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ICON: chronic rhinosinusitis

Claus Bachert, Ruby Pawankar, Luo Zhang and 13 more

World Allergy Organization Journal · 2014 · CC BY-NC-ND

doi:10.1186/1939-4551-7-25

Abstract

Chronic rhinosinusitis (CRS) is a public health problem that has a significant socio-economic impact. Moreover, the complexity of this disease due to its heterogeneous nature based on the underlying pathophysiology - leading to different disease variants - further complicates our understanding and directions for the most appropriate targeted treatment strategies. Several International/national guidelines/position papers and/or consensus documents are available that present the current knowledge and treatment strategies for CRS. Yet there are many challenges to the management of CRS especially in the case of the more severe and refractory forms of disease. Therefore, the International Collaboration in Asthma, Allergy and Immunology (iCAALL), a collaboration between EAACI, AAAAI, ACAAI, and WAO, has decided to propose an International Consensus (ICON) on Chronic Rhinosinusitis. The purpose of this ICON on CRS is to highlight the key common messages from the existing guidelines, the differences in recommendations as well as the gaps in our current knowledge of CRS, thus providing a concise reference. In this document we discuss the definition of the disease, its relevance, pharmacoeconomics, pathophysiology, phenotypes and endotypes, genetics and risk factors, natural history and co-morbidities as well as clinical manifestations and treatment options in both adults and children comprising pharmacotherapy, surgical interventions and more recent biological approaches. Finally, we have also highlighted the unmet needs that wait to be addressed through future research.

Shown for reading. Its publisher allows quoting it, not republishing it.

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    Not in our library10.1016/j.otohns.2009.07.011

  84. 84.

    Van Bruaene N, Derycke L, Perez-Novo CA, Gevaert P, Holtappels G, De Ruyck N, Cuvelier C, Van Cauwenberge P, Bachert C. TGF-β signaling and collagen deposition in chronic rhinosinusitis. J Allergy Clin Immunol. 2009;124:253-259.

    Not in our library10.1016/j.jaci.2009.04.013

  85. 85.

    Van Bruaene N, Perez Novo C, Deruyck N, Holtappels G, Van Cauwenberge P, Bachert C. Inflammation and remodeling patterns in early-stage chronic rhinosinusitis. Clin Exp Allergy. 2012;42:883-890.

    Not in our library10.1111/j.1365-2222.2011.03898.x

  86. 86.

    Yang YC, Zhang N, Van Crombruggen K, Hu GU, Hong SL, Bachert C. Transforming growth factor beta1 in inflammatory airway disease: A key for understanding inflammation and remodeling. Allergy. 2012;67:1193-1202.

    Not in our library10.1111/j.1398-9995.2012.02880.x

  87. 87.

    Li X, Meng J, Liu F, Zhang N, Zhang J, Holtappels G, Ba L, Zhou P, Zheng Y, Liu S, Lin P, Bachert C. Expression of transforming growth factor-β, matrix metalloproteinases and tissue inhibitors of matrix metalloproteinases in Chinese chronic rhinosinusitis patients with and without nasal polyps. J Allergy Clin Immunol. 2010;125:1061-1068.

    Not in our library10.1016/j.jaci.2010.02.023

  88. 88.

    De Borja Callejas F, Picado C, Martínez-Antón A, Alobid I, Pujols L, Valero A, Roca-Ferrer J, Mullol J. Differential expression of remodeling markers by tissue structure in nasal polyposis. Am J Rhinol Allergy. 2013;27(3):e69-e74.

    Not in our library10.2500/ajra.2013.27.3908

  89. 89.

    Sejima T, Holtappels G, Bachert C. The expression of fibrinolytic components in chronic paranasal sinus disease. Am J Rhinol Allergy. 2011;25:1-6.

    Not in our library10.2500/ajra.2011.25.3537

  90. 90.

    Takabayashi T, Kato A, Peters AT, Hulse KE, Suh LA, Carter R, Norton J, Grammer LC, Cho SH, Tan BK, Chandra RK, Conley DB, Kern RC, Fujieda S, Schleimer RP. Excessive fibrin deposition in nasal polyps caused by fibrinolytic impairment through reduction of tissue plasminogen activator expression. Am J Respir Crit Care Med. 2013;187(1):49-57.

    Not in our library10.1164/rccm.201207-1292oc

  91. 91.

    Huvenne W, Nan Z, Tijsma E, Hissong B, Huurdeman J, Holtappels G, Claeys S, Van Cauwenberge P, Nelis H, Coenye T, Bachert C. A pilot study using doxycycline-releasing stents to ameliorate postoperative healing quality after sinus surgery. Wound Repair Reg. 2008;16:757-767.

    Not in our library10.1111/j.1524-475x.2008.00429.x

  92. 92.

    Van Zele T, Gevaert P, Holtappels G, Beule A, Wormald PJ, Mayr S, Hens G, Hellings P, Ebbens FA, Fokkens W, Van Cauwenberge P, Bachert C. Oral steroids and doxycycline in nasal polyps: two different approaches to treat nasal polyps. J Allergy Clin Immunol. 2010;125:1069-1076.

    Not in our library10.1016/j.jaci.2010.02.020

  93. 93.

    Bassiouni A, Chen PG, Wormald PJ. Mucosal remodeling and reversibility in chronic rhinosinusitis. Curr Opin Allergy Clin Immunol. 2013;13:4-12.

    Not in our library10.1097/aci.0b013e32835ad09e

  94. 94.

    Cutting GR. Modifier genetics: cystic fibrosis. Annu Rev Genomics Hum Genet. 2005;6:237-260.

    Not in our library10.1146/annurev.genom.6.080604.162254

  95. 95.

    Antunes MB, Gudis DA, Cohen NA. Epithelium, cilia, and mucus: their importance in chronic rhinosinusitis. Immunol Allergy Clin North Am. 2009;29(4):631-643.

    Not in our library10.1016/j.iac.2009.07.004

  96. 96.

    Chen B, Antunes MB, Claire SE, Palmer JN, Chiu AG, Kennedy DW, Cohen NA. Reversal of chronic rhinosinusitis-associated sinonasal ciliary dysfunction. Am J Rhinol. 2007;21(3):346-353.

    Not in our library10.2500/ajr.2007.21.3029

  97. 97.

    Saito D, Innes A, Pletcher S. Rheologic properties of sinonasal mucus in patients with chronic sinusitis. Am J Rhinol Allergy. 2010;24(1):1-5.

    Not in our library10.2500/ajra.2010.24.3420

  98. 98.

    Zuckerman JD, Lee WY, DelGaudio JM, Moore CE, Nava P, Nusrat A, Parkos CA. Pathophysiology of nasal polyposis: the role of desmosomal junctions. Am J Rhinol. 2008;22(6):589-597.

    Not in our library10.2500/ajr.2008.22.3235

  99. 99.

    Rogers G, Beste KEH, Parkos CA, Nusrat A, DelGaudio JM, Wise SK. Epithelial tight junction alterations in nasal polyposis. Internat Forum Allergy Rhinolo. 2011;1(1):50-54.

