scholarly journals The Impact of Nasal Polyposis on Olfactory Dysfunction in Chronic Rhinosinusitis

2017 ◽  
Vol 24 (1) ◽  
pp. 31 ◽  
Author(s):  
Hee Chul Yoon ◽  
Tae Min Kim ◽  
Jae Woo Joo ◽  
In Sik Song ◽  
Seung-No Hong ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyposis ◽  
Olfactory Dysfunction ◽  
The Impact

scholarly journals Olfactory Dysfunction in Patients with Chronic Rhinosinusitis

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
María V. Sánchez-Vallecillo ◽  
María E. Fraire ◽  
Carlos Baena-Cagnani ◽  
Mario E. Zernotti
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyposis ◽  
Olfactory Dysfunction ◽  
Age And Gender ◽  
Predicting Factors ◽  
Olfactory Loss ◽  
Olfactory Test ◽  
Turbinate Hypertrophy ◽  
Clinical Research Center ◽  
And Gender

Objectives. To measure the prevalence of and identify the clinical characteristics associated with olfactory decline in patients with chronic rhinosinusitis.Methods and Materials. There is analytical, prospective, and observational study in adult patients with a diagnosis of chronic rhinosinusitis. The olfactory test used was the Connecticut Chemosensory Clinical Research Center (CCCRC).Results. They are 33 patients total. Within the group of patients aged 18 to 39, 9% had normosmia, 73% hyposmia, and 18% anosmia (P<0.001). Between 40 and 64 years old, there was no patient with normosmia, 63% hyposmia, and 37% anosmia (P<0.001). Of patients older than 65 years old, 33% showed mild hyposmia, 34% severe hyposmia, and 33% anosmia (P<0.001). 52% were females, and 48% were males.Conclusion. Nasal polyposis, asthma, septal deviation, turbinate hypertrophy, tobacco, and allergic rhinitis are predicting factors of olfactory dysfunction. Antecedents of previous endoscopic surgeries, age, and gender would not be associated with olfactory loss.

Impact of gender on clinical presentation of chronic rhinosinusitis with and without polyposis

2008 ◽  
Vol 122 (11) ◽  
pp. 1180-1184 ◽  
Author(s):  
N Y Busaba ◽  
H-J Sin ◽  
S D Salman
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Obstruction ◽  
Facial Pain ◽  
Nasal Polyposis ◽  
Clinical Presentation ◽  
The Other ◽  
Presenting Symptoms ◽  
Common Diagnosis ◽  
Significant Difference ◽  
The Impact

AbstractStudy objective:To determine the impact of a patient's gender on the clinical presentation of chronic rhinosinusitis with and without nasal polyposis.Study design and methods:Prospective study of 514 adult patients who presented with chronic rhinosinusitis with and without nasal polyposis. The patients were divided into two groups based on gender: female (n = 273) and male (n = 241). The following data were collected: presenting symptoms, co-morbidities, nasal endoscopy and sinus computed tomography findings, diagnosis, and outcome of surgery. Statistical analysis was performed using the chi-square test, with statistical significance set at p < 0.05.Results:Facial pain and headache were more prevalent among women, while nasal obstruction was more prevalent among men (p < 0.05). There was no statistically significant difference in the prevalence of environmental allergy, asthma, psychiatric illness or anatomical variants obstructing the osteomeatal unit, comparing the genders. Chronic rhinosinusitis without polyposis was the more common diagnosis among women, while chronic rhinosinusitis with polyposis was the more common diagnosis among men (p < 0.05). Following surgery, a higher percentage of male patients reported improvement in nasal obstruction (p < 0.05), but there was no statistically significant difference in the improvement of the other presenting symptoms, comparing the genders.Conclusion:Women who suffer from chronic rhinosinusitis are more likely to complain of facial pain or headache on presentation and to be diagnosed with chronic rhinosinusitis without polyposis. On the other hand, men are more likely to complain of nasal obstruction, to be diagnosed with chronic rhinosinusitis with polyposis, and to report improvement in nasal obstruction following surgery.

scholarly journals Does time to endoscopic sinus surgery impact outcomes in Chronic Rhinosinusitis? Prospective findings from the National Comparative Audit of Surgery for Nasal Polyposis and Chronic Rhinosinusitis

