OTO Helps Write International Consensus Statement

Two women with papers in front of them

By Eric. W. Wang, MD

Eric W. Wang, MD, Professor of Otolaryngology, Neurological Surgery and Ophthalmology and Vice Chair of Clinical Operations at the University of Pittsburgh and two colleagues, Edward Kuan, MD, at the University of California-Irvine and James Palmer, MD, of the University of Pennsylvania, led a group of 189 experts in writing the International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors (ICSNT), which was published in February 2024.

With contributions from international experts, the International Consensus in Allergy and Rhinology (ICAR) documents are designed to provide management recommendations based upon the current best available evidence in diseases that affect the nose and paranasal sinuses.

In 2019, Dr. Wang was the lead editor of the ICAR: Skull Base Surgery that identified the current best available evidence on the role of endoscopic skull base surgery in the management of numerous pathologies at the junction between the brain, orbit and paranasal sinuses. Using a well described methodology to carefully review the breadth and quality of the existing literature, evidence-based reviews with recommendations were proposed in pituitary adenoma, cerebrospinal fluid leak repair, and vascularized reconstruction of skull base defects among many other pathologies and surgical techniques. This well-referenced document has now spurred the development of a companion ICAR statement on sinonasal tumors.

Divided into four sections (General Principles, Benign Lesions, Sinonasal Malignancies, and Morbidity/Quality of Life), the document provides a key resource for the 200 diverse pathologies that can occur in the nose and paranasal sinuses. Some of the key pathologies discussed include inverted papilloma, nasopharyngeal angiofibroma, squamous cell carcinoma and olfactory neuroblastoma. Other UPMC faculty including Garret Choby, MD, Associate Professor of Otolaryngology and Neurological Surgery, Paul Gardner, MD, Professor of Neurological Surgery and Otolaryngology, and Carl Snyderman, MD, MBA, Professor of Otolaryngology and Neurological Surgery, were authors on this landmark article. Beyond reviewing the current literature, the document also identifies area of future research and development, many of which are being undertaken in the Department of Otolaryngology in the Division of Rhinology and the Center for Cranial Base Surgery.

The Department of Otolaryngology continues to have a key leadership role in tumors of the nose and paranasal sinuses as well as skull base surgery. Of note, all members of the Division of Rhinology were invited authors on this important multi-institutional collaboration. The Department continues to investigate these rare but challenging tumors with recent publications in novel staging systemsand the risks of occult intracranial spread of olfactory neuroblastoma as well as the impact on quality of life in all sinonasal cancers.