    Not in our library10.1002/alr.20014

  100. 100.

    Soyka MB, Wawrzyniak P, Eiwegger T, Holzmann D, Treis A, Wanke K, Kast JI, Akdis CA. Defective epithelial barrier in chronic rhinosinusitis: The regulation of tight junctions by IFN-γ and IL-4. J Allergy Clin Immunol. 2012;130(5):1087-1096.

    Not in our library10.1016/j.jaci.2012.05.052

  101. 101.

    Den Beste KA, Hoddeson EK, Parkos CA, Nusrat A, Wise SK. Epithelial permeability alterations in an in vitro air-liquid interface model of allergic fungal rhinosinusitis. Internat Forum Allergy Rhinol. 2013;3(1):19-25.

    Not in our library10.1002/alr.21077

  102. 102.

    Richer SL, Truong-Tran AQ, Conley DB, Carter R, Vermylen D, Grammer LC, Peters AT, Chandra R, Harris K, Kern R, Schleimer R. Epithelial genes in chronic rhinosinusitis with and without nasal polyps. Am J Rhinol. 2008;22(3):228-234.

    Not in our library10.2500/ajr.2008.22.3162

  103. 103.

    Fruth K, Goeble G, Koutsimpelas D, Gosepath J, Schmidtmann I, Mann WJ, Brieger J. Low SPINK5 Expression in Chronic Rhinosinusitis. Laryngoscope. 2012;122:1198-1204.

    Not in our library10.1002/lary.23300

  104. 104.

    Sha Q, Truong-Tran AQ, Plitt JR, Beck LA, Schleimer RP. Activation of airway epithelial cells by toll-like receptor agonists. Am J Respir Cell Mol Biol. 2004;31(3):358-364.

    Not in our library10.1165/rcmb.2003-0388oc

  105. 105.

    Kato A, Schleimer RP. Beyond inflammation: airway epithelial cells are at the interface of innate and adaptive immunity. Curr Opin Immunol. 2007;19(6):711-720.

    Not in our library10.1016/j.coi.2007.08.004

  106. 106.

    Matzinger P. danger model: a renewed sense of self. Science. 2002;12;296(5566):301-305.

    Not in our library10.1126/science.1071059

  107. 107.

    Bianchi ME, Manfredi AA. Immunology. Dangers in and out. Science. 2009;27;323(5922):1683-1684.

    Not in our library10.1126/science.1172794

  108. 108.

    Lane AP, Truong-Tran QA, Schleimer RP. Altered expression of genes associated with innate immunity and inflammation in recalcitrant rhinosinusitis with polyps. Am J Rhinol. 2006;20(2):138-144.

    Not in our library

  109. 109.

    Dong Z, Yang Z, Wang C. Expression of TLR2 and TLR4 messenger RNA in the epithelial cells of the nasal airway. Am J Rhinol. 2005;19(3):236-239.

    Not in our library

  110. 110.

    Claeys S, Van Hoecke H, Holtappels G, Gevaert P, De Belder T, Verhasselt B, Van Cauwenberge P, Bachert C. Nasal polyps in patients with and without cystic fibrosis: a differentiation by innate markers and inflammatory mediators. Clin Exp Allergy. 2005;35(4):467-472.

    Not in our library10.1111/j.1365-2222.2005.02215.x

  111. 111.

    Ramanathan M, Lee WK, Dubin MG, Lin S, Spannhake EW, Lane AP. Sinonasal epithelial cell expression of toll-like receptor 9 is decreased in chronic rhinosinusitis with polyps. Am J Rhinol. 2007;21(1):110-116.

    Not in our library10.2500/ajr.2007.21.2997

  112. 112.

    Lee RJ, Xiong G, Kofonow JM, Chen B, Lysenko A, Jiang P, Abraham V, Doghramji L, Adappa ND, Palmer JN, Kennedy DW, Beauchamp GK, Doulias PT, Ischiropoulos H, Kreindler JL, Reed DR, Cohen NA. T2R38 taste receptor polymorphisms underlie susceptibility to upper respiratory infection. J Clin Invest. 2012;122(11):4145-4159.

    Not in our library10.1172/jci64240

  113. 113.

    Adadppa ND, Howland TJ, Palmer JN, Kennedy DW, Doghramji L, Lysenko A, Reed DR, Lee RJ, Cohen NA. Genetics of the taste receptor T2R38 correlates with chronic rhinosinusitis necessitating surgical intervention. Int Forum Allergy Rhinol. 2013;3(3):184-187.

    Not in our library10.1002/alr.21140

  114. 114.

    Avila PC, Schleimer RP, Kay AB, Kaplan AP, Bousquet J, Holt PG. Airway Epithelium. Allergy and allergic diseases. 2008.

    Not in our library

  115. 115.

    Ooi EH, Psaltis AJ, Witterick IJ, Wormald PJ. Innate immunity. Otolaryngol Clin North Am. 2010;43(3):473-487.

    Not in our library10.1016/j.otc.2010.02.020

  116. 116.

    Laudien M, Dressel S, Harder J, Glaser R. Differential expression pattern of antimicrobial peptides in nasal mucosa and secretion. Rhinology. 2011;49(1):107-111.

    Not in our library10.4193/rhino10.036

  117. 117.

    Wolk K, Kunz S, Witte E, Friedrich M, Asadullah K, Sabat R. IL-22 increases the innate immunity of tissues. Immunity. 2004;21(2):241-254.

    Not in our library10.1016/j.immuni.2004.07.007

  118. 118.

    Wolk K, Witte E, Wallace E, Docke WD, Kunz S, Asadullah K, Volk HD, Sterry W, Sabat R. IL-22 regulates the expression of genes responsible for antimicrobial defense, cellular differentiation, and mobility in keratinocytes: a potential role in psoriasis. Eur J Immunol. 2006;36(5):1309-1323.

    Not in our library10.1002/eji.200535503

  119. 119.

    Pickert G, Neufert C, Leppkes M, Zheng Y, Wittkopf N, Warntjen M, Lehr HA, Hirth S, Weigmann B, Wirtz S, Ouyang W, Neurath MF, Becker C. STAT3 links IL-22 signaling in intestinal epithelial cells to mucosal wound healing. J Exp Med. 2009;206(7):1465-1472.

    Not in our library10.1084/jem.20082683

  120. 120.

    Aujla SJ, Chan YR, Zheng M, Fei M, Askew DJ, Pociask DA, Reinhart TA, McAllister F, Edeal J, Gaus K, Husain S, Kreindler JL, Dubin PJ, Pilewski JM, Myerburg MM, Mason CA, Iwakura Y, Kolls JK. IL-22 mediates mucosal host defense against Gram-negative bacterial pneumonia. Nat Med. 2008;14(3):275-281.

    Not in our library10.1038/nm1710

  121. 121.

    Hulse K, Norton J, Harris K, Conley D, Chandra R, Kern R, Peters A, Grammer L, Cohen E, Singh R, Carter R, Suh L, Schleimer R: Epithelial STAT3 activation is associated with expression of the antimicrobial peptide S100A7. J Immunol. 2010, 184 (14):

    Not in our library

  122. 122.