2015 ◽  
Vol 53 (1) ◽  
pp. 10-17
Author(s):  
C. Hopkins ◽  
J. Rimmer ◽  
V.J. Lund
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyposis ◽  
Surgical Intervention ◽  
Elective Surgery ◽  
Symptom Burden ◽  
Sinus Surgery ◽  
Time Points ◽  
Comparative Audit ◽  
The Impact ◽  
Snot 22

Objectives: Patients with chronic rhinosinusitis refractory to medical management undergo elective surgery. The time from initial diagnosis to surgery varies considerably. The impact of this delay on surgical success has never previously been evaluated. Design: First-time patients within the National Comparative Audit of Surgery for Nasal Polyposis and Chronic Rhinosinusitis were grouped based on time to surgery: 1) Early cohort: %lt; 12 months; 2) Mid cohort: 12-60 months; and 3) Late cohort: > 60 months. Co-morbidities and preoperative CT scores were analysed for all patients. Main outcome measures: The 22-item Sino-Nasal Outcome Test scores (SNOT-22) were collected at 0, 3, 12 and 60-months. Absolute and relative SNOT-22 changes from baseline were evaluated. Results: Asthma and allergies were significantly more prevalent in the Late versus the Early and Mid-cohorts. In addition, patients in the Late cohort had greater symptom burden on the SNOT-22 and more extensive preoperative radiographic disease as determined by Lund-Mackay (LM) scores. SNOT-22 scores demonstrated greater percentage improvements in the Early versus the Mid- and Late cohorts, at all time points after surgery. At 12 and 60 months after surgery, significantly more patients in the Early group achieved a clinically important change in SNOT-22 scores compared with the other groups. These differences were maintained when cohorts were matched for preoperative co-morbidities. Conclusion: Patients with asthma and/or allergies are more likely to experience delayed surgical intervention versus other patients. Overall, patients with delayed surgery reported less improvement in SNOT-22 scores than patients treated at earlier time points, regardless of co-morbid status. Delaying surgical intervention may worsen long term clinical outcomes.

Recovery of Sense of Smell by Mepolizumab in a Patient with Chronic Rhinosinusitis and Nasal Polyposis – A Case Report

2020 ◽  
Vol 01 ◽  
Author(s):  
Mohamed Abuzakouk ◽  
Omar Ghorab ◽  
Safieeldin Ghazala ◽  
Anastasios Hantzakos
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Nasal Polyposis ◽  
Symptom Relief ◽  
Olfactory Dysfunction ◽  
Topical Steroids ◽  
Eosinophilic Asthma ◽  
Sense Of Smell ◽  
Nasal Sprays ◽  
Oral Steroids

Introduction: To date, there is no permanent medical treatment for nasal polyposis and loss of sense of smell. Mepolizumab is an anti-IL-5 monoclonal antibody approved for the treatment of patients with eosinophilic asthma. It has been suggested that it is capable of improving olfactory dysfunction in patients with chronic rhinosinusitis and nasal polyposis. Case: We present a 35-year-old Emirati male with progressively worsening rhinosinusitis, recurring nasal polyps and total loss of sense of smell. He was treated with oral steroids, normal saline nasal sprays and all available topical steroids without significant or permanent symptom relief. He was commenced on Mepolizumab, and upon receiving the 4th dose, he reported full recovery of his sense of smell. Conclusion: Mepolizumab appears to be very effective in treating loss of sense of smell. Further studies should be conducted to assess the efficacy and effectiveness of Mepolizumab in patients with chronic rhinosinusitis, nasal polyposis and anosmia.

scholarly journals The Impact Of Chronic Rhinosinusitis On Olfaction: Immunohistochemical Study

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
Y F Elbeltagy ◽  
H S Elhalabi ◽  
N S Ahmed ◽  
A M Maarouf ◽  
M F Saleeb
Keyword(s):  
Chronic Rhinosinusitis ◽  
Olfactory Dysfunction ◽  
Olfactory Mucosa ◽  
Olfactory Function ◽  
Specific Marker ◽  
Intermediate Filament Protein ◽  
Nestin Expression ◽  
Protein Marker ◽  
Significant Difference ◽  
The Impact

