The Effect of Vidian Neurectomy on Pulmonary Function in Patients with Allergic Rhinitis and Chronic Rhinosinusitis with Nasal Polyps

2020 ◽  
Vol 360 (2) ◽  
pp. 137-145
Author(s):  
Gulibositan Maimaitiaili ◽  
Kayisaier Kahaer ◽  
Liang Tang ◽  
Jin Zhang
Keyword(s):  
Allergic Rhinitis ◽  
Pulmonary Function ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Vidian Neurectomy

scholarly journals Association of chronic rhinosinusitis with nasal polyps and asthma: Clinical and radiological features, allergy and inflammation markers

Medicina ◽  
2008 ◽  
Vol 44 (4) ◽  
pp. 257 ◽  
Author(s):  
Jūratė Staikūnienė ◽  
Saulius Vaitkus ◽  
Lidija Japertienė ◽  
Silvija Ryškienė
Keyword(s):  
Allergic Rhinitis ◽  
Pulmonary Function ◽  
Chronic Rhinosinusitis ◽  
Systemic Inflammation ◽  
Eosinophil Count ◽  
Nasal Polyps ◽  
Older Age ◽  
Bronchial Obstruction ◽  
Inflammation Markers ◽  
Nasal Symptoms

Chronic rhinosinusitis (CRS) with and without nasal polyps represent different stages of one chronic inflammatory disease of the mucosa of the nasal cavity and paranasal sinuses. Coexistence of chronic rhinosinusitis with nasal polyps and asthma and rather similar characteristics of inflammation support assumption that chronic rhinosinusitis and nasal polyps and asthma may be, at least in part, the same disease process. We therefore aimed to evaluate the differences of sinus radiologic findings, systemic inflammation and allergy markers, pulmonary function of chronic rhinosinusitis associated with nasal polyps and asthma. A total of 121 patients with chronic rhinosinusitis referred to tertiary center were evaluated; 23 healthy persons served as controls. Sinus CT scans and nasal endoscopy were performed. Allergic rhinitis was diagnosed according to history and positive skin prick tests to common inhalant allergens. Asthma was diagnosed according to GINA by history and pulmonary function tests. Aspirin intolerance was assessed by history. Total IgE, Aspergillus fumigatus-specific IgE levels, leukocyte and eosinophil count in the peripheral blood were measured. Nasal polyps were detected in 84 patients (69.4%), asthma diagnosed in 48 patients (39.6%), associated with nasal polyps (91.7%) and allergic rhinitis in 45.5% of patients. Forty-four patients with chronic rhinosinusitis and having nasal polyps and asthma were characterized by older age (P<0.01), greater duration of nasal symptoms (P<0.001), higher number previous surgeries (P<0.01), more severe sinus disease on CT scan (P<0.001), greater blood leukocyte and eosinophil count, total IgE level (P<0.01), bronchial obstruction (P<0.05), incidence of allergic rhinitis (P<0.01), and sensitivity to house dust mite D. pteronyssinus (47.7%, P<0.01) and mold allergens (29.5%, P<0.01) comparing to the patients with isolated chronic rhinosinusitis. The extent of sinus CT changes was greater in asthmatics and correlated with greater duration of asthma (P<0.0001), higher number of previous surgeries (P=0.001), leukocyte count in blood (P=0.025), and age (P=0.039). Conclusion. Our data indicate that patients with chronic rhinosinusitis compose clinically heterogeneous group and when associated with nasal polyps and asthma constitutes the most severe form of unified respiratory tract disease, which is characterized by older age of the patients, greater duration of nasal symptoms, extent of sinus radiological changes, more prominent systemic inflammation markers, greater bronchial obstruction, incidence of perennial allergic rhinitis

Pulmonary function in patients with chronic rhinosinusitis and allergic rhinitis

2014 ◽  
Vol 128 (3) ◽  
pp. 255-262 ◽  
Author(s):  
S Kariya ◽  
M Okano ◽  
T Oto ◽  
T Higaki ◽  
S Makihara ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Lung Function ◽  
Respiratory Tract ◽  
Pulmonary Function ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Immunoglobulin E ◽  
Respiratory Tract Diseases ◽  
Upper Respiratory Tract ◽  
Nasal Secretions