    Aujla SJ, Kolls JK. IL-22: a critical mediator in mucosal host defense. J Mol Med. 2009;87(5):451-454.

    Not in our library10.1007/s00109-009-0448-1

  123. 123.

    Psaltis AJ, Weitzel EK, Ha KR, Wormald PJ. The effect of bacterial biofilms on post-sinus surgical outcomes. Am J Rhinol. 2008;22(1):1-6.

    Not in our library10.2500/ajr.2008.22.3119

  124. 124.

    Psaltis AJ, Bruhn MA, Ooi EH, Tan LW, Wormald PJ. Nasal mucosa expression of lactoferrin in patients with chronic rhinosinusitis. Laryngoscope. 2007;117(11):2030-2035.

    Not in our library10.1097/mlg.0b013e31812e01ab

  125. 125.

    Tieu DD, Peters AT, Carter RG, Suh L, Conley DB, Chandra R, Norton J, Grammer LC, Harris KE, Kato A, Kern RC, Schleimer RP. Evidence for diminished levels of epithelial psoriasin and calprotectin in chronic rhinosinusitis. J Allergy Clin Immunol. 2010;125(3):667-675.

    Not in our library10.1016/j.jaci.2009.11.045

  126. 126.

    Meyer JE, Harder J, Sipos B, Maune S, Kloppel G, Bartels J, Schröder JM, Gläser R. Psoriasin (S100A7) is a principal antimicrobial peptide of the human tongue. Mucosal Immunol. 2008;1(3):239-243.

    Not in our library10.1038/mi.2008.3

  127. 127.

    Seshadri S, Rosati M, Lin D, Carter J, Norton JE, Kato A, Chandra RK, Harris KE, Chu HW, Peters AT, Tan BK, Conley DB, Grammer LC, Kern RC, Schleimer RP. Reduced expression of antimicrobial palate, lung and nasal epithelial clone (PLUNC) protein in polyps from patients with chronic rhinosinusitis is due to decreased number of glands. J Allergy Clin Immunol. 2011;127(2):AB141.

    Not in our library10.1016/j.jaci.2010.12.559

  128. 128.

    Ramanathan M, Spannhake EW, Lane AP. Chronic rhinosinusitis with nasal polyps is associated with decreased expression of mucosal interleukin 22 receptor. Laryngoscope. 2007;117(10):1839-1843.

    Not in our library10.1097/mlg.0b013e31811edd4f

  129. 129.

    Peters AT, Kato A, Zhang N, Conley DB, Suh L, Tancowny B, Carter D, Carr T, Radtke M, Hulse KE, Seshadri S, Chandra R, Grammer LC, Harris KE, Kern R, Schleimer RP. Evidence for altered activity of the IL-6 pathway in chronic rhinosinusitis with nasal polyps. J Allergy Clin Immunol. 2010;125(2):397-403.

    Not in our library10.1016/j.jaci.2009.10.072

  130. 130.

    Tieu DD, Kern RC, Schleimer RP. Alterations in epithelial barrier function and host defense responses in chronic rhinosinusitis. J Allergy Clin Immunol. 2009;124(1):37-42.

    Not in our library10.1016/j.jaci.2009.04.045

  131. 131.

    Vroling AB, Fokkens WJ, Van Drunen CM. How epithelial cells detect danger: aiding the immune response. Allergy. 2008;63(9):1110-1123.

    Not in our library10.1111/j.1398-9995.2008.01785.x

  132. 132.

    Kowalski ML, Lewandowska-Polak A, Wozniak J, Ptasinska A, Jankowski A, Wagrowska-Danilewicz M, Pawliczak R. Association of stem cell factor expression in nasal polyp epithelial cells with aspirin sensitivity and asthma. Allergy. 2005;60(5):631-637.

    Not in our library10.1111/j.1398-9995.2005.00753.x

  133. 133.

    Nishi Y, Takeno S, Ishino T, Hirakawa K. Glucocorticoids suppress NF-kappaB activation induced by LPS and PGN in paranasal sinus epithelial cells. Rhinology. 2009;47(4):413-418.

    Not in our library10.4193/rhin08.074

  134. 134.

    Kato A, Peters A, Suh L, Carter R, Harris KE, Chandra R, Conley D, Grammer LC, Kern R, Schleimer RP. Evidence of a role for B cell-activating factor of the TNF family in the pathogenesis of chronic rhinosinusitis with nasal polyps. J Allergy Clin Immunol. 2008;121(6):1385-1392.

    Not in our library10.1016/j.jaci.2008.03.002

  135. 135.

    Lu X, Zhang XH, Wang H, Long XB, You XJ, Gao QX, Cui YH, Lui Z. Expression of osteopontin in chronic rhinosinusitis with and without nasal polyps. Allergy. 2009;64(1):104-111.

    Not in our library10.1111/j.1398-9995.2008.01829.x

  136. 136.

    Keswani A, Chustz RT, Suh L, Carter R, Peters AT, Tan BK, Chandra R, Kim SH, Azam T, Dinarello CA, Kern RC, Schleimer RP Kato A. Differential expression of interleukin-32 in chronic rhinosinusitis with and without nasal polyps. Allergy. 2012;67(1):25-32.

    Not in our library10.1111/j.1398-9995.2011.02706.x

  137. 137.

    Lambrecht BN, Hammad H. The airway epithelium in asthma. Nature Medicine. 2012;18(5):684-692.

    Not in our library10.1038/nm.2737

  138. 138.

    Sanos S, Diefenbach A. Innate lymphoid cells: from border protection to the initiation of inflammatory diseases. Immunol Cell Biol. 2013;91:215-224.

    Not in our library10.1038/icb.2013.3

  139. 139.

    Hansel TT, Johnston SL, Openshaw PJ. Microbes and mucosal immune responses in asthma. Lancet. 2013;381:861-873.

    Not in our library10.1016/s0140-6736(12)62202-8

  140. 140.

    Mjoesberg J, Trifari S, Crellin NK, Peters CP, Van Drunen CM, Piet B, Fokkens W, Cupedo T, Spits H. Human IL-25- and IL-33-responsive type 2 innate lymphoid cells are defined by expression of CRTH2 and CD161. Nature Immunology. 2011;12:1055-1062.

    Not in our library10.1038/ni.2104

  141. 141.

    Allakhverdi Z, Comeau MR, Smith DE, Toy D, Endam LM, Desrosiers M, Liu YJ, Howie KJ, Denburg JA, Gauvreau GM, Delespesse G. CD34+ hemopoietic progenitor cells are potent effectors of allergic inflammation. J Allergy Clin Immunol. 2009;123(2):472-478.

    Not in our library10.1016/j.jaci.2008.10.022

  142. 142.

    Nonaka M, Fukumoto A, Ogihara N, Sakanushi A, Pawankar R, Yagi T. Synergistic induction of thymic stromal lymphopoietin by tumor necrosis factor alpha and Th2 cytokine in nasal polyp fibroblasts. Am J Rhinol Allergy. 2010;24(1):e14-e18.

