scholarly journals Correlations between symptoms, nasal endoscopy and computed tomography findings in patients with chronic rhinosinusitis without nasal polyps

2020 ◽  
Vol 77 (1) ◽  
pp. 41-46
Author(s):  
Slobodan Savovic ◽  
Natasa Dragnic ◽  
Vladimir Kljajic ◽  
Ljiljana Jovancevic ◽  
Maja Buljcik-Cupic ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Facial Pain ◽  
Nasal Polyps ◽  
Nasal Congestion ◽  
Endoscopic Examination ◽  
Nasal Endoscopy ◽  
Nasal Discharge ◽  
Strongly Correlated ◽  
Moderate Correlation ◽  
Severity Of The Disease

Background/Aim. Chronic rhinosinusitis (CRS) is one of the most common chronic conditions that is diagnosed on the basis of the condition symptoms, nasal endoscopy and computed tomograhpy (CT) of the nose and paranasal sinuses. There are two forms of CRS: CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). The aim of this paper was to determine if there is a correlation between the symptoms, nasal endoscopy and CT in patients with CRSsNP. Methods. The study included 110 patients with CRSsNP. The intensity of the symptoms assessed on the visual analogue scale (VAS) and the condition of nasal mucosa and the presence of nasal secretion was estimated by endoscopic examination of the nose while CT was used to determine the Lund-Mackay (LM) score values. Pearson?s coefficient of correlation was used for statistic data processing. Results. The severity of the disease as a whole (r = 0.509) and nasal discharge (r = 0.562) moderately correlated with CT. Nasal congestion (r = 0.354) and the reduction of loss of smell (r = 0.324) mildly correlated with CT, while facial pain/pressure (r = 0.218) had a very weak correlation with CT. The severity of the disease as a whole (r = 0.717) and nasal discharge (r = 0.821) strongly correlated with nasal endoscopy. Nasal congestion (r = 0.525) had a moderate correlation with nasal endoscopy while facial pain/pressure (r = 0.345) and the reduction of the loss of smell (r= 0.394) had a mild correlation with nasal endoscopy. A moderate correlation was found between nasal endoscopy and CT (r = 0.630). Conclusion. The severity of the disease as a whole and nasal discharge have more significant correlations both with nasal endoscopy and CT in relation to the correlations between other symptoms and nasal endoscopy, as well as CT. More significant correlations between the symptoms and nasal endoscopy in relation to the correlations between the symptoms and CT and the existence of a moderate correlation between nasal endoscopy and CT, enable a lesser use of CT diagnostics and only in precisely defined situatiations.

Cystic Fibrosis: The Sense of Smell

2019 ◽  
Vol 34 (1) ◽  
pp. 35-42 ◽  
Author(s):  
Antonella M. Di Lullo ◽  
Paola Iacotucci ◽  
Marika Comegna ◽  
Felice Amato ◽  
Pasquale Dolce ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cystic Fibrosis ◽  
Facial Pain ◽  
Nasal Polyps ◽  
Nasal Congestion ◽  
Nasal Discharge ◽  
Upper Airways ◽  
Multisystem Disease ◽  
Mean Values

Background Cystic fibrosis (CF) is a multisystem disease that involves the upper airways with chronic rhinosinusitis (CRS) causing nasal congestion, rhinorrhea, mouth breathing, facial pain, and olfactory dysfunction. Twelve percent to 71% of CF patients report smelling alterations with an impact on nutrition and quality of life. Objectives The goal was to study olfaction performance in CF patients with CRS that worsens quality of life. Methods A total of 121 subjects were enrolled in this study. Seventy-one had CF and underwent ear, nose, and throat evaluation with nasal endoscopy, sinonasal outcome test 22 (SNOT-22), visual analog scale (VAS), and “Sniffin’ Sticks.” Fifty subjects were age-matched with healthy controls. Results All 71 CF patients were affected by CRS; 59 of 71 (83.1%) had CRS without nasal polyps and 12 of 71 (16.9%) had CRS with early nasal polyps. None of the 50 controls had CRS. Total SNOTT-22 mean values in the 71 CF patients were 38.10 ± 21.08 points. If considering only the 59 CF patients without nasal polyps, the SNOTT-22 mean value was 36.76 ± 21.52 points. Moreover, based on the VAS scores, the degree of nasal symptoms was classified as mild for facial pain, smell alteration, nasal discharge, and sneezing and resulted in moderate symptoms for nasal blockage and headache. Among the CF patients, 55 of 71 (76.5%) declared to be normosmic, while the smelling ability assessed by “Sniffin’ Sticks” showed that only 4 of 71 (5.63%) were normosmic, 58 (81.69%) were hyposmic, and 9 (12.68%) were anosmic. In the controls, 41(82%) were normosmic, 9 (18%) were hyposmic, and none were reported to be anosmic ( P < .001). Conclusions We confirm that most CF patients have a relevant olfactory impairment, although only a low percentage declares such alteration. A careful evaluation with simple and rapid tests helps to select the patients who may benefit from specific therapies.