AbstractBackground:A close relationship between upper and lower respiratory tract diseases has been reported. However, little is known about pulmonary function in patients with upper respiratory tract diseases.Methods:Pulmonary function was measured in: 68 patients with chronic rhinosinusitis without nasal polyps, 135 patients with chronic rhinosinusitis with nasal polyps, 89 patients with allergic rhinitis and 100 normal control subjects. The relationships between pulmonary function and clinical parameters were assessed. These parameters included radiographic severity of chronic rhinosinusitis, serum total immunoglobulin E levels, concentrations of cytokines in nasal secretions and exhaled nitric oxide levels.Results:The pulmonary function of patients with chronic rhinosinusitis was significantly affected. The level of interleukin-5 in nasal secretions was significantly correlated with pulmonary function in patients with chronic rhinosinusitis.Conclusion:The findings indicated latent obstructive lung function changes in chronic rhinosinusitis patients. The cytokines in nasal secretions might be related to obstructive lung function changes in chronic rhinosinusitis.

scholarly journals Expression of Matrix Metalloproteinases and Their Tissue Inhibitors in Chronic Rhinosinusitis With Nasal Polyps: Etiopathogenesis and Recurrence

2020 ◽  
pp. 014556131989663
Author(s):  
Germano Guerra ◽  
Domenico Testa ◽  
Francesco Antonio Salzano ◽  
Domenico Tafuri ◽  
Eleonora Hay ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Matrix Metalloproteinases ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Polymerase Chain Reaction Analysis ◽  
Sinus Surgery ◽  
Control Group ◽  
Nonallergic Rhinitis ◽  
Tissue Inhibitors ◽  
Immunologic Diseases

Chronic rhinosinusitis with nasal polyps is a multifactorial disease of the nasal and paranasal sinus mucosa and it includes, as comorbidities, anatomic and morphologic alterations, allergic rhinitis, and immunologic diseases. We investigated matrix metalloproteinases (MMP-2, MMP-7, and MMP-9) and their tissue inhibitors (TIMP-1 and TIMP-2) concentration in different etiopathogenetical groups of patients with nasal polyposis (NP) in relation to recurrence after sinonasal surgery. The study group consisted of 45 patients with NP (those with allergic rhinitis, nonallergic rhinitis and asthma or nonallergic rhinitis, and obstruction of osteomeatal complex [OMC]) who underwent endonasal sinus surgery. We also collected 10 patients who underwent septoplasty as control. Immunohistochemistry of nasal mucosa fragments, Western blotting, and polymerase chain reaction analysis showed increased MMPs levels (MMP-9 more than MMP-2 and MMP-7) and decreased tissue inhibitors of MMPs levels (TIMP-1 less than TIMP-2), in patients with chronic rhinosinusitis with nasal polyps compared with control group, in particular in patients with nonallergic rhinitis and asthma compared to those with allergic rhinitis and nonallergic rhinitis and obstruction of OMC. We observed a higher risk of recurrence in patients with nonallergic rhinitis and asthma than in those with allergic rhinitis and nonallergic rhinitis and obstruction of OMC after 36 months from surgery. In this research, we evaluated pathogenesis of NP related to MMPs and their inhibitors concentrations in polypoid tissue.

scholarly journals Preoperative Pulmonary Function Testing to Predict Recurrence of Chronic Rhinosinusitis With Nasal Polyps

2020 ◽  
Vol 11 ◽  
pp. 215265672094699
Author(s):  
Yuji Nakamaru ◽  
Masanobu Suzuki ◽  
Aya Honma ◽  
Akira Nakazono ◽  
Shogo Kimura ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Pulmonary Function Tests ◽  
Forced Expiratory Volume ◽  
Multivariable Logistic Regression Model ◽  
Recurrent Group ◽  
Function Test ◽  
Close Relationship ◽  
Function Testing

Background Although the close relationship between the upper and lower airways has been highlighted previously, little is known about the association between lung function and the recurrence of chronic rhinosinusitis with nasal polyps (CRSwNP). This study aimed to evaluate the factors associated with pulmonary function that affect CRSwNP recurrence after surgery. Methods We performed a series of routine pulmonary function tests for general anesthesia prior to CRSwNP surgery. The values for each parameter were compared in the presence or absence of recurrence. Results Sixty-nine patients with CRSwNP were included. The percent predicted forced expiratory volume in one second (%FEV1) in the recurrent group was significantly lower than that in the non-recurrent group ( P = .005). A multivariable logistic regression model revealed that %FEV1 was a positive predictor of recurrence (odds ratio: 0.96, 95% CI: 0.92-0.99, P = .023). There were no significant differences in the other pulmonary functions between the two groups. Conclusions We found that %FEV1 may be a predictor of CRSwNP recurrence after surgery. As %FEV1 is a pulmonary function test that is routinely performed before surgery, this parameter is readily applicable. Moreover, as %FEV1 appears to have the potential to reveal concealed asthma, %FEV1 might be a particularly useful tool for the prediction of CRSwNP recurrence after surgery.

