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458

International consensus statement on rhinosinusitis

TABLE X-6 Evidence for Central Compartment Atopic Disease Study Year LOE Study Design

Clinical Endpoint Allergen sensitivity on testing

Conclusions

Hamizan 2

Higher grades of MT polypoid edema are associated with inhalant allergy. Sensitivity (94.7%) and specificity (23/4%) have been determined using multifocal MT edema as a cutoff on ROC analysis. CCAD demonstrates significantly higher association with allergy ( p < 0.001) than CRSwNP NOS. Oblique MT orientation, septal involvement and lower LM score are associated with CCAD CCAD was identified in 19.2% of REAH patients. 94.7% of REAH patients had clinical AR. Central compartment findings in AERD are significantly associated with clinical allergy ( p < 0.0001) Centrally located disease was associated with sensitivity on allergy testing ( p = 0.03, specificity 90.82%, PPV 73.53%). Paranasal sinus polyposis patients were more commonly older, male, had CRS, and had higher LM and NOSE scores. MT polypoid change patients were more commonly younger, female, had AR, and had lower LM score. There is a strong association between allergen sensitivity and MT polyps/polypoid edema.

2017

3

Cross sectional study of graded MT polyps/edema (n = 187)

Marcus 7

2020

4

Case-control evaluation of CRSwNP subtypes (n = 356) Case-control evaluation of CRS patient CT scans (n = 356) Case series of REAH patients (n = 26)

Allergy and asthma

prevalence by subtype

Roland 9

CT scan pattern of opacification

2020

4

Schertzer 6

2020

4

CCAD involvement in REAH

DelGaudio 5

2019

4

Case series of AERD patients (n = 72)

CCAD involvement in AERD

Hamizan 8

2018

4

Case series of CRS patients (n = 112)

CT scan pattern – diffuse vs central Allergy test positivity

DelGaudio 4

2017

4

Case series of CCAD patients (n = 15)

Characteristics of CCAD Introduced the term CCAD. 100% of patients had allergy symptoms. 93.3% were positive on allergy testing.

Brunner 3

2017

4

Case series Paranasal sinus polyposis (n = 23) MT polypoid change (n = 44)

Demographics Presence of CRS, AR, asthma SNOT-22, NOSE LMscore Eos, total IgE

White 1

Allergen sensitivity on testing

2014

4

Case series of MT polyps/polypoid edema pts (n = 25, 16 had allergy testing)

leukotrienes 1414 which are elevated in subsets of CRSwNP patients. Thus, pseudomonal biofilms may tonically stimu late SCC function with resultant Th2 cytokine production.

X.C.4 Contributing Factors for CRSwNP: Fungus Because of limited data, CRSsNP and CRSwNP are com bined in Section IX.C.3 . X.C.5 Contributing Factors for CRSwNP: Neo-osteogenesis Because of limited data, CRSsNP and CRSwNP are com bined in Section IX.C.4 .

Biofilms as a Contributing Factor for CRSwNP Aggregate Grade of Evidence: C (Level 3: 2 studies; Table X-7 level 4: 1 study).