Diagnosis and treatment of Chronic Rhinosinusitis in Children according European Position Paper on Rhinosinusitis and nasal Polyps –EPOS-2012 and American Academy Otolaryngology-Head and Neck Surgery 2014

2018 ◽  
Vol 7 (2) ◽  
pp. 27-32
Author(s):  
Anna Zakrzewska
Keyword(s):  
Young Children ◽  
American Academy ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Chronic Sinusitis ◽  
Nasal Congestion ◽  
Neck Surgery ◽  
Diagnosis And Treatment ◽  
Nasal Discharge ◽  
Consensus Statements

Pediatric rhinosinusitis is defined as a presence of two or more symptoms and one of them should be either nasal blockage or nasal discharge and headache/facial pain or cough. Chronic rhinosinusitis - CRS is recognized when the four most common symptoms as cough, rhinorrhea, nasal congestion and post nasal drip with a slightly higher predominance of chronic cough are presented for more than 12 weeks and influence the quality of life. CRS should be considered in respect of unique conditions because of the differences in predisposing factors (immunological and others) and the anatomy of the sinuses between children and adults. The adenoids are a prominent contributor to CRS in young children, both from bacteriologic and immunologic status. The older children suffer from CRS in the same manner as adults. During evaluation a child with symptoms of CRS , one should always consider the possibility of underlying disease as a contributing factor. Diseases impacting sinuses and nasal function include CF, primary ciliary dyskinesia (PCD) and a variety of normal immune deficiencies, including the still-developing immature immunity of healthy young children. Surgical intervention for rhinosinusitis is usually considered for patients with CRS who have failed maximal pharmacological treatment. There are two important consensus statements for pediatric chronic sinusitis (CRS): European Position papers on Rhinosinusitis and Nasal Polyps -EPOS 2012 and Clinical Consensus Statement: Pediatric Chronic Sinusitis American Academy Otolaryngology-Head Neck Surgery 2014. Both of them contain necessary information and recommendation for diagnosis and treatment of CRS in children.

scholarly journals Frequency and intensity of symptoms in patients with chronic rhinosinusitis

2019 ◽  
Vol 147 (1-2) ◽  
pp. 34-38
Author(s):  
Slobodan Savovic ◽  
Maja Buljcik-Cupic ◽  
Ljiljana Jovancevic ◽  
Vladimir Kljajic ◽  
Slobodanka Lemajic-Komazec ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Facial Pain ◽  
Analogue Scale ◽  
Nasal Congestion ◽  
Subjective Assessment ◽  
Nasal Discharge ◽  
Average Intensity ◽  
Chronic Disorders ◽  
Nose And Paranasal Sinuses

Introduction/Objective. Chronic rhinosinusitis is one of the most frequent chronic disorders which significantly influences the patients? quality of life. The objectiv? of this paper was to examine which are the most frequent and intensive symptoms in patients with chronic rhinosinusitis, and also to determine whether there is a correlation between a subjective assessment of the disease as a whole and individual symptoms. Methods. The study encircled 90 patients with clinical diagnosis of chronic rhinosinusitis that was endoscopically proven and computer tomography of the nose and paranasal sinuses. Every possible symptom was recorded in every patient (nasal congestion, nasal discharge, facial pain/pressure, reduction or loss of smell, headache, fatigue, cough, halitosis and ear pain/fullness), the intensity of every possible symptom as well as the disorder as a whole. The patients assessed the intensity of their symptoms on the visual analogue scale. Results. Nose congestion is the most frequent symptom. It occured in 82 patients (91.1%), followed by nasal discharge in 81 patients (90%) and there was no difference in frequency of these two symptoms. Nasal discharge has been recorded as the most intensive symptom (x? = 5.4) and it is significantly more intensive in comparison to nasal congestion which was the second on the intesity list (x? = 4.1, p = 0.002). All other symptoms were significantly less frequently and less intensive. The average intensity value of the disease as a whole is the same as the average intensity value of the nasal discharge (x? = 5.4) while the average intensity values of all other symptoms are statistically significantly lower than the average intensity value of the disease as a whole; in all comparisons p < 0.001. Conclusion. Nasal congestion and nasal discharge are the most common symptoms in the patients with chronic rhinosinusitis. Nasal discharge is the most intensive symptom in patients with chronic rhinosinusitis while its intensity determines the sensation of the intesity of the disorder as a whole.

scholarly journals CLINICAL PROFILE OF CHRONIC RHINOSINUSITIS: A STUDY IN CENTRAL INDIA

