Background and Objectives: Pediatric chronic rhinosinusitis (CRS) significantly affects children’s quality of life and learning abilities. This study aimed to evaluate the postoperative outcomes in pediatric patients who underwent functional endoscopic sinus surgery (FESS) for CRS. Methods: A retrospective review was conducted on pediatric patients who underwent FESS for CRS at 11 university hospitals. The inclusion criteria were patients under 20 years old with bilateral disease who were operated on between January 2005 and December 2021. The data collected included demographics, clinical history, blood tests, preoperative computed tomography, and preoperative and postoperative symptom control. The Kruskal-Wallis and Fisher exact tests were used to compare the quantitative and qualitative data, respectively. Results: In total, 213 patients were enrolled. The mean age was 13.4±3.0 years, and 145 (68.1%) were male. One hundred sixty-four patients (77.0%) had nasal polyps and 33 patients (15.5%) underwent revision FESS. The preoperative symptoms, in order of prevalence, included nasal obstruction (87.8%), rhinorrhea (71.8%), a sense of postnasal drip (58.2%), hyposmia (44.6%), cough (24.4%), and facial fullness (18.3%). These symptoms were significantly alleviated for up to 3 years after surgery (p<0.001). At the time of the last follow-up, 121 patients (56.8%) were controlled, 80 (37.6%) were partly controlled, and 12 (5.6%) were uncontrolled. Patients in the uncontrolled group had higher Lund-Mackay scores, longer follow-up durations, and more instances of revision surgery compared to those in the controlled and partly controlled groups. When age was categorized into three groups, those aged 16 years or older tended to have lower Lund-Mackay scores and better control. Conclusion FESS significantly improves both the postoperative symptoms and the long-term quality of life in pediatric CRS patients. Better symptom control is associated with older age and a lower disease burden.

Background and Objectives: Pediatric chronic rhinosinusitis (CRS) significantly affects children’s quality of life and learning abilities. This study aimed to evaluate the postoperative outcomes in pediatric patients who underwent functional endoscopic sinus surgery (FESS) for CRS. Methods: A retrospective review was conducted on pediatric patients who underwent FESS for CRS at 11 university hospitals. The inclusion criteria were patients under 20 years old with bilateral disease who were operated on between January 2005 and December 2021. The data collected included demographics, clinical history, blood tests, preoperative computed tomography, and preoperative and postoperative symptom control. The Kruskal-Wallis and Fisher exact tests were used to compare the quantitative and qualitative data, respectively. Results: In total, 213 patients were enrolled. The mean age was 13.4±3.0 years, and 145 (68.1%) were male. One hundred sixty-four patients (77.0%) had nasal polyps and 33 patients (15.5%) underwent revision FESS. The preoperative symptoms, in order of prevalence, included nasal obstruction (87.8%), rhinorrhea (71.8%), a sense of postnasal drip (58.2%), hyposmia (44.6%), cough (24.4%), and facial fullness (18.3%). These symptoms were significantly alleviated for up to 3 years after surgery (p<0.001). At the time of the last follow-up, 121 patients (56.8%) were controlled, 80 (37.6%) were partly controlled, and 12 (5.6%) were uncontrolled. Patients in the uncontrolled group had higher Lund-Mackay scores, longer follow-up durations, and more instances of revision surgery compared to those in the controlled and partly controlled groups. When age was categorized into three groups, those aged 16 years or older tended to have lower Lund-Mackay scores and better control. Conclusion FESS significantly improves both the postoperative symptoms and the long-term quality of life in pediatric CRS patients. Better symptom control is associated with older age and a lower disease burden.

Background and Objectives: Pediatric chronic rhinosinusitis (CRS) significantly affects children’s quality of life and learning abilities. This study aimed to evaluate the postoperative outcomes in pediatric patients who underwent functional endoscopic sinus surgery (FESS) for CRS. Methods: A retrospective review was conducted on pediatric patients who underwent FESS for CRS at 11 university hospitals. The inclusion criteria were patients under 20 years old with bilateral disease who were operated on between January 2005 and December 2021. The data collected included demographics, clinical history, blood tests, preoperative computed tomography, and preoperative and postoperative symptom control. The Kruskal-Wallis and Fisher exact tests were used to compare the quantitative and qualitative data, respectively. Results: In total, 213 patients were enrolled. The mean age was 13.4±3.0 years, and 145 (68.1%) were male. One hundred sixty-four patients (77.0%) had nasal polyps and 33 patients (15.5%) underwent revision FESS. The preoperative symptoms, in order of prevalence, included nasal obstruction (87.8%), rhinorrhea (71.8%), a sense of postnasal drip (58.2%), hyposmia (44.6%), cough (24.4%), and facial fullness (18.3%). These symptoms were significantly alleviated for up to 3 years after surgery (p<0.001). At the time of the last follow-up, 121 patients (56.8%) were controlled, 80 (37.6%) were partly controlled, and 12 (5.6%) were uncontrolled. Patients in the uncontrolled group had higher Lund-Mackay scores, longer follow-up durations, and more instances of revision surgery compared to those in the controlled and partly controlled groups. When age was categorized into three groups, those aged 16 years or older tended to have lower Lund-Mackay scores and better control. Conclusion FESS significantly improves both the postoperative symptoms and the long-term quality of life in pediatric CRS patients. Better symptom control is associated with older age and a lower disease burden.

