin, 10117 Berlin, Germany.
Paolo M Matricardi Institute of Clinical Epidemiology and Biometry, Würzburg University, 97070 Würzburg, Germany.
Grzegorz Brożek Department of Epidemiology, College of Medicine, Medical University of Silesia, 40-752 Katowice, Poland.
Marek L Kowalski Department of Immunology, Rheumatology and Allergy, Medical University of Lodz, 90-647 Lodz, Poland.
Joanna Makowska Department of Immunology, Rheumatology and Allergy, Medical University of Lodz, 90-647 Lodz, Poland.
Ewa Niżankowska-Mogilnicka Jagiellonian University School of Medicine, 31-008 Krakow, Poland.
Barbara Rymarczyk Clinical Department of Internal Diseases, Allergology and Clinical Immunology, Medical University of Silesia, 40-055 Katowice, Poland.
Carlos Loureiro Department of Immuno-Allergology, Coimbra University Hospital, 3000-075 Coimbra, Portugal.
Ana Todo Bom Department of Immuno-Allergology, Coimbra University Hospital, 3000-075 Coimbra, Portugal.
Claus Bachert Division of ENT Diseases, Karolinska Institute, 171 77 Stockholm, Sweden.
Bertil Forsberg Division of Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden.
Christer Janson Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, 751 85 Uppsala, Sweden.
Kjell Torén Section of Occupational and Environmental Medicine, University of Gothenburg, 405 30 Gothenburg, Sweden.
James F Potts Respiratory Epidemiology and Public Health Group, National Heart and Lung Institute, Imperial College London, London SW7 1BU, UK.
Peter Gj Burney Respiratory Epidemiology and Public Health Group, National Heart and Lung Institute, Imperial College London, London SW7 1BU, UK.

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Garcia-Larsen V, Arthur R, Potts JF, Howarth PH, Ahlström M, Haahtela T, Loureiro C, Bom AT, Brożek G, Makowska J, Kowalski ML, Thilsing T, Keil T, Matricardi PM, Torén K, van Zele T, Bachert C, Rymarczyk B, Janson C, Forsberg B, Niżankowska-Mogilnicka E, Burney PGJ. Is fruit and vegetable intake associated with asthma or chronic rhino-sinusitis in European adults? Results from the Global Allergy and Asthma Network of Excellence (GA²LEN) Survey. Clin Transl Allergy 2017;7:3. [PMID: 28149501 PMCID: PMC5273849 DOI: 10.1186/s13601-016-0140-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 12/28/2016] [Indexed: 12/31/2022] Open

Abstract

Background

Fruits and vegetables are rich in compounds with proposed antioxidant, anti-allergic and anti-inflammatory properties, which could contribute to reduce the prevalence of asthma and allergic diseases.

Objective

We investigated the association between asthma, and chronic rhino-sinusitis (CRS) with intake of fruits and vegetables in European adults.

Methods

A stratified random sample was drawn from the Global Allergy and Asthma Network of Excellence (GA²LEN) screening survey, in which 55,000 adults aged 15–75 answered a questionnaire on respiratory symptoms. Asthma score (derived from self-reported asthma symptoms) and CRS were the outcomes of interest. Dietary intake of 22 subgroups of fruits and vegetables was ascertained using the internationally validated GA²LEN Food Frequency Questionnaire. Adjusted associations were examined with negative binomial and multiple regressions. Simes procedure was used to control for multiple testing.

Results

A total of 3206 individuals had valid data on asthma and dietary exposures of interest. 22.8% reported having at least 1 asthma symptom (asthma score ≥1), whilst 19.5% had CRS. After adjustment for potential confounders, asthma score was negatively associated with intake of dried fruits (β-coefficient −2.34; 95% confidence interval [CI] −4.09, −0.59), whilst CRS was statistically negatively associated with total intake of fruits (OR 0.73; 95% CI 0.55, 0.97). Conversely, a positive association was observed between asthma score and alliums vegetables (adjusted β-coefficient 0.23; 95% CI 0.06, 0.40). None of these associations remained statistically significant after controlling for multiple testing.

Conclusion and clinical relevance

There was no consistent evidence for an association of asthma or CRS with fruit and vegetable intake in this representative sample of European adults.

