Abstract:
INTRODUCTION:Accountable care organizations (ACO) and alternative payment models are a sign of the change in reimbursement from fee-for-service to value-based reimbursement. The focus of health care under ACOs is represented by the Triple Aim: to improve the experience of health care, improve the health of populations, and reduce the per capita costs. Individuals with chronic rhinosinusitis (CRS) are heavy consumers of health care services. Results of recent studies have indicated that there is the potential for improved outcomes and cost savings from early surgical intervention. Adhering to the principles of the Triple Aim may signal a paradigm shift in regard to timing of intervention for CRS in certain patients. METHODS:A scoping review was performed to analyze the current literature related to management of CRS and the impact on cost, population health outcomes, and the patient's experience of health care. RESULTS:A growing body of literature indicates that, in appropriately selected patients, when compared with medical management, endoscopic sinus surgery has the potential to improve patient outcomes and reduce the long-term cost burden of CRS. CONCLUSION:With the advent of ACOs, a paradigm shift in the treatment of CRS is inevitable to better conform to the goals of the Triple Aim. Future treatment algorithms will need to account for the heterogeneity within CRS and seek to identify appropriate timing and interventions for patients on an individual basis if the value of health care is to be improved.
journal_name
Am J Rhinol Allergyjournal_title
American journal of rhinology & allergyauthors
Barry JY,McCrary HC,Kent S,Saleh AA,Chang EH,Chiu AGdoi
10.2500/ajra.2016.30.4348subject
Has Abstractpub_date
2016-09-01 00:00:00pages
344-50issue
5eissn
1945-8924issn
1945-8932journal_volume
30pub_type
杂志文章,评审abstract:BACKGROUND:Methods to improve the clinical efficacy of currently available antibiotics against multidrug resistant bacteria in cystic fibrosis (CF) chronic rhinosinusitis (CRS) are greatly needed. Ivacaftor, a cystic fibrosis transmembrane conductance regulator potentiator, was recently identified as having potentially...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.1177/1945892418815615
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Chronic rhinosinusitis (CRS) is recognized as a common disease that imposes a big burden on the health system worldwide. There is ongoing evidence of the anti-inflammatory effect of long-term macrolide in the management of patients with CRS. OBJECTIVE:The aim of this randomized clinical trial was to evaluat...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章,随机对照试验
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abstract:BACKGROUND:Aspirin-exacerbated respiratory disease (AERD) affects 7% of asthmatics. Usual therapies are inadequate for asthma and/or nasal polyposis, leading to decreased quality of life. OBJECTIVE:Our objective was to evaluate the efficacy of dupilumab in AERD patients with uncontrolled, chronic rhinosinusitis with n...
journal_title:American journal of rhinology & allergy
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abstract::Background Since the Food and Drug Administration approval of balloon sinuplasty (BSP) in 2005, no nationally representative population-based studies have examined the outcomes and adverse events of BSP. Objective To assess the rates of complications and revision surgery in patients who received BSP, functional endosc...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.1177/1945892418782248
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abstract:BACKGROUND:Conclusive evidence exists that biofilms are present on the mucosa of chronic rhinosinusitis (CRS) patients. Less is known about the species constituting these biofilms. This study developed a fluorescence in situ hybridization (FISH) protocol for characterization of bacterial and fungal biofilms in CRS. ME...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2009.23.3413
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:This study evaluates if there is any benefit of adding epinephrine to lidocaine in patients undergoing diagnostic rigid nasal endoscopy. A prospective, randomized, double-blinded study was performed. METHODS:Seventy patients were randomized to receive either 2% lidocaine or 2% lidocaine with 0.2% epinephrin...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章,随机对照试验
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更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:Although nasal steroids are the mainstay treatments in nasal polyposis, up to one-half of patients do not respond and need surgical treatment. This study aimed to evaluate whether oxymetazoline administration produces any additive effect on nasal steroid therapy and whether rebound congestion develops after ...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章,随机对照试验
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更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:A foreign body (FB) penetrating intracranially after passing transorbitally or transnasally is a rare occurrence. However, otolaryngologists are increasingly being asked to participate in the care of these patients for both endoscopic removal of the object and repair of any skull base defects. OBJECTIVE:To ...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章,评审
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更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:The extent of surgery required in the management of pediatric non-medial subperiosteal orbital abscess (SPOA) due to medically refractory complicated acute sinusitis is unknown. OBJECTIVES:The primary objective is to compare operative outcomes of children treated with combined endoscopic sinus surgery (ESS)...