Experience of the center for diagnosis and treatment of chronic rhinosinusitis with nasal polyps

2020 ◽  
Vol 19 (6) ◽  
pp. 8-15
Author(s):  
V. I. Egorov ◽  
◽  
O. M. Kurbacheva ◽  
E. L. Savlevich ◽  
K. N. Shachnev ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Study Data ◽  
Diagnosis And Treatment ◽  
Dynamic Monitoring ◽  
Surgical Interventions ◽  
Regional Center

Polypous rhinosinusitis (PRS) ranks as one of the most important chronic inflammatory ENT diseases that significantly impair the quality of life. Today, it is known that chronic rhinosinusitis with nasal polyps (CRSwNP) is a multifactorial heterogeneous disease characterized by chronic inflammation of the mucosa of the nasal cavity and paranasal sinuses, leading to the growth of polyps. The interrelation of CRSwNP, atopy and bronchial asthma (BA), their pathogenetic mechanisms, as well as the effect on the severity of the course and the frequency of each other’s relapses, are the subject of study. Data on the role of allergy in CRSwNP are controversial, while the relationship between PRS and BA is not in doubt. Patients suffering from CRSwNP and BA and / or allergic rhinitis (AR) require dynamic monitoring and regular correction of treatment not only by an otorhinolaryngologist, but also by an allergist-immunologist. To this end, since 2016, in Vladimirsky Moscow Regional Research Clinical Institute the Moscow Regional Center for Diagnosis and Treatment of Polypous Rhinosinusitis and Allergic Rhinitis was established, which monitored and treated patients with ARS and comorbid diseases from various medical institutions of the Moscow region. By using a multidisciplinary approach during our work from 2016 to 2020, we managed to achieve a stable remission in most patients, significantly improve their quality of life and reduce the number of surgical interventions.

Intranasal steroid therapy – EPOS 2020

2020 ◽  
Vol 74 (3) ◽  
pp. 41-49
Author(s):  
Piotr Rot ◽  
Piotr Rapiejko ◽  
Dariusz Jurkiewicz
Keyword(s):  
Allergic Rhinitis ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Over The Counter ◽  
Acute Rhinosinusitis ◽  
Counter Medication ◽  
Anti Inflammatory ◽  
New Generation ◽  
Country Specific

Introduction: Due to their strong, multidirectional anti-inflammatory activity, intranasal glucocorticoids are the mainstay of treatment in rhinosinusitis, including acute rhinosinusitis, chronic rhinosinusitis, and chronic rhinosinusitis with nasal polyps, as well as allergic rhinitis. Owing to its high systemic safety and high anti-inflammatory efficacy, mometasone furoate – a new-generation intranasal glucocorticoid – was approved in 2019 as an over-the-counter medication for Polish patients diagnosed with allergic rhinitis. Scientific societies and expert groups recommend the use of intranasal glucocorticoids in a much broader range of indications. In February 2020, an updated version of the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS 2020) was published. Aim: This article discusses the role of nasal glucocorticoids in regimens used in the treatment of nasal sinusitis as published in EPOS 2020 with Polish country-specific realities being taken into account.

Is Respiratory Epithelial Adenomatoid Hamartoma Related to Central Compartment Atopic Disease?

2020 ◽  
Vol 34 (5) ◽  
pp. 610-617 ◽  
Author(s):  
Joseph S. Schertzer ◽  
Joshua M. Levy ◽  
Sarah K. Wise ◽  
Kelly R. Magliocca ◽  
John M. DelGaudio
Keyword(s):  
Allergic Rhinitis ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Benign Lesion ◽  
Retrospective Chart Review ◽  
Central Compartment ◽  
Atopic Disease ◽  
Sinus Surgery ◽  
Respiratory Epithelial Adenomatoid Hamartoma ◽  
Respiratory Epithelial