    Not in our library10.2500/ajra.2010.24.3436

  143. 143.

    Liu T, Li TL, Zhao F, Xie C, Liu AM, Chen X, Song C, Cheng L, Yang PC. Role of thymic stromal lymphopoietin in the pathogenesis of nasal polyposis. Am J Med Sci. 2011;341(1):40-47.

    Not in our library10.1097/maj.0b013e3181f20489

  144. 144.

    Kimura S, Pawankar R, Mori S, Nonaka M, Masuno S, Yagi T, Okubo K. Increased expression and role of thymic stromal lymphopoietin in nasal polyposis. Allergy Asthma Immunol Res. 2011;3(3):186-193.

    Not in our library10.4168/aair.2011.3.3.186

  145. 145.

    Nagarkar DR, Poposki JA, Tan BK, Comeau MR, Peters AT, Hulse K, Suh LA, Norton J, Harris KE, Grammer LC, Chandra RK, Conley DB, Kern RC, Schleimer RP, Kato A. Increased activity of thymic stromal lymphopoietin in nasal polyps of patients with chronic rhinosinusitis. J Allergy Clin Immunol. 2013;132(3):593-600.e12.

    Not in our library10.1016/j.jaci.2013.04.005

  146. 146.

    Reh DD, Wang Y, Ramanathan M, Lane AP. Treatment-recalcitrant chronic rhinosinusitis with polyps is associated with altered epithelial cell expression of interleukin-33. Am J Rhinol Allergy. 2010;24(2):105-109.

    Not in our library10.2500/ajra.2010.24.3446

  147. 147.

    Schleimer R, Kato A, Kern RC. “Eosinophils in CRS”. Eosinoph Health Dis. 2011.

    Not in our library

  148. 148.

    Takabayashi T, Kato A, Peters AT, Suh LA, Carter R, Norton J, Grammer LC, Tan BK, Chandra RK, Conley DB, Kern RC, Fujieda S, Schleimer RP. Glandular mast cells with distinct phenotype are highly elevated in chronic rhinosinusitis with nasal polyps. J Allergy Clin Immunol. 2012;130(2):410-20.e5.

    Not in our library10.1016/j.jaci.2012.02.046

  149. 149.

    Krysko O, Holtappels G, Zhang N, Kubica M, Deswarte K, Derycke L, Claeys S, Hammad H, Brusselle GG, Vandenabeele P, Krysko DV, Bachert C. Alternatively activated macrophages and impaired phagocytosis of S. aureus in chronic rhinosinusitis. Allergy. 2011;66(3):396-403.

    Not in our library10.1111/j.1398-9995.2010.02498.x

  150. 150.

    Lundberg JO, Farkas-Szallasi T, Weitzberg E, Rinder J, Lidholm J, Anggaard A, Hökfelt T, Lundberg JM, Alving K. High nitric oxide production in human paranasal sinuses. Nat Med. 1995;1(4):370-373.

    Not in our library10.1038/nm0495-370

  151. 151.

    Moskwa P, Lorentzen D, Excoffon KJ, Zabner J, McCray PB, Nauseef WM, Dupuy C, Bánfi B. A novel host defense system of airways is defective in cystic fibrosis. Am J Respir Crit Care Med. 2007;175(2):174-183.

    Not in our library10.1164/rccm.200607-1029oc

  152. 152.

    Colantonio D, Brouillette L, Parikh A, Scadding GK. Paradoxical low nasal nitric oxide in nasal polyposis. Clin Exp Allergy. 2002;32(5):698-701.

    Not in our library10.1046/j.1365-2222.2002.01379.x

  153. 153.

    Ragab SM, Lund VJ, Saleh HA, Scadding G. Nasal nitric oxide in objective evaluation of chronic rhinosinusitis therapy. Allergy. 2006;61(6):717-724.

    Not in our library10.1111/j.1398-9995.2006.01044.x

  154. 154.

    Phillips PS, Sacks R, Marcells GN, Cohen NA, Harvey RJ. Nasal nitric oxide and sinonasal disease: a systematic review of published evidence. Otolaryngol Head Neck Surg. 2011;144(2):159-169.

    Not in our library10.1177/0194599810392667

  155. 155.

    Roca-Ferrer J, Garcia-Garcia FJ, Pereda J, Perez-Gonzalez M, Pujols L, Alobid I, Mullol J, Picado C. Reduced expression of COXs and production of prostaglandin E(2) in patients with nasal polyps with or without aspirin-intolerant asthma. J Allergy Clin Immunol. 2011;128(1):66-72 e1.

    Not in our library10.1016/j.jaci.2011.01.065

  156. 156.

    Van Crombruggen K, Zhang N, Gevaert P, Tomassen P, Bachert C. Pathogenesis of chronic rhinosinusitis: Inflammation. J Allergy Clin Immunol. 2011;128(4):728-732.

    Not in our library10.1016/j.jaci.2011.07.049

  157. 157.

    Chandra RK, Lin D, Tan B, Tudor RS, Conley DB, Peters AT, Grammer LC, Schleimer RP, Kern RC. Chronic rhinosinusitis in the setting of other chronic inflammatory diseases. Am J Otolaryngol. 2011;32(5):388-391.

    Not in our library10.1016/j.amjoto.2010.07.013

  158. 158.

    Kern RC, Conley DB, Walsh W, Chandra R, Kato A, Tripathi-Peters A, Grammer LC, Schleimer RP. Perspectives on the etiology of chronic rhinosinusitis: an immune barrier hypothesis. Am J Rhinol. 2008;22(6):549-559.

    Not in our library10.2500/ajr.2008.22.3228

  159. 159.

    Van Zele T, Claeys S, Gevaert P, Holtappels G, Van Cauwenberge P, Bachert C. Differen-tiation of chronic sinus diseases by measurement of inflammatory mediators. Allergy. 2006;61:1280-1289.

    Not in our library10.1111/j.1398-9995.2006.01225.x

  160. 160.

    Van Zhang Nan T, Zele CP-N, Van Bruaene N, Holtappels G, DeRuyck N, Van Cauwenberge P, Bachert C. Different types of T effector cells orchestrate mucosal inflammation in chronic sinus disease. J Allergy Clin Immunol. 2008;122(5):961-968.

    Not in our library10.1016/j.jaci.2008.07.008

  161. 161.

    Derycke L, Zhang N, Holtappels G, Dutré T, Bachert C. IL-17A as a regulator of neutrophil survival in nasal polyp disease of patients with and without cystic fibrosis. J Cyst Fibros. 2012;11:193-200.

    Not in our library10.1016/j.jcf.2011.11.007

  162. 162.

    Bachert C, Nan Z, Gabriele H, Lizzi De L, Cauwenberge P c, Liu S, Ping L, Jean B, Van Steen K. Presence of IL-5 protein and IgE-antibodies to staphylococcal enterotoxins in nasal polyps is associated with co-morbid asthma. J Allergy Clin Immunol. 2010;126:962-968.

    Not in our library10.1016/j.jaci.2010.07.007

  163. 163.

