Daniel M. Beswick

Key Points Individual sinus opacification (ISO) is measurable via a convolutional neural network approach. ISO decreased through 2 years after highly effective modulator therapy was initiated. In adults with cystic fibrosis, ISO did not correlate with quality of life or olfaction.

Background The impact of sinonasal malignancies (SNMs) on quality of life (QOL) at presentation is poorly understood. The Sinonasal Outcome Test (SNOT‐22) and University of Washington Quality of Life (UWQOL) are validated QOL instruments with distinctive subdomains. This study aims to identify factors impacting pretreatment QOL in SNM patients to personalize multidisciplinary management and counseling. Methods Patients with previously untreated SNMs were prospectively enrolled (2015–2022) in a multicenter observational study. Baseline pretreatment QOL instruments (SNOT‐22, UWQOL) were obtained along with demographics, comorbidities, histopathology/staging, tumor involvement, and symptoms. Multivariable regression models identified factors associated with reduced baseline QOL. Results Among 204 patients, presenting baseline QOL was significantly reduced. Multivariable regression showed worse total SNOT‐22 QOL in patients with skull base erosion ( p = 0.02). SNOT‐rhinologic QOL was worse in women ( p = 0.009), patients with epistaxis ( p = 0.036), and industrial exposure ( p = 0.005). SNOT extranasal QOL was worse in patients with industrial exposure ( p = 0.016); worse SNOT ear/facial QOL if perineural invasion (PNI) ( p = 0.027). Squamous cell carcinoma pathology ( p = 0.037), palate involvement ( p = 0.012), and pain ( p = 0.017) were associated with worse SNOT sleep QOL scores. SNOT psychological subdomain scores were significantly worse in patients with palate lesions ( p = 0.022), skull base erosion ( p = 0.025), and T1 staging ( p = 0.023). Low QOL was more likely in the presence of PNI on UW health ( p = 0.019) and orbital erosion on UW overall ( p = 0.03). UW social QOL was worse if palatal involvement ( p = 0.023) or PNI ( p = 0.005). Conclusions Our findings demonstrate a negative impact on baseline QOL in patients with SNMs and suggest sex‐specific and symptom‐related lower QOL scores, with minimal histopathology association. Anatomical tumor involvement may be more reflective of QOL than T‐staging, as orbital and skull base erosion, PNI, and palate lesions are significantly associated with reduced baseline QOL.

Background Poor air quality increases the risk of developing chronic rhinosinusitis (CRS) and other airway diseases. However, there are limited data on air pollutants and CRS‐specific disease severity. We assessed the impact of air pollutants on sinonasal‐specific and general quality‐of‐life (QOL) measures in a multi‐institutional cohort of patients with CRS. Methods Participants with CRS were prospectively enrolled in a cross‐sectional study and self‐selected continued appropriate medical therapy or endoscopic sinus surgery (ESS). The 22‐item SinoNasal Outcome Test (SNOT‐22) and Medical Outcomes Study Questionnaire Short‐Form 6‐D (SF‐6D) health utility value scores were recorded. Patient exposure to air pollutants was determined using residence zip codes. Unadjusted group differences were compared, and correlation coefficients were evaluated to identify the magnitude of bivariate association. Results A total of 486 patients were enrolled and followed for a mean of 6.9 (standard deviation [SD] ± 2.3) months. Pollutant exposure did not significantly correlate with baseline SNOT‐22 or SF‐6D scores. Revision ESS was associated with higher median fine particulate matter (PM2.5; Δ = 0.12, [95% confidence interval {CI}: 0.003, 0.234]; p = 0.006) compared with primary surgery. PM2.5, PM10, and nitrogen dioxide concentrations (μg/m 3 ) did not correlate with change in total SNOT‐22 or SF‐6D scores after treatment. Nevertheless, sulfur dioxide (SNOT‐22: ρ = –0.121 [95% CI: –0.210, –0.030]; p = 0.007; SF‐6D: ρ = 0.095 [95% CI: 0.002, 0.186]; p = 0.04) and carbon monoxide (SNOT‐22: ρ = ‐0.141 [95% CI: –0.230, 0.050]; p = 0.002) exposure did correlate with these outcome measures. Conclusion Air pollutants may contribute, at least in part, to disease severity in CRS; future investigation is needed to further elucidate the nature of this relationship.