MRE and FIBROSpectII are highly sensitive in detecting fibrosis due to recurrent HCV. Both are limited by the low specificity/PPV and confounding because of other graft complications. Values below the MRE and FIBROSpectII cutoffs, however, strongly suggest the absence of fibrosis and may avert the need for protocol biopsy staging.

In patients with active CRS and prior sinus surgery, both MH and SAL improved outcomes, but there was no statistically significant difference between these groups. However, in the subset that did not receive oral antibiotics/steroids, culture negativity was statistically better on MH, suggesting that MH alone may be effective for acute exacerbations of CRS.

Background In the 5 years that have passed since the publication of the 2018 International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (ICAR‐Allergic Rhinitis 2018), the literature has expanded substantially. The ICAR‐Allergic Rhinitis 2023 update presents 144 individual topics on allergic rhinitis (AR), expanded by over 40 topics from the 2018 document. Originally presented topics from 2018 have also been reviewed and updated. The executive summary highlights key evidence‐based findings and recommendation from the full document. Methods ICAR‐Allergic Rhinitis 2023 employed established evidence‐based review with recommendation (EBRR) methodology to individually evaluate each topic. Stepwise iterative peer review and consensus was performed for each topic. The final document was then collated and includes the results of this work. Results ICAR‐Allergic Rhinitis 2023 includes 10 major content areas and 144 individual topics related to AR. For a substantial proportion of topics included, an aggregate grade of evidence is presented, which is determined by collating the levels of evidence for each available study identified in the literature. For topics in which a diagnostic or therapeutic intervention is considered, a recommendation summary is presented, which considers the aggregate grade of evidence, benefit, harm, and cost. Conclusion The ICAR‐Allergic Rhinitis 2023 update provides a comprehensive evaluation of AR and the currently available evidence. It is this evidence that contributes to our current knowledge base and recommendations for patient evaluation and treatment.

Computed tomography measures quantifying tongue position and mandibular configuration can identify infants with Robin sequence, and importantly, differentiate those who have severe upper airway compromise requiring tracheotomy. Following validation, these measures can be used for objective upper airway assessment and for expediting clinical decision-making in these challenging cases for which no such tools currently exist.

Conclusions Pediatric septoplasty may be associated with short-term symptomatic benefit. This benefit may be greater in female patients and equally achievable in young patients and using less invasive surgical approaches. Objective To determine the short-term effect of pediatric septoplasty, which is not routinely performed, on sinus and nasal-specific quality of life. Methods This study is a retrospective case series of 28 pediatric patients that underwent septoplasty. Pre- and post-septoplasty SN-5 overall (mean of all 5 items, range 1–7) and visual analog scale (VAS; range 0–10) scores were obtained and compared using a Wilcoxon signed-rank test. Comparisons of pre- to post-septoplasty changes by sex (female vs. male), age (<13 vs. ≥13 years), and surgical approach (open vs. closed) were performed using a Mann Whitney U test. Median and interquartile range are reported. Results Overall and VAS scores significantly improved from pre- to post-septoplasty (3.5 [2.8, 4.3] to 2.0 [1.4, 2.8], p<0.001; 5.0 [4.0, 6.3] to 8.0 [8.0, 10.0], p<0.001). Females reported significantly greater overall and VAS score improvements compared to males (−1.8 [−2.6, −1.6] compared to −1.0 [−1.6, −0.2], p=0.01; 5.0 [4.0, 5.0] compared to 3.0 [1.5, 4.0], p=0.007). Comparisons of changes by age and surgical approach were not significantly different.

Objectives Online surgical videos are an increasingly popular resource for surgical trainees, especially in the context of the COVID-19 pandemic. Our objective was to assess the instructional quality of the YouTube videos of the transsphenoidal surgical approach (TSA), using LAParoscopic surgery Video Educational Guidelines (LAP-VEGaS). Methods YouTube TSA videos were searched using 5 keywords. Video characteristics were recorded. Two fellowship-trained rhinologists evaluated videos using LAP-VEGaS (scale 0 [worst] to 18 [best]). Results The searches produced 43 unique, unduplicated videos for analysis. Mean video length 7 minutes (standard deviation [SD] = 13), mean viewership was 16 017 views (SD = 29 415), and mean total LAP-VEGaS score was 9 (SD = 3). The LAP-VEGaS criteria with the lowest mean scores were presentation of the positioning of the patient/surgical team (mean = 0.2; SD = 0.6) and the procedure outcomes (mean = 0.4; SD = 0.6). There was substantial interrater agreement (κ = 0.71). Conclusions LAP-VEGaS, initially developed for laparoscopic procedures, is useful for evaluating TSA instructional videos. There is an opportunity to improve the quality of these videos.

(mean 4.9 [CI 4.3, 5.6] to mean 4.1 [CI 3.5, 4.7

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