scholarly journals Sinonasal Tissue Remodelling during Chronic Rhinosinusitis

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Satya Amirapu ◽  
Kristi Biswas ◽  
Fiona J. Radcliff ◽  
Brett Wagner Mackenzie ◽  
Stephen Ball ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Passage ◽  
Comorbid Condition ◽  
Tissue Remodelling ◽  
Histological Features ◽  
Basement Membrane Thickening ◽  
Special Mention ◽  
Improve Clinical Outcome ◽  
Early Surgical Treatment

The purpose of this review is to summarise contemporary knowledge of sinonasal tissue remodelling during chronic rhinosinusitis (CRS), a chronic disease involving long-term inflammation of the paranasal sinuses and nasal passage. The concept of tissue remodelling has significant clinical relevance because of its potential to cause irreversibility in chronic airway tissues. Recent studies have indicated that early surgical treatment of CRS may improve clinical outcome. Tissue remodelling has been described in the literature extensively with no consensus on how remodelling is defined. This review describes various factors implicated in establishing remodelling in sinonasal tissues with a special mention of asthma as a comorbid condition. Some of the main histological features of remodelling include basement membrane thickening and collagen modulation. This may be an avenue of research with regard to targeted therapy against remodelling in CRS.

The Absurd Injunction to Not Belong and the Bidūn in Kuwait

2020 ◽  
Vol 52 (4) ◽  
pp. 726-732
Author(s):  
Claire Beaugrand
Keyword(s):  
Mobile Phone ◽  
Legal Status ◽  
Personal Data ◽  
Male Voice ◽  
Central System ◽  
Additional Remark ◽  
Special Mention ◽  
The Voice ◽  
Mobile Phone Camera

In a tweet posted on 29 March 2018, a bidūn activist—who was later jailed from July 2019 to January 2020 for peacefully protesting against the inhumane conditions under which the bidūn are living—shared a video. The brief video zooms in closely on an ID card, recognizable as one of those issued to the bidūn, or long-term residents of Kuwait who are in contention with the state regarding their legal status. More precisely, the mobile phone camera focuses on the back of the ID card, on one line with a special mention added by the Central System (al-jihāz al-markazī), the administration in charge of bidūn affairs. Other magnetic strip cards hide the personal data written above and below it. A male voice can be heard saying that he will read this additional remark, but before even doing so he bursts into laughter. The faceless voice goes on to read out the label in an unrestrained laugh: “ladayh qarīb … ladayh qarīna … dālla ʿalā al-jinsiyya al-ʿIrāqiyya” (he has a relative … who has presumptive evidence … suggesting an Iraqi nationality). The video shakes as the result of a contagious laugh that grows in intensity. In the Kuwaiti dialect, the voice continues commenting: “Uqsim bil-Allāh, gaʿadt sāʿa ufakkir shinū maʿanāt hal-ḥatchī” (I swear by God, it took me an hour to figure out the meaning of this nonsense), before reading the sentence again, stopping and guffawing, and asking if he should “repeat it a third time,” expressing amazement at its absurdity. The tweet, addressed to the head of the Central System (mentioned in the hashtag #faḍīḥat Sāliḥ al-Faḍāla, or #scandal Salih al-Fadala), reads: In lam tastaḥī fa-'ktub mā shaʾt (Don't bother, write what you want).

Long-term survival in a case of ETANTR with histological features of neuronal maturation after therapy

2015 ◽  
Vol 466 (5) ◽  
pp. 603-607 ◽  
Author(s):  
Manila Antonelli ◽  
Andrey Korshunov ◽  
Angela Mastronuzzi ◽  
Francesca Diomedi Camassei ◽  
Andrea Carai ◽  
...  
Keyword(s):  
Neuronal Maturation ◽  
Term Survival ◽  
Long Term Survival ◽  
Histological Features

Efficacy of Endoscopic Posterior Nasal Neurectomy in Treating Eosinophilic Chronic Rhinosinusitis

ORL ◽  
2021 ◽  
pp. 1-5
Author(s):  
Manman Chen ◽  
Ming Xu ◽  
Xuefeng Lei ◽  
Bin Zhang
Keyword(s):  
Chronic Rhinosinusitis ◽  
Surgical Recurrence ◽  
Eosinophilic Chronic Rhinosinusitis ◽  
Group A ◽  
Sinonasal Outcome Test ◽  
Random Number Table ◽  
Group B

