Evidence map›Paper›PMID 39623019›Full record

ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2025

The Lamella Ostium Extent Mucosa (LOEM) system: a new classification and pilot study for endoscopic sinus surgery.

Serafin Sanchez-Gomez, Daniel Martin-Jimenez, Ramon Moreno-Luna, Juan Maza-Solano, Christian Calvo-Henriquez, Alfonso Del Cuvillo, Jose M Villacampa-Auba, Alfonso Santamaria-Gadea, Ainhoa Garcia-Lliberos, Alvaro Sanchez-Barrueco and 7 more

Abstract read
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In one paragraph

Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Surgical extent in chronic rhinosinusitis stratified by the LOEM system: systematic review and meta-analysis.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
    Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Serafin Sanchez-GomezRhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, Dr Fedriani Av. 3, 41009, Seville, Spain.
Daniel Martin-JimenezRhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, Dr Fedriani Av. 3, 41009, Seville, Spain.
Ramon Moreno-LunaRhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, Dr Fedriani Av. 3, 41009, Seville, Spain. ramon.morenoluna@docente.unia.es.ORCID http://orcid.org/0000-0003-0640-0550
Juan Maza-SolanoRhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, Dr Fedriani Av. 3, 41009, Seville, Spain.
Christian Calvo-HenriquezDepartment of Otolaryngology, Hospital Complex of Santiago de Compostela, 15706, A Coruña, Spain.
Alfonso Del CuvilloRhinology and Asthma Unit, Department of Otolaryngology, Jerez University Hospital, 11407, Jerez, Spain.
Jose M Villacampa-AubaENT and Cervicofacial Surgery Department, Fundacion Jimenez Diaz University Hospital, 28040, Madrid, Spain.
Alfonso Santamaria-GadeaRhinology Unit and Skull Base Unit, Department of Otolaryngology, Ramón y Cajal Hospital, Madrid, Spain.
Ainhoa Garcia-LliberosDepartment of Otolaryngology, Valencia University General Hospital, 46014, Valencia, Spain.
Alvaro Sanchez-BarruecoENT and Cervicofacial Surgery Department, Fundacion Jimenez Diaz University Hospital, 28040, Madrid, Spain.
Gabriel Martinez-CapoccioniDepartment of Otolaryngology, Hospital Complex of Santiago de Compostela, 15706, A Coruña, Spain.
David Lobo-DuroDepartment of Otolaryngology, Hospital Universitario Marqués de Valdecilla, 39008, Santander, Spain.
Jaime Gonzalez-GarciaRhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, Dr Fedriani Av. 3, 41009, Seville, Spain.
Jose Palacios-GarciaRhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, Dr Fedriani Av. 3, 41009, Seville, Spain.
Rafael Fernandez-LiesaRhinology and Anterior Skull Base Unit, ENT Department, Hospital Universitario Miguel Servet, 50009, Saragossa, Spain.
Isam Alobid *Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic, 08036, Barcelona, Spain.
Manuel Bernal-Sprekelsen *Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic, 08036, Barcelona, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study proposes the Lamella Ostium Extent Mucosa (LOEM) system as a compact and user-friendly classification for endoscopic sinus surgery (ESS), based on surgical bone extension and mucosal management, aiming to resolve inconsistencies in describing surgical techniques and extension levels, and to enhance comparability of outcomes in chronic rhinosinusitis (CRS).

methodsLOEM uses a lettering system representing a specific topographical level: L identifies the lamellae, O the ostia, E the opening of the sinus walls, and M the mucosal approach. Eleven CRS surgical cases were independently evaluated by seven rhinologists following a Delphi method in two consecutive rounds. Consensus was assessed using Cohen's kappa.

resultsA substantial agreement was found among the experts (κ = 0.77) in the first round, although the M item only showed fair agreement (κ = 0.37). Clarifications for this item were given in the second round, after which, the overall agreement increased to κ = 0.81 and to κ = 0.79 for the M item. A decrease in agreement from substantial to moderate for O and E items in the second round was found. Test-retest analysis showed an almost perfect agreement (92.96%, κ = 0.82). In this study, a web-based app is provided to assist with the regular use of the LOEM system.

conclusionsThe LOEM system provides a compact, comprehensive code for ESS, integrating anatomical and functional aspects to represent surgical techniques described so far. This system may be suitable for facilitating communication between surgeons and collecting robust labeled data, hopefully leading to further standardization and validation of surgical approaches in future CRS studies.

Indexed as

EndoscopyNasal MucosaParanasal SinusesRhinitisSinusitisChronic DiseaseDelphi TechniqueFemaleHumansMaleMiddle AgedPilot ProjectsConsensusNasal mucosaNasal surgical proceduresParanasal sinusesRhinosinusitis

Identifiers

PMID39623019
PMCPMC11805853

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.