Major Secretory Mucin Expression in Chronic Sinusitis

2005 ◽  
Vol 133 (3) ◽  
pp. 423-428 ◽  
Author(s):  
Mahmoud S. Ali ◽  
David A. Hutton ◽  
Janet A. Wilson ◽  
Jeffrey P. Pearson
Keyword(s):  
Surgical Treatment ◽  
Prospective Studies ◽  
Nasal Polyps ◽  
Inverse Relationship ◽  
Chronic Sinusitis ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Prognostic Indicators ◽  
Nasal Mucus ◽  
Mucin Expression

OBJECTIVE: The aim of this study was to investigate mucin expression in chronic sinusitis compared to that in normal nasal mucus. STUDY DESIGN AND SETTING: Sinus mucus samples were collected during functional endoscopic sinus surgery (FESS). The expression of 3 airway mucins, MUC2, MUC5AC, and MUC5B, was determined by ELISA. RESULTS: The 3 mucins are expressed in chronic sinusitis and in normal nasal mucus. MUC5AC and MUC5B represent a major component in sinus mucins while MUC5B and MUC2 predominated in normal nasal mucin. In sinus mucins, upregulation of MUC5AC was associated with downregulation of MUC2 and vice versa. This inverse relationship was strengthened in the presence of nasal polyps. CONCLUSION: At least 3 mucins are expressed at various levels in chronic sinusitis. An inverse relationship was identified between expression of MUC5AC and MUC2. Large prospective studies are required to unravel the complexities of sinus mucus in chronic sinusitis. SIGNIFICANCE: Mucins may be used as markers for assessment of disease severity and may also help as prognostic indicators following medical or surgical treatment.

Powered Nasal Polypectomy in the Office Setting

1996 ◽  
Vol 75 (9) ◽  
pp. 608-610 ◽  
Author(s):  
John H. Krouse ◽  
Dewey A. Christmas
Keyword(s):  
Surgical Treatment ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Office Setting

The use of powered instrumentation has revolutionized the practice of functional endoscopic sinus surgery. We have expanded the role of the instrument to the treatment of polypoid disease of the nose within the office setting. We have found the technique to be both safe and effective, and to allow thorough exenteration of nasal polyps with minimal bleeding and discomfort. We recommend the use of the powered device as the primary tool in the surgical treatment of nasal polyps in the office.

Histopathologic Features of Chronic Sinusitis Precipitated by Odontogenic Infection

2018 ◽  
Vol 33 (2) ◽  
pp. 113-120 ◽  
Author(s):  
Anish Raman ◽  
Peter Papagiannopoulos ◽  
Hannah N. Kuhar ◽  
Paolo Gattuso ◽  
Pete S. Batra ◽  
...  
Keyword(s):  
Nasal Polyps ◽  
Chronic Sinusitis ◽  
Squamous Metaplasia ◽  
Disease Process ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Severe Inflammation ◽  
Sinonasal Outcome Test ◽  
Inflammatory Profile ◽  
Histopathologic Features

Background Chronic rhinosinusitis (CRS) is a heterogeneous disease process that can arise in the context of odontogenic disease from the maxillary teeth. The histopathologic features of odontogenic CRS (CRSo) have yet to be determined and may have important implications on disease management and need for escalation of therapy. Objectives The objectives of this study are to characterize the histopathologic features of CRSo and determine whether the inflammatory profile of CRSo contributes to its recalcitrance to medical therapy and need for surgery in a subset of patients with this disease. Methods A structured histopathology report was used to analyze sinus tissue removed during functional endoscopic sinus surgery (FESS). Histopathology variables, Lund–Mackay scores (LMS), and Sinonasal Outcome Test-22 scores were compared among CRSo patients, CRS without nasal polyps (CRSsNP) patients, and CRS with nasal polyps (CRSwNP) patients. Results Twenty-three CRSo, 38 CRSwNP, and 53 CRSsNP patients who underwent FESS were analyzed. Compared to CRSsNP, CRSo exhibited increased moderate–severe inflammation (73.9% vs 41.5%, P < .009). Compared to CRSwNP, CRSo had decreased squamous metaplasia (0.0% vs 18.4%, P < .03) and decreased fibrosis (26.1% vs 63.2%, P < .005). Eosinophilia was prevalent in CRSo but to a lesser extent than in CRSwNP (39.1% vs 63.2%, P < .05). CRSo cases had significantly lower mean LMS compared to CRSwNP (7.83 ± 2.77 vs12.18 ± 6.77, P < .005). Conclusion CRSo exhibits histopathologic features similar to those of CRSsNP with more severe inflammation. Moreover, eosinophilia, which is not typically considered to coexist with CRSo, was present in a large portion of CRSo patients. These findings may help explain at the inflammatory level why select cases of CRSo may be recalcitrant to medical and dental therapy.