<b><i>Objectives:</i></b> Recent guidelines have revealed that eosinophilic chronic rhinosinusitis (ECRS) exhibits a strong tendency for recurrence after surgery and impairs quality of life. Neuropeptides play an important neuroimmunological role. The aim of this study was to determine the efficacy of posterior nasal neurectomy (PNN) for the treatment of ECRS by inhibiting type 2 cytokine expression. <b><i>Methods:</i></b> Forty-six patients were divided into group A and group B according to a random number table. Group A underwent conventional functional endoscopic sinusitis surgery (FESS) combined with PNN, and group B underwent conventional FESS alone. The subjective and objective symptoms included a 10-cm visual analog scale (VAS), 22-item SinoNasal Outcome Test (SNOT-22) score, nasal speculum Lund-Kennedy score, and paranasal sinus computed tomography (CT) Lund-Mackay score at the 1-year postoperative follow-up. <b><i>Results:</i></b> Postoperative VAS (10.33 ± 2.18 vs. 8.38 ± 2.11, <i>p</i> &#x3c; 0.01) and Lund-Kennedy score (1.95 ± 1.32 vs. 3.14 ± 1.35, <i>p</i> &#x3c; 0.01) were significantly improved. The rhinorrhea score (1.76 ± 0.83 vs. 2.90 ± 1.14, <i>p</i> &#x3c; 0.001) in the VAS and the discharge (0.43 ± 0.51, vs. 0.95 ± 0.67, <i>p</i> &#x3c; 0.01) and edema (0.57 ± 0.60 vs. 0.95 ± 0.59, <i>p</i> &#x3c; 0.05) scores in the Lund-Kennedy score were observed to have improved significantly in group A compared with those in group B. <b><i>Conclusions:</i></b> FESS combined with PNN suppresses edema symptoms, which might significantly decrease the surgical recurrence rate of ECRS in the long term.

Biological therapy of chronic rhinosinusitis

2021 ◽  
Vol 70 (2) ◽  
pp. 109-114
Author(s):  
Zuzana Balatková ◽  
Zdeněk Knížek ◽  
Jan Vodička ◽  
Jan Plzák
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Biological Therapy ◽  
Immunoglobulin E ◽  
Sinus Surgery ◽  
Therapeutic Choice ◽  
First Choice ◽  
Intranasal Steroids

The aim of this paper is to present an up-to-date information about therapeutical options in chronic rhinosinusitis with nasal polyps. First choice therapy is a long term regular application of intranasal steroids in combination with salinic solution douches. If this treatment is not eff ective enough, then the pulses of systemic steroids are indicated. If the sufficient control of the disease is not achieved, then surgery is a therapeutic choice; it means functional endoscopic sinus surgery in the extent corresponding to the extension of the sinus disease. However, there remains a certain group of patients in whom the results with this treatment are not optimal. The type 2 immunopathological response affects relevantly the course of the disease. Nowadays, the research is done in this field. Specific agents, which are able to block circulating inflammatory mediators or bind receptors for these mediators are developed and studied. The results of the studies having been completed by now are promising. Keywords: biological therapy – chronic rhinosinusitis – nasal polyps – dupilumab – immunoglobulin E – interleukin

Long term outcomes of balloon sinuplasty for the treatment of chronic rhinosinusitis with and without nasal polyps

2021 ◽  
Vol 42 (1) ◽  
pp. 102825
Author(s):  
Afonso Castro ◽  
Miguel Furtado ◽  
Ângela Rego ◽  
Daniela Serras ◽  
Marisol Plácido ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Long Term Outcomes ◽  
Balloon Sinuplasty

Differential expression of periostin in the nasal polyp may represent distinct histological features of chronic rhinosinusitis

2015 ◽  
Vol 42 (2) ◽  
pp. 123-127 ◽  
Author(s):  
Osamu Shiono ◽  
Yasunori Sakuma ◽  
Masanori Komatsu ◽  
Mariko Hirama ◽  
Yukiko Yamashita ◽  
...  
Keyword(s):  
Differential Expression ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyp ◽  
Histological Features

scholarly journals A 10-Year Follow-Up of a Randomized Prospective Study of 2 Treatments for Chronic Rhinosinusitis Without Nasal Polyps and Investigation of the Impact of Gastroeosophageal Reflux Disease in the Resistance to Treatment

