scholarly journals Impact of rhinosinusal polyposis on CT score in patients with chronic rhinosinustis

2010 ◽  
Vol 67 (3) ◽  
pp. 209-212
Author(s):  
Zoran Dudvarski ◽  
Ljiljana Janosevic ◽  
Ivica Pendjer ◽  
Vojko Djukic ◽  
Snezana Jesic ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Nasal Polyps ◽  
Diagnostic Algorithm ◽  
Mean Value ◽  
Mean Values ◽  
Paranasal Sinuses Ct ◽  
A Prospective Study ◽  
Inflammatory Changes ◽  
Sinonasal Polyposis

Background/Aim. Chronic sinusitis is a disease characterized with mucosal inflammatoion of nasal and paranasal sinuses for at least 12 weeks. In order to assess the extent and severity of inflammatory changes in paranasal sinuses CT score according to Lund-Mackay is the most commonly used. Recent studies show the possibility of existing different subtipes of chronic rhinosinusitis, pointing out the presence of nasal polyps and their influence on the severity of chronic rhinosinusitis. The aim of this research was to examine the influence of sinonasal polyposis on the extensity of inflammatory changes on computerized tomography (CT), evaluated by the Lund-Mackay CT score. Methods. A prospective study compared the Lund-Mackay CT score values between the patients with chronic rhinosinusitis associated with nasal polyps and those without them. We determined mean values of the total CT score in both groups of the patients, as well as mean values of CT score for each group of sinuses and ostiomeatal complexes. Results. The study included 90 patients, 47 males and 43 females, 45-year old on average, diagnosed with chronic rhinosinusitis on the basis of diagnostic algorithm. The group with uncomplicated chronic rhinosinusitis (without nasal polyps) consisted of 30 patients and the group with complicated chronic rhinosinusitis (with nasal polyps) of 60 patients. Observing these two groups of patients revealed statistically highly important intergroup difference in CT score for each group of sinuses and ostiomeatal complexes. The mean value of total CT score in the group with uncomplicated chronic rhinosinusitis was 4.37 while in the group with complicated chronic rhinosinusitis it was 16.05 (p < 0.01). Conclusion. Chronic rhinosinusitis complicated by sinonasal polyposis is characterized with more extensive inflammatory changes on CT and, consequently, with higher CT score for each group of sinuses and ostiomeatal complexes, as well as higher total CT score.

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. 

The Incidence of Concurrent Osteitis in Patients with Chronic Rhinosinusitis: A Clinicopathological Study

2006 ◽  
Vol 20 (3) ◽  
pp. 278-282 ◽  
Author(s):  
Jivianne T. Lee ◽  
David W. Kennedy ◽  
James N. Palmer ◽  
Michael Feldman ◽  
Alexander G. Chiu
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Critical Role ◽  
Clinical Findings ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
The Past ◽  
The Mean ◽  
A Prospective Study ◽  
Inflammatory Changes

Background The pathogenesis of chronic rhinosinusitis (CRS) has been found to be multifactorial, with environmental, general host, and local anatomic factors all contributing to its development. Recent studies have indicated that local osteitis of the underlying bone also may play a critical role in the elaboration of CRS by inducing persistent inflammatory changes in the surrounding mucosa. The purpose of this study was to determine the clinical incidence rate of osteitis in patients with CRS undergoing functional endoscopic sinus surgery. Methods From January to July 2003, a prospective study was performed on 121 patients undergoing functional endoscopic sinus surgery for CRS. Age, number of previous surgeries, radiographic bony characteristics, and pathological findings were all documented. The presence of concurrent osteitis was assessed using both radiographic (neoosteogenesis) and pathological (bony remodeling) criteria. Results The mean age of the patients was 44.3 years. Fifty-eight percent of the cases were revision surgeries, with each patient having an average of 2.2 operative procedures in the past. Computed tomography (CT) showed neoosteogenesis in 36% of patients, and 53% showed pathological evidence of osteitis on histological analysis of surgical specimens. Conclusion Concurrent osteitis can be found in 36–53% of patients with CRS, using both radiographic and pathological criteria, respectively. Although a causal relationship between osteitis and CRS can not be inferred from this data, these clinical findings correlate well with previous evidence of bone involvement in CRS found in animal models, further reaffirming the association between underlying osteitis and the pathogenesis of CRS.