    Ba L, Zhang N, Lin P, Liu S, Bachert C. Bacterial colonization is associated with different inflammatory pattern in rhinosinusitis with nasal polyps. Allergy. 2011;66:1296-1303.

    Not in our library10.1111/j.1398-9995.2011.02637.x

  164. 164.

    Van Bruaene N, Perez-Novo C, Basinski T, Van Zele T, Holtappels G, Schmidt-Weber C, Akdis C, Van Cauwenberge PC, Gevaert P. T cell regulation in chronic paranasal sinus disease. J Allergy Clin Immunol. 2008;121:1435-1441.

    Not in our library10.1016/j.jaci.2008.02.018

  165. 165.

    Roongrotwattanasiri K, Pawankar R, Kimura S, Mori S, Nonaka M, Yagi T. Decreased Expression of FOXP3 in Nasal Polyposis. Allergy Asthma Immunol Res. 2012;4:24-30.

    Not in our library10.4168/aair.2012.4.1.24

  166. 166.

    Kim YM, Munoz A, Hwang PH, Nadeau KC. Migration of regulatory T cells toward airway epithelial cells is impaired in chronic rhinosinusitis with nasal polyposis. Clin Immunol. 2010;137(1):111-121.

    Not in our library10.1016/j.clim.2010.05.013

  167. 167.

    Feng L, Zhang N, Zhang J, Krysko O, Zhang Q, Xian J, Derycke L, Qi Y, Li K, Liu S, Lin P, Bachert C. Foxp3 in human airway regulatory T cells is regulated by SOCS3. J Allergy Clin Immunol. 2013;132(6):1314-1321.

    Not in our library10.1016/j.jaci.2013.06.010

  168. 168.

    Calus L, Derycke L, Dullaers M, Van Zele T, De Ruyck N, Holtappels G, Lambrecht B, Bachert C, Gevaert P. IL-21 is increased in nasal polyposis and after stimulation with Staphylococcus aureus enterotoxin B. J Allergy Clin Immunol. 2013.

    Not in our library10.1159/000481435

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    Gevaert P, Nouri-Aria KT, Wu H, Harper CE, Takhar P, Fear DJ, Acke F, Deruyck N, Banfield G, Kariyawasam HH, Bachert C, Durham SR, Gould HJ. Local receptor revision and class switching to ige in chronic rhinosinusitis with nasal polyps. Allergy. 2013;68:55-63.

    Not in our library10.1111/all.12054

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    Mechtcheriakova D, Sobanov J, Knittelfelder R, Bachert C, Jensen-Jarolim E. Gene expression pattern associated with activation-induced cytidine deaminase, AID, in chronic paranasal disorders. PlosOne. 2011;6:e25611.

    Not in our library10.1371/journal.pone.0025611

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    Baraniuk JN, Druce HM. Physiology of sinusitis. Sinusitis: pathophysiology and treatment. 1994;19-39.

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    Van Cauwenberge P, Ingels K. Effects of viral and bacterial infection on nasal and sinus mucosa. Acta Otolaryngol (Stockh). 1996;116:316-321.

    Not in our library10.3109/00016489609137849

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    Calenoff E, McMahan JT, Herzon GD, Kern RC, Ghadge GD, Hanson DG. Bacterial allergy in nasal polyposis. A new method for quantifying specific IgE. Arch Otolaryngol Head Neck Surg. 1993;119(8):830-836.

    Not in our library10.1001/archotol.1993.01880200030004

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    Mempel M, Lina G, Hojka M, Schnopp C, Seidl HP, Schafer T, Ring J, Vandenesch F, Abeck D. High prevalence of superantigens associated with the egc locus in Staphylococcus aureus isolates from patients with atopic eczema. Eur J Clin Microbiol Infect Dis. 2003;22(5):306-309.

    Not in our library10.1007/s10096-003-0928-0

  175. 175.

    Schubert MS. A superantigen hypothesis for the pathogenesis of chronic hypertrophic rhinosinusitis, allergic fungal sinusitis, and related disorders. Ann Allergy Asthma Immunol. 2001;87(3):181-188.

    Not in our library10.1016/s1081-1206(10)62222-3

  176. 176.

    Bachert C, Gevaert P, Holtappels G, Johansson SG, Van Cauwenberge P. Total and specific IgE in nasal polyps is related to local eosinophilic inflammation. J Allergy Clin Immunol. 2001;107(4):607-614.

    Not in our library10.1067/mai.2001.112374

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    Bachert C, Wagenmann M, Hauser U, Rudack C. IL-5 is upregulated in human nasal polyp tissue. J Allergy Clin Immunol. 1997;99:837-842.

    Not in our library10.1016/s0091-6749(97)80019-x

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    Min YG, Lee CH, Rhee CS, Hong SK, Kwon SH. Increased expression of IL-4, IL-5, IFN-gamma, IL-6, IL-8, and TGF-beta mRNAs in maxillary mucosa of patients with chronic sinusitis. Am J Rhinol. 1999;13(5):339-343.

    Not in our library10.2500/105065899781367546

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    Perez-Novo CA, Watelet JB, Claeys C, Van Cauwenberge P, Bachert C. Prostaglandin, leukotriene, and lipoxin balance in chronic rhinosinusitis with and without nasal polyposis. J Allergy Clin Immunol. 2005;115:1189-1196.

    Not in our library10.1016/j.jaci.2005.02.029

  180. 180.

    Van Zele T, Gevaert P, Watelet JB, Claeys G, Holtappels G, Claeys C, Van Cauwenberge P, Bachert C. Staphylococcus aureus colonization and IgE antibody formation to enterotoxins is increased in nasal polyposis. J Allergy Clin Immunol. 2004;114:981-983.

    Not in our library10.1016/j.jaci.2004.07.013

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    Perez-Novo CA, Kowalski ML, Kuna P, Ptasinska A, Holtappels G, Van Cauwenberge P, Gevaert P, Johannson S, Bachert C. Aspirin sensitivity and IgE antibodies to Staphylococcus aureus enterotoxins in nasal polyposis: Studies on the relationship. Internat Arch Allergy Immunol. 2004;133:255-260.

    Not in our library10.1159/000076832

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    Van Zele T, Gevaert P, Holtappels G, Van Cauwenberge P, Bachert C. Local immunoglobulin production in nasal polyposis is modulated by superantigens. Clin Exp Allergy. 2007;37:1840-1847.

    Not in our library10.1111/j.1365-2222.2007.02838.x

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    Gevaert P, Holtappels G, Johansson SG, Cuvelier C, Cauwenberge P, Bachert C. Organization of secondary lymphoid tissue and local IgE formation to Staphylococcus aureus enterotoxins in nasal polyp tissue. Allergy. 2005;60:71-79.

    Not in our library10.1111/j.1398-9995.2004.00621.x

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    Zhang N, Holtappels G, Gevaert P, Patou J, Dhaliwal B, Gould H, Bachert C. Mucosal tissue polyclonal IgE is functional in response to allergen and SEB. Allergy. 2011;66:141-148.