Objectives: . Due to the rarity of olfactory neuroblastoma (ONB), there is ongoing debate about optimal treatment strategies, especially for early-stage or locally advanced cases. Therefore, our study aimed to explore experiences from multiple centers to identify factors that influence the oncological outcomes of ONB. Methods: . We retrospectively analyzed 195 ONB patients treated at nine tertiary hospitals in South Korea between December 1992 and December 2019. Kaplan-Meier survival analysis was used to evaluate oncological outcomes, and a Cox proportional hazards regression model was employed to analyze prognostic factors for survival outcomes. Furthermore, we conducted 1:1 nearest-neighbor matching to investigate differences in clinical outcomes according to the use of neoadjuvant chemotherapy. Results: . In our cohort, the 5-year overall survival (OS) rate was 78.6%, and the 5-year disease-free survival (DFS) rate was 62.4%. The Cox proportional hazards model revealed that the modified Kadish (mKadish) stage and Dulguerov T status were significantly associated with DFS, while the mKadish stage and Hyams grade were identified as prognostic factors for OS. The subgroup analyses indicated a trend toward improved 5-year DFS with dural resection in mKadish A and B cases, even though the result was statistically insignificant. Induction chemotherapy did not provide a survival benefit in this study after matching for the mKadish stage and nodal status. Conclusion . Clinical staging and pathologic grading are important prognostic factors in ONB. Dural resection in mKadish A and B did not show a significant survival benefit. Similarly, induction chemotherapy also did not show a survival benefit, even after stage matching.

The Korean Society of Otorhinolaryngology-Head and Neck Surgery and Korean Rhinologic Society appointed a guideline development group (GDG) to establish a clinical practice guideline, and the GDG developed a guideline for nasal irrigation for adult patients with chronic rhinosinusitis (CRS). The guideline focuses on knowledge gaps, practice variations, and clinical concerns associated with nasal irrigation. Nasal irrigation has been recommended as the first-line treatment for CRS in various guidelines, and its clinical effectiveness has been demonstrated through a number of studies with robust evidence. However, no guidelines have presented a consistent nasal irrigation method. Several databases, including OVID Medline, Embase, the Cochrane Library, and KoreaMed, were searched to identify all relevant papers using a predefined search strategy. When insufficient evidence was found, the GDG sought expert opinions and attempted to fill the evidence gap. Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. The committee developed 11 evidence-based recommendations. This guideline focuses on the evidence-based quality improvement opportunities deemed the most important by the GDG. Moreover, the guideline addresses whether nasal lavage helps treat CRS, what type of rinsing solution should be used, and the effectiveness of using additional medications to increase the therapeutic effect.

Objectives: . In extracorporeal septoplasty (ECS), the entire septal cartilage is harvested, and a neo-L strut is built extracorporeally. Thus, ECS can simultaneously achieve septum straightening and tip projection. This study evaluated the functional and esthetic outcomes of the ECS technique for rhinoplasty in Asian patients. Methods: . We conducted a retrospective review of 64 patients who underwent rhinoplasty using ECS between January 2016 and March 2018. Subjective patient satisfaction was assessed and objective surgical outcomes were evaluated. Improvement in nasal obstruction was rated using a visual analog scale (VAS). Anthropometric changes were compared between preoperative and postoperative facial photographs. Complications and revisions were also analyzed. Results: . The participants comprised 64 patients (48 males and 16 females, with a mean age of 29.3 years). The mean operative time was 89.3 minutes. In total, 61 patients were satisfied with the esthetic outcome, and the overall objective rhinoplasty outcome score was 3.45. Preoperative nasal obstruction symptoms (7.9±1.2 on VAS) improved postoperatively (3.1±1.3, P<0.001), and significant improvements were also observed in the nasofrontal angle (152.3° to 148.1°, P<0.001), nasolabial angle (88.8° to 92.0°, P<0.001), and nasal tip projection (0.62 to 0.66, P<0.033). Recurrent deviation of the nasal septum and external nose or tip deprojection did not occur in any patients, and there were no cases of revision during the mean follow-up period of 13.3 months. Conclusion . ECS might be an esthetically and functionally satisfactory alternative rhinoplasty technique for Asian patients with a shortage of septal cartilage.