scholarly journals Chronic rhinosinusitis in adult patients with cystic fibrosis: clinical manifestation and therapeutic approaches

2019 ◽  
Vol 29 (3) ◽  
pp. 311-320
Author(s):  
G. L. Shumkova ◽  
E. L. Amelina ◽  
V. M. Svistushkin ◽  
E. V. Sin’kov ◽  
S. A. Krasovskiy ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Surgical Treatment ◽  
Treatment Group ◽  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Adult Patients ◽  
Sinus Surgery ◽  
Markers Of Inflammation

The aim of this study was to evaluate prevalence of chronic rhinosinusitis (CRS) and nasal polyps in adult patients with cystic fibrosis (CF) in Russian Federation. Additionally, we investigated the clinical course of CRS and developed the optimal therapeutic strategy.Methods. Three hundred and forty eight CF patients were involved in the study. Physical examination, computed tomography (CT) of paranasal sinuses and audiometry, if needed, were used. CRS and bilateral nasal polyps were diagnosed in 28 patients. Nasal endoscopy, SNOT-20 questionnaire, rhinomanometry, micro - biological examination of sputum and mucus from paranasal sinuses (obtained during puncture or surgery), spirometry, and measurement of serum markers of inflammation were used. Endoscopic sinus surgery was used in 14 patients (the group 1) and others were treated non-surgically (the group 2). Both group were treated during 6 months using intranasal mometasone, mucolytics and antibiotics via PARI SINUSTM nebulizer.Results. An improvement in symptoms, CT signs, rhinomanometry parameters and endoscopic signs was seen in both groups after treatment and was more prominent in the surgical treatment group compared to the non-surgical treatment group. Bacterial load reduction in nasal sinuses, decrease in the rate of pulmonary disease exacerbations, and an improvement in oxygen blood saturation were found in the surgical treatment group only. Treatment of CRS did not affect lung function, sputum microbiology and serum inflammatory markers.Conclusion. Endoscopic sinus surgery followed by intranasal mucolytics and antibacterials is an effective and well-tolerated treatment in adult CF patients with CRS. 

Milk Allergy is Frequent in Patients with Chronic Sinusitis and Nasal Polyposis

2011 ◽  
Vol 25 (6) ◽  
pp. e221-e224 ◽  
Author(s):  
Claudia Lill ◽  
Benjamin Loader ◽  
Rudolf Seemann ◽  
Michaela Zumtobel ◽  
Markus Brunner ◽  
...  
Keyword(s):  
Food Allergy ◽  
Healthy Subjects ◽  
Nasal Polyps ◽  
Nasal Polyposis ◽  
Chronic Sinusitis ◽  
Recurrent Disease ◽  
Sinus Surgery ◽  
Food Allergies ◽  
Milk Allergy ◽  
Wheat Allergy