Abstract Background Chronic rhinosinusitis (CRS) is one of the leading causes of olfactory. Olfactory impairments in CRS can be classified into two broad mechanisms of impairment: conductive losses from obstruction of the nasal passages, or sensorineural causes from damage to the olfactory neuroepithelium. Nestin is one type of intermediate filament protein, was a specific marker for OE stem cells. It was found that nestin is actually expressed in the axonal ends and inferior processes of OE sustentacular cells in the basal compartment of the epithelium. Nestin immunoreactivity, which is clearly present in the sustentacular cell layer of normosmic patients, was slightly reduced in the OE of subjects suffering from hyposmia. In contrast, in the OE of anosmics, nestin expression was found to be noticeably reduced. This indicates that expression of nestin protein is related to olfactory function and is down regulated with loss of olfactory function. Methods This study included 60 patients (20 chronic rhinosinusitis with polyps patients (CRSwp), 20 chronic rhinosinusitis without polyps patients (CRSsp), and 20 controls). Biopsies taken from olfactory mucosa during surgery. Immunohistochemical examination was done using nestin protein marker, a marker directly related to function in olfactory mucosa, to examine the etiology of olfactory dysfunction in CRS. Results There was a significant difference between the three study groups was found regarding olfaction. While there was a highly statistically significant difference between the three groups regarding nestin staining pattern, however, when comparing the two cases groups, the difference was not significant. Nestin staining decreased in both cases groups and patients with CRSwp have more olfactory dysfunction than patients with CRSsp. This means that while the inflammatory process is strongly present in both groups, the presence of polyps increases olfactory function loss. Conclusion Olfactory dysfunction in patients with CRS is multifactorial where both obstructive and inflammatory causes contribute in the pathogenesis.

Postoperative application of amphotericin B nasal spray in chronic rhinosinusitis with nasal polyposis. Can recidive polyposis be prevented?

2008 ◽  
Vol 149 (37) ◽  
pp. 1737-1746 ◽  
Author(s):  
Imre Gerlinger ◽  
András Fittler ◽  
Anna Mayer ◽  
Ágnes Patzkó ◽  
Fruzsina Fónay ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Chronic Rhinosinusitis ◽  
Nasal Spray ◽  
Nasal Polyposis

A krónikus rhinosinusitis (KRS) a felnőttpopuláció 1–4%-át érintő, jelentős életminőség-romlást okozó idült, multifaktoriális, gyakran orrpolipképződéssel járó, etiológiáját illetően azonban pontosan nem tisztázott megbetegedés. Az elmúlt évtizedben felmerült, hogy az orrüregi nyálkahártya jellegzetes eozinofil sejtes beszűrődését okozó megbetegedésnek az orrüregi nyákban található gombák elleni fokozott – nem IgE típusú klasszikus allergiás – immunválasz a kiváltó oka. Célkitűzés: Ha igaz ez a feltételezés, akkor kézenfekvőnek tűnik, hogy az endoszkópos orrpolypectomiákat követően megfelelő ideig és koncentrációban adott amphotericin B-tartalmú orrspray kedvező hatású lehet a betegek számára, akár csökkentve a recidívák számát. Módszer: A feltételezés igazolá­sára a szerzők 33 beteg bevonásával prospektív, randomizált, placebokontrollált, kettős vak klinikai tanulmányt végeztek. A tanulmányt végül 30 beteg fejezte be. A 2005. november 1-je és 2006. október 1-je között orrpolyposissal endoszkópos műtétre került betegek egyik csoportja (A csoport, 14 beteg) egy évig 5 mg/ml koncentrációjú amphotericin B-tartalmú orrsprayt kapott, míg a placebo­csoport (B csoport, 16 beteg) hatóanyag nélküli orrsprayt. Az eredmények értékeléséhez a módosított Lund–Mackay-féle CT-értékelő pontrendszert, a tüneti változásokat vizsgáló pontrendszert (SNAQ-11), életminőségtesztet és endoszkópos kiértékelést végeztek. A műtétek előtt és a műtéteket követően egy évvel elvégzett vizsgálatok eredményeit SPSS 14.0 for Windows program segítségével értékelték. Eredmények: Az A csoport betegeinek CT-értékelő pontrendszere egy év elteltével jelentős szórást mutatott, a javulás jelei nélkül. A B csoportban a CT-értékelő pontrendszere enyhe javulást mutatott, azonban ez az A csoporttal összehasonlítva nem volt szignifikáns (p = 0,052). A tüneti változásokat vizsgáló pontrendszer (SNAQ-11), valamint az életminőségteszt mindkét betegcsoportban lényeges javulást mutatott, a két tesztben a változások mértékét összehasonlítva azonban egyik betegcsoport javára sem találtak szignifikáns különbséget. Az endoszkópos lelet az amphotericin B-csoport javára mutatott mérsékelt javulást 12 hónappal a műtéteket követően. Következtetések: A szerzők megállapítják, hogy az orrpolyposis miatt operált betegekben az amphotericin B-tartalmú orrcsepp egy évig történő adása nem okoz szignifikáns változást a CT-pontszámok, a klinikai tünetek, valamint az életminőség vonatkozásában. A betegek endoszkópos követése során az amphotericin B-csoportban észlelt kedvezőbb kép a klinikai tünetek javulásában nem nyilvánult meg. A szerzők a tanulmány eredményeiből levont tanulságok tükrében tárgyalják a gombaelméletről rendelkezésre álló eddigi ismeretanyagot. Kritikusan elemzik az elmúlt években publikált 7, ellentmondásos konklúziót mutató klinikai tanulmány tapasztalatait is.