journal_title:American journal of rhinology & allergy
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abstract:BACKGROUND:Only a few studies have investigated the airway remodeling process in allergic rhinitis (AR), and the results reported are conflicting. We established an allergen-induced nasal remodeling model for AR using brown Norway rats and investigated time-dependent histological changes and the reversibility of the e...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
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更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Allergic rhinitis (AR) is currently the most prevalent allergic disease in children and adolescents. OBJECTIVE:Surveys conducted by population-based studies of East Asia revealed an increased prevalence of behavioral disorders in patients with AR. Thus, in this study, we explored the prevalence of attention...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2017.31.4439
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Assessing surgical competency in otolaryngology is challenging, and residency programs are now responsible for ensuring the surgical competency of their graduates. Therefore, more objective assessment tools are being incorporated into the evaluation process. Objective structured assessment of technical skill...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2014.28.4051
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Endoscopic sinus surgery (ESS) is a safe and reliable procedure for the treatment of chronic rhinosinusitis (CRS) and nasal polyposis (NP). Although most cases of CRS with NP occur bilaterally, we occasionally encounter patients with unilateral sinus disease with NP. Because no study has been conducted on th...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2010.24.3482
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:There is a correlation between (18)F-fluorodeoxyglucose (FDG) uptake and the level of intracellular metabolic tumor activity, which in turn may be associated with active proliferation, invasion, and prognosis as well as distant metastases in head and neck cancer. This study was designed to assess whether tum...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2013.27.3848
更新日期:2013-03-01 00:00:00
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pub_type: 杂志文章
doi:10.2500/ajra.2016.30.4277
更新日期:2016-03-01 00:00:00
abstract:INTRODUCTION:Criterion standard treatment of allergic fungal sinusitis (AFS) is primary surgery followed by adjuvant therapy. Even after good surgery, recurrence rates vary from 10 to 79%. Antifungals, e.g., itraconazole, and steroids have shown varying success rates in delaying recurrences given after surgery. Itracon...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章,随机对照试验
doi:10.2500/ajra.2015.29.4187
更新日期:2015-07-01 00:00:00
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journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2014.28.4042
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Epiphora has a significant impact on the patient's quality of life and is commonly caused by nasolacrimal duct obstruction. Dacryocystorhinostomy (DCR) has traditionally been performed via an external approach, which involves a skin incision. With the advent of endoscopes, the endonasal approach to DCR has g...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2018.32.4494
更新日期:2018-01-01 00:00:00
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journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2010.24.3386
更新日期:2010-01-01 00:00:00
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journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2013.27.3856
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Patients report that nasal congestion is the most bothersome symptom of allergic rhinitis (AR). Recently, a short, patient-reported congestion screener questionnaire, the Congestion Quantifier Seven-Item Test (CQ7), was developed to identify a level of congestion that may warrant patients seeking evaluation ...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2010.24.3394
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:The aim of this study was to describe and correlate radiographically the anterior ethmoidal artery (AEA) to useful endoscopic surgical landmarks, such as the nasal beak (NB), nasal crest (NC), and axilla of the middle turbinate, because these are commonly encountered during endoscopic sinus surgery and skull...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2011.25.3541
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Biofilm formation has been implicated as an etiologic factor in the development of chronic rhinosinusitis (CRS). Nasal irrigation with surfactants including dilute baby shampoo have been proposed as an antibiofilm treatment for CRS patients. The effect of dilute baby shampoo on normal sinonasal mucosal funct...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2011.25.3583
更新日期:2011-01-01 00:00:00
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journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2011.25.3723
更新日期:2011-11-01 00:00:00
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journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2012.26.3744
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Antibiotics are frequently used to treat acute rhinosinusitis (ARS; acute sinusitis), although many episodes are viral. Because of community resistance concerns, current evidence provides limited support for the use of antibiotics in ARS. We conducted a retrospective comparative effectiveness outcomes asses...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2012.26.3781
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:Concerns over radiation exposure with paranasal sinus computed tomography (CT) have recently evolved. Magnetic resonance imaging (MRI) may be more advantageous in this regard, but the diagnostic assessment of MRI in chronic rhinosinusitis (CRS) has not been reported. The purpose of this study was to determin...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章,随机对照试验
doi:10.2500/ajra.2009.23.3260
更新日期:2009-01-01 00:00:00
abstract:BACKGROUNDS:Diagnosis of allergic fungal rhinosinusitis (AFRS) is complicated because of the presence of fungi on mucosal surfaces of sinonasal passages. The objectives of this study were to define, using immunohistochemistry, lymphocyte populations associated with noninvasive fungal-related chronic rhinosinusitis (CRS...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2013.27.3882
更新日期:2013-05-01 00:00:00
abstract::Chronic rhinosinusitis (CRS) is the second most common chronic medical condition in the United States. It represents a group of disorders characterized by inflammation of the nasal mucosa and paranasal sinuses of at least 12 weeks duration. CRS with or without nasal polyps is defined as inflammation of the nose charac...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2013.27.3925
更新日期:2013-05-01 00:00:00
abstract:PURPOSE:To assess the efficacy and safety of bupivacaine compared with lidocaine in local anesthesia of nasopharynx through meta-analysis. METHODS:A number of medical literature data bases were searched electronically. Relevant journals and references of included studies were manually searched. Two reviewers independe...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章,meta分析
doi:10.2500/ajra.2016.30.4357
更新日期:2016-09-30 00:00:00