Background Respiratory epithelial adenomatoid hamartoma (REAH) is a benign lesion of the sinonasal tract that may mimic more concerning pathology. Clinical factors associated with REAH have not been well characterized. Objective To report our findings on patients with this pathologic diagnosis. Methods A retrospective chart review of patients with REAH between September 2006 and November 2019 was conducted. Data collected included clinical allergic rhinitis and asthma history, additional sinonasal diagnoses, prior sinus surgery, and the location of the REAH within the sinonasal cavity. Results Twenty-six patients were identified (53.8% male, mean age 62 years [range, 29–93]). Bilateral REAH occurred in 50%. REAH was located at the superior nasal septum in 84.6% cases, with the remainder identified in sinus contents submitted for pathology, making definitive site uncertain. Concurrent sinonasal inflammatory disorders were identified in 18 patients (69.2%), including chronic rhinosinusitis with nasal polyps—not otherwise specified (6), chronic rhinosinusitis without nasal polyps (4), aspirin-exacerbated respiratory disease (2), allergic fungal rhinosinusitis (1), central compartment atopic disease (5), and IgG4-related sclerosing disease (1). Eight patients had isolated REAH. Adequate allergy records were available for 19 patients, of which 18 of 19 (94.7%) had clinical allergic rhinitis. Conclusions REAH is a benign sinonasal lesion commonly located within the central compartment of the nasal cavity, a site of significant allergen exposure. Affected patients have a high incidence of allergy along with chronic inflammatory conditions. The coexistence of REAH within inflammatory nasal mucosa in a consistent anatomic location, suggests REAH may have a similar etiology to central compartment atopic disease, with resultant respiratory glandular ingrowth within long-standing reactive changes of mucosa derived from ethmoid embryologic origin.

Efficacy of posterior nasal neurectomy for allergic rhinitis combined with chronic rhinosinusitis with nasal polyps

2019 ◽  
Vol 139 (10) ◽  
pp. 890-894 ◽  
Author(s):  
Song Li ◽  
Jinzhang Cheng ◽  
Jingpu Yang ◽  
Yin Zhao ◽  
Zhiling Zhu ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps

Diagnostic Accuracy of Symptoms, Endoscopy, and Imaging Signs of Chronic Rhinosinusitis Without Nasal Polyps Compared to Allergic Rhinitis

2018 ◽  
Vol 32 (3) ◽  
pp. 121-131 ◽  
Author(s):  
A. Koskinen ◽  
J. Numminen ◽  
A. Markkola ◽  
J. Karjalainen ◽  
T. Karstila ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Visual Analogue Scale ◽  
Diagnostic Accuracy ◽  
Chronic Rhinosinusitis ◽  
Facial Pain ◽  
Analogue Scale ◽  
Nasal Polyps ◽  
Duration Of Symptoms ◽  
Endoscopic Score ◽  
Imaging Signs

Objectives The diagnosis of chronic rhinosinusitis without nasal polyps (CRSsNP) and distinguishing it from allergic rhinitis is difficult. Yet, early detection of CRSsNP is important to prevent progressive and severe chronic rhinosinusitis. Our aim was to compare diagnostic accuracy of symptoms, endoscopy, and imaging signs of CRSsNP and allergic rhinitis -only phenotypes. Setting Prospective controlled follow-up study. Participants Forty-two nonsmoking patients visiting tertiary care due to CRSsNP and 19 nonsmoking volunteer controls with allergic rhinitis filled a symptoms questionnaire and underwent nasal endoscopy off-seasonally. All CRSsNP patients underwent computed tomography scans of paranasal sinuses. All the allergic rhinitis control subjects and 14 of the CRSsNP patients underwent sinus magnetic resonance imaging. Results Radiologic Lund–Mackay score, duration of symptoms, visual analogue scale scores of symptoms, and Sinonasal Outcome Test 22 were significantly higher in the CRSsNP group compared to allergic rhinitis control group. These factors also correlated in part with each other. Endoscopic score did not correlate with other factors, nor did it differ between CRSsNP and allergic rhinitis groups. The highest area under curve value was demonstrated for visual analogue scale score of facial pain/pressure (0.93) and score ≥4/10 showed 60% sensitivity and 95% specificity for detecting CRSsNP group ( P < .001). Radiologic sign of obstructed osteomeatal complex showed 100% specificity and 38% sensitivity for detecting CRSsNP group ( P < .001). Conclusions CRSsNP phenotype could be primarily distinguished from allergic rhinitis by higher facial pain/pressure score and secondarily by radiologic sings of obstructed ostiomeatal complex and higher Lund–Mackay score. Endoscopic score has limited value in distinguishing CRSsNP from allergic rhinitis.

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