2019 ◽  
pp. 014556131989246
Author(s):  
Jerome R. Lechien ◽  
Gersende Debie ◽  
Virginie Mahillon ◽  
Marie-Paule Thill ◽  
Alexandra Rodriguez ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Chronic Rhinosinusitis ◽  
Reflux Disease ◽  
Nasal Polyps ◽  
Sinus Surgery ◽  
Amoxicillin Clavulanate ◽  
The Impact

Objectives: To compare the 2 long-term medical strategies in chronic rhinosinusitis without nasal polyps (CRSnNP) and to identify the role of gastroesophageal reflux disease (GERD) and Helicobacter pylori as factors of treatment failure. Material and Methods: Fifty-seven patients with CRSnNP were randomized into 2 therapeutic groups. The first group was treated with 4 weeks of amoxicillin/clavulanate and a short course of oral steroids. The second group received 8 weeks of clarithromycin. Sinonasal Outcome Test-20 (SNOT-20) and Lund and Mackay scores were assessed at baseline and after treatment, and GERD Health-Related Quality of Life (GERD-HRQL) questionnaire was evaluated in all patients. Patients with a GERD-HRQL score >8 received esogastroscopy and H pylori detection. Patients were followed during a 10-year period for clinical course and GERD evolution. The 10-year evolution of patients was described in terms of recurrence, medical, and surgical treatments. Results: Thirty-seven patients completed the study; SNOT-20 and Lund and Mackay scores similarly improved in both groups. Amoxicillin/clavulanate group had significantly more adverse reactions than the clarithromycin group (P = .03). After the therapeutic course, 35% (amoxicillin/clavulanate) and 41% (clarithromycin) of patients needed functional endoscopic sinus surgery (FESS). During the long-term follow-up, 54% (amoxicillin/clavulanate) and 40% (clarithromycin) of patients had late CRSnNP recurrence; FESS was performed in less than 15% of cases of recurrence. Gastroesophageal reflux disease complaint’s severity was associated with late recurrence of CRSnNP. Conclusion: Amoxicillin/clavulanate and clarithromycin would be competitive treatments for CRSnNP. Gastroesophageal reflux disease seems to be a negative factor for treatment response and recurrence.

How Does Age Impact Presentation and Outcomes in Chronic Rhinosinusitis?

2020 ◽  
Vol 129 (9) ◽  
pp. 872-877
Author(s):  
Thomas Holmes ◽  
Chadi Makary ◽  
Aykut A. Unsal ◽  
Paul Biddinger ◽  
Camilo Reyes-Gelves ◽  
...  
Keyword(s):  
Young Adults ◽  
Elderly Patients ◽  
Chronic Rhinosinusitis ◽  
Statistical Difference ◽  
Prognostic Indicators ◽  
Level Of Evidence ◽  
Tissue Eosinophilia ◽  
Short And Long Term ◽  
Snot 22

Objectives/Hypothesis: The presence of eosinophilia and nasal polyps are well-established prognostic indicators of chronic rhinosinusitis (CRS). The importance of demographic background, such as age, as independent variables has not been elucidated while taking these factors into account. Study Design: Respective review. Methods: CRS patients who underwent primary surgical treatment were subdivided based on age (young adults = age 18-39, adults = age 40-64, and elderly = age 65+). Groups were then subdivided based on tissue eosinophilia and nasal polyposis. Sinonasal Outcome Test (SNOT-22), Lund-Kennedy (LK) endoscopy scores, and Lund-McKay (LM) CT scores were compared preoperatively, and postoperatively during a 5-year period. Results: A total of 431 CRS patients identified and then subsequently broken down into 63 young adults (YA), 209 adults (A), and 159 elderly (E). There was no statistical difference between tissue eosinophilia and presence of polyps between the groups. All three groups had similar short- and long-term SNOT-22 patterns postoperatively. At presentation, young adults had significantly higher SNOT-22 score (33.2 YA, 25.3 A, 23.5 E, P = .029) and significantly higher rhinologic scores (1.9 YA, 1.3 A, 1.3 E, P = .0012) than the adult and elderly patients. Objective disease severity using LK endoscopy scores were only significantly higher in young adults at 1-year time ( P = .0026). There was no statistical difference between the groups in regards to preoperative LM CT scores. Conclusions: Young adults are more likely to present with overall higher subjective SNOT-22 scores over adults and elderly patients, despite similar objective findings in the groups. Short- and long-term postoperative improvement holds across all age groups. Level of Evidence: 4

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