Background and Objectives: Dupilumab is approved for the treatment of uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) and has been shown to be relatively safe and effective in randomized controlled trials. As such, real-world effectiveness and safety data should be obtained.Subjects and Method We performed a retrospective review of patients with CRSwNP who received monthly treatment of dupilumab between January 2022 and June 2023. Reviewed for the study were the following: demographic data, comorbidities, the visual analogue scale (VAS) for nasal obstruction and sense of smell, identification scores of the Korean version Sniffin’ stikc II (KVSS II) test, nasal polyp score (NPS), and serum eosinophil count. Statistical analyses were performed for each clinical variable. Results: A total of 76 patients (49 male, 27 female) were included in this study. The VAS scores decreased from 7.17 at the baseline to 4.51 at month 6; the KVSS II identification scores increased from 6.71 to 8.47, and the NPS decreased from 3.82 to 0.44. The sino-nasal outcome test-22 scores decreased from 36.29 at the baseline to 8.22 at month 6. The correlations between all clinical variables were statistically significant. Conclusion Monthly treatment of dupilumab is effective and safe for patients with CRSwNP. Further research is required to determine the predictive parameters for treatment responses and adverse events.

Background and Objectives: Dupilumab is approved for the treatment of uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) and has been shown to be relatively safe and effective in randomized controlled trials. As such, real-world effectiveness and safety data should be obtained.Subjects and Method We performed a retrospective review of patients with CRSwNP who received monthly treatment of dupilumab between January 2022 and June 2023. Reviewed for the study were the following: demographic data, comorbidities, the visual analogue scale (VAS) for nasal obstruction and sense of smell, identification scores of the Korean version Sniffin’ stikc II (KVSS II) test, nasal polyp score (NPS), and serum eosinophil count. Statistical analyses were performed for each clinical variable. Results: A total of 76 patients (49 male, 27 female) were included in this study. The VAS scores decreased from 7.17 at the baseline to 4.51 at month 6; the KVSS II identification scores increased from 6.71 to 8.47, and the NPS decreased from 3.82 to 0.44. The sino-nasal outcome test-22 scores decreased from 36.29 at the baseline to 8.22 at month 6. The correlations between all clinical variables were statistically significant. Conclusion Monthly treatment of dupilumab is effective and safe for patients with CRSwNP. Further research is required to determine the predictive parameters for treatment responses and adverse events.

Background and Objectives: Dupilumab is approved for the treatment of uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) and has been shown to be relatively safe and effective in randomized controlled trials. As such, real-world effectiveness and safety data should be obtained.Subjects and Method We performed a retrospective review of patients with CRSwNP who received monthly treatment of dupilumab between January 2022 and June 2023. Reviewed for the study were the following: demographic data, comorbidities, the visual analogue scale (VAS) for nasal obstruction and sense of smell, identification scores of the Korean version Sniffin’ stikc II (KVSS II) test, nasal polyp score (NPS), and serum eosinophil count. Statistical analyses were performed for each clinical variable. Results: A total of 76 patients (49 male, 27 female) were included in this study. The VAS scores decreased from 7.17 at the baseline to 4.51 at month 6; the KVSS II identification scores increased from 6.71 to 8.47, and the NPS decreased from 3.82 to 0.44. The sino-nasal outcome test-22 scores decreased from 36.29 at the baseline to 8.22 at month 6. The correlations between all clinical variables were statistically significant. Conclusion Monthly treatment of dupilumab is effective and safe for patients with CRSwNP. Further research is required to determine the predictive parameters for treatment responses and adverse events.

Background and Objectives: Dupilumab is approved for the treatment of uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) and has been shown to be relatively safe and effective in randomized controlled trials. As such, real-world effectiveness and safety data should be obtained.Subjects and Method We performed a retrospective review of patients with CRSwNP who received monthly treatment of dupilumab between January 2022 and June 2023. Reviewed for the study were the following: demographic data, comorbidities, the visual analogue scale (VAS) for nasal obstruction and sense of smell, identification scores of the Korean version Sniffin’ stikc II (KVSS II) test, nasal polyp score (NPS), and serum eosinophil count. Statistical analyses were performed for each clinical variable. Results: A total of 76 patients (49 male, 27 female) were included in this study. The VAS scores decreased from 7.17 at the baseline to 4.51 at month 6; the KVSS II identification scores increased from 6.71 to 8.47, and the NPS decreased from 3.82 to 0.44. The sino-nasal outcome test-22 scores decreased from 36.29 at the baseline to 8.22 at month 6. The correlations between all clinical variables were statistically significant. Conclusion Monthly treatment of dupilumab is effective and safe for patients with CRSwNP. Further research is required to determine the predictive parameters for treatment responses and adverse events.

Background and Objectives: Dupilumab is approved for the treatment of uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) and has been shown to be relatively safe and effective in randomized controlled trials. As such, real-world effectiveness and safety data should be obtained.Subjects and Method We performed a retrospective review of patients with CRSwNP who received monthly treatment of dupilumab between January 2022 and June 2023. Reviewed for the study were the following: demographic data, comorbidities, the visual analogue scale (VAS) for nasal obstruction and sense of smell, identification scores of the Korean version Sniffin’ stikc II (KVSS II) test, nasal polyp score (NPS), and serum eosinophil count. Statistical analyses were performed for each clinical variable. Results: A total of 76 patients (49 male, 27 female) were included in this study. The VAS scores decreased from 7.17 at the baseline to 4.51 at month 6; the KVSS II identification scores increased from 6.71 to 8.47, and the NPS decreased from 3.82 to 0.44. The sino-nasal outcome test-22 scores decreased from 36.29 at the baseline to 8.22 at month 6. The correlations between all clinical variables were statistically significant. Conclusion Monthly treatment of dupilumab is effective and safe for patients with CRSwNP. Further research is required to determine the predictive parameters for treatment responses and adverse events.