2021 ◽  
pp. 104-106
Author(s):  
Tanvi Rekhade ◽  
A.Z. Nitnaware ◽  
Seema Patel ◽  
R.T. Pawar ◽  
Ashish Keche
Keyword(s):  
Quality Of Life ◽  
Chronic Rhinosinusitis ◽  
Nasal Septum ◽  
Nasal Polyps ◽  
Central India ◽  
Nasal Discharge ◽  
Deviated Nasal Septum ◽  
Northern India ◽  
Causative Factors

Chronic Rhinosinusitis (CRS) has heavy implications on the quality of life and has a prevalence of about 46.1 % in northern India with similar pattern across the country.This research has been undertaken to study the presentation and causative factors for CRS in central India. Data of 100 patients diagnosed as CRS was studied. Patients presented with nasal obstruction and nasal discharge at large. Nasal polyps were seen in 37% cases. The most common associated etiopathological factor was anatomical obstruction due to deviated nasal septum.

scholarly journals Nasal Polyposis: Insights in Epithelial-Mesenchymal Transition and Differentiation of Polyp Mesenchymal Stem Cells

2020 ◽  
Vol 21 (18) ◽  
pp. 6878 ◽  
Author(s):  
Emanuela Chiarella ◽  
Nicola Lombardo ◽  
Nadia Lobello ◽  
Annamaria Aloisio ◽  
Teodoro Aragona ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Inflammatory Process ◽  
Nasal Polyposis ◽  
Epithelial Mesenchymal Transition ◽  
Nasal Congestion ◽  
Alternative Source ◽  
Mesenchymal Transition

Chronic rhinosinusitis is a common inflammatory disease of paranasal sinuses, which causes rhinorrhea, nasal congestion, and hyposmia. The genetic predisposition or the exposure to irritants can sustain the inflammatory response and the development of nasal polyposis. Nasal polyps are benign and teardrop-shaped growths that project in the nasal cavities, and originate from the ethmoid sinuses. This inflammatory process is associated with high expression of IL-4, IL-5 and IL-13 and IgE. Antibodies targeting these cytokines or receptors represent a therapeutic strategy in the treatment of nasal polyposis in combination with corticosteroids. The molecular pathogenesis of nasal polyps in chronic rhinosinusitis (CRS) patients is associated with remodeling transition, a process in which epithelial cells lose their typical phenotype, acquiring a mesenchymal-like aspect. TGFβ/SMAD, ERK, and Wnt/β-catenin pathways are altered during the nasal tissue remodeling. miRNA and inhibitor molecules targeting these signaling pathways are able to interfere with the process; which could lead to alternative therapies. Nasal polyps are an alternative source of mesenchymal stem cells, which can be isolated from surgical biopsies. A molecular understanding of the biology of PO-MSCs will contribute to the delineating inflammatory process underlying the development of nasal polyps.

scholarly journals Biofilms and inflammation in patients with chronic rhinosinusitis

2020 ◽  
Author(s):  
Lavinia-Gianina Manciula ◽  
Ionut Isaia Jeican ◽  
Lucian Barbu Tudoran ◽  
Silviu Albu
Keyword(s):  
Chronic Rhinosinusitis ◽  
Plasma Cell ◽  
Nasal Polyps ◽  
Nasal Polyposis ◽  
Inflammatory Cell ◽  
Plasma Cells ◽  
Strongly Correlated ◽  
Cell Counts ◽  
Deviated Septum ◽  
Nasal Pathology

Introduction. The aim of the present study is to evaluate the presence of biofilms in patients with chronic rhinosinusitis (CRS), with or without nasal polyps, and their relationship to eosinophils and plasma cells. We compared the results with those obtained in nonCRS patients. Methods. A total of 50 patients were included in the study, 30 CRSwNP patients, 10 CRSsNP cases and 10 control patients who were operated for deviated septum. Biofilm detection was performed by means of H&E staining and SEM. Eosinophil and plasma cell values were recorded and compared between groups. Results. Biofilms were identified in 30 patients (60%), 76.6% (23 out of 30) of the CRSwNP patients, 70% (7 out of 10) of the CRSsNP patients and none of the septoplasty patients. Eosinophil and plasma cell values were more elevated in CRS patients, being strongly correlated to biofilm presence and nasal polyposis. Conclusion. Biofilm presence was demonstrated in many of the CRS patients, with no evidence in the control cases. Our study findings indicate that inflammatory cell counts are higher in patients with CRS compared to controls, but also more elevated in patients with polyposis. In biofilm-positive patients, eosinophil and plasma cell counts were greater than those in patients without biofilms, demonstrating the proinflammatory action of the biofilm in the sino-nasal pathology.