Coagulation tests and their association with postoperative blood loss after cardiac surgery with cardiopulmonary bypass

2012 ◽  
Vol 19 (3) ◽  
pp. 166-171 ◽  
Author(s):  
Agnese Ozolina ◽  
Eva Strike ◽  
Antonina Sondore ◽  
Indulis Vanags
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Blood Loss ◽  
Mean Value ◽  
Postoperative Blood Loss ◽  
Mean Values ◽  
Coagulation Tests ◽  
Range Correlation ◽  
A Prospective Study ◽  
Adult Cardiac Surgery

Background. Platelet count (PLT), activated partial thromboplastin time (APTT), prothrombin time (PT) and fibrinogen are standard coagulation tests used for patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Materials and methods. 83 adult cardiac surgery patients were en­ rolled into a prospective study. Blood samples for APTT, PT, PLT, fibrino­ gen were collected preoperatively (T0), on admission to the intensive care unit (T1), 6 and 24 hours postoperatively (T6, T24). 24-hour postopera­ tive blood loss (24h-PBL) was registered. Results. The highest APTT mean value was 47  ±  13 sec at T6, in­ creasing from the baseline by 37%. The lowest mean value of PLT was 140 ± 47 × 109/L at T24, decreasing from the baseline by 32.5%. PT and fibrinogen mean values at all time points were within the normal range. Correlation with 24h-PBL was shown by T0 and T6 fibrinogen (r = –0.5, r  =  –0.4, P 

Comparison of Delivery of Topical Medications to the Paranasal Sinuses via “Vertex-to-floor” Position and Atomizer Spray after FESS

2005 ◽  
Vol 133 (5) ◽  
pp. 735-740 ◽  
Author(s):  
Steven B. Cannady ◽  
Pete S. Batra ◽  
Martin J. Citardi ◽  
Donald C. Lanza
Keyword(s):  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Statistical Significance ◽  
Sinus Surgery ◽  
Olfactory Cleft ◽  
Frontal Recess ◽  
Nasal Drop ◽  
Topical Medications ◽  
Sinonasal Symptoms ◽  
Sinonasal Polyposis

INTRODUCTION: Topical nasal medications are frequently employed for persistent sinonasal symptoms after functional endoscopic sinus surgery (FESS) in chronic rhinosinusitis patients. The optimal means for the delivery of these medications is unclear. In this study, the efficacy of the vertex to floor (VF) position compared to atomizer spray was evaluated in post-FESS patients. METHODS: Three trials were performed: two trials in which patients maintained the VF position for 1 and 5 minutes, respectively, after nasal drop administration were compared to a third trial utilizing an atomizer spray in the upright position. Two independent observers rated the distribution of fluorescein-dyed dexamethasone drops at 5 sinonasal sites: maxillary sinus (MS), ethmoid cavity (EC), frontal recess (FR), sphenoid sinus (SS), and olfactory cleft (OC). RESULTS: VF position consistently delivered nasal drops to the MS, EC, SS, and OC. The atomizer distributed drops to the MS, EC, SS, and FR. The greatest difference was noted with the nasal drops in the olfactory cleft in the VF position; statistical significance was achieved with ANOVA testing ( P = 0.012). Student's paired t test comparing trial 1 to 2, 1 to 3, and 2 to 3 demonstrated greater distribution in the OC at 5 minutes compared with 1 minute and spray ( P = 0.042 and 0.003). CONCLUSIONS: The VF position and atomizer spray were both effective in delivery of the dexamethasone drops to the paranasal sinuses. This has significant implications for management of patients suffering from recalcitrant chronic rhinosinusitis and/or sinonasal polyposis through the delivery of topical medications to the paranasal sinuses and olfactory cleft.

scholarly journals MASKS OF POLYPOUS RHINOSINUSITIS

2018 ◽  
Vol 3 (1) ◽  
pp. 41-43
Author(s):  
RM M Pestova ◽  
EE E Saveljeva ◽  
R A Sharipov ◽  
D N Bogomanova
Keyword(s):  
Chronic Disease ◽  
Nasal Mucosa ◽  
Paranasal Sinuses ◽  
Nasal Polyps ◽  
Diagnostic Algorithm ◽  
Functional Surgery

Polypous rhinosinusitis is a chronic disease of the nasal mucosa and paranasal sinuses, which is characterized by recurrent growth of nasal polyps. This disease is found in 1-5% of the population. According to the data of 2017, patients with nasal polypous rhinosinusitis account for 13% of all patients treated in our clinic. Polypous rhinosinusitis can be either an independent disease or a manifestation of other diseases. Aim - to present a case from practice, which is interesting due to the fact that two independent diseases were hiding under the mask of polypous rhinosinusitis. Results. Strict administration of the diagnostic algorithm, modern principles of functional surgery of the paranasal sinuses led to the recovery of the patient.

scholarly journals Histopathological analysis of sinonasal lesions associated with chronic rhinosinusitis and comparison with computed tomography diagnoses