scholarly journals Mucosal Eosinophilia and Neutrophilia Are Not Associated With QOL or Olfactory Function in Chronic Rhinosinusitis

2021 ◽  
pp. 194589242098743
Author(s):  
Nyssa F. Farrell ◽  
Jess C. Mace ◽  
David A. Sauer ◽  
Andrew J. Thomas ◽  
Mathew Geltzeiler ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyposis ◽  
Cross Sectional Study ◽  
Olfactory Function ◽  
Sinus Surgery ◽  
Small Subset ◽  
Cross Sectional ◽  
Snot 22

Background Chronic rhinosinusitis (CRS) is often differentiated by histopathologic phenotypes (eosinophilic versus neutrophilic), which may impact disease severity measures and outcomes. As such, it has been suggested that counts of cellular elements be included as part of a standard pathological report following endoscopic sinus surgery (ESS). Objectives This cross-sectional study evaluated associations of mucosal eosinophilia and neutrophilia with measures of quality-of-life (QoL) and olfactory function. Methods Patients with medically refractory CRS completed the SNOT-22 survey and Brief Smell Identification Test (BSIT) at enrollment. In addition, baseline Lund-Mackay computed tomography (CT) and Lund-Kennedy endoscopy scores were collected. Ethmoid mucosa was biopsied during ESS and reviewed using microscopy to quantify densest infiltrate of eosinophils or neutrophils per high-powered-field (HPF). Eosinophilic CRS (eCRS) and neutrophilic CRS (nCRS), both with and without nasal polyposis (NP), were compared across SNOT-22 and BSIT scores. Results 77/168 patients demonstrated mucosal eosinophilia (eCRS) while a total of 42/168 patients demonstrated mucosal neutrophilia (nCRS). After adjusting for polyp status, 35/168 had eCRSsNP, 42/168 eCRSwNP, 75/168 non-eCRSsNP, 16/168 non-eCRSwNP. Additionally, 22/161 were noted to have nCRSsNP, 20/161 nCRSwNP, 84/161 non-nCRSwNP, and 35/161 non-nCRSsNP. A small subset of patients demonstrated both eosinophilia and neutrophilia: 14 CRSwNP and 7 CRSsNP. When evaluating average Lund-Mackay Scores (LMS), significant differences existed between non-eCRSsNP and eCRSsNP (p = 0.006). However, after controlling for nasal polyps, eosinophilia did not significantly associate with differences in the Lund-Kennedy Score. Neutrophilia did not significantly associate with any changes in LMS or LKS after controlling for NP. Eosinophilic and neutrophilic histopathologic subtypes did not significantly associate with differences in baseline SNOT-22 or BSIT measures after controlling for NP. Conclusion Neither the presence of mucosal eosinophilia nor mucosal neutrophilia demonstrated significant associations with SNOT-22 quality-of-life or BSIT olfactory function scores when controlling for comorbid nasal polyposis.

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