Background Chronic sinusitis and nasal polyps with subsequent nasal blocking, anosmia, and relapsing infections are frequent in the rhinological practice. Often, recurrent disease necessitates repetitive conservative therapy and surgical treatment (functional endoscopic sinus surgery). This study was initiated to scrutinize the relationship of wheat and milk allergies to chronic polypoid sinusitis (CPS) and recurrent disease. Methods Blood samples of 50 healthy controls and 50 patients with clinically and radiologically diagnosed CPS and nasal polyposis were screened for common food allergies including wheat and milk allergy. On inclusion into the study, none of the patients reported a symptomatic food allergy. Results Fifteen of 100 tested subjects (15%) revealed a previously undiagnosed allergy to inhalant (dust, rye, and pollens) and other food allergens (corn and egg white). Six of 50 patients (12%) with CPS exhibited a wheat allergy, and a milk allergy could be identified in 7 patients (14%). In the control group, seven healthy subjects (14%) showed a wheat allergy and no case of milk allergy could be identified (p = 0.0125). Conclusion In contrast to previous studies in other countries presenting a food allergy incidence of ∼75% in patients with nasal polyposis, we could not show such a high incidence. In the group with chronic polyposis 14% of the patients were positive for milk allergy compared with none of the tested healthy subjects, resulting in a strong statistical significance. Therefore, we conclude that cow's milk but not wheat allergy might be a relevant pathogenetic entity in chronic nasal polyps.

Understanding the Propensity for Chronic Sinusitis in Patients on Immunosuppressive Therapy

2018 ◽  
Vol 32 (6) ◽  
pp. 478-484 ◽  
Author(s):  
Peter Papagiannopoulos ◽  
Hannah N. Kuhar ◽  
Anish Raman ◽  
Ashwin Ganti ◽  
Paolo Gattuso ◽  
...  
Keyword(s):  
Immunosuppressive Therapy ◽  
Nasal Polyps ◽  
Chronic Sinusitis ◽  
Immunosuppressive Treatment ◽  
Disease Process ◽  
Sinus Surgery ◽  
High Power Field ◽  
Immunosuppressive Medications ◽  
Sinonasal Outcome Test ◽  
Neutrophil Infiltrate

Background Chronic rhinosinusitis (CRS) is a frequently observed condition in patients with immunodeficiency secondary to immunosuppressive medications. The histologic features of CRS among patients undergoing immunosuppressive treatment have yet to be determined and may have important implications on understanding the pathophysiology of the disease process. Methods A structured histopathology report was utilized to analyze sinus tissue removed during functional endoscopic sinus surgery (FESS). Histopathology variables, Lund–Mackay score (LMS), and sinonasal outcome test 22 scores were compared among patients with CRS on immunosuppressive therapy (CRSi), CRS without nasal polyps (CRSsNP) patients, and CRS with nasal polyps (CRSwNP) patients. Results Fifteen CRSi, 36 CRSwNP, and 56 CRSsNP patients undergoing FESS were analyzed. Compared to CRSsNP, CRSi patients exhibited a trend toward increased moderate–severe inflammation (66.7% vs 42.1%, P < .080), increased neutrophil infiltrate (40.0% vs 24.6%, P < .192), and decreased fibrosis (26.7% vs 43.9%, P < .182). Compared to CRSwNP, CRSi patients demonstrated decreased fibrosis (26.7% vs 66.7%, P < .010), decreased eosinophil aggregates (13.3% vs 44.4%, P < .032), and a trend toward fewer eosinophils per high-power field (46.7% vs 66.7%, P < .154). CRSi cases had significantly lower mean LMS (8.20 ± 4.30 vs 12.78 ± 6.56, P < .017) compared to CRSwNP. Conclusion CRSi patients exhibit histopathology and disease severity more similar to CRSsNP with trends toward increased neutrophilia and reduced fibrosis. In the appropriate clinical context, discontinuing or changing a patient’s immunosuppressive regimen may be a valid treatment option in patients with CRSi. This study provides initial insight into understanding the propensity for chronic sinusitis in patients undergoing immunosuppressive treatment which may have implications on disease management.

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