2019 ◽  
Vol 36 (2) ◽  
Author(s):  
Sultan Abdulwadoud Alshoabi ◽  
Abdulkaleq Ayedh Binnuhaid ◽  
Moawia Bushra Gameraddin ◽  
Kamal Dahhan Alsultan
Keyword(s):  
Computed Tomography ◽  
Nasopharyngeal Carcinoma ◽  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Nasal Polyps ◽  
Medical Center ◽  
Sinus Surgery ◽  
Histopathological Analysis ◽  
Fungal Sinusitis ◽  
Chronic Rhino Sinusitis

Background & Objective: Chronic rhino sinusitis (CRS) is an inflammatory condition of the paranasal sinuses and the nasal passage lasting more than three months either with or without sinonasal polyps. This study aimed to report the common sinonasal lesions associated with CRS according to the histopathology results, to compare between clinical and histopathological diagnoses, and to compare between radiological and histopathological diagnoses of the sinonasal lesions. Methods: A retrospective study of the electronic records of 82 patients diagnosed with CRS with nasal polyps. All patients underwent endoscopic sinus surgery and histopathological examination of surgical biopsies. The collected data were analyzed using SPSS program. Coparison between clinical and histopathological diagnoses was done. This study was conducted at Alsafwa Consultative Medical center (ACMC) in Almukalla city, Hadhramout province in Republic of Yemen. Results: Out of 82 patients, the ages ranged from 4 to 90 years (mean: 34.48±17.74 years), and 54.88% were females. Inflammatory polyps were the most common lesion (31.4%), then allergic polyps (30.5%). Nasopharyngeal carcinoma (NPC) was reported in 9.8% of the lesions and all were unilateral. The results revealed strong compatibility between clinical and histopathological diagnoses (p<0.001, kappa= 0.215), and significant compatibility between radiological and histopathology diagnoses (p=0.007). Conclusion: Inflammatory and allergic polyps are the most common benign bilateral lesions associated with chronic rhinosinusitis, which can be correctly diagnosed clinically in most cases. Unilateral nasal polyps have high rates of malignancies and should be check carefully by endoscopy and histopathology. Computed tomography has some pitfalls in diagnosing of fungal sinusitis. Abbreviations: CRS: Chronic rhino sinusitis, CRSwNP: CRS with nasal polyps, CRSsNP: CRS without nasal polyp, Eos CRSwNP: CRSwNP and eosinophilic inflammation, PNS: paranasal sinuses, EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012, ACMC: Alsafwa Consultative Medical center, NECT: non-enhanced computed tomography, SPSS: Statistical Package for the Social sciences, IBM: International Business Machines, NY: New York, NPC: Nasopharyngeal carcinoma. doi: https://doi.org/10.12669/pjms.36.2.1453 How to cite this:Alshoabi SA, Binnuhaid AA, Gameraddin MB, Alsultan KD. Histopathological analysis of sinonasal lesions associated with chronic rhinosinusitis and comparison with computed tomography diagnoses. Pak J Med Sci. 2020;36(2):---------.  doi: https://doi.org/10.12669/pjms.36.2.1453 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Short Term Pre-Operative Oral Corticosteroids—Tissue Remodeling in Chronic Rhinosinusitis with Nasal Polyps

2021 ◽  
Vol 10 (15) ◽  
pp. 3346
Author(s):  
Kamil Radajewski ◽  
Paulina Kalińczak-Górna ◽  
Marek Zdrenka ◽  
Paulina Antosik ◽  
Małgorzata Wierzchowska ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Nasal Polyps ◽  
Tissue Remodeling ◽  
Oral Steroid ◽  
Topical Steroids ◽  
Preoperative Period ◽  
Oral Corticosteroids ◽  
Nasal Steroid ◽  
Group 1

Chronic rhinosinusitis is a process involving a number of adverse changes in the mucosa of the paranasal sinuses and nasal polyps. The main histological features of tissue remodeling are changes in epithelial structure, oedema, degradation of ECM (extracellular matrix), angiogenesis, and subepithelial fibrosis. In this study, patients were divided into two groups: group 1—patients with CRSwNP (chronic rhinosinusitis with nasal polyps) taking a nasal steroid and an oral steroid in the preoperative period, and group 2—patients with CRSwNP taking only the nasal steroid in the preoperative period. All samples were subject to histopatologic evaluation. The aim of this study was to investigate the effect of oral corticosteroids and topical steroids on the tissue of paranasal sinuses. We have shown statistically significant decreases in tissue eosinophilia per 5HPF and decreased fibrosis in group 1. No significant differences were presented in the percentage of total tissue oedema, epithelium, neutrophils, basement membrane thickening and vessels. Using systemic administration of 40 mg of prednisone for seven days decreased the counts of eosinophils and decreased fibrosis in the nasal polyps tissue in CRSwNP.