    Not in our library10.1111/j.1398-9995.2010.02448.x

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    Hamilos DL, Leung DYM, Huston DP, Kamil A, Wood R, Hamid Q. GM-CSF, IL-5 and RANTES immunoreactivity and mRNA expression in chronic hyperplastic sinusitis with nasal polyposis (NP). Clin Exp Allergy. 1998;28:1145-1152.

    Not in our library10.1046/j.1365-2222.1998.00380.x

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    Nonaka M, Pawankar R, Saji F, Yagi T. Distinct expression of RANTES and GM-CSF by lipopolysaccharide in human nasal fibroblasts but not in other airway fibroblasts. Int Arch Allergy Immunol. 1999;119:314-321.

    Not in our library10.1159/000024209

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    Pawankar R. Mast cells as or orchestrates of the allergic reaction: The IgE-IgE mast cell network. Curr Opin Allergy Clin Immunol. 2001;1:3-6.

    Not in our library10.1097/01.all.0000010977.11360.f4

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    Hamilos DL, Leung DYM, Wood R, Cunningham L, Bean DK, Yasruel S, Schotman E, Hamid Q. Evidence for distinct cytokine expression in allergic versus nonallergic chronic sinusitis. J Allergy Clin Immunol. 1995;96:537-544.

    Not in our library10.1016/s0091-6749(95)70298-9

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    Schleimer RP, Kato A, Peters A, Conley D, Kim J, Liu MC, Harris KE, Kuperman DA, Chandra R, Favoreto S, Avila PC, Grammer LC, Kern RC. Epithelium, inflammation, and immunity in the upper airways of humans: studies in chronic rhinosinusitis. Proc Am Thorac Soc. 2009;6:288-294.

    Not in our library10.1513/pats.200808-088rm

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    Di Lorenzo G, Drago A, Esposito Pellitteri M, Candore G, Colombo A, Gervasi F, Pacor ML, Purello D'Ambrosio F, Caruso C. Measurement of inflammatory mediators of mast cells and eosinophils in native nasal lavage fluid in nasal polyposis. Int Arch Allergy Immunol. 2001;125(2):164-175.

    Not in our library10.1159/000053811

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    Pawankar R, Okuda M, Yssel H, Okumura K, Ra C. Nasal mast cells in perennial allergic rhinitics exhibit increased expression of the Fc epsilonRI, CD40L, IL-4, and IL-13, and can induce IgE synthesis in B cells. J Clin Invest. 1997;99(7):1492-1499.

    Not in our library10.1172/jci119311

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    Vagic D, Ferencic Z, Drvis P, Geber G, Dzidic S, Baudoin T, Kalogjera L. Local IgE and inflammation in chronic rhinosinusitis of asthmatics and non-asthmatics. Eur Arch Otorhinolaryngol. 2008;265:1205-1209.

    Not in our library10.1007/s00405-008-0621-0

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    Cerutti A, Chen K, Chorny A. Immunoglobulin responses at the mucosal interface. Annu Rev Immunol. 2011;29:273-293.

    Not in our library10.1146/annurev-immunol-031210-101317

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    Bachert C, Zhang N. Chronic rhinosinusitis and asthma: novel understanding of the role of IgE “above atopy. J Intern Med. 2012;272:133-143.

    Not in our library10.1111/j.1365-2796.2012.02559.x

  195. 195.

    Gevaert P, Calus L, Van Zele T, Blomme K, De Ruyck N, Bauters W, Hellings P, Brusselle G, De Bacquer D, Van Cauwenberge P, Bachert C. Omalizumab is effective in allergic and nonallergic patients with nasal polyps and asthma. J Allergy Clin Immunol. 2013;131:110-116.

    Not in our library10.1016/j.jaci.2012.07.047

  196. 196.

    Akdis M, Akdis CA. IgE class switching and cellular memory. Nat Immunol. 2012;13:312-314.

    Not in our library10.1038/ni.2266

  197. 197.

    Talay O, Yan D, Brightbill HD, Straney EE, Zhou M, Ladi E, Lee WP, Egen JG, Austin CD, Xu M, Wu LC. IgE(+) memory B cells and plasma cells generated through a germinal-center pathway. Nat Immunol. 2012;13:396-404.

    Not in our library10.1038/ni.2256

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    Akdis CA, Bachert C, Cingi C, Dykewicz MS, Hellings PW, Naclerio RM, Schleimer RP, Ledford D. Endotypes and phenotypes of chronic rhinosinusitis: a PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology. J Allergy Clin Immunol. 2013;131(6):1479-1490.

    Not in our library10.1016/j.jaci.2013.02.036

  199. 199.

    Kilty SJ, Desrosiers MY. Are biofilms the answer in the pathophysiology and treatment of chronic rhinosinusitis? Immunol Allergy Clin North Am. 2009;29:645-656.

    Not in our library10.1016/j.iac.2009.07.005

  200. 200.

    Lanza DC, Kennedy DW. Adult rhinosinusitis defined. Otolaryngol Head Neck Surg. 1997;117:S1-S7.

    Not in our library10.1016/s0194-5998(97)70001-9

  201. 201.

    Brook I, Yocum P, Frazier EH. Bacteriology and beta-lactamase activity in acute and chronic maxillary sinusitis. Arch Otolaryngol Head Neck Surg. 1996;122:418-423.

    Not in our library10.1001/archotol.1996.01890160058011

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    Bhattacharyya N, Kepnes LJ. The microbiology of recurrent rhinosinusitis after endoscopic sinus surgery. Arch Otolaryngol Head Neck Surg. 1999;125:1117-1120.

    Not in our library10.1001/archotol.125.10.1117

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    Bhattacharyya N. The role of infection in chronic rhinosinusitis. Curr Allergy Asthma Rep. 2002;2:500-506.

    Not in our library10.1007/s11882-002-0091-1

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    Huvenne W, Hellings PW, Bachert C. Role of staphylococcal superantigens in upper airway disease. Curr Opin Allergy Clin Immunol. 2008;8:34-38.

    Not in our library10.1097/aci.0b013e3282f4178f

  205. 205.

    Suh JD, Cohen NA, Palmer JN. Biofilms in chronic rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg. 2010;18:27-31.

    Not in our library10.1097/moo.0b013e328334f670

  206. 206.

    Suh JD, Ramakrishnan V, Palmer JN. Biofilms. Otolaryngol Clin North Am. 2010;43:521-530.

    Not in our library10.1016/j.otc.2010.02.010

  207. 207.

    Lewis K. Persister cells, dormancy and infectious disease. Nat Rev Microbiol. 2007;5:48-56.

    Not in our library10.1038/nrmicro1557

  208. 208.

    Palmer JN. Bacterial biofilms: Do they play a role in chronic sinusitis? Otolaryngol Clin North Am. 2005;38:1193-1201.

    Not in our library10.1016/j.otc.2005.07.004

  209. 209.

    Al-Mutairi D, Kilty SJ. Bacterial biofilms and the pathophysiology of chronic rhinosinusitis. Curr Opin Allergy Clin Immunol. 2011;11:18-23.

    Not in our library10.1097/aci.0b013e3283423376

  210. 210.