The main aim of this video article is to demonstrate the combined use of O-arm navigation and unilateral biportal endoscopy (UBE) to manage far-out syndrome (FOS). In FOS there is entrapment and compression of the fifth lumbar nerve beyond the foramen and between L5 transverse process and the sacral ala at the lumbosacral junction. Conventional microscopic decompression using a paraspinal approach had been the gold standard for its management. However, the surgery is technically challenging due to the deep location of the pathology and intricate anatomy of extraforaminal space. There have been some published reports of unsatisfactory outcomes with microscopic decompression for FOS. We decided to integrate navigation with UBE to increase precision for the management of FOS. A 70-year-old female presented to us with chief complaint of left lower limb radiculopathy since 1 year. She also complained of numbness and paresthesias in her left leg and foot. She was unable to walk for more than 10 minutes due to pain. Her magnetic resonance imaging scan revealed compression of left L5 nerve root in the extraforaminal region. UBE decompression via paraspinal approach was performed for her under O-arm navigation. She experienced immediate relief of her symptoms in the postoperative period. O-arm-navigation-guided UBE is an effective and safer alternative to microsurgical decompression for the management of FOS. This video demonstrates the step-by-step implementation of O-arm navigation with endoscopy and its precise execution.

The main aim of this video article is to demonstrate the combined use of O-arm navigation and unilateral biportal endoscopy (UBE) to manage far-out syndrome (FOS). In FOS there is entrapment and compression of the fifth lumbar nerve beyond the foramen and between L5 transverse process and the sacral ala at the lumbosacral junction. Conventional microscopic decompression using a paraspinal approach had been the gold standard for its management. However, the surgery is technically challenging due to the deep location of the pathology and intricate anatomy of extraforaminal space. There have been some published reports of unsatisfactory outcomes with microscopic decompression for FOS. We decided to integrate navigation with UBE to increase precision for the management of FOS. A 70-year-old female presented to us with chief complaint of left lower limb radiculopathy since 1 year. She also complained of numbness and paresthesias in her left leg and foot. She was unable to walk for more than 10 minutes due to pain. Her magnetic resonance imaging scan revealed compression of left L5 nerve root in the extraforaminal region. UBE decompression via paraspinal approach was performed for her under O-arm navigation. She experienced immediate relief of her symptoms in the postoperative period. O-arm-navigation-guided UBE is an effective and safer alternative to microsurgical decompression for the management of FOS. This video demonstrates the step-by-step implementation of O-arm navigation with endoscopy and its precise execution.

Background and Objectives: Chronic rhinosinusitis with nasal polyposis (CRSwNP) is one phenotype of the diffuse type. In spite of surgical and medical treatment, the polyp recurrence rate is high. Recently biologics are concerned as a therapeutic option of it. To figure out adverse events associated with the dupilumab injection in adult patients with CRSwNP.Subjects and Method Retrospective chart review of patients that were treated with dupilumab from January 2022 to December 2022 for CRSwNP was performed. Results: Of 40 patients (23 of male and 17 of female), 8 patients (20.0%) experienced 9 patients (22.5%) adverse events. The most common adverse event was skin reaction (3 patients, 7.5%), followed by 2 of pruritis, 2 of epistaxis. Three patients quit dupilumab after the adverse events, 4 patients continued, and 1 patient hold the next injection. Conclusion Dupilumab is reported to be relatively safe medication. However, physician should notice that adverse events including skin rash can occur after dupilumab injection.

In human, ultrasonography is used to measure the pennation angle in various muscles to identify muscle functions such as force production, and to study alterations of the pennation angle during muscle contraction, hypertrophy, and atrophy. However, assessments of the pennation angle have not yet been conducted in dogs. This study aims to assess the normal pennation angle of the tibialis cranialis muscle in dogs using ultrasound and to detect changes in this angle in dogs with muscular atrophy. Sixty-eight healthy dogs were examined to establish normal values, while 12 ataxic and 12 lame dogs with suspected hindlimb muscle atrophy were also included. The pennation angle was measured using ultrasound at the midpoint between the proximal end of the tibia and the malleolus, measuring the angle between the muscle bundle and the deep aponeurosis. To confirm the significance between the 5 breeds and to identify a difference between normal and atrophied muscles, statistical analysis was conducted. The study found no significant difference in pennation angle between breeds, with mean values (± standard deviation) of 4.97° (± 1.88) in neutral, 7.25° (± 2.68) in flexion, and 3.31° (± 1.33) in extension positions. Decrease of the pennation angle was identified in muscle atrophy and the flexion position was determined to be the most appropriate for pennation angle measurement of tibialis cranialis muscle. We recommend considering the pennation angle as a valuable indicator of muscle health in dogs, as it demonstrates significant potential for diagnosing and monitoring muscular conditions.