Correlation between culture-identified bacteria in the middle nasal meatus and CT score in patients with chronic rhinosinusitis

2014 ◽  
Vol 63 (1) ◽  
pp. 28-33 ◽  
Author(s):  
Barbora Uhliarova ◽  
Renata Karnisova ◽  
Martin Svec ◽  
Andrea Calkovska
Keyword(s):  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Nasal Polyps ◽  
Pathogenic Bacteria ◽  
Bacterial Species ◽  
Severe Form ◽  
Healthy Controls ◽  
Endoscopic Control ◽  
And Control ◽  
Middle Nasal Meatus

The aim of this study was to compare bacteriological findings in the middle nasal meatus in patients with chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP) and healthy controls, and to investigate the correlation between the prevalence of culture-identified bacteria and the severity of sinus disease. Bacterial culture was performed using a swab from the middle nasal meatus under endoscopic control in 72 patients with CRSwNP, 25 patients with CRSsNP and 59 healthy controls. Computed tomography (CT) scans were graded for severity using the Lund–Mackay scoring system. Patients with more severe forms of CRS with and without nasal polyps had significantly higher rates of pathogenic bacteria in the middle nasal meatus compared with patients with lower CT scores of the paranasal sinuses. There were no significant differences in bacterial species among CRSwNP, CRSsNP and control patients. These results demonstrate, for the first time, that colonization by pathogenic bacteria in patients with CRSwNP and CRSsNP is associated with a more severe form of the disease, as assessed by a pre-operative CT scan of the paranasal sinuses. The results suggest a role for bacterial infection in the pathogenesis of CRS. However, bacteria do not appear to play a role in the development of nasal polyposis in patients with CRS.

scholarly journals Clinical Correlation of Chronic Rhinosinusitis with Nasal Polyps

2019 ◽  
Vol 17 (1) ◽  
pp. 13-15
Author(s):  
Lok Ram Verma ◽  
Anshu Sharma
Keyword(s):  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Nasal Polyps ◽  
Disease Process ◽  
Descriptive Study ◽  
Chronic Inflammatory Disease ◽  
Clinical Correlation ◽  
Sinus Disease ◽  
Chronic Rhino Sinusitis ◽  
Age Range

Background: Chronic rhino sinusitis with and without nasal polyps represent different group of one chronic inflammatory disease of the mucosa of the nasal cavity and paranasal sinuses. Coexistence of chronic rhinosinusitis with nasal polyps' has similar characteristics of inflammation that supports assumption that chronic rhinosinusitis and nasal polyps may at least be in part, the same disease process. Objectives: This study is aimed to correlate the chronic rhinosinusitis associated with nasal polyps. Methods: This was a prospective descriptive study was conducted on the patients attending the department of ENT in NGMC teaching hospital from March 2016 to September 2017. Result: There were 70 cases including 47male and 23 female, with an age range of 17 years to 65 years. Conclusion: This study supports that a patient with chronic rhinosinusitis associated with nasal polyps is a subtype of chronic sinus disease.

scholarly journals Influence of the Microbiome on Chronic Rhinosinusitis With and Without Polyps: An Evolving Discussion

2021 ◽  
Vol 2 ◽  
Author(s):  
Kyle S. Huntley ◽  
Joshua Raber ◽  
Lauren Fine ◽  
Jonathan A. Bernstein
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Modifiable Risk Factors ◽  
Potential Factors ◽  
Health Complications ◽  
Inflammatory Changes ◽  
A Current ◽  
Th1 And Th2 ◽  
Underlying Inflammation

Chronic rhinosinusitis (CRS) is widely prevalent within the population and often leads to decreased quality of life, among other related health complications. CRS has classically been stratified by the presence of nasal polyps (CRSwNP) or the absence nasal polyps (CRSsNP). Management of these conditions remains a challenge as investigators continue to uncover potential etiologies and therapeutic targets. Recently, attention has been given to the sinunasal microbiota as both an inciting and protective influence of CRS development. The healthy sinunasal microbiologic environment is largely composed of bacteria, with the most frequent strains including Staphylococcus aureus, Streptococcus epidermidis, and Corynebacterium genera. Disruptions in this milieu, particularly increases in S. aureus concentration, have been hypothesized to perpetuate both Th1 and Th2 inflammatory changes within the nasal mucosa, leading to CRS exacerbation and potential polyp formation. Other contributors to the sinunasal microbiota include fungi, viruses, and bacteriophages which may directly contribute to underlying inflammation or impact bacterial prevalence. Modifiable risk factors, such as smoking, have also been linked to microbiota alterations. Research interest in CRS continues to expand, and thus the goal of this review is to provide clinicians and investigators alike with a current discussion on the microbiologic influence on CRS development, particularly with respect to the expression of various phenotypes. Although this subject is rapidly evolving, a greater understanding of these potential factors may lead to novel research and targeted therapies for this often difficult to treat condition.

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