    Sanderson AR, Leid JG, Hunsaker D. Bacterial biofilms on the sinus mucosa of human subjects with chronic rhinosinusitis. Laryngoscope. 2006;116:1121-1126.

    Not in our library10.1097/01.mlg.0000221954.05467.54

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    Prince AA, Steiger JD, Khalid AN, Dogrhamji L, Reger C, Eau Claire S, Chiu AG, Kennedy DW, Palmer JN, Cohen NA. Prevalence of biofilm-forming bacteria in chronic rhinosinusitis. Am J Rhinol. 2008;22:239-245.

    Not in our library10.2500/ajr.2008.22.3180

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    Foreman A, Psaltis AJ, Tan LW, Wormald PJ. Characterization of bacterial and fungal biofilms in chronic rhinosinusitis. Am J Rhinol Allergy. 2009;23:556-561.

    Not in our library10.2500/ajra.2009.23.3413

  213. 213.

    Singhal D, Foreman A, Bardy JJ, Wormald PJ. Staphylococcus aureus biofilms: Nemesis of endoscopic sinus surgery. Laryngoscope. 2011;121:1578-1583.

    Not in our library10.1002/lary.21805

  214. 214.

    Foreman A, Holtappels G, Psaltis AJ, Jervis-Bardy J, Field J, Wormald PJ, Bachert C. Adaptive immune responses in Staphylococcus aureus biofilm-associated chronic rhinosinusitis. Allergy. 2011;66:1449-1456.

    Not in our library10.1111/j.1398-9995.2011.02678.x

  215. 215.

    Wood AJ, Fraser J, Swift S, Amirapu S, Douglas RG. Are biofilms associated with an inflammatory response in chronic rhinosinusitis? Int Forum Allergy Rhinol. 2011;1:335-339.

    Not in our library10.1002/alr.20060

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    Foreman A, Jervis-Bardy J, Wormald PJ. Do biofilms contribute to the initiation and recalcitrance of chronic rhinosinusitis? Laryngoscope. 2011;121:1085-1091.

    Not in our library10.1002/lary.21438

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    Ebbens FA, Georgalas C, Fokkens WJ. Fungus as the cause of chronic rhinosinusitis: the case remains unproven. Curr Opin Otolaryngol Head Neck Surg. 2009;17:43-49.

    Not in our library10.1097/moo.0b013e32831de91e

  218. 218.

    Ebbens FA, Georgalas C, Fokkens WJ. The mold conundrum in chronic hyperplastic sinusitis. Curr Allergy Asthma Rep. 2009;9:114-120.

    Not in our library10.1007/s11882-009-0017-2

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    Ponikau JU, Sherris DA, Kern EB, Homburger HA, Frigas E, Gaffey TA, Roberts GD. The diagnosis and incidence of allergic fungal sinusitis. Mayo Clin Proc. 1999;74:877-884.

    Not in our library10.4065/74.9.877

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    Braun H, Buzina W, Freudenschuss K, Beham A, Stammberger H. 'Eosinophilic fungal rhinosinusitis': A common disorder in Europe? Laryngoscope. 2003;113:264-269.

    Not in our library10.1097/00005537-200302000-00013

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    Sasama J, Sherris DA, Shin SH, Kephart GM, Kern EB, Ponikau JU. New paradigm for the roles of fungi and eosinophils in chronic rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg. 2005;13:2-8.

    Not in our library10.1097/00020840-200502000-00003

  222. 222.

    Davis LJ, Kita H. Pathogenesis of chronic rhinosinusitis: role of airborne fungi and bacteria. Immunol Allergy Clin North Am. 2004;24:59-73.

    Not in our library10.1016/s0889-8561(03)00103-6

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    Ponikau JU, Sherris DA, Kephart GM, Kern EB, Congdon DJ, Adolphson CR, Springett MJ, Gleich GJ, Kita H. Striking deposition of toxic eosinophil major basic protein in mucus: Implications for chronic rhinosinusitis. J Allergy Clin Immunol. 2005;116:362-369.

    Not in our library10.1016/j.jaci.2005.03.049

  224. 224.

    Shin SH, Ponikau JU, Sherris DA, Congdon D, Frigas E, Homburger HA, Swanson MC, Gleich GJ, Kita H. Chronic rhinosinusitis: an enhanced immune response to ubiquitous airborne fungi. J Allergy Clin Immunol. 2004;114:1369-1375.

    Not in our library10.1016/j.jaci.2004.08.012

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    Wei JL, Kita H, Sherris DA, Kern EB, Weaver A, Ponikau JU. The chemotactic behavior of eosinophils in patients with chronic rhinosinusitis. Laryngoscope. 2003;113:303-306.

    Not in our library10.1097/00005537-200302000-00019

  226. 226.

    Inoue Y, Matsuwaki Y, Shin SH, Ponikau JU, Kita H. Nonpathogenic, environmental fungi induce activation and degranulation of human eosinophils. J Immunol. 2005;175:5439-5447.

    Not in our library10.4049/jimmunol.175.8.5439

  227. 227.

    Romani L. Immunity to fungal infections. Nat Rev Immunol. 2011;11:275-288.

    Not in our library10.1038/nri2939

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    Douglas R, Bruhn M, Tan LW, Ooi E, Psaltis A, Wormald PJ. Response of peripheral blood lymphocytes to fungal extracts and staphylococcal superantigen B in chronic rhinosinusitis. Laryngoscope. 2007;117:411-414.

    Not in our library10.1097/mlg.0b013e31802c0707

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    Orlandi RR, Marple BF, Georgelas A, Durtschi D, Barr L. Immunologic response to fungus is not universally associated with rhinosinusitis. Otolaryngol Head Neck Surg. 2009;141:750-756.

    Not in our library10.1016/j.otohns.2009.09.016

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    Ponikau JU, Sherris DA, Kita H, Kern EB. Intranasal antifungal treatment in 51 patients with chronic rhinosinusitis. J Allergy Clin Immunol. 2002;110:862-866.

    Not in our library10.1067/mai.2002.130051

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    Ponikau JU, Sherris DA, Weaver A, Kita H. Treatment of chronic rhinosinusitis with intranasal amphotericin B: A randomized, placebo-controlled, double-blind pilot trial. J Allergy Clin Immunol. 2005;115:125-131.

    Not in our library10.1016/j.jaci.2004.09.037

  232. 232.

    Weschta M, Rimek D, Formanek M, Polzehl D, Podbielski A, Riechelmann H. Topical antifungal treatment of chronic rhinosinusitis with nasal polyps: a randomized, double-blind clinical trial. J Allergy Clin Immunol. 2004;113:1122-1128.

    Not in our library10.1016/j.jaci.2004.03.038

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    Liang KL, Su MC, Shiao JY, Tseng HC, Hsin CH, Lin JF, Jiang RS. Amphotericin B irrigation for the treatment of chronic rhinosinusitis without nasal polyps: a randomized, placebo-controlled, double-blind study. Am J Rhinol. 2008;22:52-58.