Objectives: The objective of this study was to develop models for predicting obstructive sleep apnea (OSA) based on easily obtainable clinical information of patients using various machine learning techniques. Methods: We used a data set that included the records of 1,368 patients, in which 1,074 patients were male (78.5 %), and 294 patients were female (21.5 %). We randomly divided the data into a training set (1,000) and test set (368). Five machine learning methods, i.e., support vector machine model, lasso logit model, naïve bayes, discriminant analysis, and K-nearest neighbor (KNN), with a 10-cross fold technique were used with the proposed model to predict OSA. We evaluated the accuracy, sensitivity, specificity, and precision of each model for three thresholds [Apnea-Hypopnea Index (AHI)≥5, AHI≥15, and AHI≥30]. Results: Among the machine learning techniques, KNN showed the best results compared to the other techniques. The accuracy, sensitivity, specificity, and precision of OSA prediction were 87.0%, 91.0%, 74.4%, and 91.9%, respectively, based on AHI≥5. When the threshold of OSA was AHI≥15 or AHI≥30, KNN provided lower accuracy (79.6% each) and precision (79.0% and 68.7%), which were still higher than those of the other techniques. Conclusions The model derived from the KNN technique exhibited the best performance based on its highest level of accuracy. We demonstrate that this model is a useful tool for predicting OSA.

Background and Objectives: The purposes of this study were to compare the purchase rate and adherence regarding the use of two machines, continuous positive airway pressure (CPAP) and automatic positive airway pressure (APAP), and to determine associated factors affecting the purchase rate and adherence of PAP in the treatment of severe obstructive sleep apnea (OSA).Subjects and Method From March 2016 to December 2017, 45 patients diagnosed with severe OSA by polysomnography were enrolled in this study. Patients were prescribed CPAP or APAP by one doctor and allowed to decide whether to purchase the machine after a one-month lease period, which was identified as the purchase rate. Adherence was identified as using the machine 4 hight on 70% of nights following the PAP therapy of three months. Results: The adherence rate of CPAP (84%) was statistically and significantly higher than APAP (55%) (p=0.033). However, there was no significant difference in the adherence rate between CPAP (76%) and APAP (63%). The mean pressure and 95th percentile leak were 8.62 cm H2O and 12.97 L/min in the CPAP and 10.55 cm H2O and 20.36 L/min in the APAP, respectively. The mean pressure and 95th percentile leak were significantly lower in CPAP than in APAP (p=0.010 and p=0.014, respectively). Conclusion Although adherence was not significantly different, the purchase rate was significantly higher in the fixed CPAP than in APAP, which may have been influenced by high pressure and leak patients experienced when using the particular PAP machine.

Objectives: The objective of this study was to develop models for predicting obstructive sleep apnea (OSA) based on easily obtainable clinical information of patients using various machine learning techniques. Methods: We used a data set that included the records of 1,368 patients, in which 1,074 patients were male (78.5 %), and 294 patients were female (21.5 %). We randomly divided the data into a training set (1,000) and test set (368). Five machine learning methods, i.e., support vector machine model, lasso logit model, naïve bayes, discriminant analysis, and K-nearest neighbor (KNN), with a 10-cross fold technique were used with the proposed model to predict OSA. We evaluated the accuracy, sensitivity, specificity, and precision of each model for three thresholds [Apnea-Hypopnea Index (AHI)≥5, AHI≥15, and AHI≥30]. Results: Among the machine learning techniques, KNN showed the best results compared to the other techniques. The accuracy, sensitivity, specificity, and precision of OSA prediction were 87.0%, 91.0%, 74.4%, and 91.9%, respectively, based on AHI≥5. When the threshold of OSA was AHI≥15 or AHI≥30, KNN provided lower accuracy (79.6% each) and precision (79.0% and 68.7%), which were still higher than those of the other techniques. Conclusions The model derived from the KNN technique exhibited the best performance based on its highest level of accuracy. We demonstrate that this model is a useful tool for predicting OSA.