scholarly journals GAMBARAN DERAJAT KEPARAHAN GEJALA PASIEN RINOSINUSITIS KRONIK DI RSUD DR. SOETOMO SURABAYA

2020 ◽  
Vol 8 (2) ◽  
pp. 235
Author(s):  
Anggita Putri Samara ◽  
Budi Sutikno ◽  
Reny I’tishom
Keyword(s):  
Risk Factor ◽  
Observational Study ◽  
Medical Record ◽  
Nasal Obstruction ◽  
Facial Pain ◽  
Nasal Congestion ◽  
The Other ◽  
Nasal Discharge ◽  
Analog Scale ◽  
Nasal Inflammation

Chronic rhinosinusitis (CRS) is a sinus paranasal and nasal inflammation marked with two or more symptoms, nasal congestion or nasal discharge and the other symptom like facial pain and reduced smell may present. This symptom occur >12 weeks. One of the parameter for symptom’s severity assessmentis using Visual Analog Scale (VAS) that can be classified as mild (0-3), moderate (4-7), dan severe (8-10). This study was a observational study by assessing patient’s medical record at SMF THT-KL RSUD Dr. Soetomo and analyzed descriptively. 43 patients were enrolled to study (28 male and 15 female), most of them were between age 36-45 years old (25,58%). Most of the patient’s symptom’s severity in general, nasal obstruction, nasal discharge, facial pain, and reduced smell were moderate (65,11%), moderate (58,13%), mild (41,86%), mild (58,13%), mild (62,79%) respectively. Most of the patients had risk factor (62,79%), and the most of the patient’s risk factor were allergy. Most of the CRS patients in this study were male, 36-45 years old, with the general symptom’s severity moderate, moderate nasal obstruction, mild nasal discharge, mild facial pain, mild reduced smell, and had allergy.

scholarly journals Do patients with chronic rhinosinusitis with nasal polyps suffer with facial pain?

2013 ◽  
Vol 51 (3) ◽  
pp. 231-235 ◽  
Author(s):  
A.Z. Eweiss ◽  
V.J. Lund ◽  
J. Barlow ◽  
A. Jay ◽  
G. Rose
Keyword(s):  
Chronic Rhinosinusitis ◽  
Facial Pain ◽  
Nasal Polyps

scholarly journals Postsurgical rehabilitation of patients with chronic rhinosinusitis

2020 ◽  
pp. 74-79
Author(s):  
Sergey B. Bezshapochny ◽  
Valery V. Loburets ◽  
Andrey V. Loburets ◽  
O.R. Dzhirov
Keyword(s):  
Chronic Rhinosinusitis ◽  
Postoperative Period ◽  
Healing Process ◽  
Functional Anatomy ◽  
Endoscopic Examination ◽  
Nasal Discharge ◽  
Significant Difference ◽  
Clinical Advantage ◽  
Endoscopic Score ◽  
Based Medicine

Topicality: Modern rhinosurgery in tht treatment of chronic rhinosinusitis based of tht principles of maximum preservation of the functional anatomy of the nasal cavity. This helps to improve not only the healing process but also tht quality of life of the patient. Functional endoscopic surgery (FESS) is tht most effective treatment lor chronic rhinosinusitis today. This method helps to accelerate the recovery of patients and reduce the number of postoperative complications, which in turn reduces the need lor surgery. But apart from meticulous and careful surgical technique, one of the most important places in the treatment of the patient is optimal management after surgery, for maximum potentiating of recovery. The relevance of the study is due to the need to further improve the pharmacotherapy of the postoperative period. This article high lights several different therapies aimed at the fast test restoration of the physiological work of the nasal structures. Materials and methods: In total, 50 patients were divided into three groups as part of the study. Group 1 received an isotonic solution of 0.9% NaCl from day one and topical glucocorticosteroids (Mometasone furoate) from day 7. In group 2A, phytopreparation was added to classic therapy and 0.9% NaCl was used instead of the standard saline solution, with 0.4% CO2 added. Evaluation of the effectiveness of treatment was performed using a visual-analog scale lor subjective symptoms and endoscopic examination using the scale of The Modified Lund-Kennedy Endoscopic Score lor objective symptoms. Results: On the 7th day, statistically significant differences were observed according to VAS data between patients of the 1st and 2B groups in terms of nasal discharge (p<0.05, U=77.5) and impaired olfactory function (p<0.05, U=75), in the same period a statistically significant difference was observed between MLK indices in patients of 1st and 2B groups (p<0.05, at U=73) No side effects of the drugs used in the study were detected. Conclusion: Based on the study, it can be concluded tht the use in the postoperative period of the proposed drugs have a significant clinical advantage, which is based of clinical studies and confirmed by the principles of evidence-based medicine.

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