    Not in our library10.2500/ajr.2008.22.3115

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    Ebbens FA, Scadding GK, Badia L, Hellings PW, Jorissen M, Mullol J, Cardesin A, Bachert C, van Zele TP, Dijkgraaf MG, Lund V, Fokkens WJ. Amphotericin B nasal lavages: not a solution for patients with chronic rhinosinusitis. J Allergy Clin Immunol. 2006;118:1149-1156.

    Not in our library10.1016/j.jaci.2006.07.058

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    Ebbens FA, Georgalas C, Luiten S, Van Drunen CM, Badia L, Scadding GK, Hellings PW, Jorissen M, Mullol J, Cardesin A, Bachert C, van Zele TP, Lund VJ, Fokkens WJ. The effect of topical amphotericin B on inflammatory markers in patients with chronic rhinosinusitis: a multicenter randomized controlled study. Laryngoscope. 2009;119:401-408.

    Not in our library10.1002/lary.20064

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    Isaacs S, Fakhri S, Luong A, Citardi MJ. A meta-analysis of topical amphotericin B for the treatment of chronic rhinosinusitis. Int Forum Allergy Rhinol. 2011;1:250-254.

    Not in our library10.1002/alr.20056

  237. 237.

    The Human Microbiome Project Consortium. A framework for human microbiome research. Nature. 2012;486:215-222.

    Not in our library10.1038/nature11209

  238. 238.

    Paju S, Bernstein JM, Haase EM, Scannapieco FA. Molecular analysis of bacterial flora associated with chronically inflamed maxillary sinuses. J Med Microbiol. 2003;52:591-597.

    Not in our library10.1099/jmm.0.05062-0

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    Stephenson MF, Mfuna L, Dowd SE, Wolcott RD, Barbeau J, Poisson M, James G, Desrosiers M. Molecular characterization of the polymicrobial flora in chronic rhinosinusitis. J Otolaryngol Head Neck Surg. 2010;39:182-187.

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    Lewenza S, Charron-Mazenod L, Cho JJ, Mechor B. Identification of bacterial contaminants in sinus irrigation bottles from chronic rhinosinusitis patients. J Otolaryngol Head Neck Surg. 2010;39:458-463.

    Not in our library

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    Feazel LM, Robertson CE, Ramakrishnan VR, Frank DN. Microbiome complexity and Staphylococcus aureus in chronic rhinosinusitis. Laryngoscope. 2012;122:467-472.

    Not in our library10.1002/lary.22398

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    Lobid I, Benítez P, Cardelús S, De Borja Callejas F, Lehrer-Coriat E, Pujols L, Picado C, Mullol J. Oral plus nasal corticosteroids improve smell, nasal congestion, and inflammation in sino-nasal polyposis. Laryngoscope. 2014;124(1):50-56.

    Not in our library10.1002/lary.24330

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    Benninger MS, Ferguson BJ, Hadley JA, Hamilos DL, Jacobs M, Kennedy DW, Lanza DC, Marple BF, Osguthorpe JD, Stankiewicz JA, Anon J, Denneny J, Emanuel I, Levine H. Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg. 2003;129:S1-S32.

    Not in our library10.1053/hn.2003.v128.amhn0312811

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    Meltzer EO, Hamilos DL. Rhinosinusitis diagnosis and management for the clinician: a synopsis of recent consensus guidelines. Mayo Clin Proc. 2011;86:427-443.

    Not in our library10.4065/mcp.2010.0392

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    Zacharisen M, Casper R. Pediatric sinusitis. Immunol Allergy Clin North Am. 2005;25:313-332.

    Not in our library10.1016/j.iac.2005.02.002

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    Chan KH, Abzug MJ, Coffinet L, Simoes EA, Cool C, Liu AH. Chronic rhinosinusitis in young children differs from adults: a histopathology study. J Pediatr. 2004;144:206-212.

    Not in our library10.1016/j.jpeds.2003.11.009

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    Berger G, Kogan T, Paker M, Berger-Achituv S, Ebner Y. Pediatric chronic rhinosinusitis histopathology: differences and similarities with the adult form. Otolaryngol Head Neck Surg. 2011;144:85-90.

    Not in our library10.1177/0194599810390443

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    Zuliani G, Carron M, Gurrola J, Coleman C, Haupert M, Berk R, Coticchia J. Identification of adenoid biofilms in chronic rhinosinusitis. Int J Pediatr Otorhinolaryngol. 2006;70:1613-1617.

    Not in our library10.1016/j.ijporl.2006.05.002

  250. 250.

    Brook I, Yocum P, Shah K. Aerobic and anaerobic bacteriology of concurrent chronic otitis media with effusion and chronic sinusitis in children. Arch Otolaryngol Head Neck Surg. 2000;126:174-176.

    Not in our library10.1001/archotol.126.2.174

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    Brook I, Frazier EH. Microbiology of recurrent acute rhinosinusitis. Laryngoscope. 2004;114:129-131.

    Not in our library10.1097/00005537-200401000-00023

  252. 252.

    Dykewicz MS, Hamilos DL. Rhinitis and sinusitis. J Allergy Clin Immunol. 2010;125:S103-S115.

    Not in our library10.1016/j.jaci.2009.12.989

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    Wald ER, Long S, Pickering L, Prober C. Sinusitis. Principles and practice of pediatric infectious disease. 2003;205-210.

    Not in our library

  254. 254.

    Clinical practice guideline: management of sinusitis. Pediatrics. 2001, 108: 798-808.

    Not in our library10.1542/peds.108.3.798

  255. 255.

    DeMuri GP, Wald ER. Acute sinusitis: clinical manifestations and treatment approaches. Pediatr Ann. 2010;39:34-40.

    Not in our library10.3928/00904481-20091222-04

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    Ungkanont K, Damrongsak S. Effect of adenoidectomy in children with complex problems of rhinosinusitis and associated diseases. Int J Pediatr Otorhinolaryngol. 2004;68:447-451.

    Not in our library10.1016/j.ijporl.2003.11.016

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    Brietzke SE, Brigger MT. Adenoidectomy outcomes in pediatric rhinosinusitis: a meta-analysis. Int J Pediatr Otorhinolaryngol. 2008;72:1541-1545.

    Not in our library10.1016/j.ijporl.2008.07.008

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    Duse M, Caminiti S, Zicari AM. Rhinosinusitis: prevention strategies. Pediatr Allergy Immunol. 2007;18(Suppl 18):71-74.

    Not in our library10.1111/j.1399-3038.2007.00639.x

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    Whitney CG, Farley MM, Hadler J, Harrison LH, Bennett NM, Lynfield R, Reingold A, Cieslak PR, Pilishvili T, Jackson D, Facklam RR, Jorgensen JH, Schuchat A, Active Bacterial Core Surveillance of the Emerging Infections Program Network. Decline in invasive pneumococcal disease after the introduction of protein-polysaccharide conjugate vaccine. N Engl J Med. 2003;348:1737-1746.

    Not in our library10.1056/nejmoa022823

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    Wallwork B, Coman W, Mackay-Sim A, Greiff L, Cervin A. A double-blind, randomized, placebo-controlled trial of macrolide in the treatment of chronic rhinosinusitis. Laryngoscope. 2006;116:189-193.

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