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Affiliation(s)

Vanessa Garcia-Larsen Population Health and Occupational Medicine Group, National Heart and Lung Institute, Imperial College London, London, UK.,Respiratory Epidemiology, Occupational Medicine and Public Health Group, National Heart and Lung Institute, Imperial College London, Emmanuel Kaye Building, Manresa Road, London, SW3 6LR UK
Rhonda Arthur Department of Nutrition, King's College London, London, UK
James F Potts Population Health and Occupational Medicine Group, National Heart and Lung Institute, Imperial College London, London, UK
Peter H Howarth Faculty of Medicine, University of Southampton, London, UK
Matti Ahlström Skin and Allergy Hospital, Helsinki University Hospital, Southampton, Finland
Tari Haahtela Skin and Allergy Hospital, Helsinki University Hospital, Southampton, Finland
Carlos Loureiro Immuno-allergology Department, Coimbra University Hospital, Helsinki, Portugal
Ana Todo Bom Immuno-allergology Department, Coimbra University Hospital, Helsinki, Portugal
Grzegorz Brożek Department of Epidemiology, College of Medicine, Medical University of Silesia, Katowice, Poland
Joanna Makowska Department of Immunology, Rheumatology and Allergy, Medical University of Lodz, Coimbra, Poland
Marek L Kowalski Department of Immunology, Rheumatology and Allergy, Medical University of Lodz, Coimbra, Poland
Trine Thilsing Research Unit for Occupational and Environmental Medicine, Institute of Clinical Research, University of Southern Denmark, Coimbra, Denmark
Thomas Keil Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Lodz, Germany.,Institute of Clinical Epidemiology and Biometry, Würzburg University, Würzburg, Germany
Paolo M Matricardi Deptartment of Pediatrics, Charité - Universitätsmedizin Berlin, Berlin, Germany
Kjell Torén Section of Occupational and Environmental Medicine, University of Gothenburg, Odense, Sweden
Thibaut van Zele Upper Airway Research Laboratory, Ghent University, Ghent, Belgium
Claus Bachert Division of ENT Diseases, Karolinska Institute, Stockholm, Sweden
Barbara Rymarczyk Clinical Department of Internal Diseases, Allergology and Clinical Immunology, Medical University of Silesia, Katowice, Poland
Christer Janson Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Ghent, Sweden
Bertil Forsberg Division of Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Chorzów, Sweden
Ewa Niżankowska-Mogilnicka Jagiellonian University School of Medicine, Krakow, Poland
Peter G J Burney Population Health and Occupational Medicine Group, National Heart and Lung Institute, Imperial College London, London, UK

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Pezato R, Balsalobre L, Lima M, Bezerra TFP, Voegels RL, Gregório LC, Stamm AC, van Zele T. Convergence of two major pathophysiologic mechanisms in nasal polyposis: immune response to Staphylococcus aureus and airway remodeling. J Otolaryngol Head Neck Surg 2013;42:27. [PMID: 23663431 PMCID: PMC3651231 DOI: 10.1186/1916-0216-42-27] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Accepted: 03/18/2013] [Indexed: 12/19/2022] Open

Bachert C, Zhang N, van Zele T, Gevaert P. Chronic rhinosinusitis: from one disease to different phenotypes. Pediatr Allergy Immunol 2012;23 Suppl 22:2-4. [PMID: 22762847 DOI: 10.1111/j.1399-3038.2012.01318.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]

Zhang N, Liu S, Lin P, Li X, van Bruaene N, Zhang J, van Zele T, Bachert C. Remodeling and inflammation in Chinese versus white patients with chronic rhinosinusitis. J Allergy Clin Immunol 2010;125:507; author reply 507-8. [PMID: 20061013 DOI: 10.1016/j.jaci.2009.10.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Accepted: 10/08/2009] [Indexed: 11/29/2022]

Bachert C, Zhang N, van Zele T, Gevaert P, Patou J, van Cauwenberge P. Staphylococcus aureus enterotoxins as immune stimulants in chronic rhinosinusitis. Clin Allergy Immunol 2007;20:163-75. [PMID: 17534051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]

Bachert C, van Zele T, Gevaert P, De Schrijver L, Van Cauwenberge P. Superantigens and nasal polyps. Curr Allergy Asthma Rep 2003;3:523-31. [PMID: 14531975 DOI: 10.1007/s11882-003-0065-y] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]